New Jersey Chapter, American Academy of Pediatrics (NJAAP)

What it reported doing in 2024

Tpec: nj seedlings (supporting everyone in early development) transforms how pediatric primary care is delivered for prenatal-to-five-year-old (p-5) populations eligible for nj family care or who are uninsured. This initiative brings together experts in pediatrics, parents, and healthysteps (hs) practice leaders to improve early childhood development (ecd) along with social-emotional health, school readiness, family well-being, and health equity outcomes. The aim is to: a) improve equitable access to a continuum of ecd services in pediatric patient-centered medical homes, and b) improve the capacity of pediatric practices and the workforce to deliver high-quality ecd services that address the holistic needs of children and families. The program is currently implemented at three practice sites in New Jersey. Healthysteps specialists (ecd experts) are trained to connect families to services including early developmental health promotion/prevention, screening and surveillance, care coordination and linkage, and interventions. Each practice has or is in the process of engaging a parent expert with lived experience who serves as a family resources specialist who leverages lived experience to provide peer-to-peer support for parents and ensures that family voice and perspectives are included in decision-making and routines at the practice and systems level to ensure parent-to-parent support. Training is provided via technical assistance, implementation resources, and a 6-month maintenance of certification (moc) part 4 quality improvement (qi) project echo to strengthen ecd integration, share successes and challenges, and support one another in their journey. A qi coach supports practices to support small tests of change, implementation of improvements, and provides strategies for the spread and sustainability of practice transformation. The program leverages the infrastructure and expertise of key stakeholders in the early childhood space in nj and ensures a unified, integrated, and coordinated approach that uplifts a variety of family voices throughout nj. It accomplishes this through the establishment of a steering committee, patient & family advisory council at each practice site, and a quarterly learning community. Additionally, an early relational health coalition helps to advance solutions to identify specific barriers to sustained and holistic ecd service delivery in primary care, discussing topics such as policy and financing barriers, ecd workforce needs, care coordination, and service gaps to ensure the best ecd outcomes for infants and young children in nj. Effective and ongoing evaluation of the model design and implementation is also conducted, with data analysis focused on multiple data sets, including qualitative and quantitative data from pediatric practice teams, implementation process measures, and patient and family data. The center for community health and evaluation collects, aggregates, and analyzes data from practices regarding knowledge change, evaluation of learning, and ease of implementation of the hs screening process.

Financial Efficiency

• Mission deployment rate: 88.8%; rating input score 89
• Program expense ratio: 90.6%; rating input score 91
• Fundraising efficiency: $604.17 raised per $1 spent on fundraising; rating input score 96; 96th percentile among comparable filings

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
• Pay-setting controls: 0 of 6 controls in place; rating input score 0
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Missing
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 82.6%; rating input score 83; 15th percentile among comparable filings
• Governance controls: 8 of 9 controls in place; rating input score 89
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 2%; rating input score 41; 41st percentile among comparable filings
• Total-asset coverage ratio: 0.63; rating input score 23; 23rd percentile among comparable filings
• Liabilities to assets ratio: 0.42; rating input score 25; 25th percentile among comparable filings
• Officer compensation ratio: 10.4%; rating input score 29; 29th percentile among comparable filings

Growth

• Program expense growth: 6.6% per year; rating input score 100; 48th percentile among comparable filings
• Revenue growth: 7.7% per year; rating input score 100; 58th percentile among comparable filings
• Asset growth: 19.2% per year; rating input score 100; 82nd percentile among comparable filings