Embedding Early Childhood Behavioral Health Services in Community Settings: Systems Change and Policy Efforts

Introduction:

As states move toward coordinated and comprehensive early childhood systems, determining how policies and programs interact is essential, as is describing the interactions of state agencies with each other and with community partners. For decades, programs for families (and associated policies) were implemented in response to categorical federal and state funding, were developed and administered without coordination, did not maximize resources, and were confusing to families. As states move toward a more comprehensive approach to systems building, understanding the barriers and facilitators of success is essential.

 

Method:

This talk will utilize information garnered from state-wide system building efforts that began in 2001 and were largely expanded in 2008 as a result of Project LAUNCH.  Information about how participants engaged (from state and community partners) was compiled, including data from over 200 stakeholders that helped guide the work. Also, relevant information about system change efforts was documented longitudinally (e.g., participant commitment to the work, constitution of stakeholder groups) and state and community polices were evaluated.  We also drew relevant information from stakeholder interviews conducted via Project LAUNCH (see 2^nd paper in this symposium). 

 

Results:

Results demonstrate a clear and positive change on early childhood systems in our urban core, as well as statewide.  Polices are better aligned, systems for early identification have been implemented, and sustainable funding to address early childhood needs has been identified.  Our results make clear that it was important to substantially support community settings to implement specific programs as well as to create state-wide systems in which implementation could be successful and sustainable. Project LAUNCH showed enough success that key activities were integrated into additional federal funding, with the intention of becoming part of a pediatric medical home; this will be the key to ultimate sustainability. Results also highlight that there is still much work to be completed, including expanding services state wide, further leveraging 3^rd party payers, supporting community agencies to align programs and policies, creating core competencies for early childhood professionals, and measuring long term outcomes.

Conclusion:

Early childhood systems change is an iterative process and must be comprehensive and coordinated to address all potential barriers to the implementation of individual programs as well as overall system and policy objectives. Project LAUNCH helped highlight the importance of collaboration between spheres of prevention science and public health for on-going service delivery and system change efforts.