Medicaid remains the most important part of the public safety net of health services available to low-income children. In fact, more than a quarter of U.S. children receive health care through state-administered Medicaid programs. Because children from disadvantaged backgrounds are more susceptible to developmental problems, the Fund maintains a strong focus on improving the quality of developmental services and preventive care in Medicaid. Through its Assuring Better Child Health and Development (ABCD) initiative, the Fund has had success in working directly with state officials to adopt policies that support high-quality developmental services and to test innovations in the delivery and reimbursement of such care.
Now in its second phase, the ABCD initiative is working with Medicaid programs in California, Illinois, Iowa, Minnesota, and Utah to promote the healthy mental development of young children. The initiative is encouraging routine developmental and behavioral screening of young children and screening for parental depression and is partnering with private health care providers to improve care in this area.
(5) The ABCD projects are managed by Neva Kaye at the National Academy for State Health Policy (NASHP), which conveys lessons learned in the participating states to public health leaders across the nation.
In Iowa's state budget for fiscal year 2006-07, $325,000 was set aside to spread the Iowa ABCD project statewide. In support of the measure, the Iowa Department of Public Health prepared a fact sheet for legislators detailing the importance of child development; the publication cited both the Fund and NASHP. In North Carolina, the proportion of children screened for developmental problems has been steadily increasing, thanks in large part to that state's successful ABCD initiative. North Carolina requires that all pediatric providers screen children for developmental disorders at periodic visits using a standardized instrument. In a study published in the journal
Pediatrics in July, researchers led by Marian Earls, M.D., of the University of North Carolina School of Medicine noted that screening rates rose from 20 percent to 70 percent over a four-year period at one health center.
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