The COVID-19 pandemic, along with the economic downturn it brought and the racial inequities it exacerbated, exposed cracks in our system of early childhood services. Across early care and education, family support, maternal and child health, and other family-focused services, these events have heightened the need for policy leaders, providers, advocates, and families to work together to build new foundations for our youngest children, prenatal to age five.
To understand how early childhood systems responded to the crises, the Pritzker Children’s Initiative-funded National Collaborative for Infants & Toddlers (NCIT) interviewed 101 public and private leaders—from grassroots to state level—during the summer of 2020. Focusing on people in five states (IL, LA, MA, NM, OH) and on many tribal leaders as well as leaders who work with multiple tribes, we learned of opportunities to create a stronger system for the future.
The BUILD Initiative wrote blogs about the opportunities those on the front lines have seen in their particular areas of work—Part C Early Intervention, maternal and child health, race equity, and others. The blogs are based on interviews performed by Eva Carter, ECE Consultant; Harriet Dichter, BUILD Consultant; Kay Johnson, Johnson Group Consulting; Saeed Mirfattah, M.A., CPCC; and Gail Nourse, MSW.
Creating a Racially Equitable Child Care System: The Dire Importance of Helping Policy Makers Understand the System and the Needs of Families
In Washington, DC, COVID-19 further exposed health issues for Black and Brown families and forced policy makers to reckon with the disparities. In addition, the fragility of our child care sector had been laid bare, and some lawmakers wanted to learn more. While they were empathetic to the COVID-related financial challenges of the child care sector, they did not have inside knowledge of the nuances of how the child care sector is funded; thus, they weren’t quite sure how to help.
Building on Solutions Devised During the Pandemic: Meeting the Health Needs of Marginalized Communities
In the throes of the pandemic, New Mexico successfully instituted telehealth visits for many behavioral health issues, especially for adolescents. Further, the state quickly added telehealth to the payment schedule and ensured that virtual visits pay at the same level as in-person visits. The speed and efficiency with which these things got done showed how nimble the system can be – that, in fact, it can turn on a dime if needed, especially when health systems and state government have informed and compassionate leadership.
The pandemic has forced us to acknowledge the dysfunction in our tribal homes. Domestic violence, crimes to children and elders, and existing health disparities—all heightened by the Coronavirus—compelled our leadership to look deeply at our programming and search for out-of-the-box ways to provide services. Following are some of the changes we made in early care and education.
The COVID-19 pandemic upended our way of life, changing how we go about everything - from managing our health to educating our children. One response to the social distancing this public health crisis has mandated is the wide use of virtual services for delivery of health, education, family support, and human services. If there was any doubt about the effectiveness of virtual services before the pandemic, experience now has shown they are more than just effective; they are a not-yet fully tapped asset. Their use represents an innovative and positive change in early childhood systems and services. On the other hand, solutions for the obstacles to their equitable use must be found.
Maternal and child health (MCH) providers and leaders across the country responded with great agility in service and support of families during these times of crisis. This was no easy task given that state MCH programs have responsibility for many programs seeking to ensure the health and well-being of women and children. Most state MCH agencies administer an array of programs including Title V Maternal and Child Health Services Block Grant, Maternal, Infant, and Early Childhood Home Visiting (MIECHV), Part C Early Intervention, Title X family planning, WIC nutrition services, immunizations, newborn screening, early childhood comprehensive systems, and other programs.
From the moment families discover that their children need early intervention (EI) services, a new, often confusing world unfolds before them. From one moment to the next, there are emotions to reckon with, diagnoses to understand, services to schedule, and bureaucratic mazes to negotiate. For many families, it is an overwhelming process. Ideally, EI advocates offer the support and guidance desperately needed at this time. Since the pandemic took hold, however, there has been no easy way for advocates to be in touch with families, many of whom do not have access to technology.
The Pandemic Reminds Us That Access to Healthcare is a Basic Human Right That We Are Not All Afforded
The pandemic has shown me the awe-inspiring ability of maternal and child health professionals to grow and be flexible, and of the community to collaborate. I have seen, for example, the resiliency and resourcefulness of our staff as they transitioned to a virtual platform while keeping our patients engaged, all without missing a beat. And, I have witnessed the flexibility and unity of the healthcare system to convert to virtual health visits (i.e., telephone or web conferencing).