OBJECTIVE(S): The Caring for California's Children (CCC) Project is an initiative whose overarching goal is to improve the quality of mental health care for children exposed to catastrophic, terrorist or bioterrorist events in Medi-Cal-funded outpatient primary care programs in California, including children receiving care through the Child Health and Disability Prevention (CHDP) Program.

METHODS:
(1) Compile evidence-based tables summarizing the psychological impact and interventions (prevention, screening, assessment, treatment) related to caring for the mental health consequences of extreme events on children and their families, and currently available resources for training PCPs on these issues.
(2) Examine the feasibility and capacity of the existing CHDP administrative database to identify target populations of providers, including their practice configuration, and their patient characteristics.
(3) Conduct an Advisory Work Group to integrate findings from the scientific literature and resource review and the secondary data analyses with expert opinion on the strengths, gaps, and priorities for a public health strategy to develop a statewide training program for PCPs in California.

FINDINGS / RESULTS: Findings from Phase 1 of CCC suggest that the mental health consequences of exposure to extreme events among children are of high public health significance; and that in caring for children, attention to the needs of caregivers and interventions to strengthen family functioning is paramount. Although a model training program with established effectiveness did not appear to be readily available, California is well-positioned to move forward to develop one. During this first phase, multiple training program resources were identified, provider and claimant characteristics of those served in CHDP could be estimated, and recommendations from a multi-stakeholder group to guide the selection of a training program and to build the infrastructure to support its implementation, dissemination and program evaluation were developed. California programs to prepare for the consequences of natural disasters can also serve as successful models for adaptation. Further, the emphasis on flexibility in the training program improves the likelihood that future products will be suitable for potential use in other states.

STATUS: From the information in Phase 1, a framework to guide the further development of a training program in Phase 2 was delineated. Currently in the process of designing a instructional web based training program and developing a pilot-test of its effectiveness (Phase 2).

Principal Investigator:
Bonnie Zima, MD, MPH

Sponsored by:
California Department of Health Services, California Department of Mental
Health