Sometimes it takes a crisis to show a gap in care and motivate us to create manageable solutions.

Systems have long been in place for social needs screening and support for our families in the outpatient Harriet Lane Clinic. But there is no similar system for screening inpatient families — which became glaringly apparent during the recent federal government closure and suspension of SNAP (Supplemental Nutrition Assistance Program) benefits.

Let me back up a bit. For those who don’t know, the Hopkins Community Connection program provides supportive services to patients and families during their routine medical appointments. Johns Hopkins student volunteers and community health workers are trained to screen patients and families for social needs and then provide referrals to appropriate community resources. Often this involves guiding them to enroll in services such as WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) or SNAP, in addition to offering transportation resources, or information on employment opportunities.

In 2020, in partnership with the Maryland Food Bank, Hopkins Community Connection opened the food bank’s first clinic-based food pantry in the state. Simultaneously, and at the height of COVID-19, the Children’s Center opened inpatient family food pantries in the pediatric intensive care unit, in our oncology inpatient unit and in the Family Library. These inpatient food pantries, open to all families, provide grab-and-go snacks and microwavable meals to tide families over during a child’s inpatient stay. Additionally, we have begun to stock more take-home food items, such as rice, tuna, and peanut butter and jelly. No screening is necessary and demand is consistently high. The shelves are stocked weekly, and are frequently emptied in just days.

I’ve found that a family’s needs are often exacerbated during a hospital stay, as parents frequently need to miss work and incur high out-of-pocket costs for parking, food and additional child care. While stocking a food pantry, I met a mom in oncology who had lost her job during the federal downsizing last year and was scrambling to survive while managing her child’s life-threating condition. While the pantries are helpful, this moment made me realize how much more we have to do.

Hopkins Community Connection has allowed our outpatient clinics to take a holistic, family-centered approach to providing health care. It’s time we bring that same level of social needs care to the inpatient setting. To do this, we are launching a pilot program on one unit (9N) that allows families to self-screen for certain social needs, including food insecurity and transportation needs. Advocates from Social Work, Patient-and Family-Centered Care, and Hopkins Community Connection can then provide navigation to hospital and community resources.

During the government closure and SNAP suspension, we realized that by not conducting universal social needs screenings on our inpatient units, we could not equitably identify which patients and families were most in need of assistance while in the hospital. We can’t know the needs if we don’t ask, and this pilot aims to change that.

We hope to expand to other units and hire community health workers to manage the inpatient screening and referral program, mirroring the process created by Hopkins Community Connection in the outpatient setting. Fortunately, there are models we can turn to for guidance: The adult hospital has had this type of social needs screening in place for several years now. It’s time for inpatient pediatrics to do the same.

Sue Mead is a parent adviser on the staff of Johns Hopkins Children’s Center and co-chair of the Pediatric Family Advisory Council.