In March 2019, United Hospital Fund published Plan and Provider Opportunities to Move Toward Integrated Family Health Care (see Figure A). The report described the nascent national phenomenon of child health providers pushing beyond the traditional patient-centered medical home model to pursue a more expansive model of care. Integrated Family Care aims to seamlessly meet the emerging physical health, mental health, and social service needs of families with young children who are at risk for poor outcomes across their lifetime due to significant adversity caused by structural discrimination, including structural racism, poverty, and challenges related to the inequitable distribution of the social and political determinants of health. Since publication of that report, primary care providers and community-based providers of behavioral health and social services have been tested in unprecedented ways. The COVID-19 pandemic has been financially ruinous to some child and family-serving organizations and traumatic to frontline providers across the spectrum of care. This comes on top of the historical challenges faced by children's primary care and community-based organizations. The pandemic has also exacerbated family poverty, adding to the many other major life disruptions likely responsible for the parent-reported decrease in children's mental and emotional health and increase in child mental health service utilization. In this moment, it is reasonable to focus on how to protect and maintain the core infrastructure of essential child-serving providers, including the ability of health care to deliver the core components of patient-centered care. And yet, the moment also calls for a new vision of health services. The pandemic has illuminated the many ways in which our siloed systems of care often do not meet the needs of families who are underserved, particularly families of color, especially when faced with a disaster of either national or family-wide scope. The concept of Integrated Family Care is not a panacea for solving these challenges but does represent a possible future direction for health care. Innovators across the country are actively pursuing the model, recognizing even before the pandemic the need for a better model of care for families from underserved communities. This paper highlights five of these innovators.
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