Helping your staff can help your community
Child care is just one aspect of NOVA program
Editor’s Note: In February, the American Hospital Association (AHA) of Washington, DC, presented five hospitals with its NOVA award, honoring their "innovative, collaborative projects designed to improve the health status of their communities." Over the next several months, Patient-Focused Care and Satisfaction will look at the winning organizations and the programs they created which so impressed the AHA. The first installment appeared in the April 1999 issue on p. 37.
Pittsburg, KS, has been economically stressed for decades. One in four children in the town of 20,000 live at or below the federal poverty level, and a third of residents are illiterate.
More than half of families in the town are headed by single parents who often work two jobs to provide for their children. The result of these factors often was students not ready to learn when they entered schools.
Usually, the children lacked immunizations, had unaddressed vision or hearing problems, and persistent behavioral problems. Employers, including the 140-bed Mt. Carmel Hospital, were concerned that parents were often distracted, sometimes unproductive, and many seemed overwhelmed with their personal responsibilities.
Meetings spawned a resource center
To deal with these linked problems, medical center personnel started meeting with representatives of the local school district and Pittsburg State University.
The result was a Family Resource Center that provides day care for 220 children, including a significant number of the children of Mt. Carmel employees. It provides drop-in care for patients’ children, and includes a preschool program for 90 students. Social service organizations have representatives available on site, and a doctor is available twice a week to see patients. Once a week, the center is the site of a free clinic staffed with local physicians for those without health insurance.
Monica Murnan, executive director of the center, says the awareness that community health was a hot topic certainly fueled the hospital’s participation in the project, as did the child care needs of staff and patients.
"We got together and formed a not-for-profit organization with the school district, the hospital, and Pittsburg State University as sponsoring organizations," Murnan explains.
Over two years, the players worked together to find space and develop programs. Since August 1997, the Family Resource Center has provided child care, health care, preschool, family counseling, adult education, and parent resources, says Murnan.
The preschool caters to all preschoolers with disabilities in the area.
"That was the philosophy from the beginning — to create a place for all kids," she says. "We knew there were services out there — like Head Start for economically disadvantaged children — but they were specific resources for specific groups. We joined together so we could lose some of those barriers."
Although there is no specific data available yet on the successes of the program, Murnan says there are some indications that they are doing the right thing. Firstly, there is positive feedback from parents, the school district, and the community. And the National Association for Education of Young Children is due to accredit the program. "If we can meet their research-based standards, we know we are having an impact."
Community program benefits hospital
Eighteen of the children in day care belong to hospital staff, she says. The center also provides drop-in care for patients’ children and family-related services that those families may need.
For instance, says Murnan, if a social worker says a patient doesn’t have a telephone, the center might use its network of resources to help set up phone service. There is also emergency drop-in care available for patients who might have medical emergencies.
A physician, a nurse practitioner, and two nurses handle the medical aspects of the center. "There is a lot of preventive care, school physicals, and immunizations done," she says.
Services usually are not free. For patients with insurance, the health clinic can bill directly — either Medicaid or private pay. There is also access to the hospital charity write-off to provide free or discounted care.
The child care services are considered among the more expensive in the area — $65 to $75 per week. However, the center is a vendor for state social and health services, and thus has some of its students subsidized by state money.
Groups’ cooperation was surprisingly easy
Getting diverse groups — from the medical community and educators to social services organizations — to work together was something Murnan was concerned about when she started the project.
"But the funny thing is [that] it was easy, compared to finding a location and the money we needed. We have the three largest employers and 14 other services and organizations from our area all working well together. I think that’s because we had a well-laid-out plan focused on children and proactive measures.
"The heads of these organizations signed on immediately," she continues. "That showed the rest of the community that if they felt it was a good idea, it must be worth trying."
Perhaps one reason why there was so much cooperation was because Murnan made her requests in terms that made the employers and organizations see how the project could help them.
"There can be fewer lone wolves out there when federal budgets are declining. If we come together, we can be stronger."
Finding the money was difficult, she admits. "There were some territorial issues — about who we should go to and who should do the talking. But they have been limited. You just have to be clear, persistent, and sure [that] you follow through on your plans. Then, people eventually buy into a project."
"If you have a dream . . . it can happen"
One key to success has been having a plan that states what the center is trying to achieve, how it will get there, and who will do it. But Murnan also keeps a wish list on hand.
"If you have a dream, write it down," she advises. "Note how you will get there, when it will happen, and who will be standing with you. Then it can happen."
While much of the Family Resource Center’s program seems to be outside of the traditional sphere of hospitals, Murnan thinks there are benefits that are already accruing.
First, it is a service Mt. Carmel can offer to both patients and staff. "What money can’t you measure in recruitment and retention of employees? That is worth something," she says.
Second, community health initiatives are gaining favor. Lastly, early childhood education is something that all the research shows works and can prevent educational, behavioral, social, and health problems later in life.
"Early Head Start is a part-year, part-time program. We get $9,000 per child for a full-day, all-year program; but we only spend $2,200 per child. And we are still going to be accredited," Murnan says. We know we are doing something good, and doing it economically and efficiently. This is something worth trying."
Source
• Monica Murnan, executive director, Family Resource Center, 1700 N. Locust, Pittsburg, KS 66762. Telephone: (316) 232-0165.
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