1. MCH Workforce Development
  2. Funded Projects

Funded Projects

Integrating Behavioral Health within Pediatric Primary Care

Grant Status: Active

Training Category: Healthy Tomorrows Partnership for Children Program (HTPCP)

Project Director(s):

Carol Hawk
Skagit County Public Hospital District
Skagit County Public Hospital District, No. 304
2031 Hospital Drive
Sedro-Woolley, WA  98284
Phone: 360-854-7170


Babies and young children in Skagit County face multiple developmental health and early learning challenges. Significant gaps in child and family wellbeing include prenatal care, childhood immunization, adverse childhood experiences, and domestic violence. These unmet needs are more prevalent among underserved populations including low-income white residents and the county's Latinx population. Compromised child health leads to inequities in readiness to learn, and makes it more difficult for children of low-income families and children with limited English skills to succeed in school.

Goals and Objectives:

The project goal is to: Integrate behavioral health with pediatric primary care to increase healthy early childhood development and school readiness. Objectives are: 1) By 2024, Skagit County pediatric and family medical clinics will screen and refer at least 90% of patients aged birth to three for behavioral health interventions; 2) By 2024, at least 50% of families with young children referred by Skagit Pediatrics to behavioral health services will utilize services and resources; 3) By 2024, the Children's Council, Skagit Pediatrics, and Advisory Board partners will leverage resources to sustain HealthySteps at Skagit Pediatrics and expand to other pediatric providers through a Train the Trainer model.


This project is an innovative new partnership between early learning and pediatric primary care. The Children's Council will expand its existing Board to form a project Advisory Board. They will establish a Provider Network of family medical providers and implement trainings for ACEs, Responding to Complex Trauma, and others to increase the delivery of trauma-informed care. Members will develop and share a common tool to increase behavioral health in early childhood screenings, referrals and interventions. The HealthySteps program will be piloted at Skagit Pediatrics and replicated at additional pediatric clinics through a Train the Trainer model. The Children's Council will expand outreach and engagement, prioritizing low-income and Latinx families, to increase participation in early learning resources and supports. Resources will be leveraged to sustain and expand HealthySteps.


The project will be coordinated by the Children's Council of Skagit County under the umbrella of United General District 304. Working in direct partnership with Skagit Pediatrics, the county's largest pediatric primary care clinic, the existing board of the Children's Council will be expanded to encompass the partners and scope of this project.


Evaluation will be led by the Children's Council Coordinator. Process evaluations will capture project participation and implementation; services and resources provided; number and characteristics of patients; as well as number of contacts, trainings, referrals, and utilization of referrals. Outcome evaluations will measure changes in provider and family knowledge and awareness; use of evidence-based strategies within pediatric primary care; rates of patients screened and referred; rates of referral utilization; and rates of children who possess developmentally appropriate social and emotional skills upon entering kindergarten.