I recently was introduced to a successful family centered medical home model called NC Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health). Upon hearing the words “family centered”, my ears perked up. Those words are often given little more than lip service in many clinics so I couldn’t help but feel a little skeptical. I soon met a dynamic woman named Martha Kaufman who told me more about the program and offered to stay in touch via email. What I learned since then is very encouraging.
Picture this: a child and her mother come to a pediatric office for a well child visit. The mother fills out some screening questions and then meets a Family Centered Health Navigator (FCHN) who reviews the positive screen and discusses the goals, strengths, and needs of the family. The mother agrees to the service and requests a home visit. A short time later, the FCHN and an Early Childhood Mental Health (ECMH) specialist visit the family to further identity their needs and strengths, prioritize those needs, provide child development psychoeducation, and then develop a family health plan. The health plan coordinates future referrals and consultations, connects the family with online and community resources, and lists the next action steps. The FCHN and ECMH use an approach called the Triple P to suggest specific parenting strategies.
One of the next actions steps is for the FCHN to accompany the parent to school to observe the child and support the parent in communicating the child’s needs to the teacher. Since the school also uses Triple P, there is a shared language and approach that unifies the efforts of both the care team and the school. Later on, the team checks in with the mother by phone to make sure the plan is moving forward, to provide support and further assistance as needed. The mother knows that the team is available to her by phone and at her child’s doctor’s office in the future, and she can just drop by to check in.
|NC Project LAUNCH uses an approach called the Triple P
There is much to like about this approach. First, I like that the starting point is the pediatric office. The medical team has an on-site service for psychosocial issues which can facilitate appropriate referrals while reducing the stigma of psychosocial problems. Moreover, some children have chronic medical problems that lead to chronic psychosocial problems. A pediatric office is an ideal place to find these families. Second, the approach is absolutely strength-based. Parents, like most human beings, respond well to positive invitations for help. Third, this approach can do both prevention and intervention work. Some families are surviving but not thriving. The care team can help that family reach a point of thriving. Other families are headed toward disaster which calls for a team-based intervention that includes many helping hands. Fourth, the care team focuses entirely on the family system and not just the child. They discover what the family needs and what they care about and then support the entire family with specific, tailored strategies and tips using an approach backed by decades of research.
For those of you interested in learning more, here are five questions I recently asked Martha, the woman who introduced me to this effective approach:
1. How did you become involved with NC Project Launch?
I had just completed work as a consultant with a project known as Residentially Based Services Reform (RBS), in California, when the NC LAUNCH Project was awarded to the Alamance County Health Department as the State's implementation site. RBS, like all of my previous work, focused on meeting the needs of school-aged children with enduring and complex needs, and their families. After having worked for years in the child and family mental health system, I was excited to have the opportunity to work 'upstream' in a public health and prevention initiative promoting the overall health and wellness of all children 0-8 and their families through integrated care in pediatrics and other activities.
||I was excited to have the opportunity to work 'upstream' in a public health and prevention initiative
2. What do you currently do with the program?
I am the Local Project Director for NC LAUNCH, which includes responsibility to develop and lead implementation of health promotion and prevention services. This includes the development of an innovative Family Centered Medical Home systems model that includes full integration of a 2-person team in two of the largest private pediatric practices in the County, and within the Local Health Department. These 3 full-time teams help ensure that physicians and other practitioners have ready access to comprehensive services and supports for their patients in the practice sites. We have also used a public health approach to help strengthen families through a population-based implementation of the Positive Parenting Program (Triple P), with approximately 200 individuals accredited to help families with everyday (as well as more complex) parenting strategies. The other activities for which I am responsible include the promotion of early childhood best practices in home-visiting services, social-emotional screening for young children and for their caregivers, as well as the development of policy and finance strategies to sustain implementation of NC LAUNCH beyond the period of federal funding by the Substance Abuse Mental Health Services Administration (SAMHSA).
3. What do you personally like about the service?
|I like seeing how our partners in the private pediatric practices have moved to a more comprehensive public health approach, destigmatizing parenting assistance and social-emotional health services by embedding these into familiar and trusted medical settings. I also like the two-person Early Childhood Mental Health Team model, one in which an early childhood mental health specialist works hand in hand with a parent of a child with special health care needs who is specially trained to promote family engagement, address social determinants of health, and actively assist parents/caregivers to develop a health plan that is based on their particular strengths, priorities and needs. This team-work is supported in and beyond the private practices and the health department through a 'common language-common approach' developed through implementation of Triple P in settings across the community, such as in the public school system, pediatric and public health settings, community policing, housing authority, etc. We have also supported the delivery of Triple P parenting supports in the faith community.
4. What do physicians like about Project Launch?
The best way I can describe what physicians like about the project is through their own words:
· “I feel the same about the team as I would if I needed a surgeon and did not have one easily available to me. I feel it’s just as important.”
· “We rely on the team a lot, and we refer to them a lot earlier than we would before and we use Triple P a lot more.”
· “Our role is more complete. It gives us more insight into the families we serve and makes us more sensitive to the issues that are going on.”
· “I feel more comfortable bringing up something myself, because I can do something about it.”
· “It’s very nice to have a back-up, someone who can take more time and talk to families about normal development.”
5. If people are interested in starting Project Launch, what should they do?
Feel free to contact me and we can explore: firstname.lastname@example.org
Martha Kaufman, M.Ed., is currently the local Project Director for NC Project LAUNCH, at the Alamance County Health Department in Burlington, NC. Alamance received designation as is the only implementation site in NC for LAUNCH in 2012 by the NC Division of Public Health, the grantee for the SAMHSA-funded initiative. Prior to this role, Martha worked at the Washington Business Group on Health, NC Division of MH/DD/SAS as State Project Manager for NC’s first three SAMHSA-funded System of Care grants and then as the Chief of the Child and Family Services Section, prior to the initiation of MH Reform. Subsequently she provided consultation in other communities and states to help improve life outcomes for children with complex needs and their families. Martha lives in Durham.