by Debbie Cheatham, BSN, MS, DNP, and Catherine Bodkin, MSW, MSHA, LCSW, Senior Technical Assistance Specialists supporting the ECCS CoIIN Project at ZERO TO THREE
Early childhood services stretch across state and local systems. There is an increased need for coordination and integration of these services in order to better serve children and families. To ensure that children reach their developmental potential and are ready to thrive in kindergarten, 12 states (Alaska, Delaware, Florida, Hawaii, Indiana, Kansas, Louisiana, Massachusetts, New Jersey, New York, Oklahoma, and Utah) are participating in the Early Childhood Comprehensive Systems Collaborative Improvement and Innovation Network (ECCS CoIIN). Each state selects up to five communities to develop early childhood systems that promote healthy child development and take a proactive approach to identifying developmental challenges as early as possible. The ECCS CoIIN aims to improve the developmental skills of 3-year-old children in these communities by 25% over a 5-year period. Funded by the Health Resources and Services Administration, the National Institute for Children’s Health Quality (NICHQ) uses a collaborative, innovative quality improvement methodology, in which the states and their communities implement a series of evidence-based solutions and use data to track results. ZERO TO THREE is sub-contractor under NICHQ to assist in supporting this work.
One early shining star is New Jersey, which is in Year 2 of implementing the ECCS CoIIN in Camden, Cumberland, Essex, Middlesex, and Passaic counties. These communities were selected because of the following criteria: higher rates of children living in poverty, racial and ethnic disparities, higher rates of unemployment, inadequate housing, low educational attainment, higher rates of family violence, higher rates of child abuse and neglect, higher rates of gang involvement and crime, growing need for translation services and bicultural staff, limited access to child care options, lower rates of health care coverage, and lack of services to support referral efforts. The primary focus is to develop a system of care, well-integrated across state and local supports and services, to improve infant and child outcomes, eliminate disparities, support parents and families, and strengthen communities. Through the system-building efforts, all children will receive developmental screenings and families will have access and be referred to services and supports to promote healthy child development and meet the overall aim to improve developmental skills of 3-year-old children.
Building a Successful System Through State and Local Collaboration
Through ECCS Impact, the Department of Children and Families (at the state level) facilitates state and local partnerships across early childhood service sectors and with families. At the local level, the central intake hub in each community partners with the County Council for Young Children (CCYC) to apply the ECCS CoIIN collective impact process and quality improvement approach to improve results for families. Using a two-generation approach to service delivery, New Jersey links children and their families to primary health care, screening, and early intervention for developmental delays, and it helps address other child/family services and supports. By linking families to primary health care, screening, and early intervention, New Jersey will be able to ensure children receive developmental screenings and be referred to services and supports as needed.
New Jersey started the project with a strong early childhood system infrastructure and clear state and local leaders for this effort:
- Central intake –New Jersey has a statewide network of central intake hubs encompassing all 21 counties. The county-level hub is a single point of entry that helps to simplify the referral process, improve care coordination, and ensure an integrated system of care. The primary focus is pregnancy to 5 years old. However, all sites assist families and individuals with needed connections across the lifespan.
- CCYC—There are also CCYCs in all 21 counties in New Jersey. The work of the CCYC is to strengthen collaboration between families and local community stakeholders. This shared leadership philosophy includes parents as active partners with service providers and community leaders helping to identify the needs, aspirations, and successes of collective efforts to positively impact the health, education, and well-being of children from pregnancy/birth to 8 years old.
In each community, staff at the central intake hub and CCYC assemble local CoIIN team members, including a parent leader, and ensure meaningful support and collaboration with key stakeholders in the local planning and implementation of CoIIN activities. The local team oversees the development of effective outreach and communication plans that engage families and providers within the community throughout the project. The team helps identify successful strategies that can be expanded to broader populations and enlists others to spread important findings from the CoIIN throughout the county.
Participating in the CoIIN has allowed New Jersey’s five communities to take a lot of ownership in the work so that it is reflective and responsive to their individual cultures and populations. The state team visits and supports communities and participates in community meetings, but they are not playing the traditional “prescriptive” state role. Instead, they are learning about the work in the communities and focusing on how they can spread it to other communities across the state, which has led to a strong statewide systems approach for improving child development and health.