Rural Health Care Services Outreach Grant Program - The target population for this project includes families with young children from birth to three years old and pregnant individuals living in rural communities across the Eastern Plains and Southwestern Colorado. These regions encompass 28 of Colorado’s 64 counties (See Attachment 3), spanning over 29,000 square miles, with a population of 361,588, representing 50% of Colorado’s rural residents, including 15,404 children under five (Colorado Children's Campaign, 2024). These areas face limited access to coordinated, high-quality care due to workforce shortages, geographic isolation, and systemic barriers. HealthySteps (HS), an evidence-based integrated behavioral health model, will serve as the foundation to address these gaps. Embedding professionals with expertise in early childhood development into primary care practices will enhance developmental and maternal depression screenings, promote prevention and early intervention, and provide family-centered support (Buchholz et al., 2021). Pediatric primary care is an optimal setting for these services, as practitioners see children 14 times in the first five years of life and are often the first resource parents seek for child development and parenting concerns (American Academy of Pediatrics, 2021). The project will address these challenges through five goals: 1.Establish a Collaborative Statewide Rural Healthcare Consortium: By April 2029, a consortium of healthcare providers and stakeholders will co-design strategies to scale HS in 4–5 rural communities. Members will contribute expertise to support practice readiness, workforce capacity, and sustainability. 2.Onboard HealthySteps in Four New Rural Practices:By December 2028, HS will be implemented in two practices in the Eastern Plains and two in Southwestern Colorado, addressing gaps in developmental and behavioral health services (Minkovitz et al., 2003). 3.Develop Tailored Workforce Development Resources: By December 2028, workforce training, mentorship, and technical assistance will address recruitment and retention challenges while enhancing expertise in early childhood behavioral health (Margolis et al., 2022). 4.Enhance Sustainability of Rural Health Systems: Through policy alignment, resource allocation, and capacity building, the project will establish a sustainable framework for HS integration and secure long-term funding by December 2028 (Talmi et al., 2020). 5.Evaluate and Develop a Proof of Concept: An evaluation framework will measure HS’s impact on rural health outcomes and workforce integration, informing future scaling statewide (World Health Organization, 2020). The anticipated outcomes include improved developmental and maternal health screenings, equitable access to integrated behavioral health services, and stronger engagement with families and stakeholders. Sustainability will be achieved through robust funding mechanisms and enhanced workforce capacity, enabling long-term support for rural communities (Anderer, 2024). ABCD is uniquely positioned to lead this effort as Colorado’s HealthySteps State Intermediary, with over a decade of experience scaling HS to 32 sites statewide, including rural and frontier areas. By leveraging partnerships with Federally Qualified Health Centers, public health agencies, and early childhood councils, ABCD will ensure the success of this project. HealthySteps has demonstrated positive outcomes for children and families, and this project will extend these benefits to rural communities, improving health outcomes and resilience statewide. ABCD is applying for a Regular Funding Track and qualifies for Qualification 3: Focus on Primary Care, and Wellness and Prevention Strategies funding preference because HS is an evidence-based, early childhood integrated behavioral health model that promotes prevention, wellness, and early identification of developmental concerns within primary care clinics and improves access to care in rural regions of Colorado (Buchholz et al., 2021).
