“As a pediatrician – I believe that a care infrastructure is deeply needed to enable that coordinative response to address the needs of young families and, in turn, to address the growing disparities that we see in our pediatric communities that have been highlighted during the COVID pandemic,” stated Dr. Debra Best, associate professor in the departments of pediatrics and community and family medicine at Duke School of Medicine.

Best joined a panel on May 26th with her colleagues – Kenneth Dodge, professor of public policy studies at Duke as well as founder and principal investigator at Family Connects and Kimberly Friedman, policy engagement & analysis coordinator at Family Connects – for a conversation about care infrastructure, the Family Connects model and how federal government can consider implementing programs like it and investing in deeper, more holistic care infrastructure. The event was moderated by Dr. Lee Beers, MD, the president of the American Academy of Pediatrics (AAP) and medical director of community health and advocacy at Children’s National Hospital.

Ken Dodge started the conversation by giving a description of care infrastructure and the impetus for developing the Family Connects model. Dodge explained they learned in their work, “that families giving birth are largely on their own in our society to find supportive services – whether it’s getting a housing loan or seeking mental health services for postpartum depression or finding the best childcare. As a result, many families giving birth are frightened and alone and do not access the resources that they need.”

“Family Connects works like a pediatrician,” Dodge stated, “but for psychosocial development, social services, and emotional and behavioral support.”

Dr. Best also touched on the fragmented systems of support and services for new families and the difficulty navigating them. “The answer isn’t another program, rather a system of engineering between programs,” she explained, “which would create a cohesive system of care and support whole person health and care from the start.”

Family Connects International began in Durham but has since grown to be implemented in 17 states and 43 communities nationwide. Dodge explained that in 2009, he and his colleagues set a goal to lower the child abuse rate in Durham. From there, the group launched into formative research that led to development of the Family Connects model.

“We found success,” said Dodge, “and we did actually help lower mother anxiety, increase their self-confidence, which led to positive outcomes in terms of lower rates of child abuse by about 39% and also lowered the costs for emergency medical care for young children.”

Now, the focus of the organization is supporting states and communities that seek to include the Family Connects model in their early childhood system of care, including the state of Oregon. Kimberly Friedman discussed the program’s presence in the state,In 2016 [Oregon] passed some really bold legislation that creates a universally offered newborn home visiting program to be rolled out statewide. What is unique about this, in terms of building a care infrastructure across the state, is the requirement within the legislation that commercial health plans… reimburse for the cost for those universally offered newborn home visiting services for their members.”

In terms of state and federal funding, “To have this type of service recognized as preventative service, so that for high deductible health plans, it could be covered, Family Connects should never be something that a family pays for, it should be a universal service… With a statewide or larger metropolitan rollout similar to what we are doing in Chicago, we need an infrastructure, a backbone, to partner with us and support this work.”

By Lizzie Devitt, 6/1/21