Strong Start: Information for Health Care Providers

male doctor making faces with child held by parents

Strong Start is an easy-to-use data system that can help you provide better care coordination for children in your practice.

Ways Strong Start helps you and your families:

  • You can review the history of screenings no matter where they were done.
  • You can enter and track developmental screening results. Parents and guardians can also enter records.
  • You can avoid unnecessary duplicate screenings.

 

headshot of Christina L Pease

“Let us come together with this tool and celebrate all the developmental milestones a child is meeting. If they happen to not meet all of them, let us all get on the same page, partner together and act early.... We need to empower families and each other to highlight a child's strengths and celebrate their successes in areas where they need a bit more support."

Christina L. Pease, MD
Sea Mar Community Health Centers

Getting Started

Ready to use Strong Start? Check out Strong Start Access Guide for Providers (PDF). Follow the steps to link your Secure Access Washington (SAW) account to your Provider Strong Start Account.

If you already have a SAW account, simply add Strong Start to your list of services and you are ready to begin.

Tools included in the Strong Start UDS System:

Find a quick reference guide to these tools in the Frequently Asked Questions below.

Billing for Developmental Screening

Developmental screenings are billable to Apple Health, Washington’s Medicaid. The 2023 Washington State legislature authorized a 100% increase in Medicaid reimbursement rates for developmental screening. This change went into effect in January 2024.

Private insurance coverage can vary. We recommend checking with your clinic administrator for details.

Frequently Asked Questions for Health Care Providers

What types of providers can use Strong Start to access and add information?

Health care providers with a Washington state license can sign up to use the Strong Start data system. These include primary care physicians, pediatricians, and family physicians. Advanced Registered Nurse Practitioners (ARNPs), Physician Assistants (PAs), Registered Nurses (RNs), and specialists like developmental psychologists, speech pathologists, and occupational therapists can also sign up.

Multiple providers caring for a single child can access information in the Strong Start data system. Parents and legal guardians control the permissions and may choose to add or deny access to individual providers.

Some providers may want to have their office staff use Strong Start to enter and look up information. They can authorize users through the Provider Support role option. Anyone in a Provider Support role must be trained in HIPAA rules and have their access verified by the relevant Department of Health staff.

Can I complete a screening in the Strong Start system?

No. Strong Start is not an online screening tool. It is a data system for recording results of completed developmental screenings. Records include the results, demographic information, date and location of screenings, any concern or referrals.

Are providers in Washington required to save screening information in the Strong Start data system?

Providers are not required to use the system, but we strongly encourage you to do so! We built the system to respond to the needs of families, health care providers, and early learning partners. They asked for a common platform where they could easily find information about when and where a child was screened and what the results were.

What are the recommended ages and intervals for developmental screening?

The American Academy of Pediatrics recommends developmental screening at 9, 18, and 24 or 30 months, and autism-specific screening at 18 and 24 months. These screenings can be part of routine well-child visits or done anytime the parent or provider identify a concern.

Where can I learn about the recommended screening tools and implications of scoring results?

The information below provides a high-level overview of the tools in Strong Start. Click on the tool name to learn more.

ASQ-3: Ages and Stages Questionnaires, 3rd edition
Available in Spanish, Arabic, Chinese, French
Brookes Publishing

Numerical scores in 5 domains:

  1. Communication
  2. Gross motor
  3. Fine motor
  4. Problem solving
  5. Personal social

Scores grouped into:

  • Above cutoff
  • Near cutoff
  • Below cutoff

ASQ:SE-2: Ages & Stages Questionnaires: Social-Emotional, Second Edition
Available in Spanish, Arabic, French
Brookes Publishing

Numerical scores in 7 domains:

  1. Interaction with people
  2. Self-regulation
  3. Compliance
  4. Social communication
  5. Adaptive functioning
  6. Autonomy
  7. Affect

Scores grouped into:

  • Monitor
  • Above cutoff
  • Near cutoff
  • Below cutoff

SWYC: Survey of Wellbeing of Young Children
Includes autism-screening tool
Culturally sensitive, available in Spanish, Khmer, Burmese, Nepali, Portuguese, Haitian-Creole, Arabic, Somali and Vietnamese.
Tufts University

Numerical scores in 3 domains

  1. Developmental
  2. Emotional/behavioral
  3. Family context

Scores grouped into:

  • Further investigation needed
  • Below average range
  • Average range
  • Above average range

M-CHAT-R: Modified Checklist for Autism in Toddlers, Revised with Follow-up
Available in numerous languages.
©Robbins, et al

Numerical scores in 3 domains

  1. Communication
  2. Social
  3. Behavior

Identifies risk (not a diagnosis)

  • Low
  • Med
  • High
Our practitioners monitor children’s development as part of routine care. Why the emphasis on a standardized screening of every child?

Developmental delays aren’t always obvious, and early interventions help kids thrive. The American Academy of Pediatrics (AAP) Developmental Surveillance and Screening recommends that all pediatric primary care clinicians should be prepared to screen, identify, and care for children and youth with developmental delays and disabilities Currently, fewer than half are identified before starting school, when interventions are most effective. Children and their families will benefit from identifying each child’s milestone progress, celebrating achievements, and addressing any concerns.

If there is a concern, how will I know what resources are available? What services and supports will families be able to access?

The statewide organizations below can help providers and parents connect with local resources:

For autism-specific concerns, the Medical Home Partnership Project can help connect providers and parents to their local Autism Center of Excellence.

What activities can parents do at home to help their child’s development?
How should health care providers bill for conducting a standardized developmental screening?

The CPT® Code 96110 is often associated with developmental screening. It is commonly billed together with an office visit. For Medicaid patients, please refer to the Washington Apple Health EPSDT Billing Guide for more information. For privately insured patients or uninsured patients, refer to the insurance carrier or clinic policy.

Can we bill for follow-up on a screening that occurred outside our clinic?

It may be possible to schedule and bill for an office visit, particularly if the off-site screening identified a concern. Communicate with your clinic or the patient’s insurance carrier to identify the best options for managing patient follow-up.

The developmental screening conversations with parents and families can be sensitive. Are there any resources to guide providers?

Yes, these conversations can be sensitive! Parents may wonder if they “did something wrong” or worry about the next steps when there is a developmental concern. You can use the resources below to help with those conversations: