Transcription of Claire Berkowitz for the show Kids Count #225
Dr. Lisa: When I worked in Maine Health as the medical adviser for Raising Readers, we were fortunate to cross over with the Maine Children’s Alliance on a very regular basis. Today, I’m extremely fortunate to have with me Claire Berkowitz who is the Executive Director of the Maine Children’s Alliance. In fact, she has in her hands, hot off the press, the 2015 Maine Kids County Book which is something that as a Raising Readers medical director and adviser, I spent a lot of time with. I appreciate the work that you’ve been doing and the work that the Maine Children’s Alliance is doing, and thanks so much for being in here.
Claire: Thanks for having me and for letting us lift our voices about the Data Book and about kids’ issues in Maine.
Dr. Lisa: Tell me about the Maine Children’s Alliance for people who may not be that familiar with it.
Claire: Sure. We’ve been around for over 20 years. We are a multi-issue child advocacy organization, and we are based in Augustus. We do a lot of work on policy. Making sure that when people do make policies that they’re thinking about what’s best for children, first and foremost. We also wanted then, once that policy is passed, how it’s implemented, and sharing best practices, trying to convene people who work with children and for children, and making sure that across communities in Maine, people are sharing best practices, and making sure that kids get the best start and the best access to services so that they can reach their full potential.
Dr. Lisa: What was it 20 years ago that caused the Maine Children’s Alliance to come into being? Was there any triggering events?
Claire: I think, there were some people that were doing good work around child protective services and child welfare that really are looking at what’s happening to create the need to have children taken from their homes. I think that was a catalyst. I wasn’t here when that started but that’s what I understand. From that, growing into other areas realizing that condition of poverty has so much of an impact on children and families, and so branching out into other areas of children’s lives over the years to make sure that they’re all taken care of not just by the family but by the community in which they live.
Dr. Lisa: When I worked for Maine Health and Raising Readers, one of the reasons we thought it was important to get books into the hands of children, and this was an organization that still is out there giving books to kids, ages zero through five in doctors’ offices and with healthcare providers, nurse practitioners, physician assistants, is that we understood that in order to grow as a child, you had to have all the right conditions. You had to have the right nourishment, the right food, the right education, and that poverty was something that impacted every single aspect of your life, your health, your long-term earning potential, your educational abilities, and this is one of the things that I’ve really liked about the Maine Children’s Alliance is that there are so many different places that you’ve had to work on issues. You’re really right in it. You’ve really been looking at this for quite a while.
Claire: Yeah, and we still are trying to look for where we still need to be. We’ve been doing some work around the social emotional development of young children. We’ve been hearing, through our work, just from providers of childcare and folks who work with young children that there’s behavioral health issues going on for young children that childcare providers don’t feel equipped to handle. We’ve just in the last year just from conversations, it’s led us down the path of exploring with others what needs to happen to prevent kids from being expelled or suspended from childcare. We’re talking three and four-year-olds but that’s not to fault the providers. They’re not equipped. They don’t have folks who can do the consultations and help them better understand what’s going on for a child.
We’re doing work with the Maine Children’s Growth Council, and exploring what the issues are so that we can find solutions. We’re constantly listening to people, looking at the data, research knowing full well that it’s those early years that are the most crucial in terms of mitigating negative outcomes later in life for kids. Really focusing on the birth to five, prenatal actually, is key for our public dollars, but as well as just how we think about the well-being of children. We’re really a little laser beam focused right now on that time period in a child’s life.
Dr. Lisa: Today is the release of the Maine Kids Count Book, and it’s something that I think that most providers around the state look forward to on a yearly basis because it’s such a wealth of information about the children that we care for and their families really. First of all, tell me about the Kids Count Book. What is it exactly?
Claire: It is a state-level look at data across the areas of physical and mental health of children, social and economic status, as well as education, including early care in education going through to young adults. We’ve been gathering data. This is our 19th edition of the data book. It’s funded by the Annie Casey Foundation. Every state in our country has a Kids Count grantee who produces similar kinds of data products. We’re proud to be a part of that network. There’s really great people doing this work across our country on behalf of children.
It’s really a snapshot. It’s a snapshot. It’s going to change tomorrow. This data is living, breathing data, and we’ll get new data tomorrow that will change what’s printed in the book. We do also have a data center. It’s called the Kids Count Data Center where you can find online information, and make really cool graphs, and maps, and things of county-level data on some of the indicators, but it’s really a tool for policy makers, decision makers, business leaders, grant writers, anyone who needs data to make the case for the work that they’re doing. We use state agency data. We use US Census Bureau data. It has to be reliable, it has to be consistent, and we use it, and track it, and look at trends over time.
Dr. Lisa: Give me some examples of important data points that you’re interested in looking at.
Claire: We talked about child poverty, and that is something that underlies so many of the other indicators that we’re measuring. As I said before, data changes. We printed our data book, and at the time, 18.2% of children in Maine under age 18 were living in poverty. New data came out yesterday from this source that we used for 2014, and it was up slightly to 19%. We’re basically staying steady. It’s not getting better for kids. Over the last decade, child poverty has risen in Maine, and the poorest are the youngest, our birth to five kids, one in five of our youngest are living in poverty.
That is a concern of ours, and we’ve been talking about it for years. What it tells us is that families aren’t making enough money to meet the basic needs of their kids. Trying to figure out solutions to that is what we want our decision makers to be doing. The children born into poverty, it is of no choice of their own. As a condition, it is not a personal failure. A lot of times, it’s generational. Trying to find solutions where it’s two generation approach to providing parents who maybe don’t have tools to access family supporting wages, jobs with family-supporting wages, giving them the tools maybe to finish their GED or get training so that they can access or can apply to jobs, and at the same time, making sure that there’s childcare for their kids when they do go to work, quality childcare.
There’s a lot of play then that comes out of talking about children in poverty. How do you support them and their families without punishing or being punitive because withholding supports which we’ve been doing lately with these families and with these children, it’s not clear to me what is the result of that when we’ve taken … Just a few years ago, we had about 23,000 children receiving temporary assistants for needy families or TANF, and now it’s down to a little over 10,000, but our poverty rate during that time didn’t change. The economic needs are still there for the children.
What’s happening, and we don’t have that answer in the Data Book. It’s something I’d like to explore to figure out if these stricter sanctions and strict tie limits that we’ve set in place for families in an economy that’s not working in all parts of our state, how is that working for kids? I don’t know the answer to that yet.
Dr. Lisa: Maine Magazine, Love Maine and Maine Media Collective, we spend a lot of energy getting behind the efforts of John Woods, and the Full Plates Full Potential, and Share our Strength, and this is an effort to end childhood hunger, specifically in Maine, but also around the country. When John talks about the 40% plus children of school age who are food-insecure, meaning they don’t even have enough in their bellies to be able to learn properly over the course of a school day, I find that shocking.
Part of the issue that he describes and why he is doing Full Plates Full Potential is that the money exists. There is government funding for providing lunches to children and breakfast to children, but for some reason, there’s a disconnection between the money that is out there and the children themselves. Is this the type of thing that you’re talking about is helping make connections on various levels?
Claire: Yes. The Maine Children’s Alliance, we’ve become involved with Full Plates Full Potential, and support that work. We actually gave them a Giraffe Award this year at our Champions for Children Award in October for the work they’re doing to raise awareness, and raise best practices around getting kids food. I love what he’s doing because it’s true, that money, it’s Federal money. The USDA is paying for that, and the kids are eligible. It is in our best interest to get every child to fill out their application as to whether or not they’re eligible. That’s in districts maybe where the poverty rate isn’t so high.
Then, there are other ways you can do community eligibility where based on the poverty rate, the number of your kids in your community who are receiving TANF and SNAP¸ those reach a certain threshold. Then, you can have what’s called community eligibility. Then, all kids just get lunch. It’s so simple. Then, we’re drawing down the money. That builds our economy at the same time because we’re buying food from people, from CISCO, from folks who provide food to our schools. It’s a win-win. Then, our children are ready to learn because they aren’t sitting there hungry which can cause behavior issues, which can cause feelings of sickness. Then, they go to the nurse, and it creates a disruption in their educational day.
If we can do things like if kids get there late to school, let them grab a breakfast, and take it into the classroom while they’re working. It’s easy. We need to make it easier for kids who might be struggling with living in the condition of poverty, and not even poverty level income families making less than $38,000, approximately a family of three, one parent and two kids, that’s low income. You’re not making enough to just get by. It may not look to the teacher or to someone in the school that the child is living in poverty, but they still might not have what they need in their refrigerator at home. We have these programs that feed kids. I love what Full Plates Full Potential is doing. They’re working across sectors with business leaders, politicians, communities, food service directors to make it happen.
Dr. Lisa: It’s interesting as we’re talking about this, I am thinking about kids in schools, and specifically because I have patients who are teachers and are educational technicians, and people who work in a social work field, and they so want to help children, and they are absolutely experiencing the stress of not having the tools they need, as you have eluded to like childcare providers saying, “We have behavioral issues we’re dealing with and we don’t have the background for this.”
This is something that I worry about burnout. I worry about provider burnout for these children who really needs so much and these families who need so much, and yet, even people who are dedicated, they have dedicated their lives to taking care of them and helping bring them, I guess, in a positive way, into the world. They’re feeling stressed.
Claire: Yeah. My husband is a principal in an elementary school. That’s a Title I elementary school. I can attest to the stress that he carries as an educational leader around what’s going on with kids. There are kids who are showing up with what I call trauma. What might look like behavior issues that could look like ADHD or something else, it’s trauma.
There’s some good work going on with the Maine Resilience Building Network, MRBN. They train folks in trauma-informed care working with providers, working with public health nurses, going into communities to teach people that what trauma looks like, why kids might be misbehaving because they might be exposed. It’s not just poverty, but violence, separation and divorce, death of a parent, incarceration, all kinds of things that are called adverse childhood experiences that weigh heavily on a child. If not looked at and dealt with in a way that it provides healing, it will carry into their adulthood and create issues of not just physical health, but emotional health issues, as well as possible workforce issues for them.
It’s really imperative that we have our providers, our teachers, nurses, doctors, all of the trauma-informed lens so that they can recognize it in children. When a child is misbehaving in class, understanding what might be going on for them outside of the classroom allows the teacher to not react in a way that might trigger even more for that child. Sometimes, school is a safe place for a child to let off the steam that they’ve been holding in in a home that may not feel safe to them. Sometimes, that’s a play as well, but I agree. I think that we need to do a better job of equipping the folks who are on the front lines working with our kids, and teacher training, and early education programs, making sure that that’s a part of the curriculum of folks who are working with children.
Dr. Lisa: The other group that I deal with also are the children. I’ve had, on more than one occasion, a parent who came in with a child, and maybe even a fairly young child who was told because there was no other good answer, “You should bring your child to the doctor because your child might have ADHD, and because of this attention deficit hyperactivity disorder that’s presumed, your child may need medication.” As a doctor, I struggle with that because I certainly have seen children who need medication and I have seen children for whom medication is the absolute worst thing, but in either case, it’s a multi-varied approach. It really is.
If you need medication, then you need medication, and you also need some help with logistics and how to organize your day if you’re a child or a parent. You also need family structure. You also need looking into a past trauma issues but the most successful children that I’ve ever seen are children that require and families that require multiple services. It can be very successful if we can look at it that way.
Claire: Yeah, it’s a multifaceted approach, and I think sometimes there’s silos within those systems. Maybe the parent is receiving services over here, and the child over here, and all folks in the family have case managers but they’re not communicating. It’s trying to find ways to break those silos down.
We haven’t done much around the medication of children yet but I’ve read studies. There’s over-medication of children especially in foster care, over-prescribing. What that does, it’s so important to make sure that across that it’s monitored well and constantly given. That’s not always happening when a child may be going between two households, and making sure dad is giving the medication at the same time as when mom has the child and is doing it. Those issues that then come back and play out in the school if the child was with one of the parents over the weekend and the medication didn’t get given, and then they show up on Monday. A lot of things to think about in all of this.
Then, also just as children are changing and going through puberty, what does that do? Making sure that you have a good physician who is following up on all of that, and making sure that it’s the right dosage and consistent over time. Lots of things to be concerned about over that.
Dr. Lisa: What it really is, it’s a team approach. I and the patients that I have with ADHD, or autism, or some other diagnosable issue or patients, children with trauma, as a doctor, if I was standing there by myself, I would be absolutely at lost. It’s working with my nurses, and the medical assistant, and the people in the front office, and all the people that help the family, and the teachers, and the social workers. I think it is incumbent upon all of us who want to work with children and families to learn how to be a part of a team.
Claire: That’s right. I think of that too. I keep going back to the schools but in thinking about the outcomes of schools like if we look at their reading scores or we look at graduation rates, thinking of that as a team number. It’s not just the school’s number. A high school graduation rate isn’t a reflection of what the school has done. It’s what the community has provided to the kids to give them the best chance at reaching their full potential and success.
It’s a team approach as well. How are the providers working with the school and getting feedback about that so that it informs then your decision as a medical provider how is this working for the child in their daily life? I think places like IEP meetings for kids who are diagnosed with the special education and receiving special education services, that’s a place where that kind of information is shared, and wouldn’t it be wonderful if all kids have access to people talking about them in ways that are collective and sharing information so that everyone is working, parents, providers, teachers were all working together to make sure kids are doing their best.
Dr. Lisa: I feel like there are so many different directions we could go with our conversation. You’ve been in Maine since ’96, and you’ve been the head of the Maine Children’s Alliance since 2014. You’ve worked in all different areas of helping people. What is the one thing that you would hope to see in your personal/professional career in doing the work that you do? What is the one thing you would hope to see change?
Claire: I guess I would like to turn some of the conversation around poverty. I would like for people to stop beating up on people who live with a condition of poverty. Instead of saying that that’s the problem, I think poverty is a condition that’s created by greed. There’s enough in our world. How do we talk about that? How do we then help people head way in our economy and our workforce so that everyone has the right and the potential to earn a job that supports their family and without it being about personal failing. I guess, I’d love to see the conversation change. I think it is in communities.
I live in Bath, and I think it’s been a wonderful place to raise kids. We have a high poverty rate, a high child poverty rate but I feel like there’s been interesting work, quiet work, to meet the needs of kids and understand that we need to give them what they desire to meet their best potential. We have an indoor skate park in Teen Center for Kids who maybe don’t fit the mold of sports that are offered from the schools, after school, and a place that’s safe. I worked there for a while. It’s a neat concept and our community did that. They saw a need. They saw an issue of kids skating in downtown Bath, and it was bothering our shoppers and our business folks which, of course, it was. They found a solution. Instead of being those bad teenagers, it became like, “What can we do to change that?”
I’d love to just see more of that. I think there is. It’s just we end up focusing on the bad news so much that we don’t think about what communities are doing to support kids. Then, we need to just share across communities best practices that are working. I think it’s Bowdoinham, they’re trying to build a skate park too, and they know about ours, and there’s some feedback, and some sharing of best practices. I think I just wish there would be more of that and less pointing blame at people for not living up to some standard that we expect them to be at.
Dr. Lisa: Claire, how can people find out about the 2015 Maine Kids Count Book or the Maine Children’s Alliance?
Claire: Our website is mekids.org. You’d go find the data book online. We’re on Facebook. We have a Facebook page. We also are on Twitter, and I don’t know in my head right now, it’s like @mainechildren, I think. There’s lots of ways to engage with us and we’d love to hear from folks, and we want to visit different communities in 2016. We want to go on the road and try to visit every county in the state, and talk about data, and hear what people are doing. There’s really great things happening from Washington County, the York County, up to Aroostook, and Piscataquis. Good things are happening. We just need to lift them up and share them, and then see if we can maybe replicate things in other parts of the state.
Dr. Lisa: We’ve been speaking with Claire Berkowitz who is the Executive Director of the Maine Children’s Alliance. Thank you so much for the work that you’re doing, and I hope that our conversation today is going to encourage people to find out more about what’s going on with children in our state, and the good work that the Maine Children’s Alliance is doing.
Claire: Great. Thank you for having me.
Dr. Lisa: We appreciate it.