MCHB ALL GRANTEES MEETING

Solos to Symphonies: MCH Partners Working

October 4-7, 2004

RUSH RUSSELL: Good morning. Yesterday Doug Paterson from Michigan said he always had a goal to meet five people and get at least three ideas from any conference he attended for that to be successful. The last time I attended a conference here in Crystal City , I met my future wife. So from an evaluation standpoint I know this conference won’t be replicable but it has been sustainable, so good news, bad news. I also would like to know that Children’s Futures in the city of Trenton are now really about our third year of implementation and although we have some great outcomes so far including about 100% of the children in poverty--born in poverty or enrolled in a home visiting program, more than 30% improvement in the quality of child care in year one, about 70% of women had been screened in the prenatal clinics. We’re off to a good start but we recognize that most of you have been at this for much longer than we have and therefore we’re honored to be here to share some of our early lessons and we’d be pleased to have a conversation with you about some of the ideas that you’ve learned along the way in your more experienced work.

My presentation is going to focus on a few of the lessons that we’ve learned along the way about partnership, and the first one was simply how to get started and I think we began like many, you know, what idea should we try? We tried an RFP, people got together and developed a plan, but really what we got back wasn’t a plan but a wish list. Everybody wanted more money for their own program, it was competitive, it was disconnected and it was as though that if we just could do more of what we’re doing out comes would get better and I don’t think it’s quite that simple. So we went back to the drawing board and I think we used the evidence based approach that was talked about yesterday. We set a baseline. For example, we knew twice as many women in Trenton were failing to get early prenatal care as the statewide average. We asked who was failing to get care and they identified target population of women with depression. Women with substance abuse issues, new immigrants to the community and teens.

We then reviewed what had been learned about effective practice. We brought in the evaluation of the Healthy Start grantees and found that several cities had made dramatic progress while other cities had not. We tried to learn why that had happened and then we worked together to put together a strategy that made sense for Trenton . So I think the lesson for us was we put the strategy together before any money got put on the table. What resulted was our four parent child centers, each that provide home visiting, center based supports, early literacy, mental health and supports for fathers within each of the neighborhoods of Trenton . But the key for us was developing that strategy together before the money. Our second lesson was simply maybe not to get too enamored. This was talked about yesterday as well with the word collaboration. I think it gets thrown around a lot and it’s got a pretty difficult definition. Our definition is “What’s in it for me?” Because people will sit at the table until “What’s in it for me?” comes and takes over the groove. So we’re trying to create a citywide system of supports for families in early childhood.

Every organization has a role to play and we found that some do it naturally out of long-term community commitment, enlightened leaders. Some are a little harder to work with due to tight budgets, different type of leadership, long history of competition and distrust, but we try to work with everybody in an individual way in a partnership much like a successful politician has to do. I didn’t say we were always successful. I said like a successful politician but we work very hard at that. Third, in building partnerships we work very hard to provide recognition and reward for those who worked with us. Quick examples, our annual meeting that’s going to be held in a couple of weeks is just to say thank you to the staff who work on the frontline working with families in home visiting. We’ll have a nice dinner, a jazz singer. There’ll be no keynote speaker. There’s no agenda, and there’ll be no speeches.

Second, we try to bring--it really works. Try it. Second, we try to bring small organizations which have been often left out of many of these different funding opportunities together with the larger organizations in our community in terms of meetings, funding, technical assistance and recognition. Finally, we set aside real time to work on the very difficult work and this was talked about yesterday as well--integration. How do you get the different parts--fatherhood, childcare, home visiting, mental health, birth outcomes, clinic issues--to work together? So you really have to set aside specific time just to focus on how do these pieces start to work together and we work very hard with that. Our fourth lesson that we have heard an awful lot. We’ve done probably almost 100 hours of focus groups, more than that in terms of community meetings. We continually hear so much about the issues of bias, stereotyping, discrimination, distrust is the real problems that we all have to face if we want to be successful. Wanting to be treated with respect and dignity is something that we may take for granted, especially in a conference like this, but it is not always in place in our communities, in our hospitals, our welfare offices, our child care centers and other places of service.

Everything we do at Children’s Futures working with the city as a central goal of building trust, and if we fail at that we will not achieve the outcomes that we’d all like to see. Our final lesson. Ultimately this is a political campaign and we should all recognize that. While independent evaluation is important and helpful, I think it’s important for you to tell your own story and make sure that the community hears your story and it’s not just tied to an outcome evaluation. At Children’s Futures we have set an ambitious vision of ensuring every child in Trenton enters pre-school healthy and ready to learn but we recognize that we better set some interim benchmarks along the way to be able to tell our story. We think that good timing and powerful champions are critical. We’re trying to get Irving Harris and Rob Reiner to move to Trenton . So far we haven’t been successful but if we’re not we’re going to find our own.

Finally, I was sitting in a meeting with some foundation folks a few years back, talking about change in urban communities and there was a talk about collaboration and partnership and what it took and it was counted at the 35,000 foot level as some of these conversations tend to be. I don’t know if you know Otis Johnson. He’s now the mayor of Savannah . He was listening politely and finally just put his fist down and said, “Folks, it’s about power and money,” and I think it’s an important lesson that we need to remember and we do try to remember along the way in this type of work. I think we do know--you know--the field knows an awful lot about what it really takes to improve child health development outcomes. And I think if we really wanted to adopt best practice, we would allow families who work to make enough money to meet their basic needs. I think we would find that getting women into early prenatal care would be a lot easier. There’d be an amazing reduction in maternal depression and the use of drug and alcohol would also go down.

Yesterday, Peter Morris and other people put that on the table and I think the surgeon general also talked about it as well, but I think he talked about obesity and tobacco as the underlying causes of morbidity/mortality. I think the issues of stress and poverty--if you’d reach just a little bit further, some of those other issues that the public health field could take on and maybe we’ll get some leadership from some other folks at a higher level and we can take that on. Thank you for your time.