The Wisconsin Care Integration Initiative (WiCII) is a HRSA-funded project at the Waisman Center to improve systems of care for medically underserved families of children with or at risk for ASD/DD. In order to support community-driven solutions in this area, WiCII brought together parents, policymakers, and community and state leaders to participate in the "100 Million Healthier Lives States of Solutions" program. States of Solutions, which is funded by the Robert Wood Johnson Foundation and convened by the Institute for Healthcare Improvement, provides high quality tools and consultation to advance health equity. The program is grounded in the principle that those most impacted by inequity should play a leading role in developing and implementing sustainable solutions.

After months of learning and planning with support from the States of Solutions program, the Wisconsin team launched an "Equity Action Lab" to improve early identification of ASD/DD in rural Wisconsin. In May 2019, the first Action Lab brought together over 30 community members for a day of learning and action planning. The community then broke into two action groups to engage in a 100-day change cycle. One group focused on developmental and autism screening in healthcare, while the other focused on early identification in early care and education. In August 2019, community members reconvened for a "Momentum Lab" to review progress and make plans for sustainable action. After 100 days, the community had gathered data on screening practice among primary care providers, conducted a survey of childcare sites on screening practices and training preferences, trained 29 primary care practice staff to conduct screening, distributed free screening toolkits to trained practices, and established strategies to support continued communication and future training opportunities.

This successful community initiative was made possible because community members and the Waisman Center brought together their respective knowledge and skills. The WiCII staff helped community stakeholders identify and apply for the States of Solutions program, operated as a backbone organization assisting with planning and logistics, offered their community organizing and evaluation skills, and brought LEND trainees to help run the Action Lab. Community stakeholders did the heavy lifting of analyzing community needs and assets, identifying the change cycle aim and improvement strategies, and owning the change efforts.