Transforming Pediatrics for Early Childhood: Tools for Embedding the Early Childhood Development Continuum of Care in Clinic Operations
This toolkit offers a range of tools (e.g., workflows, billing guidance, strategies for community relationship-building) to help pediatric practices operationalize the Early Childhood Development Continuum of Care, which includes services related to developmental promotion and prevention, surveillance and screening, care coordination and linkage, and early intervention (learn more).
The toolkit can be used by pediatric practice staff or state and community teams that support local clinics. The toolkit can also be used to build communities of practice across multiple pediatric teams or clinics. Sections of this toolkit are organized into key areas of clinic operations, including:
Section 1: Strengthen the Practice Team
Resources in this section are designed to help pediatric practices build, support, and sustain a strong, collaborative care team. The tools focus on defining and hiring key roles and fostering a team-based environment that supports integrated early childhood developmental and behavioral health care.
Along with this HealthySteps sample, this job description can be referenced for hiring an early childhood developmental expert within a clinic.
These best practices include tips for fostering a strong team-based care culture in a pediatric practice. They are based on focus groups with practice team members with experience in integrated community and behavioral health support, such as pediatricians, family leaders, and behavioral health specialists.
Section 2: Improve Practice Workflows
This section includes resources to support pediatric practices in designing, refining, and implementing effective workflows that promote family-centered care and early identification of developmental health needs. The tools emphasize practical, adaptable processes that can be tailored to each practice’s structure, capacity, and patient population.
This sample workflow outlines the key elements of a family-centered practice environment and offers ideas for strengthening those elements.
Pediatric practice teams can use this fillable Word document to develop a screening workflow tailored for their practice and the families they serve.
This resource supports the awareness and implementation of mental health consultation for practice teams who want to strengthen their early childhood support for families. It is especially useful for teams that do not have integrated behavioral health in their practice or a developmental behavioral pediatrician nearby. The resource includes case examples illustrating how to connect with state mental health services, such as a psychiatry access line for specific early childhood needs.
Pediatric care teams can use this planning tool to identify, track, and proactively support families with complex developmental and psychosocial needs through a structured, yet adaptable, process.
Section 3: Create Opportunities to Bill for Pediatric Practice Transformation
This section helps pediatric practices explore, understand, and implement billing strategies that support team-based care for young children and their families. Resources focus on billing and coding pathways that can support financing sustainability.
This resource provides pediatric providers with guidance on social-emotional developmental screening in well-child visits, billing and diagnosis codes, and case vignettes.
This comprehensive list of billing codes includes descriptions for various aspects of team-based billing for early childhood development experts, including integrated care, the Collaborative Care Model, codes for health centers, and community health worker payment.
This document provides guidance on team-based care billing administration and decision-making for pediatric practices that include community health workers and/or integrated licensed behavioral health providers.
This resource includes a case study on how community health workers were incorporated into Pediatrics Northwest’s care team, including how the team supported billing. It also includes a questions-and-answers summary with state- and community-level teams working to increase access to early childhood developmental services in pediatric settings.
Section 4: Improve Community Relationships and Referrals
The two-part resource in this section helps pediatric practices strengthen referral systems and build effective partnerships with community-based organizations. The materials focus on improving internal processes, enhancing coordination, and fostering strong external relationships to ensure families are successfully connected to the support they need.
Pediatric practices can use this readiness assessment checklist to identify gaps and opportunities for creating internal processes for care coordination and referrals.
This resource includes implementation guidance for how pediatric practices can build relationships with external partners to support referrals.
