Children’s Health Services Research Center

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Children’s Health Improvement Partnership of Indiana

The Children’s Health Improvement Partnership of Indiana, also known as CHIP IN, implements evidenced-based quality improvements in pediatric practices across the state of Indiana. The program provides developmental screening tools to pediatricians throughout Indiana, allowing them to provide standardized screening for autism and other developmental delays. These tools include the MCHAT R/F and the ASQ-3. Children with screens that show delays are referred to the local Early Evaluation Hub for further testing and diagnosis. CHIP IN supports these practices as they track and improve their screening rates, ensuring that more children ages 18-42 months are screened throughout the state.

CHIP IN is a collaborative partnership between IU School of Medicine’s Children’s Health Services Research, the Indiana Department of Health, and other organizations established to engage government agencies, professional medical organizations, insurers, family organizations, and community partners in collaborative, measurement based quality-improvement initiatives. The program strives to provide optimal care for Indiana’s children and youth by working with the primary care medical home to translate evidence-based practices into implementable steps; understand and work through systems to create realistic, measurable improvements in quality; and partner with families and the health care team to improve care.

CHIP IN Current Projects

CHIP IN convenes core partners to determine priorities for improving children’s health in Indiana. Current work is focused on early screening, evaluation and diagnosis of autism and other developmental disabilities. CHIP IN also works in tandem with the Pediatric and Adolescent Comparative Effectiveness Research group in the Department of Pediatrics to manage the implementation and dissemination of effective, evidence-based practices throughout Indiana.

CHIP IN is a partner and leader for the Indiana Crossroad Partnerships Care Coordination Pilot, which delivers care coordination to families of children with special health care needs. Several of the Neurodevelopmental Behavioral Services Early Evaluation hubs participate, and hub care coordinators work with care coordinators from Indiana Crossroad Partnerships and Indiana State Department of Health, Children’s Special Health Care Services. With support from CHIP IN, these pilots provide family-centered care plans and coordinated case management for participating children aged 18-48 months diagnosed with autism, developmental delay or other special health care needs. The program helps families access services across health care, education and community resources. In addition to care coordination support, CHIP IN provides data and quality improvement support.

Indiana’s average age of autism diagnosis is 5.3 years, well over the Healthy People 2020 goal of 36 months. To address this issue, with support from the Indiana State Department of Health and Riley Children’s Foundation, CHIP IN has helped develop Early Evaluation Hubs throughout the state, allowing for diagnostic service for children 18-42 months of age in local communities. Hubs are located in Bloomington, Evansville, Lafayette, New Albany, South Bend, Fort Wayne, Muncie, Terre Haute and Indianapolis. CHIP IN provides practice support, a quality improvement learning community, medical direction and other services to each of these evaluation hubs.

History

CHIP IN for Quality was established in 2011 with support from the Indiana State Department of Health and the IU School of Medicine. The first CHIP IN project centered on enhancing the primary care medical home model. The project, funded by the Indiana State Department of Health through a federal Health Resources and Services Administration Community Integrated Systems of Service grant, supported primary care pediatric practices to implement changes, track progress and make ongoing improvements to their medical home.

Partnership and Support

Many organizations support the work of CHIP IN through formal and informal partnerships and make unique contribution to children’s health in Indiana. Partners include Indiana University School of Medicine; Indiana State Department of Health, Children’s Special Health Care Services; Riley Children’s Foundation; Indiana Chapter of the American Academy of Pediatrics; Family Voices Indiana; About Special Kids; and Indiana Medicaid Managed Care Entities. CHIP IN is led by IU School of Medicine faculty members Nancy Swigonski, MD, MPH, Kathleen Swec, MD and Michelle Curtin, DO. Other staff includes Pediatric Practice Liaisons, Angela Paxton, Kara Casavan and Mary Delaney.

“Improving access to quality care and services for children, including children and youth with special health care needs, is driven through system change. Not only does effective system change require collaboration from a variety of partners working towards a common agenda, it also requires implementing measurement-based, quality improvement initiatives. Indiana’s Child Health Improvement Partnership is committed to convening government, professional, family, academic, payor and community partners to make system change a reality. CHIP IN has the unique ability to recognize the constraints that different sectors face, yet are able to create realistic, achievable change in quality of care for children. The success CHIP IN helps its partners achieve is of value to the organization and most importantly the children we serve.”

– Shirley Payne, MPH, Director Children’s Special Health Care Services, Indiana Department of Health

Early Evaluation Hub Sites

From primary care, a family’s visit to an Early Evaluation Hub can provide evaluation, diagnosis and any needed specialty care and other services that can help children grow and thrive. To make an Early Evaluation Hub appointment, a child must be 18-42 months of age and have a primary care physician. The primary physician must identify concern based on standardized screening tools (often ASQ and/or MCHAT).

Riley Outpatient Center
575 Riley Hospital Dr., MSA 1, Indianapolis, IN 46202
317-944-4846

Meridian Health Pediatrics
205 N. Tillotson Ave., Muncie, IN 47304
765-741-0324

IU Health Arnett – Lafayette
2600 Greenbush, Lafayette, IN 47905
Internal health systems referrals only.
 
IU Health Riley Physicians – Bloomington
4935 W Arlington Rd., Bloomington, IN 47404
812-353-3740

Union Associated Physicians (UAP Clinic)
221 S Sixth St., Terre Haute, IN 47807
812-242-3105

Beacon Medical Group Centennial
Neighborhood Health Center
621 Centennial Dr, Suite 402
South Bend, IN 46601
574-647-2500

Parkview Health
Parkview Children’s Clinic
11115 Parkview Plaza Dr
Fort Wayne, IN 46845
260-266-5400

Deaconess Riley Children’s Specialty Center
4133 Gateway Blvd, Suite 220, Newburgh, IN 47630
(Near Evansville)
812-858-3143

ALL IN Pediatrics
2305 Green Valley Rd., New Albany, IN 471150
812-949-0405

CHIP IN

CHIP IN Team

Medical Director
Professor, School of Public Health

Dr. Nancy Swigonski’s areas of interest are in primary care, medical home, quality of life, improvement science, quality improvement, improvement partnerships, and children with special health care needs.

Developmental-Behavioral Pediatrician

Dr. Michelle Curtin is a Developmental-Behavioral Pediatrician (DBP) as well as an Assistant Professor of Clinical Pediatrics at Indiana University School of Medicine. She currently serves as liaison for the American Academy of Pediatrics Section on Developmental-Behavioral Pediatrics executive committee.

Pediatric Practice Liaison

Angela Paxton joined the medical home project in 2010 and has been present since the beginning of CHIP-IN in 2011. She provides support to the Early Evaluation hubs and referring physician practices.

Pediatric Practice Liaison

Kara Casavan joined the team in 2015 after working for Indiana Department of Child Services (DCS). During her eight years with DCS, Kara served in many capacities, including assessor, trainer, mentor and service coordinator.

Pediatric Practice Liaison

Mary Delaney joined the team in 2015 after working for IN*SOURCE for the past eight years. She served as a Regional Program Specialist for IN*SOURCE where some of her duties included, providing one-to-one assistance for parents of children with special needs, conducting parent and school personnel training, attending Individual Education Plan (IEP) case conferences with parents and assisting with transition related activities.