By Steve “Spike” Spiker, Chief of Programs & Technology.
We’ve all heard the adage that it takes a village to raise a child. Perhaps less well known is that it sometimes takes a financial resilience coach to improve the health of children and their families. For the past two years, One Degree has been supporting an innovative community health intervention led by the Medical-Financial Partnership (MFP) team at UCLA Harbor-UCLA Primary Care Pediatrics, Prenatal, and Family Medicine Clinics and the Olive View-UCLA Primary Care Pediatrics Clinic. Focused on addressing the complex social and financial situations that low-income families struggle through daily, this novel initiative is staffing clinics with financial resilience coaches. One Degree is proud to be part of these creative approaches to caring for people and improving the health and well being of communities.
Poverty, according to the Council on Community Pediatrics, is a significant driver of adverse health outcomes for children and hinders access to essential healthcare. Underscoring the importance of early childhood interventions, the Council suggests that such interventions can yield “a high rate of return in both human and financial terms.” Studies by the RAND Corporation provide a concrete understanding of these returns, documenting that early childhood interventions can yield a return on investment ranging from $1.80 to $17 for every dollar spent.
Yet, despite this evidence, the reality for many families remains far from ideal. Consider a single mother working two jobs and relying on public transportation to support her family. She is likely to face significant barriers to securing adequate healthcare for her children, unlike a well-off mother with a high-earning spouse and access to private transportation. Even though it is clear that early access to care reduces healthcare costs and lessens the burden of disease later in life, the working poor continue to face a health and social services landscape laden with obstacles and complexity.
The Medical-Financial Partnership at UCLA is confronting these challenges head-on. By incorporating financial resilience coaches into the clinical environment, the program can address issues beyond health that lead to improved outcomes for the whole family, from improved financial wellbeing to increased rates of immunizations and preventative care visits. A recent NPR article highlights the impact of this innovative approach on Los Angeles families. Dr. Adam Schickendaz, a project lead and advocate for One Degree in clinical settings, articulated this sentiment to NPR: “Poverty drives health outcomes, especially poverty in early childhood… Food insecurity, housing insecurity, transportation issues, utility bills, all have a financial component at their core.” Similarly, Dr. Monique Holguin, another project lead at MFP, shared her insights, “Starting early, in the first few years of life, cements a pathway towards financial security.” She further stated, “Early intervention can break the intergenerational cycles of poverty that we know have long-term, detrimental health impacts on children, and on other family members as well.”
The MFP financial counseling approach supports families in building resilience through financial planning, as well as the identification of strengths, priorities, goals, and action steps aimed to improve economic stability. The MFP at UCLA also aids in connecting families to resources that can help them navigate systems and structures that might otherwise be opaque, enabling them to more easily invest in their children’s future health and wellbeing.
In addition to the support given to families enrolled in the comprehensive financial resilience coaching program, the MFP aids affiliated clinics in developing and maintaining financial and social needs resources. These resources are available to all families served by the clinic, amplifying the benefit across the community. The MFP team also works directly with healthcare team members, sharing knowledge and educating medical trainees on utilizing various tools, resources, and coaching approaches in their patient care practices. This integrated clinic approach, focused on family-centered, community-partnered clinical care improvement, has accelerated healthcare access and led to improved care for an increasing number of families.
One Degree has played a meaningful role in the MFP initiative. Our initial contribution was the development of an eligibility and screening tool to help financial resilience coaches assess the situation of each family visiting the clinics and determine which public benefits they would likely qualify for. The light-weight and user-friendly tool is also accessible for families to use directly, via mobile device or desktop, and is currently being promoted on UCLA college campuses and clinics. Early evaluation of the tool’s use have shown that 84% of users would recommend it to other families, and nearly all users identified at least one new benefit program they could enroll in.
In addition to the screening tool, One Degree’s community resource platform and closed-loop referral system support the MFP at UCLA. As the leading healthcare providers within ACES-LA, a network dedicated to reducing Adverse Childhood Experiences (ACES), the UCLA MFP clinics worked with One Degree to develop the referral system as a way for clinics and local nonprofits to make informed, warm referrals to services and resources outside their own organizations. MFP financial resilience coaches receive training on One Degree’s referral system, enabling them to support families beyond the MFP’s financial scope. In the face of poverty, families often require a range of services and benefits that no single organization can provide in its entirety. Therefore, the ability to make informed referrals is critical. It ensures that each client is personally acknowledged and supported by the referred organizations, fostering the trust that is essential to the success of whole care initiatives.
If your organization is interested in trying a novel approach to serving your community, we would love to hear from you. One Degree is more than just a community resource platform! We enjoy partnering with teams who are experimenting and designing new interventions and ways to serve people more holistically. Even if One Degree is not currently serving your community, we still want to understand your challenges and help turn them into opportunities.
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For more information about this research, you can explore the following links:
Clinic-Based Financial Coaching and Missed Pediatric Preventive Care: A Randomized Trial