The evidence is compelling: investing in the first 1,000 days of a child's life, when 85 percent of brain development occurs, can improve the entire trajectory of that life—physical and mental health, cognitive development, and educational and economic prospects.
That's why New York State has launched the First 1,000 Days on Medicaid initiative, a host of new cross-sector programs for children up to age three. New York's Medicaid program, which spearheads the initiative, covers about 60 percent of the state's very young children.
“With this initiative, the State has recognized that even in periods of tight budgets, it's important to invest in prevention,” says Suzanne Brundage, UHF's Patricia S. Levinson Fellow and director of the Children's Health Initiative at United Hospital Fund, which is a lead partner in the effort. “If young children's key needs are not met, there will be broad and profound ramifications down the road, in classrooms, the health care system, the workforce, and public budgets.”
While Medicaid can make a unique contribution in preparing children for lifelong health and success, reaching that goal is only possible if all child-serving sectors work together. Cooperation between health and education is particularly important, which is why the initiative's co-chairs are education leaders—SUNY Chancellor Emeritus Nancy Zimpher and State Education Department Commissioner Mary Ellen Elia. Additionally, every activity in the initiative's ten-point plan includes ways in which Medicaid can collaborate with non-health players to promote child health and development, regardless of where that work occurs.
The First 1,000 Days demonstrates that diverse sectors can come together to make meaningful progress, then-State Medicaid Director Jason Helgerson noted. Commending the initiative's co-chairs and its vice chairs Kate Breslin of the Schuyler Center for Analysis and Advocacy, and Dr. Jeffrey Kaczorowski, of the University of Rochester Medical Center, he also said UHF “deserves tremendous credit.”
UHF guided development of the initiative's proposals, soliciting ideas from 200 participating experts in child development, child welfare, pediatrics, mental health, and education, developing 23 proposals, and facilitating a voting and ranking process to create the final plan.
UHF will continue to be a vital resource supporting State implementation of interventions, re-convening stakeholders as necessary, and sharing lessons from its Children's Health Initiative.
“By focusing on preventing problems before they start, working collaboratively across sectors, and drawing on a broad range of experts,” says UHF President Anthony Shih, MD, MPH, “New York is again leading the way on how government can tackle tough public challenges to make a difference in vulnerable lives.”
THE FIRST 1000 DAYS TEN-POINT ACTION PLAN
Braided funding for early childhood mental health consultations—to unite several state agencies to co-fund training for early childhood teachers on how to support healthy development and identify behavioral problems;
Statewide home visiting—to expand home visiting programs that have demonstrated improved outcomes;
Preventive pediatric care clinical advisory group—to guide pediatricians on prevention, health promotion, and addressing poverty-related risks;
Expansion of “Centering Pregnancy”—to spread this successful model of group prenatal care for mothers in communities with the poorest birth outcomes;
Early literacy through local strategies—to improve early language development by expanding “Reach Out and Read” in pediatric primary care;
Requiring managed care plans to have a child-specific quality agenda—to develop quality improvement programs on common child-health quality measures;
Developmental inventory upon kindergarten entry—to create a standard measurement tool for use at that milestone;
Peer family navigators in multiple settings—to launch nine pilot projects, in homeless shelters, drug treatment programs, and other settings, to help hard-to-reach families connect to resources;
Parent/caregiver diagnosis as eligibility criterion for dyadic therapy—to allow children's Medicaid enrollment to cover a proven parent/child therapy model based solely on a parent's mood, anxiety, or substance abuse disorder diagnosis;
Data system development for cross-sector referrals—to develop a screening and referral data system that connects families to nearby health and social services.