Innovation Ecosystem

A fact-based strategy for swimming upstream toward prevention

An interview with Paige Clausius-Parks, who has taken the helm at Rhode Island Kids Count

Photo by Richard Asinof

Paige Clausius-Parks, the new leader of Rhode Island Kids Count.

By Richard Asinof
Posted 12/12/22
The ConvergenceRI interview with Paige Clausius-Parks, EdM, the new leader at Rhode Island Kids Count, the premier advocacy group in Rhode Island for children and families, whose Factbook has become the veritable policy Bible for legislators and community leaders.
What is the best way for information to be shared about what is happening with Medicaid in Rhode Island, given how much it drives the delivery of health care in the state – as well as the state’s budget? Will Neighborhood Health Plan of Rhode Island consider ending its relationship with the for-profit Optum in how it manages behavioral health care insurance claims? What are options for non-hospital centric health care delivery systems in Rhode Island, looking to Ortho RI has a potential business model? How quickly will the General Assembly move to enact the Equality in Abortion Coverage Act in the 2023 session? What course of action will the R.I. Senate President take, if any, to forestall the eviction of the Community Care Alliance from the state-owned facility at 181 Cumberland St. in Woonsocket?
There is something pathetic about the attempt by the leaders of the Providence Public School District to blame the teacher’s union for attempting to “sew turmoil” in raising issues about potential school closings in Providence. Beyond the poor spelling, it showcases how the administrators are projecting their own problems with transparency on the teacher’s union.
Similarly, the reporting that Lifespan and Care New England managed to find the money to paid their outgoing presidents and CEOs large salaries while, at the same time, losing money, has put the hospital delivery systems under financial scrutiny. R.I. Attorney General Peter Neronha was featured on CBS News for identifying how the owners of Prospect Medical took out a more than $1 billion loan – and then paid nearly half of that in bonuses to the private equity owners.
But the biggest questions that the leaders in the General Assembly will face in putting together the state budget will deal with Medicaid and, in particular, managed care under Medicaid, when the numbers about spending trends under Medicaid’s managed care become transparent, thanks to the work being done by OHIC. How much will the General Assembly be willing to raise the Medicaid rates that have been kept artificially low for more than a decade? Someone is going to have some explaining to do.

PROVIDENCE – To step into the new job as the executive director of Rhode Island Kids Count, an organization in transition after more than two decades of leadership under Elizabeth Burke Bryant, is a daunting, challenging task.

That is the mission possible that Paige Clausius-Parks, EdM, has chosen to accept, beginning on Dec. 1 – an elevation from her previous role as Senior Policy Analyst at Rhode Island Kids Count, where she had been responsible for policy analysis, advocacy, research and project management in areas related to education and economic well-being.

Her first big publication event occurred on Friday afternoon, Dec. 9, with the release of “Centering Youth Voice in Juvenile Justice Reform,” a report based on a series of focus groups that were conducted by Tides Family Service. The goal of the advocacy effort was to put “the youth voice at the center of decision-making” for juvenile justice reform, according to the executive summary. The event served as a way to amplify the voices of those challenging the status quo of the state’s juvenile justice system.

The report itself began with a provocative opening paragraph: “It is well known that during adolescence, the frontal cortex – the part of the brain that controls reasoning, weighs consequences, and helps youth consider the implications of their behavior – is still developing. This ongoing brain development means that adolescents make decisions and solve problems differently than adults.”

The report continued: “Adolescents are more likely to be impulsive, misread social and emotional situations, get into accidents and fights, and engage in risk-taking behavior With guidance and support from parents and caring adults, most adolescents will grow out of these behaviors as their brain develops. Unfortunately, many adolescents are not afforded the opportunity to grow out of their neuro-developmentally typical behaviors without encountering the juvenile justice system.”

Call it auspicious – or at least serendipitous then – that the topics being discussed in the new publication were issues that ConvergenceRI was somewhat conversant about – having hosted a statewide seminar on “toxic stress” in October of 2015. [See link to ConvergenceRI story, “How to build a collaborative strategy around reducing toxic stress in RI.”]

Chronic behavioral issues related to childhood lead poisoning has also been a major focus of ongoing reporting by ConvergenceRI, ever since the digital news platform first launched a decade ago in September of 2013. More than 20 stories have been published since then, examining lead poisoning in children and the consequences in childhood development, connecting the dots when it came to behavioral issues and lead poisoning in adolescents.

Most recently, ConvergenceRI had reported on the “2022 Summit To End Childhood Lead Poisoning,” held on Friday, Sept. 30, at Rhode Island College. [See link to ConvergenceRI story, “Navigating through the fog of wealth.”]

As ConvergenceRI had reported: Childhood lead poisoning is an entirely preventable disease. Despite the state having good laws on the books, a state health department invested in conducting aggressive inspections and testing children for lead poisoning, as well as an aggressive Attorney General willing to take negligent landlords to court and municipalities ramping up enforcing code enforcement activities, it still requires vigilance:

• In 2021, 432 children were newly lead poisoned in Rhode Island.

• Rhode Island has the second highest rate of children under the age of six with severe lead poisoning in New England.

• Lead poisoning affects 1 out of 14 rising Rhode Island kindergarten students.

• Lead exposure is caused in large part by contact with lead paint and dust in homes built before 1978. With the removal of lead hazards from a child’s home, lead poisoning is 100 percent preventable.

The opportunities to find common ground during the interview with Clausius-Parks seemed promising, which took place on Friday morning, Dec. 9, in person.

Transitions
The entire history of Rhode Island Kids Count and the production of its signature Factbook have been “dominated,” if that is the right word choice, by the leadership of Burke Bryant, who had put her own indelible stamp on the nonprofit’s activities.

The annual release of the Rhode Island Kids Count Factbook has become an annual rite of spring in Rhode Island, what Convergence described in 2021 “as annual tradition that had in years past filled the Crowne Plaza Hotel in Warwick in a celebration of children and families in Rhode Island – before the COVID pandemic disrupted our lives.”

As ConvergenceRI reported: The event had an ambience much like a political greeting card that showcased the best and brightest in the state – legislators, the Congressional delegation, business and labor leaders, and community advocates – all to be re-energized by the magic of student voices singing in an elementary school choir. It always seemed brighter and sunnier in that moment, wherever you lived in Rhode Island.

ConvergenceRI continued: The cold harsh reality, however, was that facts contained in the annual voluminous Factbook were never cheery, despite the uplifting artwork. The gaps and disparities identified in the lives of kids were always presented in a full frontal display, revealing just how much the state had never quite lived up to its promise to protect mothers and children and parents, documenting the stubborn, persistent racial and ethnic disparities.

The transition to Clausius-Parks’ leadership comes at a time when, in terms of advocacy, there have been a number of huge victories won in the last year on behalf of children – the expansion of Medicaid coverage for post-partum parents, from six weeks to an entire year, and the further expansion of Medicaid, under the rubric of “Cover All Kids,” which now enables undocumented children to receive health benefits, regardless of immigration status.

The problems, of course, difficult to document in the data tabulated and collected from state health agencies, are in the messy details: how these programs get translated into actual practice. Signing up undocumented children for access to health care has turned out to be a cumbersome, labor-intensive practice, involving filling out a 40-page application, at a time when the R.I. Department of Human Services, the agency in charge of managing this process, is severely constrained by an apparent lack of front-line employees. The latest report by WPRI’s Tolly Taylor on Dec. 8 was that “more than 100 jobs still vacant at R.I. Dept. of Human Services” – job vacancies that apparently have not been filled during the last six months.

For diligent health care providers in the field, it often requires assigning a dedicated community health care worker to manage the “Covering All Kids” application process – as well as building, maintaining, and retaining the trust of the parents in sharing information. The question is: What happens when your call to DHS is placed on hold for more than an hour?

Anticipation
ConvergenceRI had been looking forward to sitting down and talking with Clausius-Parks for an interview. However, the initial scheduling for the interview turned out to be a misfire. ConvergenceRI showed up, on time and on schedule, only to discover a locked door; there was no one at the nonprofit’s office. Apparently, an all-staff meeting had been called that had conflicted with the scheduled time of the interview, and no one had informed ConvergenceRI of the change. Thankfully, the interview was quickly re-scheduled for the next morning.

Here is the ConvergenceRI interview with Clausius-Parks, during a time of transition at Rhode Island Kids Count – and, for that matter, a time of transition across Rhode Island, when a new, more diverse generation of leadership is emerging – in government, in business, in politics, and in advocacy. The interview reflects in part the difficulty of beginning a new relationship during a relatively brief, half-hour interview.

ConvergenceRI: Thank you for agreeing to sit down and talk with me, given your busy schedule.
CLAUSIUS-PARKS: The board asked Elizabeth [Burke Bryant] to stay on for a month as a transition advisor, which has been really important time for us to sit together, and really transfer the rich history that she has, and the thought processes – and also to transfer over the many logistical things that have to happen when you change leadership as a nonprofit.

It’s been a good time to have with her, and then our staff is continuing to work diligently on a ton of different work, including the release of a new publication today.

ConvergenceRI: Yes, I am aware of that.
CLAUSIUS-PARKS: Are you coming to the event this afternoon?

ConvergenceRI: It really depends on how I am feeling. These days, I need to limit what I do. How familiar are you with ConvergenceRI? Do you get a chance to read it every week?
CLAUSIUS-PARKS: I have seen the reports; I am familiar.

ConvergenceRI: About three years ago, I was diagnosed with autoimmune encephalitis; something is eating away at the myelin in my spinal chord in my thoracic region…
CLAUSIUS-PARKS: Oh, dear.

ConvergenceRI: …So I am losing my ability to walk, among other things.
CLAUSIUS-PARKS: Geez.

ConvergenceRI: It makes my mobility very limited; the amount of stress that it puts on my body can be quite severe. It seems more important to take the time and make the priority to sit down and talk with you, and have the opportunity to introduce myself – and to get a better idea of what your vision is for Rhode Island Kids Count, moving forward.

The materials for this afternoon’s event are comprehensive. The questions that I have about what your findings are – we should probably jump into and talk about them. It’s probably a better format to talk here, rather than raising my hand and asking questions [at the event].

One of the things that I don’t think that has been brought to the forefront as much as it should be is the lingering effects of lead poisoning on children and the way that it plays out in terms of behavioral issues. Also, as a factor when kids are facing [expulsion] from schools.

My question is: As you were working [in the focus groups] with these kids, was there any correlation regarding how many might have been lead poisoned?
CLAUSIUS-PARKS: We do not have information from this report that connects lead levels who those who were part of our focus groups, and their connection to the juvenile justice system.

ConvergenceRI: There is a study that was done at Brown by Ann Aizer [“Lead and juvenile delinquency: new evidence from linked birth, school, and juvenile detention records”] that studied a whole cohort beginning in 1997-1998, that has tracked the correlations between lead-poisoned children on standardized testing but also on behavior.
CLAUSIUS-PARKS: As far as the young people we are focused on through the focus groups for this publication, and in the terms of the young people that we spoke to specifically for this publication, that was not something that was part of the discussion or the dialogue.

But, in general, if we are talking about lead poisoning, yes, you are right, lead [poisoning] has long-lasting impacts on children, and including, as we said, difficulties with learning, and we see it coming out in behavior as well.

Which is why Rhode Island Kids Count has reported data on lead poisoning and really led a lot of advocacy efforts to have laws changed in terms of lead paint in homes and residential places. And, we continue to track that.

And, we’ve seen a decrease in the number of young people, children who have been reported with lead poisoning. So, those are positive things going in the right direction. Because there is a correlation, you’re right, with lead poisoning.

But there are other things that impact children’s involvement with the juvenile justice system. In the report, we really highlight that children, adolescents, neuro-developmentally, think differently than adults do. And oftentimes, their behavior may be different; children are not tiny adults.

Without recognition and understanding of the differences between [the way that] children and adolescents think, and criminalizing that behavior, [young people] are not being given opportunities to be able to learn about their mistakes, to be able to have restorative justice opportunities. Then we are going to have young people in the criminal justice system that end up [experiencing] more trauma, and not being treated.

There are a lot of things that impact [behavior]. In a report that we released in October, around children’s mental health, young people said that the first time they ever reported getting any kind of mental health support came after they were already involved with the juvenile justice system.

There is a lot of work that we can do before we have young people interacting with the justice system.

ConvergenceRI: Yes, when you look at childhood lead poisoning prevention, it is preventative in nature.
CLAUSIUS-PARKS: Prevention is important. Absolutely.

ConvergenceRI: There was a presentation earlier this year [the 2022 Summit To End Childhood Lead Poisoning] that the Childhood Lead Action Project sponsored – the Attorney General’s office was there, and so was Joseph Braun, who is at School of Public Health at Brown. They were highlighting the opportunity to spend federal money to repair all of the water pipes in Rhode Island, and specifically in Providence, yet the General Assembly has not yet moved forward with the enabling legislation to make that happen.

It’s one of those things that have seemed to fall through the cracks; perhaps it is one of those areas of advocacy that would seem to be a natural for Rhode Island Kids Count to get behind.

You may want to talk with the folks at the Childhood Lead Action Project – Laura Brion and Devra Levy, who have been leading the fight.

I bring up Joseph Braun. Before he came to [the School of Public Health at] Brown, he was conducting research out in Cincinnati, part of a huge national clinical study, which found that the levels of PFAs in pregnant mothers could be correlated with adiposity, or childhood obesity. His lab here at Brown has continued to work on that. I wasn’t sure if you were familiar with his work.

It gets to another Kids Count area of focus, which you have been in the forefront of – looking at the disproportionate nature of childhood obesity in Rhode Island, in terms of a racial and health equity issue, and how that plays out for communities of color.

Braun’s work is remarkable, because it gets back to the roots. If you begin to look at the influence of PFAs in our water supply and what that influences, and how that then plays out, the scientific evidence is there. There is a lot of work being done here in Rhode Island, to change the standards, but connecting that to all the other environmental things, whether it is food desert or food swamps, whatever way you want to do it, all you have to do is drive down Reservoir Avenue in Cranston – it seems that every single kind of fast-food corporate outlet is right there – McDonalds, Wendy’s, Burger King, Taco Bell, you name it.

Using that as a way to map, what are the choices, if you are hungry, and you need to feed a family of four, where are you going to go. As against, the lack of ability to have nutritious meals, and where you can get fresh vegetables, and I know there are other groups, from Farm Fresh RI to the Rhode Island Public Health Institute [Food On The Move].

Here I am, I am talking too much, I apologize.
CLAUSIUS-PARKS: What you are saying is really important. We had started the conversation talking about prevention, and how key and critical prevention is. The systems are all interconnected. We started out talking about juvenile justice system. And how that is impacted by health, environment, and nutrition. I would add in economics – about who can afford food.

All of these things are all part of interconnected systems. At the end of the day, we see the results that we track every year in our Factbook.

It’s really important for us that we start swimming upstream. I shouldn’t say “start” – we have been doing that. We continue to work in partnership… to swim upstream and make the investments so that we can prevent…”

An exchange of information
Much of the rest of the interview devolved into more of a conversation, with ConvergenceRI asking questions, but then which quickly devolved into a sharing of information about stories ConvergenceRI had been busy reporting on – such as the current number of Rhode Islanders on Medicaid, nearly 350,000, more than one-third of the entire population of the state, and the threat looming that some 50,000 to 60,000 of those would soon lose their eligibility once the federal COVID emergency declaration was rescinded, and how that might impact emergency rooms across the state. Stay tuned.

© convergenceri.com | subscribe | contact us | report problem | About | Advertise

powered by creative circle media solutions

Join the conversation

Want to get ConvergenceRI
in your inbox every Monday?

Type of subscription (choose one):
Business
Individual

We will contact you with subscription details.

Thank you for subscribing!

We will contact you shortly with subscription details.