Project Hope: Helping to Manage Disjointed Services for Effective Community Care Coordination

With half the children in the U.S. living in or near poverty, policymakers and providers realize that early action is one of the best ways to control downstream adverse medical and social costs. Such expenditures are estimated at $500 billion annually. A 2018 funding program, Project HOPE (Harnessing Opportunity for Positive, Equitable Early Childhood Development) by the Robert Wood Johnson Foundation (RWJF) offers a lesson in funding – and how to acquire it – to achieve such innovative child welfare solutions. Project HOPE seeks to help better manage existing, disjointed services for more effective community care coordination

RWJF is intent on promoting good health and well-being for children that will flourish across geographic, demographic, and social sectors. It’s a strategy that has merit, according to the American Academy of Pediatrics (AAP), as noted in its April 2016 issue of Pediatrics:

“Poverty and related social determinants of health (SDoH) can lead to adverse health outcomes in childhood and across the life course, negatively affecting physical health, socioemotional development, and educational achievement… With an awareness and understanding of the effects of poverty on children, pediatricians and other pediatric health practitioners in a family-centered medical home can assess the financial stability of families, link families to resources, and coordinate care with community partners.”

Project HOPE operates under the axiom that’s it better to spend upfront on child welfare to keep a little problem from turning into a big, expensive problem later in life. Two health systems, Boston Medical Center and Nemours Children’s Health System, received the grant, which addresses SDoH. The two health systems, in turn, expanded to seven states and eight communities. Selected communities received awards of up to $80,000 over 18 months. Also, selected state teams and individual leader survey respondents received seven state grants of up to $200,000 each over up to 24 months.

The funded projects all shared a common trait: preference was given to agencies that demonstrated existing ability to create a backbone infrastructure (staffing, data systems, organizational capacity). This included:

1: Demonstrated collaboration and cross-sector work across agencies.

2: Collected and shared data for innovative use in program planning, decision making, and tracking progress.

3: Flexibility in responding to political change and other external factors.

RWJF defined the guiding principles of the Project HOPE as twofold. First, every child is part of a family and/or community. And second, those families and communities are in the best position to work with local and state policy leaders to solve SDoH problems. Project Hope intends to target concentrated poverty through community care coordination to improve child well-being.

It’s a big ambition. Between 2013-2017 child protective response or alternative response increased ten percent to 3.5 million cases annually, according to the U.S. Department of Health & Human Resources. Technology is an integral part of achieving the Project HOPE goals, especially quickly sharing and analyzing data. Many organizations rely on case management systems to reinvent such social and medical delivery.

Some examples of the community care coordination projects funded by Project Hope best make the point. These include:

A cross-sector stakeholder Group (CSSSG) in Florida with previous and current efforts to promote equality and reduce disparities among young children. The Florida CSSSG has committed to focus on increasing developmental screening and the promotion of social-emotional development in young children. Florida has worked diligently over the past year to promote social and emotional health as well as improve support for children.

Infant mortality has been selected as Oklahoma’s issue of focus for Project HOPE, as it represents a measure of the overall health of a community and is, unfortunately, an indicator in the state in which significant disparities exist. Infant mortality is a measure that can be compared across geographic, racial, and income levels, and can serve as a compass to monitor the impact of a collaborative approach to improving infant health. Through Project HOPE, Oklahoma will focus on infant mortality to help understand how barriers, discrimination, and a lack of access impact this indicator.

Networks of Opportunity for Child Wellbeing (NOW) was selected as a Project HOPE recipient in several states. NOW works on a network approach to build the capacity of other local communities and coalitions across the country working to promote child wellbeing; align systems of care and education in early childhood; and improve neighborhood opportunity structures that promote optimal wellbeing and reduce inequities in child health and education – all through a trauma-informed lens. Over the next 18 months, the NOW Learning Community will support the selected communities to build a robust set of knowledge, skills, and tools to scale and sustain equitable transformation of early childhood, education, and health systems in their neighborhood, city, or county

The ultimate goal of Project Hope is to better apply modern methods – from machine learning management platforms to professional empathy – to find better ways to serve children at risk. As the AAP noted:

“Child poverty is associated with lifelong hardship…Programs that help low-income families and children take many forms and often involve stakeholders from multiple communities, including governmental, private nonprofit, faith-based, business, and other philanthropic organizations…These programs help families by increasing access to cash, providing “near-cash” benefits, and investing in child development.”

Sources:

http://www.buildinitiative.org/Portals/0/Uploads/Documents/Work/Recent%20Events/ProjectHOPEPPT.pdf

https://pediatrics.aappublications.org/content/137/4/e20160339

https://www.acf.hhs.gov/sites/default/files/cb/cm2017.pdf

https://eccoviasolutions.com/technology-is-central-to-child-welfare-management/

https://www.movinghealthcareupstream.org/scaling-a-promising-model-statewide-to-address-inequities-in-washington-state/

https://www.bmc.org/news/press-releases/2018/08/01/bmc-selects-10-communities-strengthen-trauma-informed-early-0

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