Families with young children in California often struggle to access preventative care – things like behavioral and developmental screenings and vaccines – that could help them be healthier and happier in the long run.
The state’s Medicaid program, called Medi-Cal, will be one of the first in the country to cover preventive services that treat children and their parents together.
The new benefit, which takes effect in July, is designed to cover the costs of a person such as a community health worker, who could connect families with resources such as food banks, legal aid, classes parenting education or therapy before leaving the doctor’s office.
“The social and emotional development that [children] going through them in those first few months literally transforms the architecture of their brains for their lives, ”said Dr. Gina Johnson, pediatric medical director of a group of Los Angeles County health centers.
“If we can intervene in a way that supports patients and their families at this early stage in their lives, we can make a real difference. “
Connect parents with resources
When Michelle Humphrey became a mom, her relationship with Google changed.
Searching for recipes turned to “Is it normal for my child’s bottom to be this color?” “And” My child has a bubble on his gums, what does this mean? ”
“There is so much that no one as a parent knows until you are in the middle of it,” Humphrey said.
But there were challenges she couldn’t solve online.
After the birth of her youngest son and the downsizing of the family to a smaller house in the Southern California suburb of Temecula, her oldest son’s demeanor changed. Boden went from almost complete toilet training to accidents and bouts of assault that included beating and biting.
“I think he just had a made up of several big changes in his life,” Humphrey said. They weren’t all bad, but they were just things that, like her little 3 year old brain, couldn’t handle.
She brought her questions to her next pediatric appointment at Children’s Primary Care Medical Group – not to the doctor, but to developmental specialist Bella Lopez.
“A lot of the time providers don’t have time to deal with other areas like, you know, mental health development, the family system as a whole,” Lopez said. “It’s really kind of where I come in.”
She is part of a program called HealthySteps which places a child development specialist on routine visits to answer parents’ questions, perform developmental and mental health screenings, and browse the local resource network.
The nonprofit Zero to Three for the early years operates 200 HealthySteps sites nationwide. Research shows that participating children receive more prevention and developmental services and are more likely to get the vaccine on time, among other benefits.
Lopez initially connected Humphrey to a parenting class and clinic that took Medi-Cal and offered therapy to parents and young children. Humphrey said it improved the relationship between his sons and helped Boden get back on the path to development.
It “made me feel like I had an ally, a liaison to help me find answers that I can’t find on my own,” Humphrey said.
Once her sons are older, Humphrey said, she could become a doula, helping childbirth, or a lactation consultant, in jobs where she could pass what she learned on to other parents. .
A question of funding
The Temecula HealthySteps program is funded by a local government agency, but sustainability has been a struggle with similar programs in other places.
Northeast Valley Health Corp. from Los Angeles County, where Dr. Gina Johnson works, piloted a program similar to HealthySteps.
“To have this family specialist, whose purpose was to assess the family’s needs and connect them with the resources they needed… philosophically, it’s a no-brainer,” Johnson said. “It’s the right thing to do, always.”
Despite the popularity of the program, Northeast Valley has not been able to sustain it after grants expired in 2020. Part of the reason is that providers often cannot charge for services that specialists or health workers provide to families.
“This is the key, because you have to be able to bill in order to support the staff to provide these types of services,” said Kate Margolis, a pediatric psychologist who heads the Integrated Behavioral Health division at San Francisco General Hospital. She led a team that pushed California to create the new Medicaid benefit covering more preventive services.
It’s an approach that can save the health care system money, but only if clinics can afford to offer it in the first place.
“By providing these supports based solely on the presence of risk, we can really anticipate problems before they get worse,” said Margolis.