Transforming Pediatrics for Early Childhood - TPEC Project Abstract Summary CHCI Transforming Pediatrics for Early Childhood (TPEC) Program Community Health Center, Inc. (CHCI), Connecticut's largest Federally Qualified Health Center and largest Medicaid provider, will use Transforming Pediatrics for Early Childhood (TPEC) funding to strengthen developmental screening, follow-up, and referral services for the 11,421 children ages 0–5 it serves annually—14% of all Connecticut Medicaid children in that age group. CHCI's participation is projected to increase TPEC's reported 38,700 annual well-child visits by 30%. CHCI proposes a two-pronged approach. First, CHCI will place Regional Early Childhood Development (ECD) Support Teams—each an ECD Care Coordinator and community health worker—at four regionally anchored practice hubs (Hartford/Enfield, New Britain/New London/Groton, Stamford/Norwalk/Danbury, and Meriden/Waterbury/Bristol) to pursue four goals: 90% of children 0–5 receiving a timely well-child visit; 90% receiving a timely, validated developmental screening; 75% of families screened for needs such as caregiver depression, food, and housing using the PRAPARE tool; and 90% of children with a positive screen referred, through a closed-loop electronic health record process, to Connecticut's Birth to Three program or local school evaluation. Second, working with the Weitzman Institute (WI) and partners including the Connecticut Department of Public Health, CHCI will establish a TPEC Early Childhood Development Advisory Council and deliver a statewide Early Childhood Learning Collaborative and Project ECHO series to expand best-practice training across Connecticut pediatric practices. This work builds directly on CHCI's 2023–2025 HRSA Early Childhood Development grant, under which an ECD team embedded at CHCI's largest pediatric site in Hartford increased well-child visits and screening rates; TPEC extends this model statewide. CHCI's 2024 Medicaid HEDIS data show it already outperforms national medians on well-child and developmental screening measures, but identify a remaining gap of roughly 511 visits and 237 screenings annually needed to reach TPEC's 90% targets, driven by barriers including insurance and transportation access, housing instability, food insecurity, and language needs across a patient population accessing interpretation in 72 languages. Sustainability rests on two pillars: training the current and next generation of pediatric workforce—leveraging CHCI's NP postgraduate residency, NIMAA medical assistant program, and university nursing and medical student rotations—and pursuing financial durability by engaging Connecticut Medicaid to embed ECD metrics into the state's forthcoming value-based payment model. The program will be directed by Dr. Robert Dudley, with day-to-day team management by Kate-Lynn Murphy, research and evaluation led by Mandy Lamb of the Weitzman Institute, and advisory support from Dr. Janice Gruendel of Yale University.
