The titles and roles of activists may differ, but a good activist can be spotted by their passion and dedication to their work. Most of us choose our paths of activism based on the impact we want to have or life sort of decides for us by placing us in social locations where the only path that makes sense is one of resistance. High levels of recognition are typically reserved for a few select folks. This blog series is not a remedy to this situation, but rather designed to highlight activists and their justice work through brief interviews.
This installment is an interview with Michelle Trupiano, The Executive Director of Missouri Family Health Council. Responses were provided during a one-on-one call, and this transcription was reviewed and approved by the interviewee prior to publication.
As the Executive Director of the Missouri Family Health Council (MFHC), can you briefly explain what MFHC is?
The mission is championing the access for every individual to culturally sensitive, quality, sexual and reproductive health education and services. I always say that’s a great mission but doesn’t really tell anyone who we are or what we do. We work to achieve our mission in two ways: through advocacy to break down systemic barriers that impede access to reproductive health care, and through our programmatic work that funds and support health centers to provide high quality family planning services. We administer local and federal funding including the Title X and The Right Time programs. Through those funding streams we fund a variety of health centers across the state like health departments, federally qualified health centers, community action agencies, and stand-alone family planning clinics to reduce cost barriers for people who may be uninsured or underinsured. We seek to ensure every person, regardless of their ZIP code or income, has access to quality reproductive health education and services, including the full range of contraceptive methods.
Can you speak about the trajectory of your advocacy and how it led you to becoming the Executive Director of MFHC?
I’m a social worker. That’s how I started my career. When I was 16 I thought I would do direct service. I initially worked as a case worker with the homeless population and then in foster care. Those experiences helped me see that more work was needed to eliminate the systemic barriers that people face. I went on to get my Master’s in Social Work (MSW) and through that began to see policy as another form of social work. I learned about community organizing and how people have the power to make changes. I went to the capitol for the first time and have never looked back. My first organizing job was with Planned Parenthood where I learned about reproductive justice and how the decision to decide if and when to start a family was the most important decision you can make. Ever since, I have been on this trajectory in reproductive and broader health care. My career has included everything from organizing phone banks and rallies, testifying in front of legislatures, working on campaigns – including running a state-wide ballot initiative in South Dakota, and leading the effort to pass Medicaid expansion in Missouri. The key to all of these initiatives was building authentic relationships.
When I joined MFHC, I was able to bring a lot of different skills like advocacy but also an understanding of health centers and service deliveries. I came in valuing stakeholders, providers, patients, and bringing all those skills together.
What is something that makes your work frustrating?
The biggest thing is how our work and our goals become political. Access to reproductive healthcare is political and it shouldn’t be. For the last few years attacks on our work has us spending too much time defending our work. We have had to change policies and manage providers leaving the Title X network. As we spend time on the defense, we are not able to use our resources doing the proactive work we want to be doing. It’s frustrating and it’s hard and can make work unnecessarily difficult.
What are some things that make your work the most rewarding?
In simple terms, it’s knowing that our organization can play a small part in improving people’s lives. Being able to support, fund, and help providers provide quality care, and helping people connect to that care. I work with an amazing team. I have fantastic colleagues across the state and country, and it’s those relationships that let me know we’re all in this together and constantly looking to improve. We’re not satisfied with the status quo, so we’re challenging ourselves, challenging each other, and challenging the system to do better because people deserve it. That’s what makes this work fulfilling and why I’ve stuck with it for almost 20 years.
MFHC works on a variety of specific issues, but I want to home in on birth control access via The Right Time Initiative (TRT). What is TRT and what did MFHC set out to accomplish with this campaign?
The Right Time (TRT) is pretty simple and based on the premise that every person should be able to decide if and when they have children. The initiative seeks to remove all barriers that people may face while trying to make that decision and access care. It reduces or removes cost barriers for patients seeking counseling and contraceptive services, while at the same time ensuring patient centered care and availability of all contraception options the same day of request by working with providers. People make decisions about accessing contraception or not accessing contraception for many different reasons, so we focus on empowering patients to make whatever decision is right for them. At the core, it’s really about empowering people so they have real power and real choices.
Have you encountered any responses to this campaign that surprised you?
In general, we have received almost entirely positive feedback about the initiative. The focus is on empowering people and removing barriers so people can have real choices about the decisions that they are making. Because it’s easy to say, “Here, go to a health center,” but if they can’t get there because they don’t have transportation or childcare, and it’s going to cost them $500 to access the method they want then that’s not a real choice.
Much of TRT is focused on educating people but what has this campaign taught you?
When we first started the initiative, we had 18 months of planning where we worked with all sorts of stakeholders across the state to figure out what the need was, but the most informative piece was what did everyday people needing to access services think. We did a lot of focus groups with people between the ages of 18 and 29 to figure out what they needed and what barriers they faced, and what their thoughts were around contraception. I had the privilege of sitting in on those focus groups and they were so enlightening for me and my colleagues. We learned how young people think about contraception, where they’re going for information, their views on pregnancy, and whether controlling and timing pregnancy was even something that they wanted to do. We took in that information to really think about how we present the initiative and our ultimate goals. As a result, we did not focus the initiative on preventing pregnancy but instead made it about helping people to achieve their goals, whatever those may be. The movement and goals around reproductive health are changing to focus on removing barriers so people can access quality, comprehensive, and culturally appropriate care so that people feel safe and have the ability to make decisions that are right for them.
How will working on this campaign inform campaigns that you lead in the future?
Building on what I was just sharing about the changing narrative, we’re constantly learning about what other folks are doing. This initiative has taught me that we have to be nimble. We have to be open to changing what we thought we were going to do. We want everything to be evidence-based, so when research is showing us that what we were doing isn’t as effective as we thought it would be, we need to be able to change and be able to take in what patients are saying and what providers are saying, and constantly do that evaluation to ensure we are providing the best care possible. The ability to evaluate and integrate that evaluation is so important that all initiatives, regardless of the end goal, should include robust evaluation. That can be hard sometimes because you want to just chart your path and say this is what we’re doing, but this initiative has shown me that it’s a winding road to get to the end.
Michelle Trupiano, MSW, has led Missouri Family Health Council Inc. as Executive Director since April 2016 where she champions access for every individual to culturally sensitive, quality, sexual and reproductive health education and services by developing and managing family planning and related reproductive health programs. Michelle oversees the administration of Title X and The Right Time initiative and ensures the quality of reproductive health services throughout the network of 70 clinic sites. Michelle provides leadership and strategic direction for MFHC’s advocacy program which seeks to break down the systemic barriers that impede access to care. Michelle has an extensive background in administration, advocacy, strategic planning, grassroots organizing, training, coalition building, and organizational development in the field of health care, especially reproductive health. Before joining MFHC, Michelle was the Director of the Missouri Medicaid Coalition where she led the state’s efforts and planning to expand Medicaid. She was responsible for developing a coalition and building the advocacy capacity of over 100 diverse organizations. Prior to that, Michelle spent 12 years as the Manager of Public Affairs for Planned Parenthood affiliates in Missouri where she developed strong relationships with reproductive health allies, community leaders, and legislators throughout Missouri. She holds a Master’s Degree in Social Work from Saint Louis University.
For a general overview of Missouri Family Health Council
For more information about The Right Time Initiative
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