Innovation in Care Integration for Children and Youth with Autism Spectrum Disorders and Other Developmental Disabilities Program

The summary for the Innovation in Care Integration for Children and Youth with Autism Spectrum Disorders and Other Developmental Disabilities Program grant is detailed below. This summary states who is eligible for the grant, how much grant money will be awarded, current and past deadlines, Catalog of Federal Domestic Assistance (CFDA) numbers, and a sampling of similar government grants. Verify the accuracy of the data FederalGrants.com provides by visiting the webpage noted in the Link to Full Announcement section or by contacting the appropriate person listed as the Grant Announcement Contact. If any section is incomplete, please visit the website for the Health Resources and Services Administration, which is the U.S. government agency offering this grant.

Innovation in Care Integration for Children and Youth with Autism Spectrum Disorders and Other Developmental Disabilities Program: This announcement solicits applications for the Innovation in Care Integration for Children and Youth with Autism Spectrum Disorders and Other Developmental Disabilities (ASD/DD) Program.  This program supports the implementation of innovative, evidence-informed strategies to integrate care at a system-level within a state for children and youth with autism spectrum disorders (ASD) and other developmental disabilities (DD), with a special emphasis on medically underserved populations (based on poverty, rural geographic location, and/or populations that experience health disparities).[1]  The target population for this program is all children and youth within a state identified as at risk for or diagnosed with ASD/DD.

Using the care integration framework recommended by the American Academy of Pediatrics (AAP), the care for children and youth with ASD/DD within the state will be integrated across systems to improve access to appropriate screening, referral, diagnosis, care coordination, and services.[2]  Recipients/awardees will implement innovative, evidence-informed models of 1) family support and navigation, 2) shared resources, and 3) telehealth and/or telemedicine (including mobile health) health information technologies.

Program Goals

Improve access to a coordinated, comprehensive state system of services that leads to early diagnosis and entry into services for children with ASD/DD within the state and their families, emphasizing medically underserved and rural populations.[3]

Program Objectives

Objective 1:  By August 31, 2019, increase the proportion of children within the state identified as at-risk for ASD diagnosis and referred for diagnosis and ASD/DD services by 25 percent over baseline.

Objective 2:  By August 31, 2019, increase the percentage of children with ASD and other DD within the state enrolled in services before 37 months of age by 10 percent over baseline.

Objective 3:  By August 31, 2019, increase the percentage of children with ASD/DD residing in medically underserved communities within the state (based on poverty, rural, and/or populations that experience health disparities) enrolled in services before 37 months of age by 10 percent over baseline.

Objective 4:  By August 31, 2019, increase the proportion of children and youth with ASD and other DD within the state and their families by 25 percent over baseline who report increased knowledge, skill, ability and self-efficacy in family-centered care; specifically related to referrals, diagnosis and access to services for ASD/DD (with a special emphasis on medically underserved populations).

Objective 5:  By August, 31, 2019, increase the number of referrals of at-risk children for ASD/DD within the state to early intervention programs and/or specialists for comprehensive evaluation by 25 percent above baseline.

The intention of this funding opportunity is to support the use of innovative, evidence-informed methodologies to achieve the goal of improving state system-level care integration for children and youth with ASD/DD and their families.  All grantees of this funding opportunity will participate in a community of learners and implement quality improvement activities.  This grant opportunity will allow grantees to collectively problem solve and share strategies through brainstorming sessions, workshops, and skills training sessions.  Participants in the community of learners will share their successes and failures and rapidly make modifications and adaptations to support achieving objectives and allow for replicability of strategies.  The learning community will consist of the following:

Sharing of diverse perspectives and experiences from grantees;

Collaborative problem-solving among participants; and

Application of rapid cycles of improvement to support the testing and replicability of innovative strategies.

Program Requirements

Applicants must:

Establish a multidisciplinary project advisory group made up of stakeholders, including families and experts who have specialty background and experience in ASD/DD.  The advisory group should consist of representatives of the following organizations: State Title V Program, State Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program, state Part B and C of the Individuals with Disabilities Education Act (IDEA), family leaders/family organizations (i.e. autism support groups and state family-to-family health information centers) and relevant state chapters of their professional organizations (i.e. the AAP).  Other entities to consider including are: pediatric primary care clinicians, pediatric specialists, universities, community agencies, state legislatures, Medicaid, Children’s Health Insurance Program (CHIP), private payers, early childhood education and school systems, Federal Qualified Health Centers, Community Health Centers and Rural Health Clinics.  The applicant must demonstrate the capacity to develop effective partnerships with ASD/DD stakeholders in their state through letters of support, formal agreements and/or memorandum of understandings (MOU/MOA).

Use innovative, evidence-informed strategies to improve access to a coordinated, comprehensive system of services for children and youth with ASD/DD.  Each evidence-informed strategy must include family engagement activities to ensure partnership between ASD/DD families and providers.  The innovative, evidence-informed strategies are as follows:

A Shared resource can support care coordination and case management.  For the purposes of this funding opportunity, the shared resource can improve management of care for children with ASD/DD and improve communication and coordination between providers, specialists and community resources.[4]  Resources that can be shared are as follows:

Community networks;

Community health teams;

Regional Extension Centers;

Area Health Education Centers; and

Care teams.

Telemedicine is the use of electronic communications and information technologies to provide clinical services when participants are at different locations.  Telehealth is a broader application of technologies to distance education, consumer outreach, and other applications utilizing electronic communications and information technologies to support healthcare services.[5]  Mobile Health (mHealth) is a form of telemedicine using wireless devices and cell phone technologies.[6]  For the purposes of this grant opportunity, the telehealth/telemedicine activities should do the following:

Facilitate ASD/DD diagnosis by observing behavior;

Facilitate ASD/DD treatment through behavioral therapy;

Increase access to medical and non-medical ASD/DD providers in medically-underserved communities; and

Facilitate cross-system coordination, integration, and data sharing between and among providers and families.

Family Navigators[7] guide families through and around barriers in the healthcare system to assist them in overcoming obstacles faced in accessing or receiving care.[8],[9]  For the purposes of this grant opportunity, the selected navigator model should assist children, youth, and families of ASD/DD in:

Reducing delays in accessing the continuum of care services with an emphasis on timeliness of diagnosis and treatment of ASD/DD;

Choosing, understanding, and using health coverage;

Choosing, understanding, and using health providers and services;

Making decisions about treatment;

Providing care management by and through multiple providers; and

Receiving care that is culturally[10] and linguistically[11] competent.

Include quality improvement activities in the implementation of the innovative, evidence-informed strategies.  The quality improvement methodology should be used to achieve the project goals and objectives including: identifying needs, implementing small tests of change, using data to inform decisions, spreading successful change strategies, engaging stakeholders, and measuring improvement.

Include components of family engagement activities.  Family engagement activities should address the continuum of needs and work at multiple levels in order to ensure children, youth and families of ASD/DD receive the level of participation that is best for them.  The levels of engagement can be in direct care, organizational design and/or governance and policymaking.  The continuum of engagement can be in consultation, involvement and/or partnership, and shared leadership.  Each applicant should incorporate the appropriate family engagement activity that supports the chosen strategy.

Designate the target population that includes a minimum of twenty percent medically underserved (e.g. poverty, rural, and/or populations that experience health disparities).  The medically underserved population can be defined as a population with one or more of these attributes:

A part of a Health Professional Shortage Area (HPSA); with a shortage of primary care clinicians and/or mental health professionals; and/or

An area that includes groups of persons who face economic, cultural or linguistic barriers to health care.

Use a minimum of twenty percent of the project budget for performance monitoring and to develop a comprehensive evaluation plan incorporating national, state, and community data.  The evaluation plan should contain methodologies to measure the achievement of the program purpose, aim, and objectives and to track the status of the applicant’s individual project goals and objectives.  In addition, the grantee will be required to design and track an evaluative measure that shows improvement of the system of care for the ASD/DD population in the state.

Develop a plan that will sustain key project activities beyond federal funding.

Grantee Requirements:

In addition to the above program requirements, successful applicants will also be required to participate in the following:

Collaborate with other MCHB-Funded Grants:  Funded applicants will be expected to collaborate and where possible coordinate activities with other MCHB grants including the LEND Training Programs, the Intervention Research Program, the State Public Health Coordinating Center, Family-to-Family Health Information Centers, Early Childhood Comprehensive Systems (ECCS) and the Systems Integration Grants for Children and Youth with Special Health Care Needs (CYSHCN).  More information and links to resources for these programs can be found in Section VIII of this FOA.  It is also an expectation that successful applicants will collaborate with other MCHB-funded programs listed below in the Background section of this FOA.

Annual MCHB Collaboration, Accountability, Research, Education, and Support (CARES) Grantee Meeting:  Funded applicants will be required to attend an annual MCHB CARES grantee meeting which will include all grantees funded under MCHB CARES.  This meeting occurs in the Washington, D.C. area every other year and virtually in the consecutive year.  The meeting will be held in the greater Washington, D.C. area in 2017.  Applicants should budget for two (2) staff to attend the in-person meeting.

Annual Autism State Program Grantee Meeting:  Funded applicants will be required to attend the annual state autism program meeting, which will include all State Autism Implementation Grantees.  Applicants should budget for two (2) staff to attend the annual meeting.

Innovation Community of Learners:  Grantees will be required to participate in the innovation community activities via a virtual format.  These activities include conference calls, brainstorming sessions, workshops, webinars and skills training to support the implementation of selected innovative strategies.

Evaluation:  Successful applicants will be required to work with MCHB’s evaluation contractor who will be collecting quantitative and qualitative data for the evaluation of the MCHB Autism CARES Act Initiative.

[1] The medically underserved population can be defined as a population with one or more of these attributes:

a. A part of a Health Professional Shortage Area (HPSA); it may be a whole county or group of county or group of contiguous counties, a group of civil divisions or a group of urban census tracts to which residents have a shortage of primary care clinicians and/or mental health professionals; and

b. An area that includes groups of persons who face economic, cultural or linguistic barriers to health care.

[2] American Academy of Pediatrics (2014)

[3] Definition of “coordinated care” is provided in Section VIII. Other Information of this FOA.

[4] Stanek. (2014)

[5] The American Telemedicine Association (2006)

[6] http://www.americantelemed.org/about-telemedicine/faqs#.VniUL_5dPIU

[7] (Also known as Patient Navigators)

[8] Ferrante et al . (2010).

[9] Wells et al. (2008)

[10] MCHB definition of “culturally competent” is provided in Section VIII. Other Information of this FOA

[11] MCHB definition of “linguistically competent” is provided in Section VIII. Other Information of this FOA