“The Burrito Challenge”
I had a problem;I was hungry and had limited funds. I was looking for way to get full. I was sent to a Mexican restaurant. I prefer meals from places that I can trust to have my best interest at heart. ELI (friend/trusted relationship sent me there). Do we need nonprofits? Yes. Our community tends to trust us because they believe we truly desire to fulfill our mission. However, that trust has been compromised with recent scandals on large, historic institutions.
The challenge was that the restaurant offered me a way to resolve my hunger and get rewarded. There was risk involved in the challenge. The rules were clear that I would be charged up front andI had to promise to pay for my meal if I failed. The restaurant laid out the resultsand outcomes they expected.If I accomplished the challenge, not only would they cover the cost of $20, they would reward me with a $25 gift card and celebrate my success with a picture to encourage others to also take the challenge.
The challenge was a risky proposition and burritos can be messy. We all assumed the problem was the size of the burrito, it was huge. Our assumption was wrong, it was that the burrito was spicy that kept people from accomplishing the challenge. -Need to be clear on what Problems – Outcomes we are really after.
Everyone at the table encouraged me to take the challenge. I was given moral support but no one stepped up and said if you don’t finish it I’ll pick up the tab or at least share in the cost of failure.
As a group we didn’t challenge the restaurant and try and change the rules. For example, could we all share the burrito at the table (group effort) to complete the challenge?
What if they agreed and we accomplished the challenge would we get the $25 gift card? Would it be divided equally or would the one who ate the most get more?
What happens if the restaurant fails to deliver on its promise and they only offered the reward because they really didn’t believe we could accomplish the challenge? What would we do if in fact we accomplished the challenge, solved the problem? Would that be enough for us? Or if we knew no money was being exchanged would we ignore the problem and the real solutions?
The real challenge is,can we together, through a focus on impact (social success), reduce the number of people living in poverty, increase the number of people living healthy and safe lives (thus reduce overall health care cost, waste of money on prisons etc.) and provide more people with opportunities for educational and employment success. Thus, positively impacting our national economy.
All of us have a responsibility to children and families that the promise and reality of opportunity involve a fair chance to develop their capabilities and reach their full potential as well as to become productive and responsible members of the broader community.
Securing and expanding opportunities for children and families even in the midst of an extremely challenging environment including health, education, economic security, radical community violence and impact of trauma.
We know, and research consistently supports, the fact that growing up in poverty brings a myriad of disadvantages that impact health, cognitive development, social development, economic opportunities, and development of the relationships within the community that are critical for support.
We also know that living in secure supportive families, neighborhoods, communities and countries can and do create solid foundations for children to develop and prosper.
Community assets such as neighborhood safety, cultural amenities and access to services and supports and development of key relationships shape opportunities for children.
Another extremely important sphere of opportunity is access to health care that includes physical, mental and behavioral components. Children’s health impacts both educational outcomes and future economic opportunities. Yet poor economic opportunities and unsecure families and communities lead to significant health concerns in all areas and impact the long term stability of the entire community’s well being. (ACES study).
How do we begin to address;
Access to affordable stigma free healthcare (bio-psycho-social)
Reduce occurrence and impact of unsafe environments and trauma related experiences for children
Increase family income opportunities (economic well being)
Have we correctly identified the families who are in need today who are the ones being threatened by the loss of our government safety nets (homeless shelters, foodpantries, behavioral health)?
Do we need to/or have we begun shifting the fight against prevention to really fighting for opportunities?
We know that the skyrocketing cost of healthcare is taking a serious toll on families in our communities. This one thing is impacting the promise of opportunities for positive futures. If we truly believe in our missions don’t we have to tackle this issue?
Don’t we have to find a way to reduce the cost of the safety net? Isn’t the best way to do that is by reducing the need for it?
I truly believe our nonprofit can partner effectively with government and for profit industry to create a Return of Profit industry that can offer powerful solutions to these problems.
However, if we cannot focus on the anti -opportunity rhetoric that exist our families won’t make it.
We know that the wounds and scars of child abuse and neglect can last a lifetime and reinforce ‘nati-opportunity’.
The ACES study clearly shows a strong correlation between exposure to multiple adverse childhood experiences and negative adult behavior and health outcomes.
These problems cost our society unfold sums of money to address and treat.
Even more important they disrupt families, educational institutions, workplaces, communities and our country as a whole.
Therefore, I believe the use of integrated service approaches that intervene early and comprehensively is essential;
Home based natural setting delivery.
Comprehensive coordinated health (bio-psych-social) services.
Focused efforts of prevention of adversities.
Intentional and highly focused advocacy efforts to design and create priority on policy changes are needed to implement these efforts.
WHY ARE WE WAITING TO BE THE COMPREHENSIVE CARE PROVIDERS (i.e. 8 year old now residential)
1:5 children have a diagnosable mental health issue. Only 20-25% receivestreatment or lives with families who even know how to access help. Families lack coverage, finances or there isn’t a community resource available.
WE NEED TO MEET THE NEEDS OF FAMILIES WHERE THEY ARE COMFORTABLE AND WHERE ACCESS IS ROUTINE AND CONVIENENT (PRIMARY CARE, Pediatrician – evaluation, assessment, and coordinatedcare)we can do it and we can move the impact we have to our partners.
1)There is an increase demand for high quality impact measures- “Solution Investment”.
2)Measurement remains a significant and real challenge for nonprofits.
3)We exist and change lives – measuring that is how we show the impact and worth we have as organizations.
4)What is impact measurement?
5)We need to inform and influence the debate on what works and what’s worth investing in. When we find those solutions we must take the lead in ensuring they can be effectively implemented across all communities.
Alliance
Help us secure funding and support to truly get these Quality impact measure figured out.
Can not afford to hire a Pediatrician/Nurse Practitioner, health care works, - how can that be funded (assessment, evaluation, coordinated care).
Create the Shared measurement and impact report.
Can we be more impactful then the Patient center Medical home being created by for profit hospitals and medical clinics?
Could we all begin using the same assessment tools and measures? Could Alliance help secure funding for this?
Can Alliance help fund positionfor data collection analysis and reporting?
Can Alliance help fund us tracking down clients who are gone from services?
Can UM help with the Analysis and publishing of data and sharing with the industry?
Develop, fund, find andcreate outcome measurement tools that actually demonstrate reduction in health problems over time, increased educational success and economic stability improvement.
1)Develop Impact Measure Report
2)Secure funding
3)Train Industry
4)Change the system to what really works
If we truly got it right and our system change worked, we should see a need for less residential beds. Are we really ready to accept that and give it up?
Could we become the social bonding institution and partnership with the Alliance?
Can we together create an organization that will develop and report hard data/outcomes on the social impact we are having on reducing healthcare cost, improving educational opportunities and making our communities safer?We become seen not only as nice to be in a community but vital.
Can we create an organization that takesEvidence Base Practice models and create adaptions necessary for specific community to utilize?
Can we create an organization that will take the lead informing the healthcare industry on best practice to reduce healthcare expenditures?
Can we create an organization that is creative, innovative, a leader in the way of the future use of technology in health/behavioral healthcare delivery and train professionals around the country?
Can we become the Patient Centered Medical Homes for our communities?
Forget trying to fund transportation and developing rural resources. This hasn’t happened in 25 years.Why would we think it is suddenly going to happen now with less funding available? How do we partner to take services to where they are needed? Ipads, mobile apps, telehealth etc.