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PACEs in Pediatrics

O’Donnell: Opening 'so many doors for families': COVID-19 underscores importance of wraparound care for new moms and children

 

For once, being a biracial, low income, Medicaid patient didn't work against Selina Martinez.

In 2015, two weeks after giving birth at a Manhattan hospital, Martinez arrived at Montefiore Medical Center in the Bronx where she was diagnosed with salmonella. During a monthlong stay, hospital staff members learned times were tough for the new mom. She'd been getting psychiatric care since the stillbirth of her last child, her husband was recovering at home from pancreatic cancer treatment and a neighbor was caring for her infant son, Blake.

Montefiore diagnosed the baby as special needs and enrolled the family in its HealthySteps program, which provided wraparound health and social services through a "care team" that coordinated with the baby's pediatrician.

"When you have a resource like that, it opens up so many doors for families," Martinez said. "A lot of people suffer in silence. If they have a special needs child, they keep the hurt and frustration inside of them."

During the pandemic, such programs connecting at-risk new mothers and their babies with medical, mental health and social services – through home visits or teams of health workers– have become more critical, and harder to come by. When doctors' offices closed, it magnified health care access challenges for low-income people, especially those of color. Organizations such as HealthySteps, which has 170 locations in 23 states, helped to fill the void, continuing to link patients with resources.

Navigating government, hospital and charity-covered health and social services for new parents can be mind-numbingly complicated. Studies show the programs stop the cycle of domestic violence, child abuse and neglect that is more prevalent in, though hardly limited to, lower-income families. They boost parenting skills, reduce childhood obesity and improve babies' lifelong health, academic and career achievement, research shows.

HealthySteps and more than a dozen programs offering similar services are paid for through a hodgepodge of public, private and philanthropic sources. Proponents said the pandemic proves these programs should be the baseline for early childhood care, not an add-on available only in places where funding exists.

"We do not need anymore evidence that parents need support," said Lori Poland, an abuse survivor who is executive director of the National Foundation to End Child Abuse and Neglect, known as ENDCAN. "These ought not be programs, they ought to be health benefits for prevention and well-being."

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