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February 5, 2019
For our latest staff spotlight, we sat down with Alice Bufkin, CCC’s Director of Policy for Child and Adolescent Health. Alice focuses on improving outcomes for children in areas including mental health, school readiness, and young child and maternal health. In our Q and A, Alice touches on the differences between advocacy work in Texas compared to New York (and their similarities).
She also discusses what she sees as the most pressing health issues New York children are facing today including recent federal attacks on immigrant communities, children’s behavioral health, and maternal health.
Lastly, Alice tells us what about the new year has her excited.
Before joining CCC, I was living in Texas, where I spent several years doing advocacy on a range of issues impacting women, children, and families in the state. I served as the Director of Policy for a coalition focused on increasing access to family planning and women’s preventive health services in the state. Prior to that, I did policy work for a multi-issue child advocacy organization very similar to CCC, where I focused on issues including infant/maternal health, early intervention services, and family financial security.
I believe healthcare is a right. Unfortunately, I think it’s clear that we have a system with vast disparities in who has access to high quality healthcare and who doesn’t. Children rely on adults to have their best interest in mind – whether those adults are their parents, or those passing laws that impact their healthcare every day. We have a responsibility to use our power to hold elected officials accountable and work towards a world that’s safer and better for kids.
One of the things that makes me most passionate about children’s healthcare is the incredible advocacy I’ve seen from the families of children who aren’t getting the healthcare services they need. The healthcare system is huge, complicated, hard to navigate, and not designed with everyday people in mind. The same could be said for the legislative process. Despite all these challenges, I’ve seen so many parents show up to hearings in the middle of a workday to fight tooth and nail for their children. I’m driven a lot by their passion and dedication. That said, I don’t think we should have a healthcare system that forces parents to ask elected officials year after year to fund services for their children – another reason I think it’s so important for advocates to do this work.
Federal threats are undoubtedly some of the most pressing issues impacting children and families in New York and across the country. We’ve just witnessed the deep damage the government shutdown has had on families whose parents were going unpaid. Families facing poverty and hunger were at risk of seeing critical programs like SNAP and WIC cut and will be at risk again if the shutdown resumes.
This administration’s dogged pursuit of anti-immigrant policies is clear in the impasse over the border wall, and in countless other policies impacting immigrant families in New York and across the country. It recently came to light that thousands more children were separated from their parents at the border than previously reported. Many of these children ended up here in New York, where child-serving agencies desperately needed resources to provide them with trauma-informed care. We are also concerned about the impact of the public charge, a proposed rule that will force thousands of New York families to choose between accessing basic food, housing, and health services, and risking their immigration status. These and other federal threats make it more important than ever that the city and the state step up to protect immigrant New Yorkers.
Another area that is critical for New York to continue addressing is the city and the state’s high maternal mortality rates. Non-Hispanic black women are 8 times more likely to die of pregnancy-related complications than white women. That disparity should be shocking to everyone. It points to the need for continued attention not just on healthcare delivery, but on the social determinants of health – including environmental challenges, economic inequality, and institutional racism – that are underlying contributors to poor health outcomes.
We are also very invested in the Early Intervention Program, which provides services to infants and toddlers with developmental delays or disabilities. In recent years, we’ve seen a concerning decline in available providers, and know how important it is to find statewide solutions to make sure all children who need them are able to access these critical services.
And while there are a lot of other areas I could mention, I do want to highlight that there is so much more work to do to ensure that New York’s children have access to the behavioral services they need. After seven years of delay, the state is finally undergoing a big transition of its children’s behavioral health system. This transition includes the introduction of new family focused, community-based services that could make a real difference for more children. We want to make sure these services are successful, but we also need to do more to increase overall capacity, reduce wait-times, and address provider shortages.
This is a big question to tackle! There are certain aspects of children’s policy that remain the same across states, for better or worse. Regardless of whether you’re in New York or Texas, we know that there are children who just can’t access the kind of care they need to be healthy and thrive. And, unfortunately, there are deep inequities baked into our country’s history and institutions that play out regardless of where you live. Advocates in every state are paying new attention to the social determinants of health and how we can tackle children’s health in a way that steps outside of a purely medical model.
All of that said, there are clearly some big differences between doing this work in New York versus Texas. In Texas, so much of the healthcare conversation has been driven by the state’s decision not to expand Medicaid, which would lead to more than half a million low-income Texans getting health coverage. One in ten children and a quarter of parents in Texas are uninsured. In New York, those numbers are closer to 3% and 8%, respectively. That, to me, is a stark example of how states can really move the needle on healthcare if they commit to it. Obviously New York has its own work to do to improve health care and outcomes, but there is a lot of momentum to support progressive healthcare policies.
Policy work in Texas definitely builds an in-the-trenches mentality among advocates, and I worked with some really brilliant, dedicated colleagues who continue to fight so that all Texas families and children have access to basic resources. The good thing is that a commitment from advocates, parents and direct service providers is another thing common across states. I’ve been impressed by all the incredible work being done in the city and state on behalf of kids, and I look forward to building on those relationships with new partners.
I really value CCC’s commitment to integrating advocacy, research, and civic engagement. We have an incredible data team, and I’ve been so impressed with our community and youth leadership work. I’m looking forward to all the ways we can better collaborate and strengthen each other’s work. I’m also excited to continue building relationships with new and old community partners that are committed to improving outcomes for New York’s children and families. There’s a lot of work to do!