By Lynne Terry/Oregon Capital Chronicle
The only pediatrician — and medical doctor — in the state Legislature treats vulnerable children in her practice and now she’d like to help them as a policymaker.
Sen. Lisa Reynolds wants to reverse cycles of poverty, drug addiction, illiteracy and mental illness by funding programs for vulnerable people during pregnancy and their child’s first year of life.
That’s the most effective way to help children later reach their full potential, she told members of the Senate Humans Services Committee on Tuesday during a presentation of her initiative — which she’s calling Momnibus — that will be introduced next session. It follows the “Black Maternal Health Momnibus Act” that was introduced and died in Congress last year and stems from her practice at the Children’s Clinic in southwest Portland.
Research shows the brain develops in the first years of life.
“If there’s disruption in that time period, whether it’s being in a situation where a parent is not able to truly bond or attach to a child, or even in a worst-case scenario, when child is removed from their home because of child endangerment, that really interrupts human brain development,” Reynolds said.
Reynolds, a Democrat who chaired the House Committee on Early Childhood and Human Services, has focused on children’s issues during her two terms representing the 34th House District in northwest Portland. In November, she easily won a third term but was sworn-in Monday as a senator, taking the Portland-based seat vacated by Elizabeth Steiner, who’s also a physician and was just elected state treasurer.
Reynolds has more than a dozen children in her practice in foster care — all because their parents have a drug problem. The initiative would aim to reduce those placements by addressing drug and behavioral health problems, poverty and housing for vulnerable pregnant people and their children early in life and expand the traditional health care workforce to includes more doulas, lactation specialists and peer workers, who are trained professionals with personal experience of addiction and mental health problems.
Tackling poverty, drug addiction and homelessness in an integrated way and focusing on young children is the only way to move the needle, Reynolds said.
Building on current programs
She’s working on the initiative with Dr. Angela Zallen, a Eugene pediatrician, who told the committee that the state should expand two related programs — Project Nurture and Nurture Oregon. Project Nurture, launched in 2015 by Health Share of Oregon, a large Medicaid insurer in the Portland area, provides prenatal, inpatient maternity and postpartum care for women addicted to drugs. The program, at four sites in the Portland area, has reduced the placement of kids in foster care and decreased child neglect and abuse, according to Health Share. In 2020, the Oregon Legislature mandated that the Oregon Health Authority expand Project Nurture to focus on rural areas and it is now in five rural counties: Benton, Deschutes, Jackson, Lincoln and Umatilla counties.
The Momnibus initiative would expand the program further and ensure five-day hospital stays during any point in a pregnancy or right after birth to support the mother during withdrawal, start drug addiction treatment and help with breastfeeding and bonding.
Another focus of the initiative is housing. It proposes funding long-term rental assistance for vulnerable families through the first year of their child’s life and encouraging the building of multi-bedroom units in subsidized housing projects. Reynolds said ensuring stable housing is key to getting families off to a good start.
“When we talk about the importance of being present and bonding with your baby, that’s really hard to do if you are either homeless or are really in fear of losing your home,” Reynolds said.
Last month, the Oregon Health Authority launched a Medicaid initiative that offers rental assistance to vulnerable patients for up to six months. The program is experimental and includes nearly $1 billion in funding for housing and other services. Most of the money comes from the federal government, and Reynolds said it could be used to help families stay housed during the first crucial months of their children’s lives.
“We’re really looking at prohibiting the expulsion of a baby or a pregnant person just for lack of rent nonpayment,” Reynolds said.
Tackling workforce and poverty
The initiative also includes measures to expand the perinatal workforce, establish a perinatal provider fund while setting up a task force to recommend other ways to bolster and diversify the perinatal workforce.
The last focus of the initiative is child poverty. Among a few ideas, Reynolds and Zallen said the state could expand the existing tax credit for kids for low-income parents by increasing the amount allowed and extending it to more people by increasing the income limit.
“When we talk about moving the needle on reducing child endangerment or kindergarten readiness or third-grade reading scores or preventing substance use disorder, it really comes to ending child poverty,” Reynolds said.
Reynolds and Zallen have been working on the initiative for more than a year with Oregon health, social service and housing professionals. They’ve met with Gov. Tina Kotek and her staff and discussed ideas with advocates and nonprofits. The initiative has the backing of officials in Oregon’s Department of Human Services, the Oregon Health Authority and Oregon Housing and Community Services, as well as advocates for underserved populations, members of the medical community and social service experts.
Reynolds does not know how much these measures would cost or whether she’ll introduce a series of measures or one big bill. But she said the initiative would flip Oregon’s current approach to social services by directing funding toward the start of life rather than paying after problems occur.
“We need to have the courage and the will to reprioritize some of our spending streams so that we’re providing resources at the beginning instead of catching folks after they fall off the deep end,” Reynolds said.
This story first appeared in the Oregon Capital Chronicle.
