health

What it Really Means to Put Kids First

October 2, 2017 – Community leaders and advocates convened at Wayne State University for a community forum hosted by the United Way for Southeastern Michigan and the Merrill Palmer Skillman Institute for Child and Family Development.

Dr. Herman Gray, CEO of United Way for Southeastern Michigan, shared an experience from his time as president of Children’s Hospital of Michigan. A child was being treated for an ailment which was not very serious but required several weeks of antibiotics. After keeping the child in the hospital receiving the medication through an IV, it was time to discharge the family with a prescription. When given directions to refrigerate the antibiotic, the child’s parent surprised the staff:

The family did not have a refrigerator at home.

I took two important lessons from this story:

  1. Poverty is real, and its impacts are real. How healthy can a family be if they are unable to keep perishable items at home? And, if there is no refrigerator in the house, what else might they be missing?
  2. Important instructions are given to parents and families every day for the care of their children. With what assumptions are well-intentioned professionals delivering these instructions and advice?

Writer and radio host Stephen Henderson, who keynoted the event, shared his experience with the Tuxedo Project, which he started in an effort to improve the quality of life in his old neighborhood by repurposing the house he grew up in on the west side of Detroit’s Tuxedo Street. The home had been abandoned in the years after his family moved out.

Based in part on conversations had throughout the past year with current Tuxedo Street residents, such as an elderly man living without power or running water and around the debris where a fire caved his second floor into his first floor, Henderson argued that urban poverty has become increasingly like rural poverty, characterized by isolation.

These stories stayed with me until later in the day, when an attendee shared information about a program run by her agency to benefit young children who have experienced trauma. When her team members began planning for the program’s implementation, they took a step back to think through and identify desired outcomes. Then, they determined what would be needed to achieve those intended outcomes for the children and families who would be enrolling in the program. It was then that I realized something I do not often hear in public discourse relating to social policy. We often hear about what the government’s role should be, how much funding should be allocated, and which programs and services should be prioritized. What I do not remember hearing much of, however, at least in bipartisan conversations, is what we actually want to see for all Michigan children.

Maybe we should start there. What do we want for kids? This is the conversation we need to be having. What do we want to see for Michigan’s children, and what do we need to do to get there? What do kids need to get to that point, and what policies, funding levels, and services will take them there? If we can start there – and truly prioritize those outcomes – we can begin to make long-term, positive improvements for Michigan’s children.

And, in a society where very few decision-makers have personally experienced poverty and its effects, it is critical that we think carefully about which voices are at the table when discussing solutions to these issues.

If we fail to include the voices of those most impacted, we risk wasting time and resources providing solutions which will not address the complete problems and therefore fail to be impactful – or, in other terms, we risk continuing to provide medications needing refrigeration to people without refrigerators.

Kayla Roney-Smith, Executive Director of the Hazel Park Promise Zone and College Access Network, attended the “Families First for 100 Years” community forum at Wayne State in Detroit. Here, Roney-Smith shares what major lessons she took from the event.

A Mixed Budget for Equity

Last month, Governor Snyder signed the fiscal year 2014 (FY2014) budget into law.  The state budget is the single most powerful expression of the state’s priorities and can be used as a tool to improve opportunities for children and families or worsen disparities.  The FY2014 budget proves to be a mixed bag with some significant steps forward and some hugely missed opportunities.

A  big win for children is the $65 million expansion for the Great Start Readiness program.  This 60 percent increase will ensure that thousands of additional children will have access to a high quality preschool program and be better prepared to succeed in school, reducing the achievement gap.  We can also applaud the $11.6 million expansion of the Healthy Kids Dental Program, which will ensure that 70,500 Medicaid-eligible children in Ingham, Ottawa, and Washtenaw Counties will have access to high quality dental care.  Dental disease is the most common chronic illness for children – more so than asthma or hay fever – and disproportionately affects children of color and children from low-income families.

There were some mixed results in the final budget.  For example, the final budget included $2.5 million to support the state’s Infant Mortality Reduction Plan.  This level of funding to support the state’s plan is a step in the right direction, but falls short of the $11 million needed to fully implement the plan.  In a state where African American infants continue to be three times more likely than white infants to die during the first year of life, fully implementing the state’s Infant Mortality Reduction Plan while ensuring that other supports that promote healthy pregnancy and birth are essential to mitigate this unacceptable disparity.

And there were some missed opportunities.  Efforts were made to increase support for school-community partnerships through the Communities in Schools program; and we know that incentives for schools to create community links aimed at strengthening schools, increasing parent involvement, and meeting children’s needs can improve student outcomes and reduce the achievement gap.  Unfortunately, support for CIS did not come to fruition in the final budget.  Also, the final budget provided no additional resource for before- and after-school programming which improve educational success for all students and demonstrate the greatest benefit for students who face the most extraordinary educational challenges; and no funding increases for opportunities for the 5th and 6th year of high school – additional years that have proven to increase graduation rates for students who struggle the most in school.

And of course, the battle to expand Medicaid still rages on.  While more children would not be insured, Medicaid expansion would benefit children in significant ways.  More than one out of four individuals covered by the expansion would be women of child-bearing age, one out of four would be young adults who might not otherwise have health insurance, and 91,000 additional parents would have health care coverage.  However, Medicaid expansion is not a lost battle.  The House has already passed a Medicaid reform package separate from the budget bill, which includes the expansion, and the Senate continues to debate this bill.  The Senate Government Operations committee met today to provide a brief overview of the Senate workgroup that will be working over the summer in the hopes that Medicaid reform and expansion can be approved by the Senate in the fall.  We encourage you to continue talking to you State Senators about the importance of Medicaid expansion for your family and your communities.

Learn more about the FY2014 budget and Medicaid Expansion by visiting our Budget Basics library.

-Mina Hong

Medicaid Expansion Matters to Michigan Children

Governor Rick Snyder made a huge step in a healthier direction for the state when he proposed to expand Medicaid access to Michigan residents by taking advantage of the federal Affordable Care Act (ACA).  Under the ACA, states can choose to expand Medicaid to uninsured individuals living at 133% of the federal poverty level (FPL) or below, $31,322 for a family of four.  This expansion would not cover additional children under the age of 19 since they are already covered by Medicaid or MIChild up to 200% FPL.  However, it would have a significant positive impact on the well-being of Michigan children from cradle to career.

One major group of young people who will benefit from the Medicaid expansion is young adults – young people between the ages of 19 and 24 would make-up one-quarter of the individuals covered by the expansion.  There are many young adults who work beyond the traditional four years toward completing their high school diplomas – 18% of low-income students in Michigan utilize a 5th or 6th year of high school to graduate, and are unlikely to have access to workplace health insurance during this time.  Expanding Medicaid will allow young adults to continue to work towards their high school credential while having access to affordable health care and can continue to have access to health care as they transition into the workforce, expanding those options.

Additionally, many young adults in the 19 to 24 age range are also parents of young children.  Medicaid expansion would improve more young parents’ health and subsequently their ability to keep consistent employment and provide for their children.  Currently, the Michigan Medicaid program covers parents below 50% FPL, leaving many low-income parents without access to care.  Yet studies show that insured children with insured parents are more likely to receive check-ups and other health care than insured children with uninsured parents.  And for those young adults without children, having access to health insurance means access to family planning services to plan for their futures and behavioral health services to assist them in their success.  This includes planning for future pregnancies and ensuring that they are healthy before becoming pregnant so that they can have healthier pregnancies and healthier babies.  In a nutshell, expanding access to health insurance for parents and young adults leads to better health outcomes for Michigan families.

So what’s the status of Medicaid expansion in Michigan?  Neither the House nor Senate has included this expansion in their budget proposals for fiscal year 2015.  However, the Senate Appropriations Committee is continuing to discuss the possibility of including Medicaid expansion in their version of the Department of Community Health budget bill before they pass it out of committee.  Now is the time to reach out to the Senate Appropriations Committee members about the importance of Medicaid expansion for you, your children, your family, and your community.

Learn more about Medicaid expansion and what it means for Michigan children in our Budget Basics fact sheet.

-Mina Hong

What Will You Be Doing This Spring Break?

Over the next two weeks, Michigan’s Legislature is on spring break.  Sure, many legislators may be, literally, taking a break with their families but this also provides a great opportunity to connect with your legislators in your community – in their districts.  And boy, is there a lot to talk about.

Last week, the Michigan House of Representatives Appropriations Subcommittees approved most of their budgets for fiscal year 2014 (FY2014), which begins October 1 of this year and goes through September 30th of 2014.  The subcommittees made many changes from the Governor’s proposed budget for FY2014 – particularly in the Community Health budget – and many will continue to be topics of debate as the budget process continues.  We know that good health is critical to education and life success, and in fact, the Michigan Department of Education – Office of Great Start agrees as demonstrated by their first objective to ensure that all children are born healthy.  With children of color disproportionately challenged by access to consistent, high quality health care, changes made to the Community Health budget will have the greatest impact on them.

House changes that will affect child and family health disparities include the following.

  1. Medicaid Expansion: The House Appropriations Subcommittee for Community Health did not include the Governor’s proposed Medicaid Expansion in their budget proposal.   This expansion would’ve insured more than 320,000 adults who are living at 133 percent of the federal poverty level or below (that’s an annual income of $25,975 for a family of three), and we know that African American and Latino Michiganders are more likely to be uninsured than their White counterparts.  As a result, Medicaid expansion is important for Michigan children of color as we know that low-income adults are often parents or caregivers of young children and that many uninsured young adults are still working to complete their high school credentials.
  2. Infant Mortality Reduction: The House Subcommittee eliminated the Governor’s proposed $2.5 million to support the state’s Infant Mortality Reduction Plan.  In a state where African American babies are three times more likely to die before their first birthday than White babies, this elimination of funding is unacceptable.
  3. Healthy Kids Dental Program: The House Subcommittee rejected the Governor’s proposal to expand the Healthy Kids Dental program to an additional 70,500 children and youth in Ingham, Ottawa and Washtenaw counties.  This program increases provider reimbursement rates, encourages provider participation and helps more children receive the high quality dental care they need.  Dental disease is the most common chronic illness for children – more so than asthma or hay fever – and disproportionately affects children of color and children from low-income families who lack access to sufficient dental care.
  4. Mental Health Innovations: The House Subcommittee rejected the Governor’s proposed $5 million to support his new Mental Health Innovations, which would’ve supported comprehensive home-based mental health services for children, a pilot high intensity care management team for youth with complex behavior disorders, and mental health “first aid” training to recognize mental health problems in youth and connecting them to professional help.  These efforts could assist in ensuring that children – particularly children of color – who struggle with mental health issues get  appropriate intervention services rather than being mislabeled as youth with bad behavior at-risk of school suspension.

This spring break provides opportunities to connect with legislators on these important health programs that reduce disparities and ensure that children are on-track to succeed in school and life.  Though the House Subcommittee made these inequitable changes to the Department of Community Health budget, the full House Appropriations Committee has yet to adopt these recommendations.  Additionally, the Senate Appropriations Subcommittee on Community Health has yet to finalize their budget for FY2014 and is expected to do so shortly after the break.  Now is the time to talk to your legislators in both the House and Senate about these important health programs and what they mean to your children and your community.

-Mina Hong

The State of the Union

Last night, President Obama gave his fourth State of the Union address.  As his White House Senior Advisor, David Plouffe, alluded to prior to his address, President Obama focused on the U.S.’s economic recovery by “lay[ing] out … A very specific blueprint for how we build an America that’s durable and that works for as many people in this country as possible.”

While the bulk of President Obama’s speech focused on economic recovery, jobs, energy, and foreign policy; he did spend some time discussing his vision for education.  President Obama stated, “[Education] challenges remain. And we know how to solve them.”  But more importantly, we know how to solve them for all children – regardless of socioeconomic status or racial/ethnic background.  We know what public programs and policies can be improved so that disparities in outcomes for kids – including education – can be reduced.

We need a health care system that ensures access to quality health care for young women before they become pregnant so that when they do become pregnant, they can have healthy, full-term pregnancies and deliver healthy babies.  This is particularly important for African American women who, regardless of socioeconomic status, are more likely to deliver underweight, preterm babies – babies who face greater challenges from birth.

We need an early childhood system that encompasses health, mental health, and early education that begins at birth and supports families with young children through age three.  This means that parents need access to supports – such as high quality home visiting programs – that ensure they can be their children’s first and best teachers.

We need a high quality early childhood education system that supports the healthy development of children and prepares them for school.  A high quality early childhood education that includes parental support and involvement can turnaround the educational equity gap that emerges long before children reach kindergarten doors.

We need a K-12 education system that is strong enough to provide an academically challenging course of instruction, and also flexible enough to meet the ever-changing needs of students and the economy.  The K-12 system needs to provide multiple paths to graduation which lead to equitable outcomes and post-secondary success.

We need education, business and community leaders to form partnerships to build sustainable programs that meet the needs of children, families and communities. Businesses know what types of workers they need and they can work with schools and career training programs so youth can receive job training while gaining a school diploma or post-secondary credential.

We need politicians that will listen to youth and families about the challenges they face – and then stand up for those youth and families through action in their communities and elected roles.

In order to achieve President Obama’s idea of “winning the future” our children need a great start in life that prepares them to be ready to learn when they enter school and supported as they move toward post-secondary success. Turning the economy around certainly needs to include business incentives, adult workforce retraining and support for troops coming back to the U.S., but unless we recognize the importance of ensuring the success of the next generation of workers the economic turnaround won’t last.  Investing in children, particularly those most challenged by their circumstances, must be a key part of rebuilding and strengthening Michigan’s economy.

To learn more about how Michigan’s Children believes policies can support children from cradle to career, check out our website: www.michiganschildren.org.

– Beth Berglin and Mina Hong

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