MCHSO spring symposium focuses on children and youth with special needs

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The USF College of Public Health’s (COPH) Maternal and Child Health Student Organization (MCHSO) held its annual symposium on March 6.

The MCHSO is a forum for students interested in maternal and child health to interact and engage in service and learning opportunities related to the well-being of women and children. It is open to all USF students, regardless of major or graduate/undergraduate status.

The annual event aims to bring students, faculty, staff and community members together to discuss issues that impact women, children and families.

The theme of this year’s event—its 11th—was “Improving Systems of Care for Children and Youth with Special Needs.”

“Each session was designed to explore opportunities of interprofessional collaboration between disciplines, including public health, medicine, education, and social work,” said Sharonda Lovett, one of the research and education chairs for MCHSO and an MPH student pursuing combined concentrations in epidemiology and maternal and child health.

The Maternal and Child Health Organization students with their faculty advisor, Dr. Kirby Russell, at the 11th Annual MCHSO Symposium. (Photo by Caitlin Keough)
The Maternal and Child Health Organization students with their faculty advisor, Dr. Kirby Russell, at the 11th Annual MCHSO Symposium. (Photo by Caitlin Keough)

The symposium began with opening remarks from MCHSO research and education chairs, Lovett and Mariya Qaderi, and Dr. Russell Kirby, MCHSO faculty advisor and USF Distinguished Professor and Marrell Endowed Chair.

“In the last 10 years, we emphasized focusing on equity in maternal and child health informed by a deeper understanding of the social determinants of health, but we have a lot of work yet to do,” Kirby said. “That work needing to be done will be the focus of our program, specifically looking at special needs and the systems of care for children with special needs.”

Dr. Kirby Russell presenting the opening remarks at the MCHSO Annual Symposium. (Photo by Caitlin Keough)
Dr. Kirby Russell presenting the opening remarks at the MCHSO Annual Symposium. (Photo by Caitlin Keough)

Dr. Donna Petersen, dean of the College of Public Health, opened the symposium setting the stage contextually: where does the work sit, the history of the transitions of care for children and youth with special health care needs (CYSHCN), and where she thinks we need to go to advocate for these systems.

Petersen said that throughout the history of healthcare in this country, circumstances have changed, the nature of the conditions change, children change as they grow, resources wax and wane, and policies have been supportive and then not, but with all these changes public health professionals have to be flexible and creative because “as good as our systems may be for children, they are terrible for adults with childhood-onset disorders.”

“We need to continue to develop data systems, treat this work like the applied research it is, present and publish and understand that addressing issues facing all children also benefits those with special needs and that making systems work for the CYSHCN population benefits all children,” she said.

“To do this, we must advocate within agencies and programs and with related programs to promote seamless access and coordination, advocate at the policy level to remove unnecessary barriers and advocate with community partners to work in collaboration,” Petersen said. “Finally, we must advocate on behalf of single families, classes of families, and communities to fulfill the promises we make to all children born in this country –that they will have an opportunity to succeed.”

Petersen ended her presentation calling for audience members to listen closely to the upcoming speakers and topics.

“Listen for the opportunities to make a difference, listen for where changes are taking place and remember transitions, and listen for the needs for strong advocacy and let your voice be heard!” she said.

Dean Donna Petersen presenting “Transitioning Systems for Transitions in Life: Advocacy for CYSHCN.” (Photo by Caitlin Keough).
Dean Donna Petersen presenting “Transitioning Systems for Transitions in Life: Advocacy for CYSHCN.” (Photo by Caitlin Keough).

The keynote speaker was Dr. Jeffrey P. Brosco, director of Title V, Children with Special Health Care Needs for the Florida Department of Health and professor of clinical pediatrics from the University of Miami Miller School of Medicine.

Brosco addressed the crowd, made up of mostly undergraduate and graduate students along with some faculty, about the current health care system and if value-based care will sink or save us.

He started his presentation explaining how the CYSHCN populations is more vulnerable to the social determinants of health and how important hospital and health care systems are to this population.

“For example, a child with asthma is going to suffer a lot more if there’s air pollution than a child who doesn’t have asthma, it’s simply because, by definition, you need more health care, more physical therapy or mental health care,” he said. “If you have any kind of social determinants of health, like transportation, poverty, no health insurance, you’re going have limited access to the things you need. So, for the CYSHCN, they’re a relatively small number of children but they require more resources and have a high impact on health outcomes.”

Brosco explained that the current health care system spends more time on treatment, which can result in more visits for the CYSHCN population, and spends less time on prevention and the social determinants of health that can greatly affect this population.

The value-based health care mode, on the other hand, offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes are difficult to measure, so pay for performance systems evaluate process quality and efficiency. This model also penalizes health care providers for poor outcomes, medical errors, or increased costs. This model can help the CYSHCN population with the social determinants of health, by increasing preventative measures and in turn improving healthcare performance measures.

“So, to sum up, twentieth century health care system: episodic acute care with very little prevention or upstream kind of work, CYSHCN need more care so therefore are doubly sensitive to the social determinants of health, and will that value-based care sink or save us? Yes.” Brosco said.

Dr. Jeffrey Brosco (Photo courtesy of the University of Miami Miller School of Medicine)
Dr. Jeffrey Brosco (Photo courtesy of the University of Miami Miller School of Medicine)

Brosco ended his presentation with a quote from Fred Rogers, “No child is perfectly whole in mind, body, spirit, ability, nor can any child meet all of a parent’s hopes and expectations. Yet there is a wholeness of each and every child, a wholeness that is unique and brings with it a unique set of possibilities and limitations, a unique set of opportunities for fulfillment.”

View all the presentations here.

Story by Caitlin Keough, USF College of Public Health