Cutler Institute for Health and Social Policy

Population Health and Health Policy

First Steps Phase II Initiative: Improving Developmental, Autism, and Lead Screening for Children


First STEPS (Strengthening Together Early Preventive Services) is a learning initiative supported by Maine's CHIPRA quality demonstration grant to support measure-driven practice improvement in pediatric and family practices across the state on improving developmental, autism, and lead screening for children. This report, authored by research staff at the USM Muskie School, evaluates the impact of Phase II of Maine's First STEPS initiative, which was implemented from May to December 2012 and included 12 practices serving more than 20,000 children on MaineCare (Maine's Medicaid system). The authors assess changes in developmental, autism, and lead screening rates and evidence-based office processes in participating practices before and after the initiative, as well as related systems changes. They also summarize lessons learned in implementing changes in practices and challenges in using CHIPRA and IHOC developmental, autism, and lead screening measures at the practice-level to inform quality improvement.

Suggested Citation: Fox K, Gray C, Elbaum-Williamson M. First STEPS Phase II Initiative: Improving Developmental, Autism, and Lead Screening for Children. Portland, ME: University of Southern Maine, Muskie School of Public Service; August, 2013. Improving Health Outcomes for Children (IHOC) Final Evaluation Report.

Publication Type: 
Publish Date: 
August 30, 2013

Cutler Institute awarded $600,000 to help youth raised in foster system

Marty Zanghi

USM's Cutler Institute for Health and Social Policy has been awarded a $600,000 grant to help young people raised in Maine's foster system to prepare for college and the workforce.

The money comes from the Annie E. Casey Foundation as part of a $5.4 million national effort aimed at youth who are homeless or in either the foster care or juvenile justice systems.

"Many of these young people have suffered abuse or trauma and were raised in poverty and neglect," said Marty Zanghi, the Cutler Center's youth development director.

The money -- including an expected $400,000 more in matching funds -- will pay for contracted work with agencies in the target areas, starting with the greater Portland area and Penobscot, Kennebec and Somerset counties.

Nationally and in Maine, only about 3 percent of people who grow up in the foster care system achieve a college degree, he said.

"It's dramatically lower than the rate for the general population," Zanghi said. "It's a horrible outcome."

It doesn't have to be that way, though.

"There are young people that overcome these circumstances," he said. "I know people who have master's degrees and Ph.Ds."

The Casey Foundation's national effort is being called the "Learn and Earn to Achieve Potential" (LEAP) initiative.

The initiative is working on partnerships in Maine and nine other areas: Alaska, Arizona, California, Massachusetts, Michigan, Minnesota, Nebraska and New York. In each case, people will adapt two evidence-based models to meet the needs of these youth, including support to address the trauma they may have experienced in their lives.

In Maine, the work will include a pair of successful programs, Jobs for Maine Graduates (JMG) and Jobs for the Future. Results will be carefully tracked, Zanghi said.

After the first year, the program is expected to grow.

"Eventually, the additional help will be available to all children, 14 and over, in the foster care system in the state of Maine," Zanghi said.

Connect With Us