How Iowa Replicated Colorado’s T.I.G.E.R.S. Practice
June 2017

Lynda Krisowaty
Program Manager, Evidence-Based Practice
Association of Maternal & Child Health Programs

As part of AMCHP’s Replication Projects, Iowa received funding to replicate Colorado’s emerging practice entitled Transition Interagency Group Envisioning Realization of Self (T.I.G.E.R.S.).  Below we share why that practice was chosen to be replicated, what’s been learned so far, and where Iowa is going next.

One of the top priorities for Iowa’s Maternal and Child Health Title V program is to increase the percent of Youth With Special Health Care Needs (YSHCN) who receive services needed for transition to adulthood. Part of improving transition services involves moving from an agency-centered approach to a youth and family-centered approach. Colorado offered an effective model to accomplish this: The Transition Interagency Group Envisioning Realization of Self (T.I.G.E.R.S.) is a coalition of 10 organizations in southwest Colorado that has been coordinating services for youth transitioning to adulthood since 2002. Iowa’s Title V program for children and youth with special health care needs wanted to learn how T.I.G.E.R.S was able to maintain and grow its coalition over 15 years with no designated funding.

T.I.G.E.R.S. provided a valuable example of collaboration between agencies, with long-term and tangible benefits for youth, families, organizations and the community. Although new money will not magically appear to help carry out such an initiative, agencies are motivated to put past grudges and individual missions aside to learn new strategies for collaboration to help YSHCN and their families. This is especially so for families with Medicaid coverage, as many organizations are facing significant challenges due to Iowa’s new privatized Medicaid managed care program, including changing coverage and reimbursement issues. Working across agencies will improve transition services for YSHCN and other services that have been affected by changes to Medicaid.

The T.I.G.E.R.S. representatives shared strategies to create buy-in among participating organizations, encourage systems thinking, and guarantee commitment over time. They also identified obstacles, including time constraints, concerns over whether to expand an existing coalition beyond its original mission or form a new coalition, and frustration that the priorities of agencies serving those with disabilities do not always align with those of the state government or insurance providers.

Iowa’s Title V CYSHCN program at The University of Iowa Division of Child and Community Health (DCCH) plans to meet with the steering committee for the Iowa Coalition for Integrated Employment to discuss collaborating on an environmental scan that will identify transition to adulthood activities in Iowa. DCCH would use the results of the environmental scan to identify new partners and discuss developing a state coalition and/or regional coalitions similar to T.I.G.E.R.S.

DCCH appreciates AMCHP and T.I.G.E.R.S. for providing this valuable opportunity to study the feasibility of replicating this emerging practice and encourages others to apply for replication projects as well.

Do you have an effective or innovative MCH practice you’d like to share so other states can replicate it?  Help us strengthen Innovation Station by submitting a practice to AMCHP’s spring best practices review.  All applications must be received no later than June 9th.