Friday, May 30, 2014

Community ParaMedicine

On April 16 I spoke with Lincoln Fire Chief Steve Carter. He told me about Community ParaMedicine, a collaborative effort he is working on involving the Council on Aging, public safety, and social service agencies etc. This is a community outreach effort designed to help families remain safe in their homes. http://communityparamedic.org/. An article in today’s Boston Globe highlighted a similar roll-out happening at EasCare, an ambulance company in Dorchester. http://www.bostonglobe.com/business/2014/05/30/paramedics-branch-into-home-care/WIBIbjRuBx6mQCeoNb3c3K/story.html

The article reports, “How ambulance companies deliver home care services vary. In some programs, they respond to calls from patients or providers. In others, they make scheduled visits, following up, for example, after patients are released from hospitals to ensure they take medications and adhere to doctors’ instructions.” This is quite similar to what I was told by Carter. In essence, they provide the eye and ear of the professional in a home base setting. Carter said that to a large extent they know who these people are already and many are repeat customers. By proactively checking in with them and making sure they are safe in their homes they can circumvent the need for emergency treatment.

This approach seems like common sense to me, help people before they get themselves into a, in this case health related, jam and many a crisis can be averted. The approach is being driven by the Affordable Care Act which is providing strong incentives for hospitals and providers to reduce both trips to the emergency rooms and hospital stays. According to the article in the Globe, “a pilot program showed that paramedic care eliminated emergency room visits for 73 percent of 135 seniors treated over nine months in 2011.” That sounds like good planning to me.

Saturday, May 17, 2014

Pay Now or Pay Later

I am sitting here at my dining room table that I use as a desk, thinking about the fact that it is sixty years since Brown v the Board of Education.  Sixty years since the Supreme Court decided that separate but equal is inherently unequal.  Sixty years since the Supreme Court ordered states to use “all deliberate speed” to rectify the situation.  From where I am sitting, we are not there yet.

We have, at least in our communities of Lincoln and Waltham, achieved desegregation.  Our schools are full of the energy and excitement of a diverse group of students.  Waltham schools are close to 50% non-white and Lincoln schools are coming up on 40% non-white.  On the face of it that looks great.  But are these students achieving equal ‘access’ to education?  Is the law meant to say that all students, regardless of race are to be offered equal opportunity to education?  That is how I read the law, not just that they shall be allowed to sit in the seats next to white students but all students have an equal right to the opportunity to learn. 

If we look at the drop out rates we can see this is not occurring.  If we look at MCAS scores we can see this is not occurring.  If we look at unemployment rates and socioeconomic data we can see that this is not occurring.  Just allowing all students to share an educational environment is not the same as providing them with an equal opportunity to acquire an education.  Children that are blind can not learn to their potential if they need to see to learn the material, but we accommodate for that.  Children that are deaf cannot learn to their potential if they need to hear to access the material, but we accommodate for that.  

Children are natural born learners; they come to school excited to learn!   They soak up and process new information from the moment they arrive here and they are fast learners.  They are eager learners.  They learn early on to differentiate among people, to communicate, to reciprocate, to regulate themselves.  They learn all manner of complex social, emotional and physical tasks and behaviors without missing a beat.  How is it then that so many of them come to school and their learning slows down drastically.  One minute they are engulfed in a sea of knowledge and the next they are mired in the muck, not able to make their way to shore.  It is not because they can’t learn, they are proven learners.  It is not because they don’t want to learn, they thrive on mastery of new concepts.  So what is it, why do they suddenly get stuck?  

Is it because we don’t know how to reach them?  Is it because we have not figured out how to teach in the manner in which they can learn?  Is it because other things are getting in their way?  I once had a 2nd grader say to me, "Sharon, it is not Arnold's (his 13 year old brother) fault he doesn't know how to study, when he was my age he was too worried about where would sleep that night and what we were going to eat".  Teachers are forever differentiating their instruction and finding new and innovative ways to teach our kids but something is not working.  It is not the kids’ fault!  Yet it is the kids that bare the burden of our failings.  It is the kids that get lost in the tide of education.  It is the kids that suffer the humiliation of underachieving and feel ‘less than’.  It is the kids that end up dropping out of high school or graduating unprepared to face the future.  In the end it is us, society, that loses out.  We lose out on all the marvelous accomplishments these kids do not make.  We lose out on all the inventions and contributions these kids will not make. We lose out when we see them in the streets and in the clinics, not able to take care of themselves or addicted to substances.  We lose out when we lock them up and lose their presence in society.  We lose out when instead of paying for an education they can access, for supports that allow them to access, we end up paying for ‘three hots and a cot” when we lock them up.