Leading system change, even in times of uncertainty

Advocates working to shift systems often face immense challenges: limited time, limited resources, too many roles, not enough influence. And in uncertain times like these, the challenges we’re working to address may seem so insurmountable that the idea of creating any kind of change feels impossible.

These are the moments when we especially need to pause and recognize what we are accomplishing.  Collectively, these wins add up to significant change, even if we don’t immediately recognize it.

In the spirit of honoring our wins, we’ve compiled just a few examples of what the HealthConnect Fellows have achieved over the past few months. These achievements also highlight what system change can look like and the impact it has on the well-being of our children.

System change means imagining new ways of doing our work.

For several years, Andrea Dencklau has built relationships within the Iowa Dept. of Human Services (DHS) and with providers to support their work with youth in foster care. Knowing how critical maintaining connections are to youths’ well-being, Andrea has found creative ways to partner by providing ideas and tools. The Discovering Connections tool she created allows youth to identify who is important to them, and after months of promoting it within her network, she is now partnering with DHS and providers to test it. The hope is that this tool increases opportunities for youth to maintain valuable connections in their lives.  

System change means connecting new dots.

Seeing the looming crisis that could occur when migrant farmworkers traveled to Iowa this summer to work, with many having chronic health conditions and living in close quarters, Daniel Hoffman-Zinnel and other Proteus leaders and advocates urged state departments to meet to identify ways to support farmworkers' health and safety. After weeks of reaching out, the request was received, and his team is now meeting weekly with state department leaders to address challenges that arise.

System change means taking a stand.

Leading the Iowa Public Health Association means taking on many significant issues that have the potential to improve children’s health and well-being. When the pandemic hit, Lina Tucker Reinders saw an opportunity to center her focus on the storm of inequities people of color are experiencing during this crisis. Her op-ed was the start of an effort to convene representatives from multiple sectors across Iowa to learn from each other. This group of about 25 individuals will map the health equity work that is already underway and identify opportunities for new partnerships and to fill gaps where work needs to be initiated to have a greater impact.

System change means embedding new knowledge into institutions.

Unlike a business model where you want to hold onto what you develop, Lisa Cushatt, who leads efforts to address childhood trauma, has taken the approach that it’s better to provide training and assistance in a way that infuses new knowledge and practices into existing systems, so they can own and sustain a shift in culture. During the pandemic, she has led efforts to support supervisors in government and nonprofit agencies in normalizing their feelings of stress and identifying opportunities to help staff who serve families. Also through Iowa ACEs 360, she is hosting learning opportunities on how historical trauma and collective stress are causing poor outcomes today, particularly for people of color, and the importance of equitable recovery efforts.

System change means protecting what is critical to families.

Mary Nelle with Child & Family Policy Center has worked for years to protect Medicaid from harmful regulations, such as work requirements that would add layers of burden for people in poverty to access health care. She started by raising awareness that Medicaid is a children’s health insurance program, with nearly half of all those enrolled under the age of 18. In response to the COVID-19 pandemic, the state made several positive changes to its Medicaid program, making it easier for Iowans to get and stay enrolled. Mary Nelle is now tracking the impact of these changes to make a case that this program is the foundation families need to work toward stability, especially parents with young children to set the foundation for healthy development.

System change means creating the table to plan.

Since COVID-19 hit, Angie Arthur, who leads Polk County Continuum of Care, has often been a convener or at tables deciding how to best support Central Iowa’s homeless population. Many individuals live in group settings and face complex challenges that make it difficult to protect themselves and maintain their health. The organizations serving individuals who are homeless also lacked access to safety supplies. Angie has spoken up about the need for testing and to share test results with organization staff to prevent outbreaks. She also is helping lead efforts to inform residents who are at risk of eviction about their rights with a flyer that is now available in 10 languages and to work with partners to provide legal and financial support to prevent a significant increase in homelessness.

Thank you, fellows!

This list does not capture all the great work each fellow has achieved in the past few months and is meant to highlight what achievement can look like during this time. A huge congrats to all of the fellows for their hard work and passionate commitment to leading changes that create equitable opportunities for children and families to thrive, especially during this moment of crisis.