Advocacy: The Alabama Chapter of the American Academy of Pediatrics has engaged in a number of initiatives to integrate Bright Futures recommendations into pediatric care. In 2008, the chapter worked with the Alabama Academy of Pediatric Dentistry to successfully propose that Alabama Medicaid provide coverage for children who receive oral health risk assessment and fluoride varnish application in the primary care medical home. The resulting program requires pediatricians to receive training from a pediatric dentist and pass a test before receiving payment. The chapter recently made this process easier by developing an online continuing medical education training module.

Changes in the state Medicaid program have provided the chapter an opportunity to integrate Bright Futures recommendations. When Alabama began the process of transitioning to a managed care system for Medicaid services, chapter representatives worked with the Medicaid Quality Assurance Committee in a yearlong process to identify the measures required of managed care organizations. Among these are several Bright Futures metrics related to immunizations, weight assessment, and developmental screening.

The chapter was invited to be part of an Association of Maternal and Child Health Programs collaborative for states transitioning to Medicaid managed care. The goal of this yearlong initiative is for states to learn from one another about the best strategies for ensuring that children with special health care needs receive treatment under the new system. Included in these strategies are many Bright Futures recommendations related to developmental and behavioral screening.

Learning collaboratives: The chapter also led learning collaboratives on developmental screening in 2011 and 2012. As a result of these collaboratives, 3,419 patients received screenings. More recently, the chapter has joined with organizations like Alabama Medicaid, the Alabama Department of Public Health, the University of South Alabama, and Family Voices to form the Alabama Child Health Improvement Alliance (ACHIA). ACHIA is a partnership whose goal is to improve health outcomes of children in Alabama by partnering with practitioners, families, payers, and organizations that deliver care to children. As part of ACHIA, the chapter has launched two additional learning collaboratives: a developmental screening initiative that includes 7 practices and 20 pediatricians and an obesity preventing and training program that includes 13 practices and 35 pediatricians.