NOI_W27007.docx

Department of Public Health Bureau of Family Health and Nutrition Transforming Pediatrics for Early Childhood Notice of Intent: Waiver 27007

GENERAL DESCRIPTION: The Massachusetts Department of Public Health (MDPH) Bureau of Family Health and Nutrition (BFHN is applying for Transforming Pediatrics for Early Childhood (TPEC) notice of funding opportunity HRSA-26-104. HRSA will award 10 grants nationally for up to $950,000 each for 5 years.

The purpose of this grant is to prevent chronic disease early in life and promote healthy development in early childhood by supporting the placement of early childhood development (ECD) experts in local pediatric practices that primarily serve children enrolled in Medicaid/CHIP to deliver team-based care to young children and their families.

Grant funding would enable the Department of Public Health to enhance and scale existing practice transformation, quality improvement, and health care policy and finance initiatives to spread integrated, team-based primary care for young children to practices across the Commonwealth. MDPH seeks partners with unique expertise in integrated pediatric primary care models, including a national evidence-based model (e.g., Healthy Steps[footnoteRef:1]) and a state practice-based evidence models (e.g., TEAM UP[footnoteRef:2]). These partners will provide model implementation and early childhood integration capacity building support to embed, evaluate, and sustain ECD experts and high-quality services for young children in primary care teams. [1: https://www.healthysteps.org/ ] [2: https://teamupforchildren.org/]

The grant objectives are as follows:

· Place early childhood development (ECD) experts in pediatric practices that primarily serve families covered by Medicaid/Children’s Health Insurance Program (CHIP) and deliver high-quality ECD services using a team-based approach.

· Build the skills of pediatric primary care staff statewide to deliver high-quality ECD services using a team-based approach.

· Improve statewide administrative policies and financing strategies to expand and sustain team-based pediatric primary care, improving the standard of care for all young children.

The purpose of this notice is to publicize the MDPH/BFHN intent to submit a federal grant application naming the HealthySteps National Office as a training and technical assistance partner. MDPH/BFHN intends to contract with the HealthySteps National Office because the organization is exceptionally well positioned to provide training, technical assistance and practice transformation support to pediatric and family medicine practices on the integration of early childhood development experts within a primary care team.

HealthySteps, a program of ZERO TO THREE (ZTT), is a population health model grounded in scientific understandings of how early childhood development works and how it might be best supported. HealthySteps adds early childhood development and behavioral health promotion and prevention experts, known as HealthySteps Specialists, to the pediatric primary care team. Working alongside pediatricians, HealthySteps Specialists help identify whether infants and toddlers are reaching developmental milestones, address developmental challenges early while preventing others, promote nurturing caregiving, strengthen the quality of relationships and environments, and make connections to other community programs that support healthy development and family well-being. While HealthySteps Specialists play a key role, the broader practice transformation facilitated by the model is equally essential to achieving and sustaining outcomes: HealthySteps supports pediatric practices in becoming integrated early childhood care systems focused on promotion, prevention, and early intervention. Together, these individual and practice-level efforts help improve the healthy development and well-being of infants and toddlers, preparing them for school and life.

HealthySteps is a resource-efficient, risk-stratified approach that trains the entire practice to work together to implement the model. The model is organized into three tiers of services responsive to each family’s needs:

1. Universal services (Tier 1): provided to all families with children 0-3 years of age in the practice and include child and family screenings and access to a family support line.

2. Short-term support services (Tier 2): provided to children and families to address specific, time-limited concerns and include consults with the HealthySteps Specialist, referrals, and care coordination, and positive parenting guidance and information.

3. Comprehensive services (Tier 3): provided to families identified with significant risk factors and include ongoing, preventive team-based well-child visits intended to prevent children from having poor developmental and social-emotional outcomes.

HSNO has a team of experts who provide support to sites to assure they deliver the HealthySteps model to fidelity, including staff who are dedicated to supporting practices in Massachusetts. Their team supports practices in starting up, implementing, evaluating, and sustaining the risk-stratified, population-based model. Their team provides training and coaching on the following topics: billing and coding, early childhood development content, integrated behavioral health, Medicaid and the Children’s Health Insurance Plan, prevention, reflective supervision, research and evaluation, team-based care and toxic stress and Adverse Childhood Experiences (ACEs) specific to the HealthySteps model. The HSNO is engaged in additional research and evaluation and policy and sustainability work at the state and national levels.

HealthySteps will assist in capacity building to support integration, evaluation, and sustainability of ECD experts and high-quality early childhood services within primary care teams. Through a partnership with HealthySteps, MDPH proposes to provide Virtual HealthySteps Institute (3 days of training) to onboard TPEC participating practices implementing the HealthySteps model. HealthySteps will also provide technical assistance to these sites on readiness, hiring, training, and implementation planning, teaming, fidelity to the model, EMR integration, data collection and reporting and sustainability. The Massachusetts HealthySteps National Office staff will also collaborate with MDPH to provide general ECD integration resources and capacity building supports to a broader range of practices through a virtual Early Childhood Integration Learning Network.

If you have equal qualifications to the organization mentioned above and would like to be considered for partnership on this grant, send qualifications along with any questions or comments with the subject line: Transforming Pediatrics for Early Childhood Project in writing to Eve Wilder at eve.wilder@mass.gov by 07/02/26 at 4:00 PM