Promoting Children’s Optimal Healthy Development

A chat with Paul Dworkin, MD, executive vice president for community child health at Connecticut Children’s, director of the Connecticut Children’s Office for Community Child Health  and founding director of the Help Me Grow® National Center

Connecticut Children’s Medical Center launched the Office for Community Child Health in August 2012 as part of its commitment to making Connecticut’s children the healthiest in the nation. Can you tell us more about why the Office was formed?

Dr. Dworkin: “What if our goals for child health services did not merely include diagnosis and treatment of a wide array of childhood diseases and disorders? What if our goals also included the promotion of children’s healthy optimal development? This would have profound implications for the way in which we deliver our services, build our programs and evolve our systems.

With that in mind, the Office for Community Child Health was formed to serve as a coordinating entity for the Medical Center’s existing community-based programs, including the Help Me Grow® National Center. I developed and piloted Help Me Grow® here in Hartford starting in 1997. The program expanded statewide and now is being replicated in many states around the country. It links children with behavioral and developmental delays to existing programs and services. In addition, the Office serves as an incubator for innovative ideas that advance partnerships between various sectors to work toward systemic solutions to child health problems.”

What role is the Office playing in advancing the optimal healthy development of children?

Dr. Dworkin: “The Office for Community Child Health strengthens existing community-based programs in the areas of fundraising, strategic planning, and developing strong performance metrics. The Office also builds synergies among existing programs by encouraging those with similar missions and target populations to work on collaborative projects to enhance their effectiveness while reducing duplication of efforts. Finally, the Office’s role as an innovation incubator paves the way for promising community-oriented models of care to be pilot-tested, launched and even scaled up nationally if successful.

All of our programs have measurable results that document positive impacts on the health of children in Connecticut and beyond. Our approach encourages children to achieve their best possible health outcomes which leads to long term benefits including economic success, happiness and improved health across their lifetimes.”

What role is the Office playing with public policy reform?

Dr. Dworkin: “We act as a key consultant for policy makers on a wide variety of public policy issues. In order for children to achieve their optimal healthy development, we believe that effective system transformation is necessary to contribute to and sustain long-term impacts on the overall health of children. That requires public policy reform in ways that focus on promoting the healthy development of all children, as opposed to exclusively focusing on children with significant delays, disorders or diseases. In order to achieve effective system transformation, we believe it is crucial for policy makers to maximize existing resources by focusing on programs with strong communication and collaboration across and among diverse sectors. We also feel strongly that public policy changes must be shaped by a strong evidence base of performance metrics which is why we encourage the use of rigorous metrics in all of our programs.”

Can you give some examples of how the Office’s programs are helping reduce healthcare costs?

Dr. Dworkin: “It’s well documented that some programs overseen by the Office for Community Child Health are not only improving health outcomes for children but they are also reducing healthcare costs and the demand for specialist care.

For example, the Medical Center’s nationally recognized Easy Breathing© asthma management program addresses an epidemic among urban populations where children are disproportionately affected by the condition. The program is changing treatment protocols in a way that improves school attendance, reduces emergency room visits and results in significant cost savings. The program also offers the state of Connecticut an opportunity to extend the savings by changing Medicaid reimbursement rules. Initially piloted in Hartford, the program has now expanded statewide and is being replicated in other states.

Another example of cost savings can be found with the Mid-Level Developmental Assessment program which provides a new model for assessing mild to moderate behavioral and developmental delays in children. After undergoing the assessment, children are then linked to existing community-based services and programs and are able to quickly get needed assistance before issues escalate. A study of the program found that utilizing the assessment saves an average of $540 per child compared to the cost of formal evaluations in early intervention programs or a specialist’s office. The early detection and intervention spurred by MLDA also may result in additional cost savings by reducing or eliminating costs for special education, mental health and other social services.”

What is the long term impact the Office hopes to have on families in Connecticut and around the country?

Dr. Dworkin: “Ultimately, the Office for Community Child Health will enable the Medical Center to play a role in optimizing the health of children by engaging all sectors critical to child and family well-being, as well as preventing and treating diseases and disorders.”

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