142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Healthy Harbors: An innovative medical home collaboration between primary care, accountable care, and child protective services to reduce health disparities for children impacted by child abuse/neglect

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 8:30 AM - 8:50 AM

Bernard Birnbaum, MD , Fort Collins Family Medicine Residency Program, Fort Collins, CO
Mary Beth Swanson, LCSW , Healthy Harbors Program, Fort Collins, CO
Healthy Harbors is an innovative program providing integrated care to children impacted by child abuse and neglect in a comprehensive, patient-centered medical home.  These children experience health and mental health comorbidities more than any other group of children.   Historically, these health conditions have been under-identified and under-treated due to poor access to continuous medical care and medical homes. Healthy Harbors assists caregivers with complex care coordination of physical, mental, dental, and developmental care. Because of the program’s integration with the Accountable Care Organization, this care continues into adulthood as needed.

Across the nation, child protection services are evolving with recognition that biological family relationships are imperative to healthy outcomes for children.  As a result, Healthy Harbors works with both foster families, and biological and kinship families in which child protection concerns have arisen. We work with children across placements, and throughout their infancy, childhood and young adulthood. Because poverty, substance abuse and mental health issues impact these children and families across generations, our medical home model addresses the social determinants of health through intensive and holistic case management.

To develop a program that could significantly impact the extensive needs of these children and families, as well as sustain long-term changes, we developed a multi-agency oversight group that envisioned, planned, and now guides Healthy Harbors. Active members of the oversight group includes representatives from the two primary care centers it serves, the region’s Accountable Care Organization, the county child protective system, the health department, the mental health center, dental providers, and University of Colorado Health (the regional health system).The group works together to at both an administrative level, and at a day-to-day level to ensure access to community resources and comprehensive health care.

Healthy Harbors is a model program that reduces duplication of services, improves communication among families, providers and agencies, and ensures access to appropriate, ongoing care.  During our session, we will discuss challenges and lessons.  We will share data that includes Medicaid claims and program outcomes.  We will present case samples that highlight the need for multi-agency collaborations to address health disparities.  Participants will be provided with a toolkit to bring back to their community to support their planning efforts. We will demonstrate how a model navigation program for high risk children and adolescents can address and overcome health inequities and significantly impact public health.  

Learning Areas:

Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
Describe the Healthy Harbors program model and components Discuss the health risk factors inherent in the foster care population through their lifespan Design a similar intervention using a toolkit Analyze data from the Medicaid Accountable Care Collaborative population

Keyword(s): Child Abuse, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am core clinical faculty in a Family Medicine Residency Program and direct our pediatric and community medicine curricula. I have present community projects and curricular innovation a multiple national and regional meetings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.