Innovation in Care Integration for Children and Youth with Autism Spectrum Disorders and Other Developmental Disabilities Program

This announcement solicits applications for the Innovation in Care Integration for Children and Youth with Autism Spectrum Disorders and Other Developmental Disabilities (ASD/DD) Program.  This program supports the implementation of innovative, evidence-informed strategies to integrate care at a system-level within a state for children and youth with autism spectrum disorders (ASD) and other developmental disabilities (DD), with a special emphasis on medically underserved populations (based on poverty, rural geographic location, and/or populations that experience health disparities).[1]  The target population for this program is all children and youth within a state identified as at risk for or diagnosed with ASD/DD. Using the care integration framework recommended by the American Academy of Pediatrics (AAP), the care for children and youth with ASD/DD within the state will be integrated across systems to improve access to appropriate screening, referral, diagnosis, care coordination, and services.[2]  Recipients/awardees will implement innovative, evidence-informed models of 1) family support and navigation, 2) shared resources, and 3) telehealth and/or telemedicine (including mobile health) health information technologies. Program Goals Improve access to a coordinated, comprehensive state system of services that leads to early diagnosis and entry into services for children with ASD/DD within the state and their families, emphasizing medically underserved and rural populations.[3] Program Objectives Objective 1:  By August 31, 2019, increase the proportion of children within the state identified as at-risk for ASD diagnosis and referred for diagnosis and ASD/DD services by 25 percent over baseline. Objective 2:  By August 31, 2019, increase the percentage of children with ASD and other DD within the state enrolled in services before 37 months of age by 10 percent over baseline. Objective 3:  By August 31, 2019, increase the percentage of children with ASD/DD residing in medically underserved communities within the state (based on poverty, rural, and/or populations that experience health disparities) enrolled in services before 37 months of age by 10 percent over baseline. Objective 4:  By August 31, 2019, increase the proportion of children and youth with ASD and other DD within the state and their families by 25 percent over baseline who report increased knowledge, skill, ability and self-efficacy in family-centered care; specifically related to referrals, diagnosis and access to services for ASD/DD (with a special emphasis on medically underserved populations). Objective 5:  By August, 31, 2019, increase the number of referrals of at-risk children for ASD/DD within the state to early intervention programs and/or specialists for comprehensive evaluation by 25 percent above baseline. The intention of this funding opportunity is to support the use of innovative, evidence-informed methodologies to achieve the goal of improving state system-level care integration for children and youth with ASD/DD and their families.  All grantees of this funding opportunity will participate in a community of learners and implement quality improvement activities.  This grant opportunity will allow grantees to collectively problem solve and share strategies through brainstorming sessions, workshops, and skills training sessions.  Participants in the community of learners will share their successes and failures and rapidly make modifications and adaptations to support achieving objectives and allow for replicability of strategies.  The learning community will consist of the following: Sharing of diverse perspectives and experiences from grantees; Collaborative problem-solving among participants; and Application of rapid cycles of improvement to support the testing and replicability of innovative strategies. Program Requirements Applicants must: Establish a multidisciplinary project advisory group made up of stakeholders, including families and experts who have specialty background and experience in ASD/DD.  The advisory group should consist of representatives of the following organizations: State Title V Program, State Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program, state Part B and C of the Individuals with Disabilities Education Act (IDEA), family leaders/family organizations (i.e. autism support groups and state family-to-family health information centers) and relevant state chapters of their professional organizations (i.e. the AAP).  Other entities to consider including are: pediatric primary care clinicians, pediatric specialists, universities, community agencies, state legislatures, Medicaid, Children’s Health Insurance Program (CHIP), private payers, early childhood education and school systems, Federal Qualified Health Centers, Community Health Centers and Rural Health Clinics.  The applicant must demonstrate the capacity to develop effective partnerships with ASD/DD stakeholders in their state through letters of support, formal agreements and/or memorandum of understandings (MOU/MOA). Use innovative, evidence-informed strategies to improve access to a coordinated, comprehensive system of services for children and youth with ASD/DD.  Each evidence-informed strategy must include family engagement activities to ensure partnership between ASD/DD families and providers.  The innovative, evidence-informed strategies are as follows: A Shared resource can support care coordination and case management.  For the purposes of this funding opportunity, the shared resource can improve management of care for children with ASD/DD and improve communication and coordination between providers, specialists and community resources.[4]  Resources that can be shared are as follows: Community networks; Community health teams; Regional Extension Centers; Area Health Education Centers; and Care teams. Telemedicine is the use of electronic communications and information technologies to provide clinical services when participants are at different locations.  Telehealth is a broader application of technologies to distance education, consumer outreach, and other applications utilizing electronic communications and information technologies to support healthcare services.[5]  Mobile Health (mHealth) is a form of telemedicine using wireless devices and cell phone technologies.[6]  For the purposes of this grant opportunity, the telehealth/telemedicine activities should do the following: Facilitate ASD/DD diagnosis by observing behavior; Facilitate ASD/DD treatment through behavioral therapy; Increase access to medical and non-medical ASD/DD providers in medically-underserved communities; and Facilitate cross-system coordination, integration, and data sharing between and among providers and families. Family Navigators[7] guide families through and around barriers in the healthcare system to assist them in overcoming obstacles faced in accessing or receiving care.[8],[9]  For the purposes of this grant opportunity, the selected navigator model should assist children, youth, and families of ASD/DD in: Reducing delays in accessing the continuum of care services with an emphasis on timeliness of diagnosis and treatment of ASD/DD; Choosing, understanding, and using health coverage; Choosing, understanding, and using health providers and services; Making decisions about treatment; Providing care management by and through multiple providers; and Receiving care that is culturally[10] and linguistically[11] competent. Include quality improvement activities in the implementation of the innovative, evidence-informed strategies.  

Application Instructions

Please submit:

1. a one-page letter of intent with a description of proposed aims and approach
2. Biosketch or CV of the PI
3. A letter of support from the Dean or Chair. This letter of support signifies that the Dean or Chair have ensured that the nominee and application are likely to be of sufficient quality to be competitive nationally

to research@uw.edu by 5:00 PM Thursday, April 7, 2016. Full proposals are due to the sponsor 5/8/16, so you will need to have your materials in to the Office of Sponsored Programs by 4/28/16 for processing, if given the go ahead by the Proposal Review Committee.