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Children’s Health Improvement Partnership of Indiana

The Children’s Health Improvement Partnership of Indiana, also known as CHIP IN, implements evidenced-based quality improvements in pediatric practices across the state of Indiana. The program provides developmental screening tools to pediatricians throughout Indiana, allowing them to provide standardized screening for autism and other developmental delays. These tools include the MCHAT R/F and the ASQ-3. Children with screens that show delays are referred to the local Early Evaluation Hub for further testing and diagnosis. CHIP IN supports these practices as they track and improve their screening rates, ensuring that more children ages 18-42 months are screened throughout the state.

CHIP IN is a collaborative partnership between IU School of Medicine’s Children’s Health Services Research, the Indiana Department of Health, and other organizations established to engage government agencies, professional medical organizations, insurers, family organizations, and community partners in collaborative, measurement based quality-improvement initiatives. The program strives to provide optimal care for Indiana’s children and youth by working with the primary care medical home to translate evidence-based practices into implementable steps; understand and work through systems to create realistic, measurable improvements in quality; and partner with families and the health care team to improve care.

CHIP IN Current Projects

CHIP IN convenes core partners to determine priorities for improving children’s health in Indiana. Current work is focused on early screening, evaluation and diagnosis of autism and other developmental disabilities. CHIP IN also works in tandem with the Pediatric and Adolescent Comparative Effectiveness Research group in the Department of Pediatrics to manage the implementation and dissemination of effective, evidence-based practices throughout Indiana.

  • Indiana Crossroad Partnerships Care Coordination Pilot
    CHIP IN is a partner and leader for the Indiana Crossroad Partnerships Care Coordination Pilot, which delivers care coordination to families of children with special health care needs. Several of the Neurodevelopmental Behavioral Services Early Evaluation hubs participate, and hub care coordinators work with care coordinators from Indiana Crossroad Partnerships and Indiana State Department of Health, Children’s Special Health Care Services. With support from CHIP IN, these pilots provide family-centered care plans and coordinated case management for participating children aged 18-48 months diagnosed with autism, developmental delay or other special health care needs. The program helps families access services across health care, education and community resources. In addition to care coordination support, CHIP IN provides data and quality improvement support.
  • Neurodevelopmental Behavioral Services
    Indiana’s average age of autism diagnosis is 5.3 years, well over the Healthy People 2020 goal of 36 months. To address this issue, with support from the Indiana State Department of Health and Riley Children’s Foundation, CHIP IN has helped develop Early Evaluation Hubs throughout the state, allowing for diagnostic service for children 18-42 months of age in local communities. Hubs are located in Bloomington, Evansville, Lafayette, New Albany, South Bend, Fort Wayne, Muncie, Terre Haute and Indianapolis. CHIP IN provides practice support, a quality improvement learning community, medical direction and other services to each of these evaluation hubs.

CHIP IN for QualityHistory

CHIP IN for Quality was established in 2011 with support from the Indiana State Department of Health and the IU School of Medicine. The first CHIP IN project centered on enhancing the primary care medical home model. The project, funded by the Indiana State Department of Health through a federal Health Resources and Services Administration Community Integrated Systems of Service grant, supported primary care pediatric practices to implement changes, track progress and make ongoing improvements to their medical home.

Partnership and Support

Many organizations support the work of CHIP IN through formal and informal partnerships and make unique contribution to children’s health in Indiana. Partners include Indiana University School of Medicine; Indiana State Department of Health, Children’s Special Health Care Services; Riley Children’s Foundation; Indiana Chapter of the American Academy of Pediatrics; Family Voices Indiana; About Special Kids; and Indiana Medicaid Managed Care Entities. CHIP IN is led by IU School of Medicine faculty members Nancy Swigonski, MD, MPH, Kathleen Swec, MD and Michelle Curtin, DO. Other staff includes data manager, Jennifer Stanton Tully, and pediatric practice liaisons, Megan Overgaard, Angela Paxton, Kara Casavan and Mary Delaney.

“Improving access to quality care and services for children, including children and youth with special health care needs, is driven through system change. Not only does effective system change require collaboration from a variety of partners working towards a common agenda, it also requires implementing measurement-based, quality improvement initiatives. Indiana’s Child Health Improvement Partnership is committed to convening government, professional, family, academic, payor and community partners to make system change a reality. CHIP IN has the unique ability to recognize the constraints that different sectors face, yet are able to create realistic, achievable change in quality of care for children. The success CHIP IN helps its partners achieve is of value to the organization and most importantly the children we serve.”

– Shirley Payne, MPH, Director Children’s Special Health Care Services, Indiana Department of Health

Early Evaluation Hub Sites

From primary care, a family’s visit to an Early Evaluation Hub can provide evaluation, diagnosis and any needed specialty care and other services that can help children grow and thrive. To make an Early Evaluation Hub appointment, a child must be 18-42 months of age and have a primary care physician. The primary physician must identify concern based on standardized screening tools (often ASQ and/or MCHAT).
  • Central Indiana

    Riley Outpatient Center
    Pediatric Care Center (PCC) | 1002 Wishard Blvd. | Indianapolis, IN 46202

    Meridian Health Pediatrics
    205 N. Tillotson Avenue, Muncie, IN 47304

    IU Health Arnett – Lafayette
    2600 Greenbush, Lafayette, IN 47905
    Internal health systems referrals only.

    IU Health Riley Physicians – Bloomington
    4935 W Arlington Road, Bloomington, IN 47404

    Union Associated Physicians (UAP Clinic)
    221 S Sixth Street, Terre Haute, IN 47807

  • Northern Indiana

    Beacon Medical Group Centennial
    Neighborhood Health Center

    621 Centennial Dr, Suite 402
    South Bend, IN 46601

    Parkview Health
    Parkview Children’s Clinic

    11115 Parkview Plaza Dr
    Fort Wayne, IN 46845

  • Southern Indiana

    Deaconess Riley Children’s Specialty Center
    4133 Gateway Blvd, Suite 220, Newburgh, IN 47630
    (Near Evansville)

    ALL IN Pediatrics
    2305 Green Valley Rd., New Albany, IN 471150



  • Nancy Swigonski, MD, MPH

    Medical Director 
    Professor, School of Public Health

    The areas of interest for Nancy Swigonski, MD, MPH, are in primary care, medical home, quality of life, improvement science, quality improvement, improvement partnerships, and children with special health care needs.

  • Donita Roettcher, MD


    Donita is a recent graduate of the IU Pediatrics Residency in 2019. She spent a year with AMPATH, the IU-Kenya partnership through the IU Center of Global Health, as the Pediatrics Team Leader in which she was involved in the clinical care of children and medical education of both Kenyan and North American residents and students. She has joined Dr. Swigonski’s research team to further her interest and knowledge of clinical health services research strategies and how they can be applied to improve the care of children.

  • Jennifer Tully

    Data Manager

    Jen has been with Children’s Health Services Research (CHSR) since January 2011, originally as a Clinical Research Assistant and Research Database Specialist for the Pediatric Research Network, and currently as Data Manager for Child Health Improvement Partnership Indiana and the Riley Maternal Newborn Health Quality Improvement Project. Her work experience with CHSR has primarily involved management of electronic data capture for health services research and healthcare quality improvement, specializing in data sharing among cross-sector collaborations.

  • Marlee Case

    Pediatric Practice Specialist, Early Childhood Systems

    Dating back to her pre-professional years, Marlee had a passion for infant development. Since then, she has worked to turn that passion into a career by attempting to improve the lives of children and their families. Her experience as an Early Childhood Educator, Infant Specialist, and DCS worker have helped shape her philosophies and practice to ensure that every child and their family is treated with respect, dignity, and compassion.

  • Kara Casavan

    Program Manager, Infant Mortality Projects

    Mrs. Casavan first worked for the Indianapolis Metropolitan Police Department implementing and developing the Body Safety Program. After 7 years with IMPD, Kara began her career at Indiana Department of Child Services first as an assessment worker and serving as a mentor, then as a trainer, and finally as a Regional Services Coordinator. During her time at DCS, Ms. Casavan started her quality improvement and implementation training.  In 2015, Kara started working with Children’s Health Services Research - IUSM working in quality improvement for various projects.  Ms. Casavan has participated in IHI trainings and is Bronze Certified in Lean methodology and has a passion for bringing a quality improvement framework to projects focused on reducing infant mortality.

  • Katie Lynch

    Pediatric Practice Specialist, Early Childhood Systems

    Katie is currently focused on addressing infant mortality in Marion County by increasing safe sleep practices and improving community conditions. She came to this project after working as an early childhood educator in Indiana for many years. Katie has grown and learned so much from her work with young children and their families and is excited to contribute to the valuable mission of early childhood education and advocating for young children’s health and safety, in a new capacity. Katie’s work is inspired by early childhood professionals and she is excited to support our community's child care networks as we work to provide even safer and more respectful environments for our young friends.

  • Kim Walker

    Faith Base Outreach Worker

    Kim Walker joined the team in 2020 after working for Unleavened Bread Cafe for the past fourteen years. She serves as a Faith-Based Outreach Worker for the IU Pediatrics Department, where some of her duties include raising awareness in congregations and surrounding neighborhoods about infant mortality and help them build skills to foster healthy pregnancies and infants.

  • Whitley Wynns

    Team Lead, Early Childhood Systems

    Whitley Wynns started as an AmeriCorps VISTA focused on Education and Public Health and Safety at John Boner Neighborhood Centers before joining the CHIP IN team in 2017 as a part time employee. She transitioned the quality improvement skills she began to developed while being an AmeriCorps VISTA to focus on addressing Infant Mortality in the state of Indiana by partnering with the Early Learning and Development sector to improve the coordination of early childhood systems.