Working Together to Assist Children and Families Obtain Well-Child Care with the Patient-Centered Medical Home

RI American Academy of Pediatrics (RIAAP) leadership has been working closely with the Governor's Office, the Executive Office of Health and Human Services, Office of the Health Insurance Commissioner, and Rhode Island Department of Health to develop and implement action plans that support primary care practices in their efforts to provide well-child care within the primary care patient-centered medical home.

In partnership with KIDSNET, CTC-RI/PCMH Kids has been able to provide practices that successfully applied for the RI Pediatric Relief Fund with practice-specific immunization and lead screening performance reports. Practice facilitators are providing practices with targeted technical quality improvement assistance to support efforts to address gaps in care prior to the start of the school year.

Populations of focus include: children in need of immunizations for kindergarten and 7th grade and children who need lead screening tests. Pediatric practices are making steady progress in reaching the goal of returning to pre-COVID-19 immunization rates, and implementing CDC-recommended infection control measures to ensure families receive care in a safe environment.

Nurse Care Manager (Improving Access to Well Child, Immunization & Lead Screening in COVID-19 (without practice level data) and Practice Reporting and Transformation Committee meetings (Improving Access to Well Child, Immunization & Lead Screening in COVID-19 - without practice level data) have provided primary care practices  with important peer learning opportunities. Practices shared information on what is working, what works but could be better, and how to support families that need added assistance with returning to care.

With input from the health plans and RI Department of Health School Liaison, we continue to update our Pediatric Immunization Resource Guide which has helpful tools for outreach to families and implementing immunization strategies.