The Cohen Children’s Medical Center, located where Queens County and Nassau County meet, provides care to families from both counties but draws a majority of its patients from Queens. It is a high-volume pediatric clinic and sees more than 5,000 children per year under the age of 5. Most of its patients’ parents were born outside the United States and have limited English proficiency; some are recent immigrants. The Center is a major pediatric training site, with an average of 70 residents, and it is part of the extensive Northwell Health System.
Cohen Children’s Medical Center: Key Elements
Type of practice
- High-volume pediatric clinic, part of the Northwell Health System, providing full range of general pediatric care, and serving more than 5,000 children per year under age 5
- Training site for 70 pediatric residents
- On-site staff and programs include lactation consultants, psychologists, an asthma clinic and an obesity prevention program
- 76th Avenue, Queens County, New York, drawing patients from both Queens and Nassau County on Long Island
- 66% of patients are enrolled in Medicaid
- A majority of patients’ parents were born outside the United States and have limited English proficiency
- Recruit and train pre-med students to serve as “navigators” for families, helping them complete the screening process and linking them to community resources
- Seek regular feedback from families through surveys, an in-person parent forum, and a Caregiver Advisory Board
- Analyze the impact of the screening and referral program on the health status and health services utilization of the families it served
The Center began its screening and referral program, which it calls FAMNEEDS, in the summer of 2016. The screening questionnaire, developed by the Center, covers a broad range of possible psychosocial needs, from housing and food to intimate partner violence and depression. To administer the survey, the Center recruits college students, mostly pre-med students from nearby Hofstra University, to act as “patient navigators.” The navigators go through a formal training program at the Center and then are stationed in the waiting room to help parents complete the self-administered screen. After the family meets with the clinician and agrees to seek assistance, the navigators develop an action plan and refer the family to appropriate community resources. The navigators also follow up with the families over the next three months to learn if they actually connected with the community organization and had their social needs resolved.
Obtaining family feedback on the FAMNEEDS program in multiple ways has been a high priority with the Center’s leadership. It conducts random satisfaction surveys on site and also asks families who received referrals to provide information on their experience. In addition, in both 2018 and 2019 the Center leadership hosted an in-person dinner meeting with parents to hear from them about the navigators and the program. It has also established a formal Caregiver Advisory Board.
Center leadership is invested in evaluating the impact of the FAMNEEDS program on patients and families. From the beginning, FAMNEEDS survey data has been captured electronically in REDCap, a secure web application for building and managing online surveys and databases. Using the FAMNEEDS data from REDCap and other data from patient records, Center staff can explore whether a significant association exists between successful participation in FAMNEEDS and the child’s health outcomes (developmental progress, obesity, and asthma) as well as health care utilization outcomes (delayed or missed well-child visits, and number of ER visits or hospitalizations). In late 2019 a co-director joined the FAMNEEDS team to assist in these research efforts.
The Center’s close community partner since 2017 has been the Child Center of New York (CCNY), and, particularly, CCNY’s Single Stop program. Single Stop staff provide Center families with assistance in enrolling in public benefit programs, getting financial counseling, and finding child care. In addition, CCNY units provide mental health and substance use disorder services, crisis intervention, and parenting classes and workshops.
Other CCNY staff provide training to the Center’s navigators and staff on motivational interviewing and cultural competency, working directly with the navigators on specific referrals. The CCNY-Cohen Center partnership also led CCNY to initiate broad social needs screening of its own clients. “The collaboration,” notes CCNY leadership, “allows the partners to leverage their greatest strengths toward a common goal of improving the health outcomes for children through a holistic approach to working with families.”
In 2019 the Center expanded its relationship with community-based social service partners to the Interfaith Nutrition Network of Long Island in order to serve more families.