Overview

The North Carolina Division of Medical Assistance, in collaboration with the North Carolina Office of Research, Demonstrations and Rural Health, has developed, implemented and replicated a new health care delivery model that provides child development services to young children. The project has created a community-based comprehensive and coordinated child development services system, one that builds upon the existing infrastructure of the state's enhanced primary care case management system (The ACCESS II/III program). The new health care delivery model consists of the integration of developmental screening and surveillance into well-child visits in pediatric and family practice offices and is followed by case management for parents who express concerns about their child's development. As part of the project, North Carolina has also formed a state advisory group to identify changes to state policies and reimbursement mechanisms that may be necessary to support the new model.
The North Carolina project is supported by the Commonwealth Fund's Assuring Better Child Health and Development program (ABCD) and administered by the National Academy for State Health Policy. The ABCD initiative seeks to build the capacity of states to provide child development services to low-income children enrolled in Medicaid.
As the project enters its third year (and the final year of foundation support), objectives include replicating the demonstration in two other counties in the state and augmenting the evaluation to better assess the impact of the program on young children's health and development. The demonstration project has already shown significant promise. This field report provides an overview of the project, its accomplishments to date, and lessons for other states.

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