Minnesota

 How Minnesota is implementing Bright Futures

Adaptation: Minnesota’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program is referred to as the Child and Teen Checkups (C&TC) program. The C&TC periodicity schedule is closely aligned with the Bright Futures/American Academy of Pediatrics (AAP) Periodicity Schedule, but there are differences with respect to the timing and frequency of well-child visits. Specifically, the Bright Futures/AAP Periodicity Schedule recommends a prenatal visit and visits at birth, at 3–5 days, by 1 month, at 2 months, and every year between ages 3 and 21, whereas Minnesota’s 2016 C&TC periodicity schedule recommends visits at 1 and 2 months and every other year after age 6, stopping at age 20. The C&CT periodicity schedule mentions that these recommendations are a minimum standard and that more visits or screening should be done and billed for as medically necessary. Most of the C&TC screening recommendations are similar to those in the Bright Futures Guidelines. Certain Bright Futures requirements, such as those for autism and developmental screening, are only recommended rather than required in Minnesota, whereas others, like maternal depression screening, are an additional service.

In 2013, Minnesota evaluated and reviewed current literature and key resources such as the Bright Futures Guidelines to inform the development of recommendations for C&TC and the health supervision of infants, children, and adolescents that reflect evidence-based practices. When the Minnesota Department of Health released the updated C&TC periodicity schedule, it also released supporting resources such as updated screening component fact sheets and e-learning training modules for providers. Increased in-person and Web-based trainings for providers who screen infants and toddlers during the preschool years (e.g., Head Start, primary care, early intervention) are designed to educate and support professionals in implementing updated recommendations for developmental/social–emotional, maternal depression, and other screenings.

Implementation: In 2014, Minnesota selected 4 of the 11 pediatric preventive care measures to focus on: child and adolescent access to primary care providers (PCPs), well-child visits in the first 15 months, well-child visits for children ages 3 to 6, and preventive dental visits. These measures are closely aligned with the Bright Futures Preventive Services Quality Improvement Measures. At that time, the state’s quality performance rates for access to PCPs were higher than the national average, while the rates for well-child visits for infants and young children and for preventive dental visits were lower than the national average.

Integrated Health Partnership (IHP): The IHP program is an accountable care model for Minnesotan Medicaid recipients in managed care and fee-for-service arrangements. The program delivers higher quality and lower health care costs through innovative approaches to care. The IHP model encourages integration of physical health care with mental health and chemical dependence services, safety net providers, social service agencies, counties, and public health resources. The program uses earned shared savings from its total cost of care contracts with the state to expand care coordination infrastructure to serve the most vulnerable members of the state. Through the IHP program, Minnesota’s Medicaid agency and C&TC are striving to improve healthful development among children by effectively integrating services and working with vulnerable families.​

Training: The Minnesota Chapter of the American Academy of Pediatrics (MNAAP) has integrated key elements of the Bright Futures Guidelines into pediatric care across the state. For instance, in 2013 the chapter partnered with several state agencies, including the Departments of Health, Human Services, and Education, and a health plan provider to highlight the need for increased behavioral and developmental health screening. Experts identified by the Department of Education led a training session that covered topics such as the benefits of developmental screening and coverage under the Affordable Care Act. MNAAP convened pediatrician leaders for the session and shared the training Webinar with pediatricians, educators, and local public health officials statewide. Two additional in-person training events were held.

Raising community awareness: The chapter has engaged in a Healthy Tomorrows program to promote immunization among immigrant Somali communities. Funded by the Health Resources and Services Administration, MNAAP's Healthy Tomorrows initiative helped the chapter work with Somali community agencies, pediatric healthcare providers, and family partners to develop community-specific education material in three locations. In Rochester, for instance, the program produced educational videos that addressed immigrant families' concerns regarding immunization and autism. These videos were developed with the families, ensuring that they were relatable to the community.

In St. Cloud, a similar strategy was used to produce videos that starred local Somali families and addressed seven key concerns identified by the community. Topics addressed by these videos include developmental screening, car seat safety, thermometer use, nutrition, safety in the home, and safe sleeping. In Minneapolis, MNAAP worked with community health workers and community leaders to increase awareness of Bright Futures components among Somali families. By creating a dialogue between providers and families and addressing specific concerns, the Healthy Tomorrows program helps ensure that children in these communities continue to receive the pediatric care recommended by Bright Futures.

Visit the MNAAP Resources for Parents​ page to obtain information on various topics ranging from health insurance eligibility to suicide prevention. The page also includes a section on videos for Somali Parents​.

 Contacts:

Minnesota Chapter
www.mnaap.org

For more information about maternal and child health activities in your state, visit the Health Resources and Services Administration's Web site to find local contact information for the Maternal and Child Health and Children With Special Health Care Needs representatives.