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Generations

Implementation Requirements and Guidance

Program Structure and Timeline

The Generations program is a family-centered medical home model, designed to provide integrated pediatric care, reproductive health care, mental health care, and social work services to teen parent families. Program entry is typically soon after an infant is born, and program services continue for a family until the teen parent’s 22nd birthday. Both parents and their children receive preventive health care at the recommended Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) intervals. In addition, the program is designed to provide individualized services to adolescent-headed families beyond the recommended preventive care as determined by individual family needs assessments.

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Staffing

The Generations Model is ideal for health care settings where multidisciplinary services can be integrated and co-located. The following staff positions and credentials are necessary to implement the Generations program, but the number of staff members needed will vary based on the size of the setting and patient population: (1) one or more medical providers, which can be physicians and/or nurse practitioners; (2) one or more clinically licensed social workers; (3) one or more mental health providers, which can be licensed psychologists (preferred) or licensed social workers; (4) a fathers counselor is optional but is beneficial if programs intend to provide services to young fathers.

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Program Materials and Resources

Generations utilizes an electronic medical record system and separate program database to collect and store patient assessments, screens, and provider contact. These systems are reviewed monthly and process data are discussed during monthly multidisciplinary meetings. Patient outcomes are monitored with an outcome evaluation tool administered annually to participants.

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Additional Needs for Implementation

Generations needs to be delivered in an integrated care setting, where the family of the teen mother has access to multiple providers (physicians, social workers, mental health providers) in one location.

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Fidelity

Fidelity of implementation is typically assessed through review of electronic medical records data. However, this can be adapted for organizations that don’t have adequate EMR capacity. The Generations team will oversee assessment and reporting of fidelity indicators during the early phases of implementation through a process of consultation and reporting.

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Training and Staff Support

Staff Training:

A two-day onsite training provided by the Generations implementation team is required. The cost of the training will vary depending upon the size and location of the organization, but will be based upon the cost of staff time and travel to the site. Following the two-day training, monthly phone-based consultation will be provided for at least 6 months after implementation.

Technical Assistance and Ongoing Support:

Monthly phone-based consultation will be provided following program implementation. Additional phone-based consultation is available as needed.

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Allowable Adaptations

Adapting the Generations program can be discussed in consultation with members of the Generations implementation team.

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