​Implementation Resources from the National Resource Center for Patient/Family-Centered Medical Home

• Identification and Screening of Social Determinants of Health Among Children with Special Health Care Needs in Medicaid 
  Developed by the National Resource Center for Patient/Family-Centered Medical Home in partnership with the National Academy for State Health Policy, this fact sheet outlines opportunities for collaboration among Medicaid, Title V Maternal and Child Health / CYSHCN programs, and pediatricians. This resource highlights how state Medicaid agencies are working to incorporate social determinants of health (SDoH) screenings into their programs to improve health outcomes for children and youth with special health care needs (CYSHCN). State-level case studies are included to exhibit innovative, replicable strategies for SDoH screening implementation.
• Care Coordination in the Community: The Medical-Legal Partnership Program
  Developed in partnership with the Center for Children and Youth with Special Health Care Needs at St Christopher's Hospital for Children and the National Center for Care Coordination Technical Assistance, this profile highlights the Medical-Legal Partnership program at an urban primary care practice in Philadelphia, Pennsylvania. In this program, attorneys are available onsite at the primary care practice to provide families with legal services. This profile includes strategies for building inhouse resources in clinics to address social determinants of health, including legal challenges facing families. Care coordination tools and resources that support this work include the Care Coordination Measurement Tool and the Pediatric Integrated Care Survey. 
• Get More Information on our Facebook Page
  The National Resource Center for Patient/Family-Centered Medical Home (NRC-PFCMH) bi-monthly e-Newsletter is full of information from the NRC-PFCMH and our partners—see all issues on our website. In addition, you can also receive the latest implementation information and resources from our Facebook page—follow us today!

Additional Implementation Resources

• COVID-19 Frequently Asked Questions (FAQ) for State Medicaid and Children's Health Insurance Program (CHIP) Agencies
  In a disaster or other emergency situations, the Centers for Medicaid and Medicare Services (CMS) can offer states a number of options that can help them meet the emergency needs of Medicaid and CHIP beneficiaries. CMS has published an FAQ document providing information and guidance about a range of topics including eligibility and enrollment, benefits (such as telehealth and prescription drugs), and financing.
• State Medicaid & CHIP Telehealth Toolkit
  This toolkit developed by the Centers for Medicare and Medicaid Services (CMS) is designed to facilitate states' adoption of telehealth coverage policies. The toolkit highlights considerations for pediatric care and includes a detailed checklist for states as they develop telehealth policies. 
• State Medicaid Strategies to Maintain Access to Care for Children with Special Health Care Needs during the Pandemic
  Presented by the National Academy for State Health Policy (NASHP), this article outlines mechanisms within Medicaid that states have used to relax prior authorization requirements, including increasing access to telehealth. An earlier NASHP article, “States Modify Medicaid Home- and Community-Based Waivers to Respond to COVID-19" discussed how states can temporarily amend programs serving Medicaid enrollees using long-term services and supports through waiver and state plan amendment applications. The article describes the 1915(c) Appendix K waivers that 3 states have sought, and the flexibilities permitted under these waivers.
• Health System Research Priorities for Children and Youth With Special Health Care Needs
  Published in Pediatrics, the “Health System Research Priorities for Children and Youth With Special Health Care Needs (CYSHCN)" abstract and accompanying video describe stakeholder priorities for a CYSHCN research agenda. The priorities highlighted in the article act as a first step toward developing an efficient and cohesive research blueprint for achieving effective health systems for CYSHCN.
• Five Steps to Prepare for Health Care Transition
  This checklist from Got Transition, “Are You Ready to Take Charge of Your Health: 5 Steps to Prepare for Health Care Transition" helps young people learn about their own health and plan for health care transition. The steps and resources in this interactive tool can prepare youth, young adults, and families to transition smoothly from pediatric to adult care.

​Conferences, e-Learning, and Events

• Making Connections: The Critical Role of Family-Centered Care in Addressing Social Determinants of Health for Children and Youth with Special Health Care Needs (CYSHCN)
• Episode 1: Thursday, June 18, 2020
                      10-11am Central
                       Register Here
• Episode 2: Tuesday, June 23, 2020
                      10-11am Central
                      Register Here

The National Resource Center for Patient/Family-Centered Medical Home (NRC-PFCMH), in partnership with Bright Futures National Center and the Screening Technical Assistance and Resource (STAR) Center, is hosting an educational webinar series, Making Connections: The Critical Role of Family-Centered Care in Addressing Social Determinants of Health for Children and Youth with Special Health Care Needs (CYSHCN).

The goal of this 2-part webinar series is to provide state Title V Maternal and Child Health (MCH) / CYSHCN programs, pediatricians, families, and others with information about the impact of social determinants of health (SDOH) on CYSHCN and their families, including implementation strategies for state programs. The series will discuss the role of these groups and state systems in addressing SDOH for CYSHCN by using components of the medical home model.

The first webinar in this series will provide relevant background information about how CYSHCN are impacted by SDOH, including a review of current data. The second webinar will feature 2 state Title V MCH / CYSHCN programs who will discuss how their states are addressing SDOH for CYSHCN.

Each webinar will include a presentation by faculty and time for audience question and answer. The webinars will be recorded and archived on the NRC-PFCMH website.

In preparation for the webinar series, participants are encouraged to review the following resources:

• Identification and Screening of Social Determinants of Health among Children with Special Health Care Needs in Medicaid Factsheet
• Integrating Social Determinants of Health Into Health Supervision Visits Implementation Tip Sheet
• Promoting Lifelong Health for Families and Communities
• Bright Futures Tool & Resource Kit, 2nd Edition
• Social Determinants of Health Information and Resources
• Conversation Simulations for SDOH Counseling

• Live Webinar: COVID-19 Discussion for Families
  Friday, May 29, 2020
  1:00 pm Central
  Register 
  The Association of Maternal and Child Health Programs (AMCHP) Family and Youth Leadership Committee will host a live virtual forum on May 29, 2020 to discuss COVID-19. Family leaders are encouraged to participate. All registrants will receive an agenda and login information prior to the webinar.  
• National Academy of State Health Policy (NASHP): Annual State Health Policy Conference
  August 17-19, 2020
  Boston, MA
  Register
  The annual National Academy for State Health Policy Conference provides educational opportunities for state Title V Maternal and Child Health / Children and Youth with Special Health Care Needs programs, pediatricians, and other professionals interested in pediatric health policy. Sessions include those with a focus on emerging issues and current best practices within states. Participants will also have the option to engage in networking and visit the exhibit hall.
• Podcast: Pediatric CARE: Childhood, Adversity and Resiliency Education
  The American Academy of Pediatrics Screening Technical Assistance & Resource (STAR) Center has launched a podcast entitled Pediatric CARE: Childhood, Adversity and Resiliency Education. Hear the conversations of pediatricians and other pediatric healthcare providers and partners working to address social determinants of health in their pediatric setting. Listen in as leading experts in the field share tested strategies, success stories, and discuss community resources, and clinical tools that are educational and practical, to aid your practice and families. Search for “STAR Center" on iTunes, Good Play or Sound Cloud.
• Archived Webinar: Family Caregiving Policies and Innovations
  This recorded webinar, presented by National Academy for State Health Policy (NASHP) focuses on NASHP's Recognize, Assist, Include, Support and Engage (RAISE) Family Caregiver Resource and Dissemination Center. The webinar provided an overview of the RAISE Family Caregivers Act and featured Tennessee and Washington State leaders who shared their innovations to support family caregivers. 
• Archived Webinar Series: COVID-19 and Complex Health and Social Needs
  The National Center for Complex Health and Social Needs conducted a series of 4 webinars on COVID-19 and individuals with complex needs. Recordings and resources from the series are now available online. The 4-part webinar series included the following topics: 1) Immediate approaches for collaboration during the COVID-19 pandemic; 2) Supporting complex care teams during the COVID-19 pandemic; 3) Unique impacts of the COVID-19 pandemic on individuals with complex health and social needs; and 4) Using social needs screening and patient feedback for complex care. All resources from the series are available for free to the public.
• American Academy of Pediatrics: Duchenne Muscular Dystrophy Education Series
  Although patients with rare conditions are primarily cared for by subspecialists, the initial care pediatric patients receive in the medical home helps establish early diagnosis. Early diagnosis can inform prognosis, service planning, and monitoring for associated developmental and medical conditions. This free education series on PediaLink includes 5 modules highlighting the updated care considerations and emerging therapies related to the care and management of Duchenne Muscular Dystrophy (DMD) (Pediatrics Supplement, October 2018). The series emphasizes the common issues affecting children with DMD and the role of pediatricians, other physicians, nonphysician clinicians, and allied health professionals as effective partners in providing coordinated care for individuals living with DMD. View detailed session descriptions at www.aap.org/DMD. Each of the modules are eligible for AMA PRA Category 1 Credit™ and Maintenance of Certification (MOC) Part 2.
• American Academy of Pediatrics: Spina Bifida Webinar Series
  Spina bifida is the most commonly occurring complex congenital birth defect and has been associated with increasing survival rates. This free, recorded webinar series from the American Academy of Pediatrics addresses important care guidelines, and highlights the critical role of pediatricians, subspecialists and other clinicians in caring for individuals with spina bifida. Each of the webinar modules are eligible for AMA PRA Category 1 Credit™ and Maintenance of Certification (MOC) Part 2.
• Developmental Surveillance, Screening, and Autism Spectrum Disorder Resources
  One in six children has a developmental disability or a developmental delay, and every pediatric clinician will care for these children and their families in practice. The following resources from the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) build capacity among pediatric clinicians to care for children with developmental delays and disabilities. These resources were intentionally designed to align and reference AAP policy.
• American Academy of Pediatrics (AAP) PediaLink Courses
• Milestones Matter: Don't Underestimate Developmental Surveillance
  Available through January 2023
  The AAP offers a FREE online PediaLink course that highlights the importance of developmental surveillance as an essential component of the new recommendations in the clinical report titled, “Promoting Optimal Development: Identifying Infants and Young Children with Developmental Disorders Through Developmental Surveillance and Screening." This course will help pediatricians recognize the value of early identification and intervention when developmental delays are suspected, and to identify the key surveillance and screening steps to incorporate into practice. Participants are eligible for 1 AMA PRA Category 1 Credit™ and 1 Maintenance of Certification (MOC) Part 2 point.                          
• Identifying and Caring for Children with Autism Spectrum Disorder: A Course for Pediatric Clinicians
  Available through April 2023
  Developed by the AAP Council on Children with Disabilities Autism Subcommittee, this free, self-paced online PediaLink course educates pediatric clinicians about evidence-based practices in caring for children with autism spectrum disorder (ASD). The course consists of 7 units, each grounded in recommendations from the AAP clinical report, “Identification, Evaluation and Management of Children with Autism Spectrum Disorder." Learners may complete all units or select specific units they would like to complete based on their needs, capacity, and professional interests. Units within the course are eligible for AMA PRA Category 1 Credit™ and Maintenance of Certification (MOC) Part 2 points.
• Centers for Disease Control and Prevention (CDC) Resources
  The CDC is offerring an Autism Case Training (ACT) web-based continuing education course. This course is designed to help primary health care clinicians gain knowledge and skills to improve early identification of children with ASD and ensure timely and appropriate care. This resource will expire in fall 2020, however clinicians can continue to receive Continuing Medical Education and Maintenance of Certification Part 2 points on activities related to ASD through the AAP PediaLink courses on ASD and developmental surveillance.
• The CDC will continue to offer:
• A collection of Autism Case Training Videos, which will continue to be accessible to the public after fall 2020. Videos present numerous strategies on identification and evaluation of children with ASD, shared decision-making with families, and referral to appropriate interventions.
• The “Autism Case Training (ACT): A Developmental-Behavioral Pediatrics Curriculum" a downloadable, PDF version of a curriculum designed for in person/in class use to educate future health care clinicians on fundamental components of identifying, diagnosing, and managing ASD through real-life scenarios.

• Safeguard Against Disability Discrimination during COVID-19
  From the Center for Dignity in Healthcare for People with Disabilities, and based on guidance from the Department of Health and Human Services Office for Civil Rights, 2 COVID-19 factsheets have been developed. One factsheet is for individuals with disabilities, Do You Know Your Rights with COVID-19?. The second factsheet is for health care providers, Safeguard Against Disability Discrimination During COVID-19.
• A Roadmap to Emotional Health for Children with Chronic Pediatric Conditions and Their Families
  A new article in Pediatrics tracks the development of The Roadmap Initiative funded by the American Board of Pediatrics to increase the resilience and emotional health of children with chronic conditions and their families. The article addresses The Roadmap Initiative from the perspectives of a family of a child with a chronic condition and a pediatrician. The Roadmap Initiative aims to raise awareness among patients and families to normalize stress and promote self-care among clinical teams to address these issues and provide support, resources, and connections for clinicians and families. This article provides tools and resources to help pediatricians achieve the aims of The Roadmap Initiative and outlines next steps.
• Children with Special Health Care Needs Face Challenges Accessing Information, Support, and Services
  This issue brief developed by Child Trends examines the most recently available comprehensive data on children and youth with special health care needs (CYSHCN) and their families. The issue examines topics like socioeconomic status, access to medical home, and truancy. Authors found that compared to their peers without special health care needs, CYSHCN are more likely to experience marginalization.
• The Child Care Crisis Disproportionately Affects Children with Disabilities
  From the Center for American Progress, this report examines the child care experiences of families who have young children with disabilities. The report discusses that families of young children with disabilities are more likely to experience marginalization, such as job disruptions, lack of suitable care options, and challenges with scheduling medical visits, as compared to children who do not have disabilities. The report offers policy solutions that are critical to supporting access to equitable resources for families with young children with disabilities.
• Your Help is Needed to Count all Kids in the US Census! 
  The Association for Maternal and Child Health Programs (AMCHP) is pleased to release a package of materials to promote an accurate count of all children in the 2020 US Census. Accurate measurement of children in the 2020 Census is important to ensure appropriate allocation of funds and resources for public services. The AMCHP 2020 Census package includes fact sheets for state Title V Maternal and Child Health / Children and Youth with Special Health Care Needs programs, advocates, and parents, along with a social media resource guide.
• COVID-19 Demographic and Economic Resources
  The US Census Bureau released a new resource page “COVID-19 Demographic and Economic Resources". This interactive data hub centralizes released data from the American Community Survey and the County Business Patterns program. This data resource page can support state Title V Maternal and Child Health / Children and Youth with Special Health Care Needs programs, family lead organizations, and community partners with decision making related to the COVID-19 pandemic. 
• Family Voices Coronavirus Information and Resources
  Family Voices is deeply committed to family engagement in health and wellness of children and youth with special health care needs (CYSHCN) and their families during the COVID-19 pandemic. This resource page developed by Family Voices offers guidance and resources to frequently asked questions about COVID-19 for families of CYSHCN.
• AMCHP COVID-19 Maternal Child Health (MCH) and Community Resource Page
  The Association of Maternal and Child Health Programs (AMCHP) gathered and developed information, resources, and guidance for state Title V Maternal and Child Health / Children and Youth with Special Health Care Needs programs, families, and clinicians in responding to the COVID-19 pandemic. Resources are available free of charge and are updated regularly.