Health and Learning Initiative

We launched the Health and Learning Initiative (HLI) because we believe children need to be supported in their physical and social-emotional health to improve their school readiness. HLI is a partnership between Children’s Institute, the Oregon Health Authority (OHA), and the Oregon Pediatric Improvement Partnership (OPIP) to transform the relationship between Oregon’s health care and early learning systems. It will enable the state to more effectively support children’s healthy development and ensure their kindergarten readiness. The first of its kind, HLI can model to other states how to improve health and learning outcomes for children.

Research continues to demonstrate that a child’s physical, cognitive, and social-emotional development and skills when they enter kindergarten—their kindergarten readiness—reliably predict their academic trajectory, long-term health, and success in life. The experiences children have starting at birth set the foundation for their future learning: a baby’s brain produces a million neural connections each second, and 90 percent of brain development takes place in the first five years. During this critical period, we must ensure all kids get the health services and supports they need to ensure optimal development.

Research continues to demonstrate that a child’s physical, cognitive, and social-emotional development and skills when they enter kindergarten—their kindergarten readiness—reliably predict their academic trajectory, long-term health, and success in life. The experiences children have starting at birth set the foundation for their future learning: a baby’s brain produces a million neural connections each second, and 90 percent of brain development takes place in the first five years. During this critical period, we must ensure all kids get the health services and supports they need to ensure optimal development.

The Role of CCOs

Coordinated Care Organizations (CCOs) are coordinated networks of physical, behavioral, and dental health providers that provide comprehensive health services in their communities. Oregon launched CCOs in 2012 to improve the health care system for children and families enrolled in Medicaid. CCOs are accountable to the Oregon Health Authority (OHA) for improving health outcomes. Their progress is tracked by a range of metrics, some of which are incentivized. When a CCO meets an improvement target on an incentivized metric, they receive financial bonuses. Unique to Oregon, incentivized metrics allow OHA to influence the health sector’s priorities. For example, after Oregon incentivized CCOs to increase developmental screenings for young children, the percentage of children who received screenings went from 21 percent in 2011 to 69 percent in 2017.

The Role of CCOs

Coordinated Care Organizations (CCOs) are coordinated networks of physical, behavioral, and dental health providers that provide comprehensive health services in their communities. Oregon launched CCOs in 2012 to improve the health care system for children and families enrolled in Medicaid. CCOs are accountable to the Oregon Health Authority (OHA) for improving health outcomes. Their progress is tracked by a range of metrics, some of which are incentivized. When a CCO meets an improvement target on an incentivized metric, they receive financial bonuses. Unique to Oregon, incentivized metrics allow OHA to influence the health sector’s priorities. For example, after Oregon incentivized CCOs to increase developmental screenings for young children, the percentage of children who received screenings went from 21 percent in 2011 to 69 percent in 2017.

Identifying Metrics to Reward

The principal behind incentivized metrics is simple: the health sector is rewarded for delivering the services deemed most important to people’s long-term health. These metrics are chosen by Oregon’s Metrics and Scoring Committee. In 2018, Children’s Institute collaborated with OPIP and OHA, to form the Health Aspects of Kindergarten Readiness Technical Workgroup to recommend a set of metrics important to kindergarten readiness. The workgroup included CCO representatives, health care providers, early learning hub and program representatives, health care quality measurement experts, and consumer representatives. (See the Additional Resources below for more information on this workgroup.)

Prior to making their recommendations, the workgroup conducted family focus groups to better understand family perspectives on how health services currently support school readiness and how those services could be improved. The communities and participants selected for the focus groups were identified to represent cultural, linguistic, and geographic diversity. Children’s Institute, the Center for Improvement of Child & Family Services, and stakeholder partners already had existing relationships in selected communities and outreach was conducted through our existing networks. Most participating families were already engaged in, and recruited through, high-quality early learning program and services.

Now the Health and Learning Initiative is crucially positioned to ensure the recommended metrics are developed and implemented in a way that improve health and learning for children from birth through age 5 across Oregon. 

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Additional Resources

Technical Workgroup Final Report
Download the Final Report from the Health Aspects of Kindergarten Readiness Technical Workgroup
Workgroup Members
Dick Barsotti
Pediatrician
Metropolitan Pediatrics

Helen Bellanca
Associate Medical Director
Health Share of Oregon

Suzanne Dinsmore
Pediatrician
Childhood Health Associates (Salem)

Susan Fischer
Health and Education Integration Coordinator
AllCare Health

Xin Gao
Early Childhood Education Specialist
Oregon Child Development Coalition

Lisa Harnisch
Executive Director
Marion and Polk Early Learning Hub

Julie Harris
Director of Quality Programs
Children’s Health Alliance and
Children’s Health Foundation

Nicole Jepeal
Quality Improvement Analytics Supervisor
CareOregon

Sharity Ludwig
Director of Community Dental Programs
Advantage Dental

Rebeca Márquez
Community Health Worker
Immigrant and Refugee Community Organization

Alison Martin
Assessment and Evaluation Coordinator
Oregon Center for Children and Youth with Special Needs

Ashley Oakley
Early Childhood Policy Advocate
Native American Youth and Family Center

Sara Ruiz Weight
Parent, Preschool Classroom Aide
Yoncalla Elementary School

Maureen Seferovich
Child Provider Services Supervisor
Washington County Health and Human Services

Charles Smith
Program Director
Black Parent Initiative (formerly)

Project Contact
Elena Rivera
Senior Health Policy & Program Advisor
elena@childinst.org
971.346.2670

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