Wisconsin Care Integration Initiative 2019-23

2022

Early identification and access to services are essential to ensure optimal outcomes for children with autism spectrum disorder (ASD) and other developmental disabilities (DD), but systems of care are often fragmented and fail to reach children in medically underserved areas and populations. Nationally, an estimated 11.2 million children (15.1%) younger than 18 years of age have a DD, and the prevalence of children with ASD has in-creased to 1 in 59 (1 in 71 in WI). The Wisconsin Surveillance of Autism and Other Developmental Disabilities System (WISADDS) data indicate that although 89.5% of children identified with ASD at age 8 had developmen-tal concerns documented by 3 years of age, only 47.2% received a comprehensive developmental evaluation by the same age. Black and Hispanic children are significantly less likely to receive a comprehensive developmental evaluation by 3 years of age. Findings from the 2016-17 National Survey of Childrens Health indicate only 37% of WI children between 9 to 35 months of age had received recommended developmental screening in the previ-ous 12 months. Developmental screening rates were lower in low-income households and among non-white chil-dren. The literature suggests that family navigation services help medically underserved families overcome pa-tient-specific barriers to accessing services. Simultaneously, there is a need to address systems-based barriers. Primary care and other community providers express the need for education and support to achieve improve-ments in surveillance, screening, referral, and care coordination. In response to this need, the Wisconsin Care Integration Initiative (WiCII) will: 1) provide family navigation services to medically underserved families of children with/at risk for ASD/DD, 2) educate providers through a learning community and direct training, and 3) increase access to culturally and linguistically competent educa-tional resources to improve family self-efficacy in navigating systems of care. 1) WiCII will build capacity in 5 or more primary care practices to screen, refer, and provide family naviga-tion services to a minimum of 500 families annually in medically underserved areas and populations (increasing to a minimum of 625 served by 2023). 2) Primary care providers from each practice, along with community providers and family leaders, will par-ticipate in a statewide learning community to promote knowledge exchange. Learning community members from each practice locale will constitute an Engaged Community Quality Improvement Pro-ject (ECQuIP) team, which will receive support to identify solutions to local systemic barriers. In addi-tion, two or more continuing education activities will be provided annually to address identified gaps in provider knowledge and skill. 3) In collaboration with WI Maternal and Child Health/Children and Youth with Special Health Care Needs (Title V) programs and parent organizations, WiCII and its partners will increase, promote, and evalu-ate the effectiveness of culturally and linguistically appropriate family education resources. To support sustainable dissemination and integration of effective innovations, WiCII will convene the Act Early State Team stakeholder group, partner with Act Early State Team stakeholders to develop and implement a plan to support statewide dissemination and integration, and share innovations nationally through participating in ac-tivities of the national grantee Community of Learners. By addressing the goals of the Act Early State Plan, and in partnership with other state MCH programs, the Wis-consin Care Integration Initiative will implement and test innovative strategies to improve care integration for chil-dren with ASD/DD in underserved communities.

screening, autism, early intervention, family navigation, primary care

Continuing Education/Community Training, Other Direct/Model Services

Health-Related Activities

Professionals and Para-Professionals, Family Members/Caregivers, Children/Adolescents with Disabilities/SHCN, Legislators/Policy Makers

Racial or Ethnic Minorities, Disadvantaged Circumstances, Geographic Areas, Rural/Remote, Urban

State

Federal

N/A