Creating a Life Course Community System MCAH Programs within a Broader Context . May 19, 2011 Malin & Fine: MCAH Action Education Day

Overview ` What does a successful life course community system look like? How do we connect all the dots? What’s needed to make this happen? Examples from the field Discussion – What works? What’s difficult? Malin & Fine: MCAH Action Education Day May 19, 2011

How can the Life Course Perspective Shape Our Work? Transform the way we view MCAH programs and services Facilitate shared planning across multiple sectors Expand our circle of agencies with which to partner Help us to do less with more in these tight budget times. More specifically, we’ll be looking at HV from the lens of multi-sector, place-based initiatives for young children. We’ll also be looking at systems for linking children and families to a broad set of services and supports… again focusing on where HV fits. Finally, I want to spend a few minutes talking about what works and what’s needed to put together a comprehensive and integrated set of community services, supports, and opportunities that improve outcomes for children and families. Malin & Fine: MCAH Action Education Day May 19, 2011

Characteristics of Projects Operating from a Life Course Perspective Go beyond individual programs Focus on system change and integration Focus on changing physical, social, economic and policy environments Take a whole woman, whole child, whole family, whole community approach – to effect change across the population Malin & Fine: MCAH Action Education Day May 19, 2011

Where Do We Start? Initiatives or projects that are rooted in the life course perspective can take different forms Integrating new approaches/content to traditional services Coordinating and streamlining existing services Making alliances with “non-traditional” partners to transform communities so that women, children and families can thrive We are all at different stages of life course implementation Some efforts also focus on changing the environments in which children live, learn and grow – to create communities of opportunity Neighborhood revitalization/community development Housing Transportation Healthy food options Safe outdoor spaces Recreational opportunities Malin & Fine: MCAH Action Education Day May 19, 2011

What questions are we asking? Framing the Problem What questions are we asking? How do these questions define the problem? How does the definition of the problem define the solution? What does it take? It takes flipping the questions. Flipping the question and everything that supports us flipping it—working more closely with community, investing in staff capacity, looking at policy.

Flipping the Question Why do people smoke? What social conditions and economic policies predispose people to the stress that encourages smoking? Unnatural Causes is an excellent tool to reframe the debate, shift perspectives, and flip the question. Reframing the questions from individuals problems to societal problems with societal level solutions. With this new perspective, people can engage in their work or participate in their school differently. Doak Bloss, Ingham County Health Department

Alameda County Public Health Department Building Blocks Collaborative (BBC) Started as Perinatal Systems Re-design Morphed into an external community collaborative with a broader purpose Connected to an internal Life Course System Design Committee (LSDC) Implications for the ACPHD MPCAH program Changes/additions to existing programs (home visitors, assessment tools, staff involvement in collaboratives) “Food to Families” – Kresge grant Response to State’s RSI for Home Visiting monies . Malin & Fine: MCAH Action Education Day May 19, 2011

Flipping the Question/Solution We need to teach people how to eat more healthful meals. What policies and practices by government, commerce, and corporations led to the decline of food stores in West Oakland?

Alameda County First 5 Every Child Counts (ECC) Children’s SART (Screening, Assessment, Referral and Treatment) Universal screening and messages for all children and families Prevention/promotion Early identification Core Components – Help Me Grow (HMG) Centralized telephone access point Child healthcare provider outreach Community provider outreach and networking Data collection and analysis Malin & Fine: MCAH Action Education Day May 19, 2011

Opportunities to link HMG to Home Visiting Home visitors refer families directly to HMG Home visitors obtain referrals for families via HMG HMG refers children/families to HV programs Home visitors participate in HMG networking breakfasts HMG outstations care coordinators at HV programs such as Early Head Start, care coordinators use HMG data system, participate in same activities as on-site coordinators Malin & Fine: MCAH Action Education Day May 19, 2011

Connecting All the Dots Environmental changes  Opportunity Community Change, Universal Opportunity Promotion Early Identification Universal Services Intervention Treatment Tiered Services Children Families Better Outcomes This is how the pieces fit together for broader community change strategies. Malin & Fine: MCAH Action Education Day May 19, 2011

Develop a common language/framework Connecting Services within a Life Course Community System – What’s needed? Efficient and effective two-way linkages between services and systems of care. Develop a common language/framework Shared planning – across sectors, across disciplines Shared set of outcomes – shared accountability for results Shared data, monitoring and analytic capacity Be at the table for broader community change Malin & Fine: MCAH Action Education Day May 19, 2011

Panel Presentation Examples of: Shared referrals and linkages? Common languages/frameworks? Shared planning? Shared outcomes/data collection and analysis? Participation in broader community change? Malin & Fine: MCAH Action Education Day May 19, 2011

Questions for Discussion What kind of life-course influenced strategies most appeal to you and/or would be most realistic to implement in your LHJ? Where are you in developing or implementing this work in your LHJ? What’s worked? What’s been challenging? What have been your biggest realizations about this work to date? last bullet: Especially about challenges Malin & Fine: MCAH Action Education Day May 19, 2011

Creating a Life Course Community System Kiko Malin, MPCAH Director Alameda County Public Health Department Christina.malin@acgov.org (510) 208-5979 Amy Fine Health Policy/Program Consultant Washington, DC 202-966-6361 afinehome@aol.com Malin & Fine: MCAH Action Education Day May 19, 2011