The ABCD experience has demonstrated that Medicaid and other state agencies can play an important role in promoting system and practice level change to improve routine identification of young children with developmental problems. Policy improvements most often occurred when they were an integral part of the work from the start rather than added on later in the project. Projects were most successful when senior officials within state government supported them and there was a defined line of communication between project staff and these decision-makers.
The success of the ABCD Initiative provides lessons for states and other entities wishing to improve the quality of health care while controlling costs and improving efficiency. ABCD states changed state statutes, state regulations, contracts, provider manuals, Web sites, and other documents that define state policies designed to improve the delivery of child development services. They also changed eligibility and claims processing systems to implement the policies described in the documents, conducted quality improvement projects designed to assess performance and foster change, and helped providers better understand new and existing policies through workshops, letters to providers and other means. These states made changes not only to Medicaid policies, but also to those governing related programs, such as early intervention and maternal and child health programs.*
Additionally, a background paper written for the ABCD III initiative, Improving Care Coordination, Case Management, and Linkages to Service for Young Children: Opportunities for States, highlights areas where states policies can affect and improve care coordination, case management, and linkages. Specifically, states can:
- Maximize use of personnel in assuring effective linkages and CC/CM;
- Assure and monitor quality of referrals, linkages, and CC/CM;
- Support data, information, and technology that facilitates linkages and communication among families and providers;
- Support individualized care plans and cross systems planning.
This section focuses on resources designed to assist states working to address the health and developmental needs of children and families. This section includes resources highlighting state activities in identifying and implementing key processes to improve policy for preventive services.
*Neva Kaye and Jennifer May, State Policy Improvements that Support Effective Identification of Children At-Risk for Developmental Delay: Findings from the ABCD Screening Academy, (Portland, ME: National Academy for State Health Policy).
