This early intervention and development program fosters strong partnerships between educators, health professionals, and social workers, thereby coordinating care across multiple systems to form a medical home neighborhood. The program has successfully provided comprehensive, coordinated care to children and families for over 35 years.

Implementation Insights:

  • Form a multidisciplinary, cross-system health care team consisting of individuals who care for families and children.
  • Create a shared plan of care between educators, clinicians, and social workers.
  • Utilize volunteers from universities and other community organizations.

    Updated: June 2016


 Background Information

  • Type of Practice: Non-profit organization
  • Location: West Haven, Connecticut
  • Population Served: Over 170 children and youth are served on an annual basis from 6 weeks to 6 years of age. The organization serves all demographics including immigrants, homeless youth, and those living at or below the poverty line.

 Pediatric Medical Home Implementation Strategies

  • Hire a full time social worker to complete a comprehensive intake proces, identifying the unique needs of each family.
  • Partner with pediatric nurses to determine the health needs of every child; make referrals to pediatricians when necessary.
  • Form a multidisciplinary health care team consisting of pediatric nurses, pediatric nurse practitioners, social workers, mental health consultants, educators, dietitians, and pediatricians.
      • Create a plan of care that is shared between the team.
      • Upload the shared plan of care to a computerized system used by clinical staff to monitor and track the health status of children, including immunizations, screenings, and appropriate physical examinations.
  • Train and hire multilingual staff.
  • Enhance cultural competency and language access by recruiting language interpreter volunteers from surrounding universities and community organizations.
      • Ask families about their religious beliefs, traditions, and cultural values.
      • Modify food menus to meet the needs of multiple diverse populations.
      • Provide toys, books, equipment, and other materials that reflect diversity.
  • Provide families with information to help them enroll in health plans and health insurance.
  • Refer families to community services when necessary and appropriate.
  • Field family surveys to obtain family feedback and make continuous improvements to quality of services offered.

 Challenges

  • The project has successfully served families and children for over 35 years, however continues to struggle sustaining financial resources. To overcome this challenge, the project relies on surrounding area universities and recruits volunteers to assist with projects and initiatives.

 More Information

  • For more information, contact Patrice Farquharson, EdD, Executive Director of the West Haven Child Development Center, Inc. at westh@snet.net.