By Eileen Forlenza
President of the Board, AMCHP
Stephanie pulled up to her son’s school just in time for recess, so she decided to simply watch for a while. Alec never saw his mom, because she stayed in the car, watching and crying. For the entire recess period, Alec walked the perimeter of the playground. No one played, laughed, skipped or clapped with him. He did not appear to be unhappy – he was just alone. He was not being bullied – he was just isolated. He wasn’t bothering anyone – he was just disengaged. Simply put, he was not included. Period.
Within weeks, Stephanie developed a facilitated recess program to assure that all children had access to team building, shared goals and social integration. She engaged the school nurse, physical education team, psychologist, principal, school board and of course, the kids. Some of these community partners had never worked together, but instinctively Stephanie knew they all had a shared goal for the school and the kids. Anchored by their vision of positive outcomes for children, the team created an integrated approach to wellness, including social-emotional health, that really worked! Alec soon had plenty of friends, increased activity and heightened self-esteem. He was on track for a great school year. While Stephanie was motivated by her own son’s situation, her dedication to quality and inclusion improved the lives of hundreds of children.
I am certain you see yourself reflected in Stephanie’s story – dedicated, inspired and equipped to make a difference. For MCH professionals, there are other components of Stephanie’s approach that we know are critical:
Families often create innovative solutions because their perspectives are from a different view.
Convening non-traditional partners leads to trust building.
The solution was not clinically-based; it was community-based.
Quality improvement starts with a belief that services and programs can be better.
In this era of health care reform, we have an opportunity to commit to improving the quality of our services and programs in a manner that is inclusive and innovative. Across the country, state Title V agencies are uniquely qualified to build from their strengths as “systems builders” to illuminate not only the gaps and barriers but to present solutions that work. The biggest gap in the implementation of the Affordable Care Act is the lack of acknowledgement that health outcomes are not solely dependent on clinical interventions; there are opportunities to address wellness on the playground. If payment incentives were designed to honor non-clinical “health care” I am certain we would have a generation of healthier people. Like Stephanie, sometimes we as MCH professionals have to come out from the parking lot and step in as innovative leaders.
As the president of AMCHP, I want to inspire a shared vision that we can improve our programs and services by integrating systems of care. Stating the problem is part of solving the problem. Sustaining vertical, competitive and disconnected systems is not supporting the best outcomes for kids, youth and families. As a parent of a young adult who requires 24/7 care, I have been involved in myriad quality improvement initiatives for over 20 years. In 2007 when I testified in our state for legislation to support the medical home model, I proclaimed, “’Medical home’ is a verb, not a noun!” I often reflected that it doesn’t matter where we receive our care, but rather that the actions taken to assure the care is excellent and relevant.
Sadly, I am afraid that our nation’s well-intentioned efforts to integrate systems through the medical home movement only segregated specialists more deeply as a “place based” approach triumphed. Creating integrated services and systems of care is indeed a step in the right direction, and I am hopeful that recent investments and initiatives will garner outstanding results.
I assure you that as long as I am serving as president of AMCHP, I will carry the torch for quality, integrated systems of care and services on your behalf. As MCH professionals, we can indeed link arms and cross the bridge together!
All the best,