This is a guest post by Megan Sheeran. Garden City, Mich. is one of eight cities NLC has awarded funding to reduce the number of uninsured children.
Our nation thrives when the health of its smaller communities is good. Access to health insurance for vulnerable populations, importantly children and families, is crucial in securing a better future for us all. The city of Garden City is well aware of what makes a great community and has committed to strengthening its resident’s awareness and enrollment in Michigan’s low cost or no cost insurance programs.
Garden City, MI: In a Nutshell
Garden City is a small city with a lot of heart located in southeast Michigan, just a 30 minute drive from downtown Detroit. Its residents are hard working and service-oriented people. The city’s community leaders are always working hard to meet the needs of those people living within the city limits and beyond. As the city’s motto states, it’s “A Great Place To Call Home”.
Getting a Plan in Motion
Garden City is one of the eight cities awarded the National League of Cities grant and technical assistance to support the city leader’s efforts to educate and enroll those residents that are eligible for low cost or no cost health insurance.
A Task Force, made up of community leaders, was organized to carry out the planning phase of the healthcare initiative- named the Healthy Kids-Happy Families Project. Numerous community leaders signed on to be involved with the project including representatives from the school district, the local hospital, and the city government. The Task Force is a shining example of the commitment and passion this community’s leaders have for the well-being of those residing in their city.
The goal of the Healthy Kids-Happy Families Project is to enroll 100% of Garden City children and adults who are eligible for the Healthy Michigan insurance program but are not currently insured. During the preliminary stage of program development, it was found that 10% of children in the city were uninsured and eligible for Healthy Michigan (roughly 633 children!). Clearly, this number doesn’t include the many parents and family members that are also uninsured but are eligible for a Healthy Michigan plan. It has been estimated that a large percentage of the city’s population will be positively influenced by this project.
Meeting the Significant Healthcare Need in the City: A Two-Pronged Approach
Healthy Kids-Happy Families Project is to increase awareness and knowledge of the Healthy Michigan, the state’s low cost or no cost insurance program. Majority of residents surveyed during the planning process reported the reason they were not signed up for Healthy Michigan was due to the complicated and time-consuming process of enrolling. It was important for the initiative to incorporate an educational dimension; therefore the residents of Garden City would be informed about their potential eligibility for Healthy Michigan, the potential benefits this would offer to their individual families and how simple it can be to enroll.
The Project will offer enrollment assistance to those residents who qualify for the Healthy Michigan insurance program. The key to this enrollment assistance is that it be offered by trusted community members in trusted community locations such as in schools, the community center, and at the local hospital. A new city department, the Community Resource Department (CRD), will carry out the day-to-day workings of the project. City staff and volunteer community members will be the “boots on the ground”, going out into the community and offering one-on-one personal assistance to adults and parents during the application process.
The Project will be in operation year round, apart from the initial campaign, to offer those individuals who have enrolled continuous form assistance and help with choosing a healthcare plan, select a local primary care physician and schedule their first well visit appointment. It is crucial that these families and individuals do not fall through the cracks once they are found to be eligible for Healthy Michigan.
Increasing Health Insurance Coverage in Garden City: The Benefits
According to the National Center of Children in Poverty, children have higher health-related school absentee rates, affecting educational attainment and future employability (Present, Engage, and Accounted For: The Critical Importance of Addressing Chronic Absence in the Early Grades, 2008). Parents of these children experience the challenges of coping with an ill child; employee absenteeism to be home with a sick child that causes lost wages and negatively impacts a parent’s ability to maintain consistent employment (C. Teng, Citispeak.org, 2013). The Health Kids-Happy Families project will reduce the number of uninsured children in the city, thereby improving school attendance and educational attainment; preventing their parents’ from the threat of falling into a debilitating financial crisis.
In addition, the local hospital is currently challenged with a high rate of Emergency Room visits by uninsured families for non-emergency issues; majority of these visits go unpaid, causing tremendous financial burden on the hospital. Also, when the Emergency Room is busy with non-emergency issues, true emergency treatment is often delayed. Reducing non-emergency use of the Emergency Room will benefit the community greatly, financially and otherwise.
Garden City: Setting a Course to Thrive!
The City of Garden City’s Healthy Kids-Happy Families project is going to enrich its community immensely. Being an example to other communities of what can happen when city leaders come together for the sole purpose of cultivating healthier outcomes for families and individuals and in doing so enriching the nation as a whole.
About the author: Megan Sheeran is a limited licensed Master of Social Work and is a recent graduate of the University of Michigan’s School of Social Work. She recently returned to the City of Garden City as the Community Resource Coordinator and will be organizing the day-to-day tasks for the Healthy Kids-Happy Families Project as well as coordinating many other community support program.
One of the key priorities for the Resilient Communities for America campaign (RC4A) has been to urge federal leaders to support local resilience through meaningful policy changes. As we reflect on the first year of this campaign it is clear that our message, which has been endorsed by nearly 200 local leaders, is being heard. There is much more to do, but in a time of political polarization and Congressional inaction, this campaign is building genuine consensus and support for executive action on preparedness and resilience.
In November 2013, President Obama issued an Executive Order to create a State, Local, and Tribal Leaders Task Force on Climate Preparedness and Resilience. Of the local officials that were appointed to advise the President, over two-thirds were RC4A signatories, a clear recognition that the leaders who joined this campaign are among the most credible voices in the nation on this issue.
But the RC4A signatories sitting on the President’s Task Force are not the only ones having their voices heard in Washington. In May, recommendations from the ‘Resilient Communities for America Federal Policy Initiative’ were delivered to the Task Force. This document was prepared by surveying RC4A members and soliciting input during two workshops. It includes nine policy recommendations broadly embraced by the local leaders that make up the campaign.
Even before the formal recommendations of the Task Force were released, several of the RC4A policy recommendations were incorporated in legislation and new agency programs. Two notable highlights are proposals that would increase local control over transportation funding and a new $1 billion National Disaster Resilience Competition.
First, RC4A recommended greater flexibility for local governments to utilize transportation funding and related federal resources to enhance resilience. Multiple proposals, including the President’s GROW Act and the Senate’s proposal to reauthorize MAP-21, have included important changes that reflect this objective.
Additionally, the RC4A Federal Policy Initiative recommended that the federal government increase awareness of resilience related activities, make available new sources of funding and enhance coordination between federal agencies. In June, the administration announced a $1 billion National Disaster Resilience Competition that builds upon Rebuild by Design, a program coordinated by HUD with the assistance of agencies such as the Department of Transportation, Small Business Association, Department of Labor and many other agencies that had already been brought together in the Sandy Rebuilding Task Force.
In order to thrive in the 21st century, America needs to become a nation of resilient cities, towns and counties, and that is the message that the Resilient Communities for America has been striving to promote. That when storms strike our coastal communities, droughts persist in valuable agricultural land and economic fragility threatens industrial centers, all Americans share in the cost. That the fate of America is determined by the success of its local governments.
There is much to be done to advance federal-local collaboration on resilience, and despite a slow-moving and divided Congress, progress is evident as the federal government increasingly responds to and champions local leadership.
This is the first article in a multi-part series from the National League of Cities (NLC), the Corporation for National and Community Service (CNCS) and Cities of Service on the national and community service movement and its impact on cities and towns nationwide.
“Everybody can be great…because anybody can serve. You don’t have to have a college degree to serve. You don’t have to make your subject and verb agree to serve. You only need a heart full of grace. A soul generated by love.” – Martin Luther King, Jr.
In the U.S., we like to bemoan the civic disengagement we see all around us: the people who don’t vote, volunteer, or take an avid interest in current events. And by we, I really mean me, as I wrote a blog post on this topic less than a month ago. But like most things, the state of Americans’ engagement in the community is truly a matter of perspective.
You can fret over the just under 2/3 of Minnesotans who don’t volunteer, or you can rejoice over the 37.7% of Minnesotans who choose to devote a portion (or more) of their free time to serving others. Whereas last month I chose to focus on engaging those who have not been active in traditional forms of civic participation, today I want to celebrate that latter group, the people of all ages, regions, and walks of life who have chosen to serve their communities.
As NLC’s members know, local communities are stepping up to the plate to make tangible improvements in people’s lives. In many ways, the national service movement has stemmed from a similar place. People, including many young people, have an intense desire to take matters into our own hands, to put our boots on the ground in our own cities and towns in order to address everything from climate change to the high school dropout crisis.
This passion for problem-solving is seen everywhere from the church that holds a food bank for community members in need, to the local businesswoman who clears her calendar every week to make time to read with children at the neighborhood elementary school. And, increasingly, it is being seen in the form of organized volunteering through both federal programs including Senior Corps and AmeriCorps, and local programs such as mayoral offices of civic engagement or service.
This more coordinated approach to volunteerism has given rise to “impact volunteering” – the idea that regular citizens are capable of making measurable differences in our communities in response to focused goals. It more fully incorporates volunteers into the operations of cities and towns, making them not just individual actors, but a part of a concrete vision for community improvement.
By including volunteers in an overall strategy, impact volunteering acknowledges their power, recognizing the vital, but often underappreciated role they play. It also allows city leaders to determine which needs are most acute in their communities, and gives cities a low-cost, high-impact tool to address those needs.
National service is another vital resource that city leaders are increasingly using to address critical challenges in a focused, strategic way. More than 400,000 AmeriCorps and Senior Corps members serve at 60,000 locations in 8,500 cities across the country, tackling pressing challenges including tutoring and mentoring underserved youth, removing blight and increasing public safety, and helping communities recover from natural disasters. AmeriCorps members multiply their impact by recruiting and managing other community volunteers – more than four million last year alone.
In Baltimore, Md., the significant number of individuals suffering from substance addictions was identified as a critical issue facing the community by Mayor Stephanie Rawlings-Blake. Recognizing the key role that volunteers can play, and with support from Cities of Service, the mayor launched the “Recovery Corps initiative,” in which 100 volunteers, themselves recovering from addictions, are placed in recovery centers in order to help guide others through sustained sobriety.
In existence only since 2011, the Recovery Corps volunteers have already worked with 603 individuals to help them “enter, stay in, complete, and/or manage recovery after treatment,” in addition to having “provided support services or linked individuals to support services in 1180 instances.” Despite being a low-cost, volunteer-based program, the Recovery Corps is having a measurable impact in the city of Baltimore.
In Philadelphia, Mayor Michael Nutter has worked to strategically engage citizens in addressing local challenges, particularly in the areas of education, food security, community revitalization, and youth engagement. Mayor Nutter has made extensive use of AmeriCorps VISTA and other AmeriCorps resources to increase citizen engagement and volunteer impact.
In 2013, the City of Philadelphia launched PowerCorpsPHL, a workforce development initiative for Philadelphia’s young adults that uses AmeriCorps as a vehicle for job training and skills development. While serving as AmeriCorps members, participants support Philadelphia Parks and Recreation and the Philadelphia Water Department in planting trees, revitalizing public land and preserving the City’s watersheds.
Given the impending retirement of the Baby Boomers and the emergence of the Millennials, there has never been a better time for cities to embrace community and national service. These two populations, not to mention those in between, are an incredibly rich resource for our communities; by making strategic decisions now, cities will be able to harness the service movement like never before, leading to truly transformative change in our nation.
Over the next few months, CitiesSpeak will feature blog posts from NLC, Cities of Service, the Corporation for National and Community Service and city leaders as we showcase the power of service and the concrete steps that can be taken in order to ensure that your community benefits from this movement.
This is a guest post by Peter Kleinbard. It is the fourth in a series on dropout reengagement drawn from the case study: For Young Adults Who Drop Out: Pathways Or Merely Stops Along The Way?
“It is not a time like when I was a teenager I could go to McDonald’s … impress a manager, fill out the application, and I had a job. …But now…I have to consistently show [youth] they can’t get discouraged. They still have to keep trying… And that’s my fear. Frustration and despair.” -Ralph (Counselor for Site B).
Ralph’s comment highlights the heightened risks for young adults who have dropped out in today’s difficult job market and the importance of helping them, not only to get a job, but to avoid the consequences of “frustration and despair” that can lead to high-risk behavior. This post, the last of a series, focuses on how to identify the elements that build high-quality programs.
Outcomes, such as employment and postsecondary placements, are necessary when assessing the quality of programs, but they are not adequate. Given that programs have different approaches to selecting participants and reporting results, outcomes will have different meanings about effectiveness. A site that chooses to work with youth who have serious obstacles to success may be doing a good job even though it may not produce as many outcomes or as rapidly as one that works with those who are nearly job-ready.
In assessing programs, much depends also on the purposes of the organization making the assessment. Those seeking to build the field – to improve opportunities for young adults in their city or region area – will want to extract lessons from the operation of a program for wider application, rather than merely counting results. When this is the objective, it is important to look broadly and thoughtfully at how programs actually work.
When I assess programs as a funder or program manager, I begin by identifying elements that I can readily observe: Does the number of young adults present match the number the program claims to serve? Do participants attend designated activities and do they participate actively? Do staff members demonstrate by their activities and comment on engagement with participants?
Do program leaders state clearly the relationship between what the site offers and how participants are expected to benefit from it? Their ideas should be consistent with what we know about what works for young adults. (See, for example, The National Employment Coalition’s PepNet site.) Often, “youth development” is cited as an approach. What does that mean? It means combining caring support with high expectations, and assuring that young people have a voice in setting their goals and assessing the program. Staff and participants should express awareness that these ideas are present in the program and that they experience them.
Support should be reflected in how frequently and the manner in which staff speak with youth who are on their caseloads. Public/Private Ventures, a national nonprofit organization, explained in their research that across all ages and program types, supportive relationships with staff appear to be the most important reason youth stay in programs.
Students should be able to state their goals and say where they stand in their quest to achieve them. They must trust that their aspirations and feelings are understood and responded to by staff.
The program structure – for example, a sequence of increasingly demanding classes and training experiences- must reinforce good practices such as regularly scheduled assessments to determine whether youth can ascend to more demanding classes and/or work experiences as they gain skills and understanding.
While most programs have databases, utilizing them to help guide and improve program activities can be uneven. An observer should ask: Is staff updating information about student attendance and scores, and are there counselor notes that highlight growth and emerging issues? Do staff and leaders consult and use this information in their work with participants?
Coherence: It is important that young adults get the same messages from all staff and that everyone is pushing in the same direction. To assure that this occurs, staff members who interact with the same young person must consult among themselves so that there is a common understanding and approach to addressing problems and supporting strengths. In Afterschool Centers and Youth Development, authors B.J. Hirsch, N.L. Deutsch, and D. L. DuBois describe Collective Mentoring – the idea is that all staff working with the same young person consider themselves responsible for his/her progress and consult regularly. In my observations, the ability of staff to interact face-to-face on a regular schedule increased the depth and frequency of consultation about participants.
Leadership: Considering limited space, I will not address the ways that leaders contribute to program quality, nor the role of hiring, orientation and supervision practices. However, these issues are explored at length in the program descriptions in the full paper.
About the Author: Peter Kleinbard is a graduate of Yale University. From 2001 until 2010, he was executive director of the Youth Development Institute, a national intermediary based in New York City. He also founded the Youth Transition Funders, an affinity group for foundations. To comment on this blog or related issues, write: email@example.com.
More than 5,000 kids 18 and younger are uninsured in Chatham County, putting them at risk for preventable diseases, burdening families with financial distress resulting from medical bills and increasing costs to our hospitals (and taxpayers) for emergency room visits for routine care. A new initiative aims to change that.
A National League of Cities grant, just announced, will fund the Mayor’s Campaign for Healthy Children and Families to reduce by 50% the number of uninsured children in our county. Savannah is one of eight cities in the U.S. awarded these innovative grants that set 18-month goals to boost the numbers of eligible children and families enrolled in Medicaid and PeachCare.
Step Up, with its partner, Chatham County Safety Net Planning Council, the county’s healthcare collaborative, and City of Savannah staff produced the successful proposal. Key city departments such as the Public Information Office, the Citizen’s Office 311 service, plus enrollment and outreach partners will work hand-in-hand with community-based organizations, health clinics and hospitals to accomplish the ambitious enrollment gains.
Strategic points where kids and parents regularly intersect such as schools, health clinics, even public events will have information and direct families to trained enrollment assistance staff.
Georgia lags behind other states in terms of health insurance coverage for children and families. Eleven percent of Georgia’s children are uninsured, representing 4.3% of the nation’s total population of uninsured children. Additionally, 23% of Georgia adults with dependent children are uninsured; 78% of Georgia’s uninsured children are eligible, but not enrolled in Medicaid or PeachCare.
Access to health insurance is a critical piece of the poverty puzzle — medical debt causes undue hardship, particularly on low-income families, and in most cases is avoidable by signing up for existing public health insurance programs. The National League of Cities grant funds raise the possibility of fostering real change and getting more eligible families signed up in our county.
About the author: Suzanne Donovan is executive director of Step Up Savannah, the City of Savannah’s poverty reduction initiative.
Supreme Court cases are usually known for what they hold. Harris v. Quinn will forever be known for what it did not hold. The Court did not overrule Abood v. Detroit Board of Education, a 35-year old precedent that is a cornerstone of public sector collective bargaining. But it certainly foreshadowed its demise.
In Harris v. Quinn the Supreme Court held 5-4 that the First Amendment prohibits the collection of an agency fee from home health care providers who do not wish to join or support a union.
Medicaid recipients who would otherwise be institutionalized may hire personal assistants. In Illinois, the Medicaid recipient is the employer and is responsible for almost all aspects of the employment relationship. But the personal assistant is a state employee for collective bargaining purposes. A number of personal assistants did not want to join the union or pay it dues.
In 1977 in Abood v. Detroit Board of Education the Court held that state and local government employees who don’t join the union may still be compelled to pay an agency fee (fair share) to cover the cost of union work related to collective bargaining. The Court refused to extend Abood to personal assistants who aren’t “full-fledged” public employees. What justifies an agency fee is that unions must promote the interests of members and nonmembers alike, meaning they cannot negotiate higher pay for members or only represent members in grievances. This justification has little force where a union cannot negotiate pay or represent nonmembers (or members) in grievances.
While the Court was highly critical of Abood, it did not overrule it, which many predicted the Court might do. But, this case is still a significant blow to public sector organizing. It has been widely reported that numerous states have recognized Medicaid personal assistants as state employees for collective bargaining purposes. As a result of this decision, none of these employees will have to pay fair share if they don’t join the union.
About the author: Lisa Soronen is the Executive Director of the State and Local Legal Center and a regular contributor to CitiesSpeak.
This is a guest post by Cheryl Townsend, Cover Jacksonville Project Director. Jacksonville is one of eight cities NLC has awarded funding to reduce the number of uninsured children.
There are over 25,000 uninsured children in Duval County (Jacksonville, FL). Many of these children qualify for insurance through Medicaid or Florida Healthy Kids (Florida KidCare), but most of their parents are simply not aware. And, while efforts have been made in the community to increase enrollment, ongoing challenges have created barriers to its success. Some of Jacksonville’s challenges have historically been a lack of strategic focus on community health, a very large five-county geographic service delivery area, and insufficient funding for educational outreach to get to all areas. Therefore, Jacksonville is extremely excited to begin implementation of the Cover Jacksonville campaign as a result of receiving the Cities Expanding Health Access to Children and Families grant from the National League of Cities.
Cover Jacksonville is a health campaign that builds on existing enrollment efforts and leverages community resources in order to reduce the number of uninsured Duval County children by 20% by December 2015. Led by the City of Jacksonville and the Jacksonville Children’s Commission, the campaign’s key partners include the Mayor’s appointment of Jacksonville’s first-ever Commissioner of Health, THE PLAYERS Center for Child Health at Wolfson Children’s Hospital, United Way of Northeast Florida, the Health Planning Council of Northeast Florida and Duval County Public Schools. Cover Jacksonville will focus on four outreach and enrollment strategies:
- Building Capacity: Understanding and tackling obstacles through training and education of community stakeholders, parents, and elected officials.
- Raising Awareness: Promoting a culture of health and education about insurance options, using phone banks and on-the-ground enrollment events, and online at http://www.coverjax.org (coming soon!).
- Establishing a Single Point of Access: Streamlining the consumer information-gathering process by directing consumers to United Way of Northeast Florida’s 2-1-1 hotline, where parents will be able to schedule appointments with Community Enrollment Assisters at various sites located throughout the city.
- Identifying Uninsured Children through Public Schools: Establishing a pilot program at three schools (Bartram Springs Elementary, Twin Lakes Middle School, and Atlantic Coast High School) to identify uninsured children through school enrollment questionnaires and using trained school officials, who will work to get these children coverage.
After analyzing secondary data and input from community leaders and parents, Cover Jacksonville will target working poor families with uninsured children. Previous community enrollment efforts utilized Health Zone designations to identify targeted areas, which left out families from pockets of poverty that fell outside the city’s urban core. By targeting working poor families throughout the county, however, Cover Jacksonville ensures these families will no longer be overlooked.
The Cover Jacksonville campaign will govern itself using a shared governance model, emphasizing: collaboration, shared decision making, and accountability to improve the quality of care, safety, and enhance work life. This includes the creation of the Cover Jacksonville Advisory Board, led by the Commissioner of Health, and the Cover Jacksonville Action Committee, led by the Project Director.
During the planning process, participation and invaluable input from the city’s top leadership provided a vision for what would eventually become Cover Jacksonville. These leaders included Jacksonville Mayor Alvin Brown; The Honorable Mia L. Jones, Florida House of Representatives and Special Assistant to the Mayor; Dr. Nikolai Vitti, Superintendent, Duval County Public Schools; The Honorable Kimberly Daniels, City of Jacksonville Public Health and Safety Committee Chair and City Council liaison to the Children’s Commission Board of Directors; The Honorable Ray Holt, Jacksonville City Council; Michael Aubin, Hospital President, Wolfson Children’s Hospital; Dr. Kelli Wells, Director, Duval County Health Department; Dawn Emerick, Principal/Owner, Impact Partners (formerly President & CEO, The Health Planning Council of Northeast Florida); Connie Hodges, CEO of United Way of Northeast Florida (ret.); and Jon Heymann, CEO of the Jacksonville Children’s Commission.
From January to April 2014, key partners held three additional meetings, in which they reviewed data, developed key messages, inventoried assets, developed a process map for the referral system, and established campaign performance measures. In parallel to the community leadership meetings, five consumer focus groups were also conducted. The initial campaign strategy was to target child and family health insurance enrollment, however, the consumer focus groups and key partners unanimously indicated a strong need to combine those outreach efforts and messaging with the Federal Health Insurance Marketplace’s existing adult enrollment efforts. As a result of this significant finding during the market analysis, the business plan reflects noteworthy collaborative efforts between the child and adult efforts such as a new consolidated brand, Cover Jacksonville.
In July of 2014, as we move into the implementation phase of Cover Jacksonville, we will continue to share our lessons with the hope that more stakeholders will understand the needs in our community and become more direct with their priorities for our children. And through collaboration and alignment of existing efforts and resources, the outcomes we expect to emerge not only include a decrease in the number of uninsured children, but a community-wide approach to sustaining a culture of health and wellness in Jacksonville, Florida.
For more information on how participate in the campaign, contact Cheryl Townsend at firstname.lastname@example.org or (904) 630-6405.