I have continued my services this semester with Early Childhood Partnerships of Adams County (ECPAC). The community partners and I have been steadily working on our community referral system. This system involves initiating a referral system in Adams County community preschools that directly links preschoolers and their families to medical, dental, mental health or Medicaid/CHP+ enrollment sites. We have partnered with one clinic for each of the needs that has committed to helping these children and their families. The referral system begins with a basic survey of health care access questions in the annual preschool enrollment packets. The preschool director reviews the packets, identifies there is a need and meets with the family to discuss the need. After consents are signed, the child's information is faxed over to the site of need. The site takes over at this point and contacts the family to schedule an appointment. This system is different from the usual process that takes place because all the family has to do is show up for the appointment. Previously, a need might have been discovered by a teacher that had limited knowledge of health care resources. A phone number to a random agency may have been given to a family and thus the family becomes lost in the system and never calls the agency.
This week was exciting because we implemented the referral system in twenty local underserved preschools in Adams County. We held a meeting with the directors last week to explain the referral system and let them know we are available and are a resource for any questions they might have along the way. I was also able to explain the expected impact the referral system will have on health care access, preventive care and the importance of following up with these families. We assembled packets for the directors with information from each of the sites we will be using. Yesterday we traveled around to each of the preschools and delivered the packets and explained the process again. We are expecting the initial health care access survey will reach 500-1000 preschool children in Adams County! The Colorado Department of Public Health and the Colorado Maternal and Child Health Bureau have recently shown interest in forming partnerships to implement this program throughout the state if it proves to be effective in increasing health care access (this is where my Capstone project begins!).
The most challenging aspect of the referral system has been the time commitment for all of those involved. The preschool directors voiced the concern that they have a lot of paperwork that they already have to sort through and the referral system will increase their workload even more. As the system is complex and has several parts, much time has been spent on educating the preschool directors and the community health sites about the program. Our biggest fear at this point is knowing that the referral system and paperwork for the directors may get pushed aside and the children will not be identified or referred to the appropriate site.
As we have pulled this project together over the last year, I have had the opportunity to collaborate with many non-profit organizations that support underserved children and families. I have established a strong relationship with Partnerships for Healthy Communities and with ECPAC. Partnerships for Healthy Communities ensures school age children have the right environment at home and at school to grow and learn. This organization does a lot of education in the schools involving health and nutrition. I have also worked with the Adams County Head Start program. All of these organizations work towards the same goal of improving the lifestyle of underserved children. I have learned that these organizations greatly appreciate even an hour or two of your time. They also appreciate the opinions of health care professionals when they are developing community projects. I plan to continue to volunteer a few hours a week at Partnerships for Healthy Communities and ECPAC after graduation. I have found a few hours of my time can greatly improve the life and health of a child!
Sunday, August 14, 2011
Thursday, June 23, 2011
Service Learning Blog Entry 1
Review in detail your service learning site?
Where are you serving?
I am continuing my services with the childhood council in Adams County Colorado, Early Childhood Partnerships of Adams County (ECPAC).
What does the agency do?
ECPAC provides a venue for coordinated governance, planning, resource development, leadership, education and shared accountability in order to achieve the outcomes specified in the Early Childhood Colorado Framework in the areas of Early Learning; Family Support and Parent Education; Social, Emotional and Mental Health; and Health. ECPAC directs resources and funding toward helping childhood facilities obtain quality ratings, quality improvement coaching and college-level training in child development. ECPAC is supporting the expansion of the Incredible Years Parenting Series and Family Leadership Training Institute in Adams County to help strengthen and support families. In mental health, ECPAC provides individualized mental health consultation to empower parents and early childhood professionals with the knowledge and skills they need to support children's development. ECPAC is also committed to promoting strong health practices in early childhood settings, by forming partnerships between medical providers, to ensure the diverse health needs of children and families are met.
Who are the clients and what needs are served?
The clients are mostly underserved, at risk preschool aged children in Adams County. Many of these children are at or below 200% Federal Poverty Level and qualify for free and reduced cost lunches, Medicaid and Child Health Plan Plus. ECPAC develops a more coordinated system of services and supports for young children and families through strategic agency partnerships and collaborations. ECPAC improves children's school readiness by increasing quality, availability and affordability of early childhood services and supports. ECPAC trains early childhood professionals and provides advocacy and leadership at the state and local levels so that Adams County is best positioned to receive and utilize available public and private funding opportunities.
What is the agency funding support?
ECPAC is funded through grants from Mile High United Way.
What roles do DNPs play in promoting health and wellness in underserved populations?
Chism (2010) states "leadership and collaboration are integral aspects of every potential role a Doctor of Nursing Practice (DNP) graduate may assume" (p. 35). The DNP is in the perfect role to promote health in underserved populations by being an advocate, problem solver and role model. The DNP is in a position to collaborate effectively across disciplines to help decrease disparities and to problem solve with agencies. The DNP can educate the underserved populations to promote health and wellness autonomy. The DNP can be a role model in an agency by being the health care professional and offering evidence based information to improve decision making and policy making.
How do you perceive your role in this?
I perceive my role at ECPAC as a leader in health care and as an educator for systems changes in the pediatric underserved population. As many of the leaders involved at ECPAC are teachers, they do not understand how the health care side of their mission works so they are relying on my decisions and advice. I have collaborated with medical, dental and mental health services to discuss the implementation of the referral system in medical terms. I then relay the information back to ECPAC and we make decisions about the system from there. I have also served as an educator for ECPAC by informing them of regulations involved in our project such as HIPPA. I also used evidence based data from my epidemiology study to help ECPAC develop their community assessment for Adams County. I am planning to stay with ECPAC for the long-term and envision my role as being a community educator and collaborator to inform ECPAC about evidence based health data and information and to inform the medical community about the goals of ECPAC. These goals will hopefully promote patient centered care for the underserved pediatric population.
Reference:
Chism, L. (2010). The doctor of nursing practice. A guidebook for role development and professional issues. Sudbury, MA: Jones and Bartlett Publishers.
Where are you serving?
I am continuing my services with the childhood council in Adams County Colorado, Early Childhood Partnerships of Adams County (ECPAC).
What does the agency do?
ECPAC provides a venue for coordinated governance, planning, resource development, leadership, education and shared accountability in order to achieve the outcomes specified in the Early Childhood Colorado Framework in the areas of Early Learning; Family Support and Parent Education; Social, Emotional and Mental Health; and Health. ECPAC directs resources and funding toward helping childhood facilities obtain quality ratings, quality improvement coaching and college-level training in child development. ECPAC is supporting the expansion of the Incredible Years Parenting Series and Family Leadership Training Institute in Adams County to help strengthen and support families. In mental health, ECPAC provides individualized mental health consultation to empower parents and early childhood professionals with the knowledge and skills they need to support children's development. ECPAC is also committed to promoting strong health practices in early childhood settings, by forming partnerships between medical providers, to ensure the diverse health needs of children and families are met.
Who are the clients and what needs are served?
The clients are mostly underserved, at risk preschool aged children in Adams County. Many of these children are at or below 200% Federal Poverty Level and qualify for free and reduced cost lunches, Medicaid and Child Health Plan Plus. ECPAC develops a more coordinated system of services and supports for young children and families through strategic agency partnerships and collaborations. ECPAC improves children's school readiness by increasing quality, availability and affordability of early childhood services and supports. ECPAC trains early childhood professionals and provides advocacy and leadership at the state and local levels so that Adams County is best positioned to receive and utilize available public and private funding opportunities.
What is the agency funding support?
ECPAC is funded through grants from Mile High United Way.
What roles do DNPs play in promoting health and wellness in underserved populations?
Chism (2010) states "leadership and collaboration are integral aspects of every potential role a Doctor of Nursing Practice (DNP) graduate may assume" (p. 35). The DNP is in the perfect role to promote health in underserved populations by being an advocate, problem solver and role model. The DNP is in a position to collaborate effectively across disciplines to help decrease disparities and to problem solve with agencies. The DNP can educate the underserved populations to promote health and wellness autonomy. The DNP can be a role model in an agency by being the health care professional and offering evidence based information to improve decision making and policy making.
How do you perceive your role in this?
I perceive my role at ECPAC as a leader in health care and as an educator for systems changes in the pediatric underserved population. As many of the leaders involved at ECPAC are teachers, they do not understand how the health care side of their mission works so they are relying on my decisions and advice. I have collaborated with medical, dental and mental health services to discuss the implementation of the referral system in medical terms. I then relay the information back to ECPAC and we make decisions about the system from there. I have also served as an educator for ECPAC by informing them of regulations involved in our project such as HIPPA. I also used evidence based data from my epidemiology study to help ECPAC develop their community assessment for Adams County. I am planning to stay with ECPAC for the long-term and envision my role as being a community educator and collaborator to inform ECPAC about evidence based health data and information and to inform the medical community about the goals of ECPAC. These goals will hopefully promote patient centered care for the underserved pediatric population.
Reference:
Chism, L. (2010). The doctor of nursing practice. A guidebook for role development and professional issues. Sudbury, MA: Jones and Bartlett Publishers.
Saturday, April 16, 2011
Second Reflection on Service Learning
Are the people you came into contact with through this experience having some needs met through the community activities? Are community activities like these necessary and/or sufficient to fulfill these community and individual needs? Do you see other means to do so?
I have been working with Mile High United Way (MHUW) and Early Childhood Partnerships of Adams County (ECPAC) over the past semester for my service learning hours. MHUW provided grant funding to ECPAC to develop a referral system that starts in the community (Head Start programs, WIC, Early Childhood Learning Centers) and links preschool aged children to a primary care medical home. Our goal is to make a seamless referral system, not to add another piece of paper to the system to become lost. These children come from low income families. Most of the children qualify to receive Medicaid and CHP+, however many of the families have difficulties going through the process to become qualified and accessing health care services in the community. Also many of the families are undocumented and are afraid to seek healthcare for their children for fear of being "discovered" by the state. However, many of these undocumented children are eligible for healthcare in a sliding scale clinic.
While working with ECPAC in forming a referral system, I have met some truly amazing people in the community that all have the same goal of improving outcomes for families and children. We are still in the process of designing the referral system, however I can speculate how this system will address the needs of these children in the community. Once the referral system is in place, children will have greater access to health and dental care and will experience fewer barriers in obtaining health care coverage.
In working in a family practice with privately insured children, I did not realize the depth of needs of children in the community. Early childhood councils and other non profit organizations are absolutely a necessary entity to improve the health and lifestyle of children in the community. One insight I have had while working with these non profit organizations, is that people and providers in the community are not aware of these services. I am realizing community education to providers, parents and teachers regarding the resources available in the community is another necessary step in meeting the health care needs of children.
What is the best/worst/most challenging thing that happened this semester?
My largest challenge by far is realizing that working on a grant and meeting needs in the community is a very long, tedious process. As mentioned previously, the community members and I are only just beginning to formulate the referral that will be implemented in the Fall of 2011. We are meeting with community members and obtaining their opinions and input about how to make the referral process seamless. We are also trying to discover all of the resources available in the community. So far, by the process of elimination, we have come up with one preschool in Adams County to pilot the project with. Also through several interviews, we have determined that Community Health Services (a community and school based medical clinic that also provides assistance in Medicaid enrollment) will be our pilot primary care medical home. After the referral system is in place, we will then implement the system and collect our data. Then, after the system is in place, we can finally measure our outcomes. The grant is being funded for a period of three years. This is difficult for me to process, because I want the needs of these children immediately met. As a nurse practitioner in clinical practice, I am used to immediate results. For example, if you incise and drain a cyst, the cyst is gone. If you see a high blood pressure and medicate, the blood pressure usually drops in over 2-3 months! I am seeing the challenge in working with system changes!
What have you learned about yourself?
I have learned that there are many unmet needs in the community. There seems to be limited funding to projects and non profit organizations that are working to improve outcomes for children. With limited funding and limited time, many needs and services are going unmet. Honestly at first, I felt I did not have time to tackle a service learning project and offer voluntary time to services in the community. However, after working with ECPAC I have realized that organizations like these greatly appreciate any time that someone can help with activities. ECPAC has been very grateful for my assistance during this project! I have realized that my volunteer time, no matter how little it is, really can influence changes and outcomes. It is a very worthy cause and I plan to continue my services as long as I can.
What are your future service learning plans?
The Health Initiative Grant expands over a period of 3 years and we are only in the beginning steps of the program. I plan to follow out the grant and help with its initiation even after I graduate. I have also talked to the directors of some non-profits about holding some educational conferences to inform providers in the community about these early childhood councils, Head Start programs, Healthy Steps, WIC and other community resources. I have also agreed to hold some educational conferences for teachers so they are aware of health care services in the community. I am dedicated to informing and improving access to improve outcomes in children in the community!
I have been working with Mile High United Way (MHUW) and Early Childhood Partnerships of Adams County (ECPAC) over the past semester for my service learning hours. MHUW provided grant funding to ECPAC to develop a referral system that starts in the community (Head Start programs, WIC, Early Childhood Learning Centers) and links preschool aged children to a primary care medical home. Our goal is to make a seamless referral system, not to add another piece of paper to the system to become lost. These children come from low income families. Most of the children qualify to receive Medicaid and CHP+, however many of the families have difficulties going through the process to become qualified and accessing health care services in the community. Also many of the families are undocumented and are afraid to seek healthcare for their children for fear of being "discovered" by the state. However, many of these undocumented children are eligible for healthcare in a sliding scale clinic.
While working with ECPAC in forming a referral system, I have met some truly amazing people in the community that all have the same goal of improving outcomes for families and children. We are still in the process of designing the referral system, however I can speculate how this system will address the needs of these children in the community. Once the referral system is in place, children will have greater access to health and dental care and will experience fewer barriers in obtaining health care coverage.
In working in a family practice with privately insured children, I did not realize the depth of needs of children in the community. Early childhood councils and other non profit organizations are absolutely a necessary entity to improve the health and lifestyle of children in the community. One insight I have had while working with these non profit organizations, is that people and providers in the community are not aware of these services. I am realizing community education to providers, parents and teachers regarding the resources available in the community is another necessary step in meeting the health care needs of children.
What is the best/worst/most challenging thing that happened this semester?
My largest challenge by far is realizing that working on a grant and meeting needs in the community is a very long, tedious process. As mentioned previously, the community members and I are only just beginning to formulate the referral that will be implemented in the Fall of 2011. We are meeting with community members and obtaining their opinions and input about how to make the referral process seamless. We are also trying to discover all of the resources available in the community. So far, by the process of elimination, we have come up with one preschool in Adams County to pilot the project with. Also through several interviews, we have determined that Community Health Services (a community and school based medical clinic that also provides assistance in Medicaid enrollment) will be our pilot primary care medical home. After the referral system is in place, we will then implement the system and collect our data. Then, after the system is in place, we can finally measure our outcomes. The grant is being funded for a period of three years. This is difficult for me to process, because I want the needs of these children immediately met. As a nurse practitioner in clinical practice, I am used to immediate results. For example, if you incise and drain a cyst, the cyst is gone. If you see a high blood pressure and medicate, the blood pressure usually drops in over 2-3 months! I am seeing the challenge in working with system changes!
What have you learned about yourself?
I have learned that there are many unmet needs in the community. There seems to be limited funding to projects and non profit organizations that are working to improve outcomes for children. With limited funding and limited time, many needs and services are going unmet. Honestly at first, I felt I did not have time to tackle a service learning project and offer voluntary time to services in the community. However, after working with ECPAC I have realized that organizations like these greatly appreciate any time that someone can help with activities. ECPAC has been very grateful for my assistance during this project! I have realized that my volunteer time, no matter how little it is, really can influence changes and outcomes. It is a very worthy cause and I plan to continue my services as long as I can.
What are your future service learning plans?
The Health Initiative Grant expands over a period of 3 years and we are only in the beginning steps of the program. I plan to follow out the grant and help with its initiation even after I graduate. I have also talked to the directors of some non-profits about holding some educational conferences to inform providers in the community about these early childhood councils, Head Start programs, Healthy Steps, WIC and other community resources. I have also agreed to hold some educational conferences for teachers so they are aware of health care services in the community. I am dedicated to informing and improving access to improve outcomes in children in the community!
Wednesday, February 23, 2011
Midterm Reflections
How would you describe in detail your service learning site?
Where are you serving?
I am working with Mile High United Way in Denver in conjunction with the Early Childhood Learning Partnership of Adams County (ECPAC).
What does the agency do?
The Early Childhood Partnership of Adams County is one of 31 local early childhood councils statewide that are working in collaboration with the Office of the Governor and Lieutenant Governor through the Colorado Departments of Human Services, Education and Public Health and Environment to implement the Early Childhood Colorado Framework in order to ensure that the community works together to support the success of young children and families. ECPAC provides a venue for coordinated governance, planning, resource development, leadership, education and shared accountability in order to achieve outcomes specified by the Early Childhood Colorado Framework in the areas of Early Learning; Family Support and Parent Education; Social, Emotional and Mental Health; and Health.
Who are the clients and what needs are served?
Underserved, preschool aged children in Adams County are served by having high quality early learning supports and environments, and comprehensive health care. Families are served by having a meaningful community and parenting supports. Early childhood professionals are served by having the knowledge, skills, and supports to work effectively with, and on behalf of, families and children.
What is the agency funding support?
ECPAC has gradually grown in size and scope since 2004. The Partnership has received over $2,000,000 in grants since 2005, and implemented a wide range of programming related to the areas of early learning, health, mental health and family supports. In 2007, ECPAC became part of a larger statewide infrastructure of collaborative early childhood councils through the Colorado Lieutenant Governor's Office, an alliance that brought further vision, funding and state-level support to ECPAC's work.
What is it about the community partner that calls you to work with them?
Why are you engaged with this agency?
The ECPAC provides a strong collaboration and support network for underserved preschool aged children and their families in the community where I reside. They view the child in a holistic perspective taking into account the whole picture of learning, family support, parent education, social, emotional and mental health and physical health. I believe these families and children need outside support to enable learning to take place in the classroom and to give these children a bright future.
What is your passion here?
I have always been passionate in working with underserved women, infants and children. My passion was realized when I worked as a staff RN in Labor and Delivery, Post Partum and the Well Nursery. I have done many volunteer hours with underserved children including shots for tots, volunteering at a pregnancy center and performing sports physicals for various schools and providing physicals for homeless children and their families. While I am caring for the entire family in family practice now, I am passionate about the health and well fair of the children. The ECPAC is the perfect site to gain a broader understanding of how I can have an impact on the health care system that effects these preschool children in Adams County.
What are you currently doing with this organization and how do you see it evolving as you sustain your commitment with them?
What is your role in this service learning experience?
As I am incorporating my service learning hours into my application to practice hours, I will have two projects that I am working on. One project is a community needs assessment. The needs assessment is comprehensive covering four domains: early learning, family support and parent engagement, social and emotional health and physical health. The needs assessment includes a data review of demographic and population indicators, focus groups and partner surveys. A second project I am working on is part of an ongoing grant project funded by the Colorado Trust. The ECPAC is working with partners to plan, pilot and evaluate a system of service referrals from early childhood education sites to community based primary care service centers. I will serve as a project leader in the area of health assessment. I will focus on the health related referral systems as there will also be dental, mental health and physical education components.
What hours did you spend at the site and what activities where performed?
I have spent approximately six hours in meetings working on the specific components to the referral system and collaborating with community partners to initiate the referral system. I have spent another 4 hours researching the most recent data indicators to add updated information to the community needs assessment.
What are the opportunities there ?
There are continuous grant projects that are going on at ECPAC. The current Health Integration grant that I am working on implementing is expected to take approximately two years. This timeline allows me to be involved over the next year for a long term project.
What can you see yourself doing more long-term?
The Health Integration grant will be piloted in a few preschools before it is fully implemented. Since this grant project is expected to take approximately two years, I will be able to work with ECPAC until I graduate. I can see myself being involved with this organization in the future to serve as the "health expert" in system wide changes for the underserved pediatric population.
Where are you serving?
I am working with Mile High United Way in Denver in conjunction with the Early Childhood Learning Partnership of Adams County (ECPAC).
What does the agency do?
The Early Childhood Partnership of Adams County is one of 31 local early childhood councils statewide that are working in collaboration with the Office of the Governor and Lieutenant Governor through the Colorado Departments of Human Services, Education and Public Health and Environment to implement the Early Childhood Colorado Framework in order to ensure that the community works together to support the success of young children and families. ECPAC provides a venue for coordinated governance, planning, resource development, leadership, education and shared accountability in order to achieve outcomes specified by the Early Childhood Colorado Framework in the areas of Early Learning; Family Support and Parent Education; Social, Emotional and Mental Health; and Health.
Who are the clients and what needs are served?
Underserved, preschool aged children in Adams County are served by having high quality early learning supports and environments, and comprehensive health care. Families are served by having a meaningful community and parenting supports. Early childhood professionals are served by having the knowledge, skills, and supports to work effectively with, and on behalf of, families and children.
What is the agency funding support?
ECPAC has gradually grown in size and scope since 2004. The Partnership has received over $2,000,000 in grants since 2005, and implemented a wide range of programming related to the areas of early learning, health, mental health and family supports. In 2007, ECPAC became part of a larger statewide infrastructure of collaborative early childhood councils through the Colorado Lieutenant Governor's Office, an alliance that brought further vision, funding and state-level support to ECPAC's work.
What is it about the community partner that calls you to work with them?
Why are you engaged with this agency?
The ECPAC provides a strong collaboration and support network for underserved preschool aged children and their families in the community where I reside. They view the child in a holistic perspective taking into account the whole picture of learning, family support, parent education, social, emotional and mental health and physical health. I believe these families and children need outside support to enable learning to take place in the classroom and to give these children a bright future.
What is your passion here?
I have always been passionate in working with underserved women, infants and children. My passion was realized when I worked as a staff RN in Labor and Delivery, Post Partum and the Well Nursery. I have done many volunteer hours with underserved children including shots for tots, volunteering at a pregnancy center and performing sports physicals for various schools and providing physicals for homeless children and their families. While I am caring for the entire family in family practice now, I am passionate about the health and well fair of the children. The ECPAC is the perfect site to gain a broader understanding of how I can have an impact on the health care system that effects these preschool children in Adams County.
What are you currently doing with this organization and how do you see it evolving as you sustain your commitment with them?
What is your role in this service learning experience?
As I am incorporating my service learning hours into my application to practice hours, I will have two projects that I am working on. One project is a community needs assessment. The needs assessment is comprehensive covering four domains: early learning, family support and parent engagement, social and emotional health and physical health. The needs assessment includes a data review of demographic and population indicators, focus groups and partner surveys. A second project I am working on is part of an ongoing grant project funded by the Colorado Trust. The ECPAC is working with partners to plan, pilot and evaluate a system of service referrals from early childhood education sites to community based primary care service centers. I will serve as a project leader in the area of health assessment. I will focus on the health related referral systems as there will also be dental, mental health and physical education components.
What hours did you spend at the site and what activities where performed?
I have spent approximately six hours in meetings working on the specific components to the referral system and collaborating with community partners to initiate the referral system. I have spent another 4 hours researching the most recent data indicators to add updated information to the community needs assessment.
What are the opportunities there ?
There are continuous grant projects that are going on at ECPAC. The current Health Integration grant that I am working on implementing is expected to take approximately two years. This timeline allows me to be involved over the next year for a long term project.
What can you see yourself doing more long-term?
The Health Integration grant will be piloted in a few preschools before it is fully implemented. Since this grant project is expected to take approximately two years, I will be able to work with ECPAC until I graduate. I can see myself being involved with this organization in the future to serve as the "health expert" in system wide changes for the underserved pediatric population.
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