Talking Points
The First things First (FTF) Board has requested public comment regarding their proposed strategic planning priorities (located at the end of this email). Please post a comment on their website to assure that the priorities identified by our members are considered.
The FTF Board has been busy this past year assessing needs around the state and creating a Strategic Plan. They will be meeting next week to discuss and vote on this plan. They are requesting public comment on this and other documents in preparation for this meeting. The strategic plan relates generally to the overall mission and goals and specifically to the 10% of funds that will be used for statewide infrastructure. (Another 10% is allocated to administrative and the remaining 80% will be divided among the regions). As you will see, the bulk of funds and goals are related to child care issues. Other top funding priorities that relate to health issues include the following:
1. Child health care consultants for day care settings
2. Developmental screening - primarily in the form of AHCCCS funding to reimburse for use of the PEDS Tool
3. Increased outreach for AHCCCS
4. Development of web-based parent information
5. Parent education kits.
The AzAAP FTF Task Force urges you to review and comment on these documents if possible. This is your opportunity to voice your professional advice regarding the needs of our youngest children. Attached is a one page summary that was developed based on the concerns expressed by pediatric providers across the state.
The Chapter Task Force also offers the following points based on our discussion of these issues:
1) We agree with support for childcare health consultants.
2) We agree with efforts to have AHCCCS reimburse providers for use of the PEDS Tool. HOWEVER, we have serious concerns regarding the lack of services for these children once they are identified. It may be detrimental and unethical to increase screening measures prior to increasing the therapy services available. Numerous practitioners throughout the state have noted difficulties obtaining therapies for children 0-5. The FTF Board has noted these concerns and their response is on p.7-8 of the Q & A document (below). However, we feel that stronger measures need to be applied to this shortage now - either statewide or as a priority for regional councils - especially in areas where there is a marked shortage
- If developmental screening is a goal of FTF, do it through an existing system that touches almost every young child – the health care system. As unpleasant as it may feel to potentially ¡Èsupplant¡É funding that may never come, it would be inefficient to try to create an external system to replace the role that already exists or should exist through health care offices.
- If funding flows as proposed, through AHCCCS, the project must be statewide and not regional. Medicaid does not allow for differential access to care for clients unless there is a special risk population. The special risk to NICU grads was the rationale for differential access for screening of this population.
- If screening is increased, we must anticipate an increase in the number of children identified with developmental disorders. We do not currently have the system capacity to diagnose and treat a large influx of children identified. However, not seeking these children out through improved detection does not make their problems go away. We must attend to the system of care and not ignore these children any longer. By working in partnership with AHCCCS, we have more leverage to ensure the health plans find therapists and pay them adequately.
3) We recommend statewide support for ROR. ROR was supported by two sub-committees as a strategy but did not make the current proposed list for state level funding. We have been told this is likely due to the staff suggesting that the program should be funded at the regional level.
- In Arizona only 46% of families read to their child daily. Reading aloud is the most important activity for building the knowledge required for eventual success in reading.
- ROR is an evidenced-based school readiness program. By building on the unique relationship between parents and medical providers, ROR helps families encourage early literacy skills so children enter school prepared to succeed.
- State level funding support of the state RORAZ Coalition which is already developed will provide the necessary infrastructure to offer site training, quality improvement and strategic growth to reach those 60% who qualify for the program but are not currently receiving the benefits of ROR.
- State level funding will allow for efficient expansion of the program while leveraging the available federal and private dollars--a very cost effective model with immediate results.
4) While obesity prevention does not appear in the roadmap as a distinct topic, it is a major issue that our state needs to address. The AZAAP workgroup is considering ways to integrate this into the above areas.
Please review the documents at the following links. Visit http://www.azecdh.gov to submit your comments.
1) Strategic Plan Roadmap Overview (includes Goals, Key Measures and Recommended Statewide Strategies)
2) Recommended Strategic Directions for FTF Statewide Funding – Questions and Answers
3) Proposed Statewide Funding Priorities State Fiscal Year 2009 - 2011
If you have any concerns or questions please contact Rebecca at rebecca.nevedale@azaap.org