New Jersey's Medicaid program has adopted the Bright Futures Guidelines
as the standard of care in the state. The state's Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program meets most of the American Academy of Pediatrics' (AAP) recommendations. Recent data
show that the state requires the 4 screenings for children ages 1 and 2 that AAP recommends, the 3 screenings for children between ages 3 and 5, and the 4 screenings for children between ages 6 and 9. However, the state requires only 6 out of the 7 screenings recommended by AAP for children younger than 1 year.Implementation:
New Jersey has a statewide home-visiting program, which uses 3 of the national evidence-based models: the Nurse-Family Partnership
, Healthy Families America
, and Parents as Teachers
. The home-visiting programs support 6,800 families throughout New Jersey. They closely adhere to the Bright Futures/AAP Periodicity Schedule, especially for developmental screenings and immunizations. The home-visiting nurses and health professionals have a variety of performance measures that they must report on such as timing of developmental screenings, scheduling of well-child visits, and immunization records.Learning Collaboratives:
Through Maternal and Child Health Services Title V Block Grants, New Jersey has implemented several projects promoting Bright Futures. The current project, Bright Futures Preventive Services Improvement Project State Spread
(PreSIPS2) learning collaborative, involves 6 pediatric practices and focuses on promoting oral health, safe sleep, developmental screening, and breastfeeding. Practices may elect to focus on one or several of these areas, including others of their choosing. The practices receive information about the Bright Futures Guidelines
and are all committed to improving Bright Futures implementation rates. Learning session presentations include practical solutions to implement screening in the practices. In addition, the practices also receive guidance and information through online resources
pertaining to each main topic area. The New Jersey Chapter team stresses the importance of all practice staff working as a quality improvement team. State and community support organizations participate in the learning sessions to link providers to local resources. One of the program's partners is the New Jersey Statewide Parent Advocacy Network (SPAN)
. SPAN works with and advocates for children with emotional, behavioral, and mental health needs and their families.
The New Jersey Chapter PreSIPS2 program holds monthly calls with all 6 participating practices to discuss different topics within pediatric health care and to provide them with additional information on the topics they may be focusing on. Past presentation and webinar topics include partnering with parents, oral health, child abuse, Bright Futures implementation, developmental screening tools, and more. Providers share their successes and challenges in implementation with their peers during the calls as well. One of the most challenging areas that practices continue to struggle with is family engagement. SPAN is working with them to encourage families to become engaged at some level. For a full list of past presentations, visit the webinars
on the NJAAP Bright Futures PreSIPS2 web site.
The New Jersey Chapter PreSIPS2 program also aids practices in their determinations of what modifications need to be made to office systems to improve the office's flow. In addition to receiving advice from the program, practices are encouraged to use the Plan, Do, Study, Act (PDSA) cycle
to determine what the issue at hand may be and how to address it.