HEALTH CARE SYSTEMS AND MODEL PROGRAMS

Click on a topic below to find links to organizations that provide successful health care systems and programs.

National/Community Programs to Support Health
Maternal and Child Health Programs (MCH programs)
Managed Care Organizations
Medicaid Managed Care Plans
Early and Periodic Screening, Diagnostic and Testing (EPSDT)

NATIONAL/COMMUNITY PROGRAMS TO SUPPORT HEALTH

American Academy of Pediatrics (AAP)

  • Functional Outcomes Project
    The American Academy of Pediatrics (AAP) Functional Outcomes Project was launched in 1992 to address a component often missing in efforts to improve quality of care -- valid and reliable measurement tools to assess the impact of disease and medical treatment on the lives of children and their families.
  • The Future of Pediatric II Project (FOPE II)
    A three-year initiative launched by the pediatric community to look at the health care needs of children in the future and the workforce necessary to meet those needs.
  • Community Access to Child Health (CATCH)
    A CATCH program is a broad-based community partnership that increases children’s access to medical homes or specific health services not otherwise available.  Every CATCH program must be led by, facilitated by, or have significant involvement of a pediatrician.
  • Division 37 of the APA—The Division of Child, Youth, and Family Services
    Publishes a scientific and professional journal, Children's Services: Social Policy, Research, and Practice and a newsletter, The Child, Youth, and Family Services Advocate
  • The Section on Child Maltreatment
    Established in 1994 to support and promote scientific inquiry, training, professional practice, and advocacy in the area of child maltreatment…it’s the only permanent organization within the APA specifically developed to address issues related to child abuse and neglect.
  • Division 54 - Society of Pediatric Psychology 
    Dedicated to research and practice addressing the relationship between children's physical, cognitive, social, and emotional functioning and their physical well-being, including maintenance of health, promotion of positive health behaviors, and treatment of chronic or serious medical conditions.
  • Children and Family Fellowship
    The Casey Foundation created the Children and Family Fellowship, an 11-month leadership development program for mid-career professionals. The Fellowship explicitly strives to increase the pool of leaders with the vision and ability to frame and sustain major system reforms and community capacity-building initiatives that benefit large numbers of children and families.
Head Start and Early Head Start are comprehensive child development programs that serve children from birth to age 5, pregnant women, and their families. They are child-focused programs and have the overall goal of increasing the school readiness of young children in low-income families.
A national initiative linked to health care practices that focuses on the importance of the first three years of life. This approach emphasizes a close relationship between health care professionals and mothers and fathers in addressing the physical, emotional, and intellectual growth and development of very young children from birth to age three.
  • Enhanced Well Child Care
    Well child office appointments are conducted jointly or sequentially by a team consisting of a physician/pediatric nurse practitioner and a Healthy Steps Specialist. The visits are designed to answer questions mothers and fathers may have about their children's upcoming developmental stages, as well as to administer physical exams and developmental checkups.
  • Child Development and Family Health Checkups
    Starting when the child is six months old, these checkups serve the following purposes: detecting early signs of developmental or behavioral problems; identifying family health risks that may affect the child's development; and providing teachable moment opportunities to discuss with mothers and fathers the child's learning and coping style as well as pattern of development.
  • Parent Groups
    These gatherings are held at the office sites and/or in collaboration with local parenting groups. Facilitated by Healthy Steps Specialists, the meetings offer mothers and fathers social support as well as interactive learning sessions and practice in problem solving.
  • Child Development Telephone Information Line
    This service complements a practice's medical information/emergency line with a resource for questions about child development or behavior issues. Healthy Steps Specialists are available to answer questions about day-to-day worries a parent may have, such as concerns about breast feeding, a baby's crying, or a toddler's temper tantrums.
  • Written Informational Materials for Mothers and Fathers that Emphasize Prevention
    Strategies to provide families with information, suggestions, and reassurance.  Available in English and Spanish.
  • Linkages to Community Resources
    Book of community resources that includes information on child care programs, libraries, and play groups as well as on programs for substance abuse, counseling, domestic stress, and housing.
  • C.H.I.L.D. Partnerships Project
    The C.H.I.L.D. Project, a Maternal & Child Health Bureau CISS grant, builds strong systems within the state CCR&R networks to foster collaboration between health and child care professionals.
  • Milk Matters Campaign
    This campaign works to educate kids, parents, and health professionals about the importance of getting enough calcium during the childhood and teen years.
  • SIDS: “Back to Sleep” Campaign
    This campaign educates about the importance of putting babies on their backs to sleep to help reduce the risk of Sudden Infant Death Syndrome (SIDS).  Sponsored by the National Institute of Child Health and Human Development, the Maternal and Child Health Bureau, the American Academy of Pediatrics, the SIDS Alliance, and the Association of SIDS and Infant Mortality Programs.
  • Autism
    The NICHD, part of the National Institutes of Health (NIH), is one of the primary Institutes doing research into various aspects of autism, including its causes, prevalence, and treatments.
  • Child Development and Behavior Branch (CDB)
    The Child Development and Behavior Branch of the National Institute of Child Health and Human Development, supports research on psychological, psychobiological, and educational development from conception to maturity. The branch focuses on the following program areas:
    • Human Learning and Learning Disabilities
      This program has a special interest in developing and supporting research and training initiatives to increase knowledge relevant to normal and atypical development of reading, written language, and mathematics abilities throughout the life span and the development of prevention, remediation, and instructional approaches and methods to ensure robust development of reading, written language and mathematics skills at different stages of development.
    • Language, Bilingual and Biliteracy Development and Disorders
      This research program has a special interest in research to increase knowledge of language development and disorders, second language acquisition, and written language development and disorders in bilingual/multilingual children. The program also supports training in the study of these areas.
  • National Center for Early Development and Learning
    A national early childhood research project sponsored by the US Department of Education’s Office of Educational Research and Improvement.  NCEDL focuses on enhancing the cognitive, social, & emotional development of children from birth through age eight.
Smart Start is North Carolina's nationally recognized and award-winning early childhood initiative designed to ensure that young children enter school healthy and ready to succeed.  To achieve their goal, local county Smart Start partnerships have focused both their attention and funds on three major areas of service implementation: child care, family support programs, and health services.
A National Pediatric Literacy program.
  • BrainWonders
    Special site about how the brain develops, within the context of relationships, from conception through three years of age.  Special sections developed especially for parents, caregivers, and pediatric and family clinicians.

 

MATERNAL AND CHILD HEALTH PROGRAMS (MCH programs)

Academy for Educational Development (AED)

Founded in 1961, AED is an independent, nonprofit organization committed to solving critical social problems in the U.S. and throughout the world through education, social marketing, research, training, policy analysis and innovative program design and management.
  • Center for Family Health
    The mission of the AED Center for Family Health is to improve family health and well-being, with a special emphasis on the health of mothers and children, through an integrated approach incorporating policy, service delivery, and community aspects.
HRSA directs national programs that improve the Nation's health by assuring equitable access to comprehensive, quality health care for all.
  • Maternal and Child Health Bureau--Information Center
    HRSA’s Maternal and Child Health programs promote and improve the health of our nation’s mothers, infants, children and adolescents, including low-income families, those with diverse racial and ethnic heritage, and those living in rural or isolated areas without access to care.
The National Center for Education in Maternal and Child Health provides national leadership to the maternal and child health community in three key areas--program development, policy analysis and education, and state-of-the-art knowledge--to improve the health and well-being of the nation's children and families.
  • Maternal and Child Health
    The public programs that address the health and well-being of pregnant women and children cut across multiple agencies and have multiple federal and state funding streams. The Governor has the unique role of directing multiple agencies and programs in the planning, coordination, and evaluation of services for this population. Governors also work closely with the private sector and the business community on initiatives to improve health status and strengthen families.
  • MCH Update: Income Eligibility for Pregnant Women and Children
    States continued to expand SCHIP and Medicaid eligibility levels for children and pregnant women in 1999, insuring 2 million children. Income eligibility levels increased as much as 80 percentage points for certain age groups.
This site provides an array of information on Maternal and Child Health resources.
  • MCH Junction
    The MCH Junction provides links to a wide array of non-profit Maternal and Child Health resource and training web sites. Become a member of the Junction and gain the opportunity for national and international visibility for your web-based presence.
  • Maternal and Child Health Bureau
    MCHB continues to provide its leadership, partnership, and resources to advance the health of all our Nation's mothers, infants, children and adolescents-including families with low income levels, those with diverse racial and ethnic heritage and those living in rural or isolated areas without access to care.
  • HRSA’s Child Health Programs
    A national vision for children.

 

MANAGED CARE ORGANIZATIONS

American Academy of Pediatrics (AAP)

CCN Managed Care, Inc. (d.b.a. CCN) is a national non-risk managed care organization that contracts with physicians, hospitals and other health care providers to form preferred provider networks for group health, workers' compensation and auto injury management.
As of July 1, 2001, the Health Care Financing Administration (HCFA) is now the Centers for Medicare & Medicaid Services (CMS).
  • Children’s Health Insurance Program
    An informational web site on the State Children's Health Insurance Program (SCHIP). This site is intended to provide materials of interest to various audiences regarding the passage of SCHIP, also known as Title XXI, as part of the Balanced Budget Act of 1997.
  • HumanaBeginnings
    HumanaBeginnings provides education and support for mothers and their families, encouraging healthy habits during pregnancy and after the baby is born.
NCQA is an independent, nonprofit organization whose mission is to evaluate and report on the quality of the nation’s managed care organizations.
  • Programs
    NCQA’s main programs and activities.
The Center for Health Services Research and Policy (CHSRP – formerly the Center for Health Policy Research) conducts sponsored health services research and policy analysis on complex health policy issues.
As of July 1, 2001, the Health Care Financing Administration (HCFA) is now the Centers for Medicare & Medicaid Services (CMS).  The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the US Department of Health and Human Services. CMS runs the Medicare and Medicaid programs - two national health care programs that benefit about 75 million Americans. And with the Health Resources and Services Administration, CMS runs the State Children's Health Insurance Program (SCHIP), a program that is expected to cover many of the approximately 10 million uninsured children in the United States.
  • Medicaid
    Medicaid is a jointly-funded, Federal-State health insurance program for certain low-income and needy people. It covers approximately 36 million individuals including children, the aged, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments.
  • Medicaid and EPSDT
    The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service is Medicaid's comprehensive and preventive child health program for individuals under the age of 21. The EPSDT programs consist of two mutually supportive, operational components: (1) assuring the availability and accessibility of required health care resources; and (2) helping Medicaid recipients and their parents or guardians effectively use these resources.
  • Annual EPSDT Report
    The annual EPSDT report (Form HCFA-416) provides basic information on participation in the Medicaid child health program. The information is used to assess the effectiveness of State EPSDT programs in terms of the number of children (by age group and basis of Medicaid eligibility) who are provided child health screening services, referred for corrective treatment, and receiving dental services.
  • Health Resources and Services Administration (HRSA)
    HRSA directs national programs that improve the Nation's health by assuring equitable access to comprehensive, quality health care for all.
  • HRSA’s Child Health Programs 
    A national vision for children.
  • HRSA'S Maternal and Child Health Bureau
    MCHB continues to provide its leadership, partnership, and resources to advance the health of all our Nation's mothers, infants, children and adolescents-including families with low income levels, those with diverse racial and ethnic heritage and those living in rural or isolated areas without access to care.
  • Insure Kids Now!
    Parents work hard to provide for their children and want to make sure they grow up strong, smart and healthy. But like many parents whose children don't have health insurance, they worry about taking care of them.  Now, they may have one less thing to worry about. Every state in the nation, has a health insurance program for infants, children and teens.  For little or no cost, this insurance pays for doctor visits, prescription medicines,
    hospitalizations, and much more.

 

EARLY AND PERIODIC SCREENING, DIAGNOSTIC, AND TREATMENT (EPSDT)

Automated Health Systems, Inc

AHS is a mission-driven organization that manages publicly funded health programs involving low-income families, providers, and relevant health and human service agencies.
  • Helping HMOs with the EPSDT Program
    AHSI contracts with HMOs nationwide to develop and manage their Early and Periodic Screening, Diagnosis and Treatment (EPSDT) programs. AHSI outreaches low-income families to educate and inform them of their health care benefits and encourages regular contact with primary care providers (PCPs) to make sure these families get the health care they need.
The Center for Health Services Research and Policy (CHSRP – formerly the Center for Health Policy Research) conducts sponsored health services research and policy analysis on complex health policy issues.
As of July 1, 2001, the Health Care Financing Administration (HCFA) is now the Centers for Medicare & Medicaid Services (CMS).
  • Medicaid and EPSDT
    The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service is Medicaid's comprehensive and preventive child health program for individuals under the age of 21. The EPSDT programs consist of two mutually supportive, operational components: (1) assuring the availability and accessibility of required health care resources; and (2) helping Medicaid recipients and their parents or guardians effectively use these resources.
  • Annual EPSDT Report
    The annual EPSDT report (Form HCFA-416) provides basic information on participation in the Medicaid child health program. The information is used to assess the effectiveness of State EPSDT programs in terms of the number of children (by age group and basis of Medicaid eligibility) who are provided child health screening services, referred for corrective treatment, and receiving dental services.