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Oregon CCOs to focus on improving the social, emotional wellness of young children statewide

New incentive metric to address health service gaps, increase kindergarten preparedness begins January 2022
A group of children clapping along to music in class.
New incentive metric for Oregon’s Coordinated Care Organizations will increase kindergarten preparedness through social-emotion services. The new metric, which begins January 2022, was developed by the Oregon Pediatric Improvement Program, Children’s Institute and the Oregon Health Authority. (Getty Images)

Beginning Jan 1, 2022, Oregon’s 16 Coordinated Care Organizations – which provide community-based, integrated care for individuals covered under the Oregon Health Plan – will begin an effort to better understand the unmet social and emotional needs of children age 5 and younger.

Driven by a new incentive metric, developed collaboratively by the Oregon Pediatric Improvement Partnership at Oregon Health & Science University, Children’s Institute and Oregon Health Authority, CCOs will actively address gaps in health services for young children at the community level with the goal to improve how Oregon’s Medicaid system supports the social-emotional health of children.

Families, as well as health care and community leaders from across the state, participated in the development of the metric, which represents a first-of-its kind approach to recognizing that social and emotional health is essential for kindergarten readiness, and that the health system plays a role in how well young children do in school.  

“A growing body of research suggests that the first five years of a person’s life are critically important to laying the foundation for long-term social, mental and physical outcomes. We must ensure that this time of growth is maximized,” says Colleen Reuland, director of OPIP. “Without proper access to social-emotional services, including counseling and parenting support, children, especially those who have adverse childhood experiences, are at greater risks for delays and health impacts, such as heart or lung disease, during adulthood.”

Statewide, less than 9% of children age 5 and younger insured through the Oregon Health Plan received any type of social-emotional service. The rates are even more troubling for those that have had adverse experiences such as childhood abuse or neglect (30%), or a parent who has been incarcerated or treated for substance abuse disorder (10%).

“Social and emotional development isn’t only important for long-term health, it is also the basis for ‘school readiness’,” says Elena Rivera, senior health policy and program advisor at Children’s Institute. “Learning is a social process, and without these skills, seemingly basic actions - such as engaging in positive personal interactions, following directions or having the ability to express feelings  - can be challenging and may limit academic success.”

According to Rivera, access to services that support social and emotional health is more crucial now than ever before, particularly because early learning environments such as preschool and child care have suffered during the COVID-19 pandemic.

Uncovering the gaps

To help identify opportunities to increase support for children in need, the CCOs will undergo a process of reviewing current access of services, mapping data and identifying currently available social-emotional resources and health services. This will involve regular engagement with community stakeholders including preschool and early learning program administrators, as well as behavioral health providers.

Findings will inform the development of community-specific action plans by 2024. CCOs will receive financial incentives, which may be used to further invest in local solutions to community needs, when they met a set of health quality measures established by the state.  More information about this metric can be found here.

“This program draws on OPIP’s experience working with communities across the state to improve the quality and access to social-emotional services for young children,” says Reuland. “It was imperative to us that the metric outlined process requirements that involved the input of community leaders and families. In alignment with OPIP’s objectives, this means that soon, Oregonians will be able to gain family-centered support services to meet their specific needs. Hopefully, these efforts will serve as a blueprint for other states as well.”   

About the Oregon Pediatric Improvement Partnership

The Oregon Pediatric Improvement Partnership, or OPIP,  is a public/private partnership

dedicated to building health and improving outcomes for children and youth by: collaborating in quality measurement and improvement activities across the state;  supporting evidence-guided quality activities in clinical practices; incorporating the patient and family voice into quality efforts; and informing policies that support optimal health and development for all children and youth.

Housed within the department of pediatrics at OHSU Doernbecher Children’s Hospital, OPIP is a soft-funded organization that leads population-based and community level efforts meant to improve the health of children in Oregon. OPIP has developed multiple reliable, valid and meaningful quality measures that have been adopted into national and state metric sets, with the purpose of galvanizing authentic population improvement efforts focused on children. This work build of improvement pilots that OPIP has conducted in 13 counties across the state.

Additional information here.

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