When Dorothy Gale clicked her heels together and repeated “There’s no place like home” in The Wizard of Oz, she thought of her family’s farm in Kansas. Although “home” looks different to each of us, we all need a familiar place that anchors us in the world, a place to live, sleep, eat and play. We also need a medical home—a model of integrated healthcare delivery involving a collaborative relationship between a patient and a team of providers, with primary care as the cornerstone.
For those of us without magical slippers, particularly families facing financial hardship, getting to a medical home isn’t easy. A lack of transportation is a big hurdle, especially as many areas of the state are experiencing a shortage of primary care providers. The healthcare system is complex and confusing. Some people feel intimidated talking to medical staff due to barriers in language, culture and education, and some parents may avoid doctors out of fear of judgment about their parenting skills or living situations.
On the other side of the equation, primary care providers are overburdened. In the current medical practice environment, many doctors simply don’t have the time or resources to fully understand the challenges financially stressed families face in navigating the system and adhering to medical advice, or to go beyond their core responsibilities to more effectively serve this particular population.
Fortunately, Michigan has its very own Glinda the Good Witch to guide children from families with low incomes to a medical home. It’s called the Michigan Children’s Health Access Program (MI-CHAP) and it’s administered by the Michigan Association of United Ways. Through strategies employed at the family, provider and system levels, MI-CHAP aims to improve the health of Medicaid-enrolled children, improve the quality of and access to medical homes, lower healthcare costs by reducing emergency department visits and hospitalizations among children on Medicaid, and promote innovation through virtual delivery of program model components statewide.
Currently, there are nine CHAP teams covering 26 counties, including Macomb County and Wayne County. Local teams work in their communities to improve access to primary care and address other factors that affect health outside of the doctor’s office. The teams provide critical services that often complement the work of Medicaid health plans and local health departments, including:
- Assistance finding and engaging with a medical home;
- Education regarding when and how to utilize medical care;
- Transportation assistance for medical appointments;
- Assistance in navigating the behavioral health system;
- Disease-specific education regarding asthma, obesity and other conditions;
- Home visits to increase access to health services;
- Translation services; and
- Connection to community resources to address a wide variety of needs such as food, housing, and utility assistance.
Childhood health status sets the stage for health status throughout a person’s life. Programs that enhance children’s access to the basic services and education necessary for good health make a difference in the lives of individual kids and the healthcare system as a whole. Through engagement with families, providers and communities, MI-CHAP is doing transformative work to make Michigan a good home for everyone.
— Julie Cassidy