Raising the Bar

 Many in our Michigan ACE Initiative Community have been involved for a number of years—and kudos to these early pioneers.  Progress is slow but is happening.  Awareness is always the first step as most folks cannot “walk” away from Adverse Childhood Experiences data once they see it.  This awareness needs to be continually provided and updated and we hope that our efforts have helped.  But we know that the question will always be, “what do we do now?”

As this question is a more recent and frequent issue discussed at the Steering Committee our conversation more often turns to what “is working” in our communities.  Our strategy has always been to rely on grassroots to lead on issues and target energy at the state level for the creation of an enabling environment.  In preparation for producing our new Michigan ACE Initiative on “Resilience” in Michigan, we conducted a survey of our Master Trainers.  We were attempting to elicit information of what type of programs are underway or in development and which ones would be good candidates for showcasing in the video.  That process is now completed and the video is being finalized to be completed in time for a debut at the May 23rd ACE Conference.  I am sure we will all be impressed and moved by these vignettes.

But we can’t simply rely on this effort.  That is why it is very encouraging to have the National Pediatric Practice Community on ACE feature a national webinar (April 23rd) and related information on Universal ACE Screening.  Under the premise, we can’t break the ACE cycle from generation to generation without a concerted effort such as screening—this effort should be applauded by all.  We already have the underlying system in Medicaid to address universal screening for children on Medicaid.  That is the Early Periodic Screening Diagnosis and Treatment, EPSDT, program.  Our public policy advocacy has raised this issue as one in needed state support to assure that adequate reimbursement can be provided.  Further, while the National Pediatric Practice Community is leading on this, we are also relying on Michigan’s Pediatric community—Michigan Academy of Pediatricians to signal its recommendation on this.

The screening, once approved and incorporated into various practices will make a difference—and will enable targeting resources for those children identified through the screening.  However, the outstanding question will still remain—what do we do?  It is my observation and that of others, that we have many outstanding programs already in place throughout Michigan that can meet the needs of children identified in the screening program.  A major issue is awareness of such programs and linkage to their location, hours of operation, and capacity.  Some communities have created an inventory—but that relies on constant updating.  Why can’t we take advantage of a system already in place for such inventories and referral? By that I mean Michigan’s 2-1-1 call centers.  Michigan 2-1-1 is available 24/7 by phone, internet, and other electronic apparatus.  They have an established database on local non-profit organizations that may be in a position to meet the needs for ACEs.  We are currently working with Michigan 2-1-1 to highlight this opportunity and their partners, particularly the Michigan Association of United Ways and their local affiliates.  You will hear more about this in the coming months.

 We continue to advocate that we don’t need “new programs”, we simply need to have existing programs to look at their program objectives through the “lens” of ACEs.  Michigan 2-1-1 and EPSDT screening are examples of this.  Let’s make it happen.  More than anything this will be to “raise the bar” for Michigan’s effort to reduce ACEs.