Guest post by Ben Anderson, Director of Health Policy at Children’s Defense Fund-New York. The New York State Department of Health (SDOH) is embarking on a “First 1000 Days on Medicaid” initiative that aims to bring together a diverse group of stakeholders from across sectors that touch the lives of young children. The stakeholders include representatives from a range of fields from the health care to post-secondary education to child welfare. The charge of the initiative is to produce recommendations for a ten-point plan that focuses on improving outcomes and access to services during the first three years of life.
The initiative arises from advances in neuroscience which tell us that most of the basic architecture in the brain is built by the time a child reaches the age of three. This basic architecture serves as the scaffolding upon which all future learning is built. Healthy physical and emotional experiences during these early years help form connections in the brain to facilitate future growth in cognitive, emotional, and social skills. Conversely, negative experiences impede the development of these connections, which make developing cognitive, emotional, and social skills more difficult.
Research from the Institute for Social and Economic Development (ISED) show that exposure to six or more risk factors prior to the age of three results in a greater than 90 percent chance of developmental delays (Barth et al. 2008). Risk factors include poverty, poor parental mental health, parental substance use disorders, domestic violence, and certain medical conditions. Additional research links adverse childhood experiences to increased risk for diabetes, heart disease, and cancer (Dong et al. 2004). Accordingly, what happens in the earliest years of life impacts lifelong well-being.
Medicaid is uniquely positioned to address these issues because the program serves many of the children who face the greatest risks for poor health outcomes (Halfon et al 2014). In New York, 59% of children in their first 1000 days of life depend on Medicaid. Developmental screenings and many early intervention services for children with developmental delays are currently covered by Medicaid. Primary care physicians who identify risk factors or developmental delays during regular check-ups are often the first point of contact and serve an important function by referring children and families to resources in the community to address the concerns.
The First 1000 Days on Medicaid initiative will convene stakeholders several times between now and November 1 to develop their recommendations. Subsequently, DOH will release its ten-point plan. HCFANY looks forward to working with the Department on this critical venture that has the promise to change the trajectories of our youngest New Yorkers.