Project Description:
PURPOSE: The purpose of CoLEND is to prepare professionals from core disciplines through advanced graduate, post graduate, and continuing education to be able to assume leadership positions within systems of care for children and their families. Long term trainees and fellows will complete a values based curriculum that includes experiences in clinical/community application, research, and teaching/mentoring within the context of systems and outcomes based perspectives and leadership skills. Through a continuing education component additional participants will receive leadership training by means of teleconferencing, day-long workshops, and self-study programs. Through a collaborative initiative among key agencies who manage health care, financing, and education, services for children with neurodevelopmental and related disabilities and their families will be enhanced through annual needs assessment, work plan development, and specialized task forces.
NEED: Colorado and the Rocky Mountain region has a complex mix of factors that present challenges to providing quality services for children with neurodevelopmental and related disabilities (referred to hereafter as simply “childrenâ€) and their families. Among these factors are geography, lack of available resources, population distribution, poverty, cultural diversity, lack of integration, and coordination of services and supports. Geographically, this diverse region includes vast difficult-to-access mountainous regions and sparsely populated plains. Even in Colorado, the most populous state in the region, 49 of the 63 counties are currently designated as Health Provider Shortage Areas. An uneven population distribution poses challenges as increasingly dense populations in a few urban areas, due to rapid influx from other states, contrast with large rural areas with few resources. Many children with disabilities in the region live below or only slightly above the poverty line, and are at greater risk for a number of problems, including not having health insurance. Colorado’s diverse cultural mix poses challenges as an estimated 62,000 state residents do not speak English well and need language assistance when receiving health care services. Resources are not only scarce for children and their families, but those available are not well identified or coordinated. For example, frequent conflicts over whether services are a medical or educational payer’s responsibilities result in many lags and gaps in services. Colorado’s Title V staff and CoLEND faculty have a standing commitment to work together to improve the accessibility, quality, and integration of services and supports for children and their families. In a year-long series of collaborative planning meetings, Title V staff and CoLEND faculty have identified the following as critical needs in Colorado: quality assurance; care coordination, the integration of services and supports; coordination of benefits; assistive technology; parent leadership development; transition points; adequate nutrition; and newborn hearing screening. There is a great need to train future leaders who will address these complex issues and advance health care systems to successfully serve the needs of children and families. Despite the formidable challenges, Colorado and the Rocky Mountain Region have many resources including exceptionally well prepared faculty, exemplary programs, dedicated families, and a strong commitment by higher education, public agencies, and local groups to collaboratively train our needed leaders. CoLEND is designed to train leaders who will apply leadership, scholarship, and partnership to improve the health of children, their families, and communities.
GOALS AND OBJECTIVES: GOAL I: Long Term Graduate Training. CoLEND will prepare leaders who will shape health and related care systems to be more responsive to the needs of children and their families by contributing to systems to insure that they are innovative, cost-effective, community-based, family-centered, culturally competent, and interdisciplinary. Those to be trained include long term interdisciplinary trainees and fellows along with pediatric, pediatric dentistry, and child psychiatry residents and additional long term trainees supported by other grants. To implement this goal CoLEND will: Objective 1.1 Implement a regional and national recruitment process which insures the enrollment of high quality long term trainees and fellows with leadership potential; Objective 1.2 Implement the full CoLEND training program annually with a minimum of 8 long term trainees and fellows, with 98 others receiving a partial curriculum; Objective 1.3 Continue to implement process evaluation of the training program; and Objective 1.4 Continue to implement outcome evaluation and follow-up of the training program and trainees and fellows. GOAL II: Community Education. CoLEND will enhance the capacity of community-based professionals from throughout Colorado and the Rocky Mountain region to provide leadership in shaping health and related care systems to be more responsive to the needs of children and their families. To implement this goal CoLEND will: Objective 2.1 Develop an annual continuing education calendar of events and recruit participants from all disciplines for community education offerings; Objective 2.2 Deliver continuing education in collaboration with Colorado (AHEC) Area Health Education Centers to a minimum of 500 continuing education participants in the CoLEND region; and Objective 2.3 Continue to implement a system to collect evaluation data. GOAL III: Systems Change. CoLEND will continue a collaborative systems change work group with Title V and other programs to improve accessibility, quality, and integration of services and supports for children and their families in Colorado and the Rocky Mountain region. To implement this goal the CoLEND program will: Objective 3.1 Conduct an annual assessment of needs and barriers related to improving accessibility, quality, and integration of services and supports for children and their families; Objective 3.2 Develop and implement an annual System Change work plan; Objective 3.3 Convene a monthly collaborative meeting of CoLEND faculty, trainees and fellows, Title V staff, and other programs to refine, implement, and monitor the work plan; Objective 3.4 Conduct program evaluation on the impact of this system change effort; and Objective 3.5 Publish and disseminate an annual summary of this initiative.
METHODOLOGY: There are two primary educational programs offered by CoLEND as well as a major systems change initiative. The first educational program is long-term leadership training designed for trainees and fellows who are recruited for their previous preparation, commitment to leadership, and their interest in interdisciplinary work in neurodevelopmental disabilities. Trainees will be recruited nationally from graduate programs in all eleven disciplines. Fellows will include physicians and post-doctoral candidates. The twelve month program offers a core of family-centered, community-based, culturally competent values, and emphasizes preparation in teaching/mentoring, research, and clinical and community applications within the context of systems and outcomes-based perspectives and the application of leadership skills. The curriculum includes ongoing seminars, problem based learning tutorials, mentoring, and multifaceted practica in which skills and knowledge are applied. The second major educational program provides leadership training to practicing professionals through continuing education (CE). Qualified CE participants will be selected in collaboration with state agencies and other current leaders in health care. Most CE participants will be currently working within state agencies and communities in leadership positions. A variety of educational opportunities will include on-site workshops, teleconferencing, mentoring, and self-study courses. A third emphasis of CoLEND will be a Collaborative Systems Change Work Group with Title V and other public and private programs. This group will develop, implement, and evaluate an annual system change work plan to improve the quality, accessibility, and integration of services and supports for children and their families. This work group will call upon a broad array of strategies including: data collection; problem and barrier identification and analysis; information dissemination; training and education; policy analysis and revision; product development; interagency collaboration; and advocacy.
COORDINATION: The CoLEND Leadership Training Program, while based in JFK Partners, benefits from the coordinated efforts and resources of a number of other programs of the University of Colorado Health Sciences Center. CoLEND’s community-based approach maintains strong connections to local agencies/systems. Collaboration takes place on many fronts including program planning, instruction/practica, mentoring, systems change, evaluation, and dissemination.
EVALUATION: Program evaluation is an ongoing activity which is integrated into the daily activities of the program. Trainees will also learn program evaluation skills as part of their coursework. Program evaluation efforts will concentrate on evaluation of: 1) trainee performance and short and long term outcomes for trainees and fellows; 2) effectiveness and impact of training program components; and 3) management and outcome of overall program design and implementation. Multiple measures will be used to assess program effectiveness and impact.
EXPERIENCE TO DATE: As one of the original UAF’s, JFK Partners, UCHSC, has operated continuously, training personnel from all required disciplines since 1968. JFK was originally funded through MCHB funds from 1968 to 1980. MCHB funding was available again under a LEND grant in 1995.
