Program Highlight: Connections in Primary Care

Connections family support program is a partnership in which Blank Children’s Pediatric Clinics refer children and families to EveryStep with the aim to improve health and well-being across all age ranges seen at the clinics. Onsite at the clinics, EveryStep outreach staff provide enhanced care coordination and establish effective connections with community resources, as well as targeted follow-up to fulfill needs identified by families.

“We interview the family, clarify needs and based on their readiness and priorities, we listen to what they want to address,” said Sarah Black, EveryStep family outreach manager. “Blank Children’s Pediatric Clinics serve a large and diverse patient population. Each family has different dynamics and healthy lifestyle needs. We might work with a family for less than 12 months or be their trusted connection to securing services for many years.”

The program, which kicked off in October of 2014, was built in part upon EveryStep’s successful 1st Five program which takes referrals from 40 health care pediatric centers in Polk and Dallas counties. Outreach workers serve those who have chronic conditions and also changing needs. Their clients are young people whose families can face crisis situations impacting healthy growth and development throughout childhood and their teen years.

One Client’s Success Story

Identified needs reach beyond medical issues. Stephanie Cassady, EveryStep family outreach coordinator, shared a scenario of a single working mom with three children, ages 6 to 13, who are seen at the clinic. The mom struggles to pay her bills and put meals on the table.

During several months of meeting with the mom, building trust and identifying numerous needs, referral options were provided to support the family with rent payments, food insecurity, child support recovery, and individual and family counseling services for children’s behavioral issues. Connections also guided the family toward discounts and scholarship cards for children’s recreational activities to help provide the family with social outlets for the best lives possible.

Referrals to Connections come from more than a dozen physicians and nurse practitioners who trust that additional services will positively impact social determinants for both a child and the family. EveryStep staff then connect families with national, state and local services that address their specific needs issues.

Program Growth & Outcomes

In just over four years Connections handled 1,721 referrals by Blank medical providers to help children and their families from 28 different Iowa counties. The number of families has grown from 68 in 2014 to 613 in 2018, resulting in 3,759 referrals for families in 2018. Since the program started, participating families were connected by EveryStep to more than 6,900 resources and services.