We know that the first three years of a child’s life form the foundation for their long-term health, well-being, and advancement. We also know how important it is for children to regularly see a pediatrician during this critical period when they are changing so rapidly. The traditional pediatric office visit, although a key element of creating a healthy environment for children, is not sufficient on its own for many children because so many aspects of a child’s environment cannot be addressed in this setting. These include whether the family has enough nutritious food to eat, has car seats or cribs, or needs guidance in dealing with a child’s tantrums or sleep difficulties. A traditional pediatric practice cannot do it alone.

At the Quality Institute, I lead our work on alternative and integrated models of pediatric care. One such model is HealthySteps, a national program recently introduced in five New Jersey pediatric practices. HealthySteps embeds a child development specialist, often a psychologist or social worker with mental health training, into a pediatric or family medicine practice or Federally Qualified Health Center. That specialist meets one-on-one with parents during pediatric appointments, educating them about their child’s development, and screens children to catch problems early on. HealthySteps also offers practical support and connects families with community resources.

Nationally, HealthySteps has shown remarkable promise in improving outcomes for young children and their families. HealthySteps has done this by emphasizing the importance of early childhood development and mental health — offering support for issues including behavioral problems and parental depression. Both families and health care providers report greater satisfaction with this comprehensive care model that addresses physical, social, and emotional needs than a traditional one.

In recognition of the model’s success, HRSA awarded the New Jersey Chapter of the American Academy of Pediatrics the Transforming Pediatrics in Early Childhood grant to expand HealthySteps in New Jersey. This grant focuses on the effectiveness of the HealthySteps model and building scalable and sustainable pathways for long-term integration of the program. Because of this grant, in addition to the three original HealthySteps sites at Hackensack Meridian Health practices, HealthySteps added sites at two Zufall Health Center locations. Five more New Jersey pediatric practices will be joining HealthySteps as the grant progresses.

NJ FamilyCare and the Managed Care Organizations will be key partners in this expansion and in the future sustainability of the model. The State included an enhanced payment for HealthySteps practices in its FY24 budget, a measure that underscores its commitment to making this program accessible to more families. The Medicaid program is now working with HealthySteps leadership to implement this payment for Medicaid beneficiaries.

The Quality Institute is working on additional payment designs to scale and sustain HealthySteps in New Jersey. At the Quality Institute, we think that including preventive behavioral health and child development specialists in pediatric primary care should be a standard practice, available to all families with young children throughout the state. Today, too few practices have the means to incorporate the HealthySteps model. The Quality Institute is seeking to change that by finding resources so these practices can incorporate this groundbreaking model.

I urge health care providers, policymakers, and community leaders to support the expansion of the HealthySteps program to pediatric care sites across New Jersey. This smart and relatively small investment today will yield big dividends  for current and future generations.