By Paul H. Dworkin, MD and Sharon Beaudoin
As debate rages on as to how best reform our health care system, we ask, “What about our children?”
It’s a question likely on the minds of the more than 400 child health advocates gathering in Seattle this week for the 9th annual Help Me Grow National Forum. This convening affords the opportunity for us all to reconsider current approaches to health care reform to ensure enhanced resiliency in children and families by making it a national priority to address developmental concerns even before they become diagnosable conditions.
The Help Me Grow system helps states and communities leverage existing resources to identify vulnerable children, link families to community-based services, and empower families to support children’s healthy development. Help Me Grow began in 1997 as a pilot project in Hartford, Connecticut. Currently, with technical support from Help Me Grow National Center at Connecticut Children’s Medical Center, 28 states operate 99 Help Me Grow systems, which include Help Me Grow Washington, the host affiliate for this year’s Forum.
Operated by WithinReach, Help Me Grow Washington launched in 2010 as the 8th state affiliate in the Help Me Grow network. WithinReach is now leading efforts to expand the system across the state. The not-for-profit makes complex social and health service systems simpler for people to access, and connects families to resources through ParentHelp123 and the Family Health Hotline.
Those of us engaged in this work from the outset are indebted to Help Me Grow Washington for helping us appreciate the magnitude and meaning of our efforts. In 2013, WithinReach shared a video featuring the Snohomish County mother who made the first call to Help Me Grow Washington. Her remarkable capacity to express her relief at finally securing help and the compassion, engagement, and skill of the care coordinator are obvious. For National Center staff, the impact of our model on a family almost 2,500 miles away was overwhelming.
The Help Me Grow experience offers important implications for our national focus on health care reform. Health insurers and providers often assume the greatest cost savings come from focusing on individuals, primarily adults, with chronic diseases who are high utilizers of care. However, the remarkable support for children and families, as experienced by Help Me Grow dissemination within states across the political divide, emboldens us to propose focusing first on children and child health services as the impetus for health care transformation.
We can marshal support for this approach, given the acknowledged long-term cost savings of early childhood investments extolled by Nobel laureate economist James Heckman; the near universal coverage and access of children to health services; the many evidence-based interventions, such as Help Me Grow, ready to be brought to scale and impact; the child health service sector’s willingness to engage other sectors (e.g., early care and education, family support) in comprehensive system building; the relatively modest cost of child health innovations; and the societal imperative to recognize children as our future.
As child health advocates gather in Seattle, they will consider the benefits of transforming health care by focusing first on children. This bold step could ensure care coordinators are able to efficiently connect all families to community-based programs that address developmental concerns at the earliest opportunity, when interventions are less costly and most effective. The success of Help Me Grow Washington highlights the need for such an approach, as it is a national model for promoting early detection and intervention for vulnerable children in a comprehensive, integrated way.
Now is the time for providers, payers and policy makers to embrace a child-first approach to health care reform to promote children’s optimal health, development and well-being. What can possibly be more important?
Paul H. Dworkin, MD is executive vice president for community child health at Connecticut Children’s and the founding director of the Help Me Grow® National Center. Dr. Dworkin is also a professor of pediatrics at the UConn School of Medicine.
Sharon Beaudoin is chief strategy officer at WithinReach where she oversees strategic direction of programs, communications, evaluation and public policy efforts.