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Early Intervention Highlights: 2021 Summary
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Talking PointsDiscussion Questions
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Across Colorado, approximately 6% of the 0-3 population is referred to EI. This number is comparable across most categories of race and ethnicity, except those who identify as American Indian or Alaskan Native. Only 2% of 0-3 year olds who identify as American Indian or Alaskan Native are referred to Early Intervention.Early Intervention referral rates vary from 0 to 18% (larger rates are typically in small counties). What is a reasonable benchmark or goal for this metric?
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In 2021, approximately 32% of Early Intervention referrals were closed before completing the process. Half of these referrals were closed because EI intake was unable to contact the family, and half were closed because parents decided not to proceed.Why are referral rates lower among those who identify as American Indian or Alaskan Native? What can we do to better partner with this community?
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The proportion of referrals that were closed before completion did not vary substantially by race, ethnicity, or primary language. However, race/ethnicity fields are not mandatory during intake. Infact, many early intervention personnel wait to discuss identity until having established rapport with the family, leaving these fields intentionally blank. With this in mind, it may not be surprising that those referrals with blank race/ethnicity are more likely to be closed before completion.The practice of waiting to note families' racial/ethnic identities may mask inequities in referral outcomes. If staff could not reach the family, their race/ethnicity will inevitably be blank. This leaves us most wondering about those who decided not to proceed. How can we learn more about these families while continuing to treat conversations about race and ethnicity as sensitive?
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CAPTA accounts for approximately one quarter (24%) of referrals that were closed before completion and have unknown race/ethnicity.The following metro counties reported less than 20% of referrals were closed before completion: Boulder, Broomfield, Douglas, and Larimer. In addition, the moderately populated counties of Clear Creek, Elbert, Gilpin, Lake, Otero, Summit, and Teller reported less than 20% referrals closed before completion. What can we learn from these communities and their CCBs?
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Importantly, primary care (and hospitals) continue to be the leading referral source. This holds true even for families who do not complete the referral process and have unknown race/ethnicity.
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HealthySteps is growing rapidly, increasing programmatic reach from 22,917 children across 16 sites in 2020, to 39,184 children across 25 sites as of 6/2022.
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Those who identify as American Indian or Alaskan Native are less likely to receive an Early Intervention referral as compared to those of other racial identities:Early Intervention Referral Outcomes are comparable across all races, ethnicities, and primary languages, with the exception of those with no race or ethnicity specified. This is likely because race and ethnicity is only asked once communication and trust is established:
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Early Intervention Referrals were made between January and December 2021, representing approximately 5.88% of the Colorado birth to three population.
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Compared to larger metro counties, there is more variability in EI referral rates among smaller rural counties. In some smaller counties, 0 referrals were made during this date range, while in others 11-12% were referred. This may be due to an uneven distribution of doctors and other EI referral partners. More regional comparisons are advised.
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However, eligibility rates appear comparable by race, with the exception of referrals where no race was specified. The same pattern holds for those who didn't specify ethnicity.
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Moreover, of the 2,617 referrals where neither race nor ethnicity were specified, 1,846 did not complete the referral process. 958 of these referrals were closed because EI was unable to reach the family. An additional 888 referrals were closed due to parental decline.
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*Cream counties had referrals representing less than 2% of the birth to three population. Dark purple counties had referrals greater than 7% of the birth to three population. Pink counties had referrals between 2 and 7% of the birth to three population. Stars denote counties with at least one HealthySteps Site present.
Referral Outcome
CAPTA
Primary Care/Hospital
Social ServicesOther
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Attempt to Contact Unsuccessful
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less than 2% of the 0-3 pop.2-7% of the 0-3 pop.greater than 7% of the 0-3 pop.Parent Declined1675250196
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93% of cases where county is left blank do not complete the evaluation process.
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Among metro counties, the proportion of referrals that do not complete the evaluation process varies from 13% to 45%. The top third of metro counties (with fewer than 25% incomplete referrals) includes Boulder, Broomfield, Douglas, and Larimer counties. It may be worth investigating what these communities are doing differently.
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Parent DeclinedAttempt to Contact UnsuccessfulChild Determined EligibleOther Referral Category
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CAPTA28%39%10%23%
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Primary Care/Hospital17%17%46%21%
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Social Services32%33%13%22%
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Head Start14%13%46%27%
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Home Visiting13%12%58%18%
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Relatives8%5%65%22%
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Public Health19%15%45%21%
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Other11%16%56%16%
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HealthySteps Highlights
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