This data companion for health care clinics shares information on food and housing measures and the NC InCK Alternative Payment Model.
Health Care Providers
Education-Related Awareness Measures Data Companion for Clinics
This data companion for health care clinics shares information on education-related awareness measures and the NC InCK Alternative Payment Model.

Concrete Economic Supports Part 2 Integrated Care Rounds (June 2023)
Description
The NC InCK team and our guests discussed economic hardship and its impact of children and families during the second part of the Concrete Economic Supports Integrated Care Rounds event (June 2023).
Click this link for the June 2023 Concrete Economic Supports Integrated Care Rounds slide deck.
Key Takeaways
- The 2023 NC Child Health Report Card found that 40% of children in North Carolina live in poor or low-income households. Poverty, the stress caused by the experience of poverty, and the interaction with multiple systems is linked with multiple poorer health and well-being outcomes.
- This training includes information on accessing supports, including clothing, internet, utilities, WorkFirst, and Unemployment benefits. Use these resources in addition to those shared in the March 2023 Integrated Care Rounds. Viewers will learn how to support families through understanding and applying for supports.
- Family Navigators should actively support families in connecting to and enrolling in economic supports through walking with them to complete forms, calling access lines, and following up on applications.
Resources
- WIC Referral Form: Complete the referral form to refer families to WIC as a nutrition support for families
- More in My Basket Referral Form: Can help families apply for SNAP; refer families today!
- Affordable Connectivity Program (ACP): Medicaid recipients are automatically eligible for the ACP internet subsidy (up to $30/month) and a discount (up to $9.25/month) on phone or internet service through the Lifeline program
- Unemployment Benefits: Find more information on what is needed to file for unemployment benefits

Early Childhood Integrated Care Rounds (May 2022)
Description
The May 2022 Early Childhood Integrated Care Rounds event shares early childhood resources and valuable family perspectives. The NC InCK team and our guests discussed the importance of well child visits, quality child care, and early literacy efforts.
Click this link for the May 2022 Early Childhood Integrated Care Rounds slide deck.
Key Takeaways
- Well-child visits are essential, and preventative care through well-child visits leads to numerous long-term, positive health and well-being outcomes.
- Family Navigators can help families attend well-child visits with three-way calls to support scheduling, connecting families to resources such as MyChart and Medicaid transportation, and by initiating conversations on the importance of well-child care.
- Family Navigators can support the importance of high-quality child care with families and connect families to the Child Care Referral Center for options.
- Early language and literacy habits in the home are key indicators of every child's healthy development. Examples of key literacy programs are provided.
Resources
- Child Care Referral Center: Search for child care options in your area or see details for calling the Referral Center for support in finding child care or applying to Pre-K
- Children’s Developmental Services Agency (CDSA): Search for your local agency for NC’s Infant and Toddler Program
- Book Harvest: Request books and parent support for reading from this Durham-based non-profit

Food Integrated Care Rounds (June 2022)
Description
The June 2022 Food Integrated Care Rounds event shares information on Food & Nutrition Support and other helpful resources. NC InCK and our guests discussed food insecurity and how Family Navigators can help address food insecurity for children and families.
Click this link for the June 2022 Food Integrated Care Rounds slide deck.
Key Takeaways
- In NC InCK’s five counties, approximately 20% of households with children are food insecure.
- Food insecurity impacts all aspects of a child’s health. Children who experience food insecurity at any age are at risk for poor health outcomes that can continue into adulthood.
- Family Navigators can address food insecurity by understanding common barriers for accessing food and nutrition support, creating safe spaces to ask about food needs, and connecting families with federal nutrition support programs and insurance provider benefits.
Resources
- NC InCK Food Resources for Schools and Partners: A two-page guide with information on accessing SNAP, WIC, and school meals
- WIC Referral Form: A DHHS referral form for the Women’s Infants and Children program to receive outreach from a child’s local health department on the program
- How to apply for SNAP: DHHS site with information on the three ways to apply for SNAP benefits
- More in My Basket: A center based at NC State University which can support families in completing their applications for SNAP
- Summer Meals: Information on how to access a summer meals site near you (June-August)

Schools Integrated Care Rounds (April 2022)
Description
The April 2022 Schools Integrated Care Rounds event shares student and family perspectives and outlines why schools are an integral part of a child's care team and community. The NC InCK team and our guests discussed how children can thrive in schools and what we can all do to support children.
Click this link for the April 2022 Schools Integrated Care Rounds slide deck.
Key Takeaways
- Many supports exist for students in schools. Services all students are eligible for include teacher intervention and muti-tiered system of support. Services students must qualify for include 504 Plans and Individualized Education Plans.
- Family Navigators can help students and families connect to school-based resources through communication with key personnel and participation in meetings already taking place within the school (e.g., IEP/504 Meetings, parent/teacher conferences).
- Family Navigators should center the student and family in conversations with schools, with families initiating communication and Family Navigators playing the role of “strengths-bringer” to any school space.
Resources
- NC InCK’s Schools Guide: Background on working with schools to support children in NC InCK’s five counties
- Legal Aid of NC materials on IEPs and 504s: Read more about student’s rights in accessing special education services and steps to take to request support for your child
- Exceptional Childrens Assistance Center (ECAC): Webinars, resources, and one on one help navigating systems to support children with special needs

Behavioral Health Integrated Care Rounds (July 2022)
Description
The July 2022 Behavioral Health Integrated Care Rounds event discusses behavioral health needs, resources, and crises. The NC InCK team and our guests got the chance to listen to family perspectives and learn more about Tailored and Standard Plans.
Click this link for the July 2022 Behavioral Health Integrated Care Rounds slide deck.
Key Takeaways
- If a child is experiencing a behavioral health crisis and there is an immediate danger to themself or others, a Family Navigator should call 911 and ask for a Crisis Intervention Team (CIT).
- Family Navigators should support families in discussing behavioral health concerns with primary care providers, and Family Navigators can reach out to PCPs directly for recommendations for a child.
- Before beginning to help a family find behavioral health supports, Family Navigators should be familiar with a child's engagement with behavioral health supports, diagnoses, and medications.
- After assessing unmet behavioral health needs, Family Navigators can also support the effects of the behavioral needs in other areas of a child’s life (school, eating, sleeping, hygiene, etc.).
Resources
- NC InCK Behavioral Health Guide: Background on supporting children with behavioral and mental health needs in NC InCK’s five counties
- Behavioral and Mental Health Services Resource Guide for Educators: A two-page guide with information on recognizing behavioral and mental health needs in children, linking children to behavioral health treatment, and available resources
- Freedom House Recovery Center: Referrals to Freedom House Recovery Center can be made by calling 1-866-275-9552
Online search engines to find providers by Prepaid Health Plans or LME-MCO:

Adolescent and Young Adult Health Integrated Care Rounds (September 2022)
Description
The September 2022 Adolescent and Young Adult Integrated Care Rounds event discusses adolescent development, adolescence, and the importance of Family Navigators during this period of growth. The NC InCK team also held conversations with a Young Adult Advocate and a Parent Advocate during this event.
Click this link for the September 2022 Adolescent and Young Adult Health Integrated Care Rounds slide deck.
Key Takeaways
- Family Navigators can work with families to listen to the wants and needs of all youth and actively involve them in care. This is especially true for adolescents and young adults.
- NC InCK’s new Adolescent and Young Adult Guide covers key phases of a youth’s development and important services and considerations for care management of young adults.
- Guest Speaker: Youth Villages LifeSet program and their resources for young adults ages 17-22 years old.
Resources
- Youth Villages LifeSet: Information about the LifeSet program
- NC InCK Adolescent and Young Adult Guide: Background on working with Adolescents and Young Adults as well as resources for this population in NC InCK’s five counties

Juvenile Justice Integrated Care Rounds (October 2022)
Description
The October 2022 Juvenile Justice Integrated Care Rounds event discusses court services, health services and advocacy for youth with special health care needs, and community programs. The NC InCK team and our guests also discussed different types of juvenile justice services during this event.
Click this link for the October 2022 Juvenile Justice Integrated Care Rounds slide deck.
Key Takeaways
- There are many phases of Juvenile Justice involvement, and court counselors support families throughout this process.
- Many Juvenile Justice-involved youth have intensive behavioral and physical health needs, and Family Navigators can play an important role in connecting children to the care they need during and after their Juvenile Justice involvement.
- Juvenile Justice-involved youth may be placed in various living arrangements, including transitional living programs, multipurpose group homes, and crisis assessment centers.
- Guest speakers: Juvenile Justice Court Counselor Supervisor, UNC Children’s Hospital, and Methodist Home for Children
Resources
- NC InCK Juvenile Justice Guide: This guide provides information on the NC Juvenile Justice and Delinquency Prevention Program, information on working with youth and young adults involved in the Juvenile Justice system, and resources available in the five NC InCK counties.

Housing Integrated Care Rounds (January 2023)
Description
The NC InCK team and our guests discussed housing instability, ways to combat housing instability, and connecting with housing specialists during the January 2023 Housing Integrated Care Rounds event.
Click this link for the January 2023 Housing Integrated Care Rounds slide deck.
Key Takeaways
- There are a variety of local and statewide resources and programs for families facing housing instability. Family Navigators can help families target appropriate programs, complete applications, and communicate questions.
- Navigating housing instability is challenging and takes a long time. Family Navigators can play an important and helpful role for families who are wading through the complex housing assistance system.
- Housing instability often impacts many other areas of a child’s life. Family Navigators should also offer support in food, child care, education, and other financial areas while waiting for housing to open for a family.
Resources
- NC InCK Housing Guide: Background on housing-related issues and resources in the five NC InCK counties
- Housing Instability Resource Guide for Educators: Information for working with school-aged children experiencing housing insecurity
- PHP Housing Specialist Referral Form: Make a referral to a PHP housing specialist