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Key Components of a Successful Early Childhood Home Visitation System: A Self-Assessment Tool for States

Smart Start National Conference May 5, 2011

Agenda

Self-Assessment Tool for States on Home Visiting System Community Planning Tool on Home Visiting Self-Assessment of Home Visiting in Wisconsin Self-Assessment of Home Visiting in Maine Discussion/Q and A

Key Components of a Successful Early Childhood Home Visitation System- A Self-Assessment Tool for States

www.zerotothree.org/homevisitingtool

Key Components of a Successful Early Childhood Home Visitation System- A Self-Assessment Tool for States

Purpose: -Define the home visiting system -Assess the home visiting systems capacity, and -Prioritize areas for improvement Useful for federal home visiting grant application process but also for ongoing assessment and continuous quality improvement

Debbie Rappaport

Key Components of a Successful Early Childhood Home Visitation System- A Self-Assessment Tool for States

Eight components of systems-building detailed through strategic questions Each component has room for state status and next steps Encouraged to rank priority of individual components Templates provided for state-specific additions Priority ranking summary at end to set stage for action plan/next steps

Key Components of a Home Visiting State System

Needs Assessment and Program Planning Evaluation and Quality Assurance Program Standards Professional Development and Technical Assistance Early Childhood Partnerships and Collaboration Public Engagement Administration and Governance Financing and Sustainability

Debbie Rappaport

Tips for Using the Self-Assessment Tool

Involve key stakeholders Divide responsibility for the self assessment Use the results
www.zerotothree.org/homevisitingtool

Home Visiting Community Planning Tool

www.zerotothree.org/hvcommplantool

Home Visiting Community Planning Tool

Can be used by communities to: - Identify community needs and strengths based on data - Explore current home visiting assets and service gaps - Choose an evidence-based model - Analyze components of both program- and system-level implementation that are critical to the replication of high-quality home visiting programs

Sections of the Community Planning Tool

The State of Your Community Existing Home Visiting Services Strengths and Gaps in Home Visiting Services Matching Community Needs to Evidence-Based Models Public Engagement Recruitment, Engagement, and Retention of Families Staff Qualifications and Professional Development Partnerships and Collaboration Coordinated Governance Financing and Sustainability Evaluation and Quality Assurance

Reflections

Self-assessments represent an ideal to strive toward. Systems create economies of scale in tight budget times. The federal grant process offers an opportunity to develop an integrated home visiting system. Coalitions of home visiting programs improve the coordination of services. Home visiting programs must connect with other services to create a continuum of care for young children and their families. Home visiting programs should be integrated into the broader early childhood system infrastructure.

My Contact Information

Barbara Gebhard Assistant Director of Public Policy ZERO TO THREE 304-776-2940 bgebhard@zerotothree.org www.zerotothree.org/policy State tool: www.zerotothree.org/homevisitingtool Community tool: www.zerotothree.org/hvcommplantool

UseofHomeVisiting SelfAssessmentInWisconsin
JenniferHammel
CHILDABUSEPREVENTIONFUNDDIRECTOR CHILDRENSHOSPITALANDHEALTHSYSTEM

Outline
ChildAbusePreventionFundofChildrens HospitalandHealthSystem. UsingtheHomeVisitingSelfAssessment: HomeVisitingLandscapeInWisconsin.
Priortofederalfunds. Postfederalfunds.

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Childrens HospitalandHealthSystem
CHHSVISION Toestablishandsupportthehealthiest pediatricpopulationinthenationthrough boththeseamlessintegrationofexceptional clinicalcare,research,EDUCATION, COMMUNITY OUTREACH andadvocacy;and POWERFUL COLLABORATIONS withlocal, regionalandnationalPARTNERS.
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Service locations
Familysupport Childadvocacy Schoolnurses PoisonCenter MedicaidHMO Primarycare Urgentcare Emergencycare Specialtycare Surgicalcare Tertiarycare Quaternarycare Research
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Determinants of health
100% 90% 80% 70% 60% 50% 40% 30% 20% 10%
McGinnis,J.M.etal.HealthAffairs2002;21(2):7893

Qualityhealthcare10% Social/ environmental20%

Genetic30%

Behavior40%
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ChildAbusePreventionFund
MISSION

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HomeVisitingSelfAssessment HomeVisitingSelfAssessment
Representativesfrom:
WisconsinDepartmentofHealthServices. WisconsinDepartmentofChildrenandFamilies. EarlyYearsHomeVisitationOutcomesProject. ParentsPlus,Inc.(PIRCAgency). WisconsinChildrensTrustFund. WisconsinCouncilonChildrenandFamilies. UniversityofWisconsinExtension. PenfieldChildrensCenter. HeadStart/EarlyHeadStart. SupportingFamiliesTogetherAssociation(StateCCR&R/FRCAssociation).
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SelfAssessmentProcess SelfAssessmentProcess
AssessmentoccurredJuly/August 2010. Individualrepresentatives completedselfassessment. ChildAbusePreventionFund collateddata. Seriesofmeetingstodiscuss individualsectionsandcometo agreement/consensusonemphasis forwork.
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Results SelfAssessmentProcess
NeedsAssessment. EvaluationandQualityAssurance. ProgramStandards. EarlyChildhoodCollaborations. ProfessionalDevelopment. PublicEngagement. AdministrationandGovernance. FinancingandSustainabilty.
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HomeVisitinginWisconsin HomeVisitingInWisconsin
PREFEDERALHOMEVISITINGEXPANSION

FundingStreams:
Medicaid. POCAN/FamilyFoundations. TANF. ChildrensTrustFund. CountyAgencies.
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HomeVisitingInWisconsin HomeVisitinginWisconsin
PREFEDERALHOMEVISITINGEXPANSION

FundingStreams:
Privatefunders.
ChildAbusePreventionFund (since 1989;varietyofprogrammodels usuallyasastartupgrant). LocalUnitedWays (Brown,Daneand Milwaukee).

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HomeVisitingInWisconsin HomeVisitinginWisconsin
PREFEDERALHOMEVISITINGEXPANSION

TrainingandEvaluation
Coretrainingprovidedby UniversityofWisconsinExtension (notprogrammodelspecific). EarlyYearsHomeVisitation OutcomesProject.

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SelfAssessmentDataUse

HeldthefindingssinceNovember duetochangeingovernorand legislature. Somedataarebeingusedtoinform thedevelopmentoftheSIR.

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HomeVisitinginWisconsin HomeVisitinginWisconsin
NOW
BundlingintooneRFP: POCAN/FamilyFoundations:$1.2 millionadministeredbythe DepartmentofChildrenand Familieswithachangeinfocus. TANFFunds$850,000. FederalFunds$1.6million. Trainingandtechnicalassistance providercontractsrebid.
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HomeVisitinginWisconsin HomeVisitinginWisconsin
NOW
Evaluationbenchmarkswillinclude additionalfederalindicators. Programmodelseligibleforfunding arethose5representedinWI currently:HFA,PAT,EHS,HIPPYand NFP.
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HomeVisitinginWisconsin Resources
LinktoWisconsinsHomeVisitingNeeds AssessmentpreparedbyDCFstaff http://dcf.wisconsin.gov/children/ho me_visiting_needs_assessment/defa ult.htm LinktoWisconsinscombinedRFP http://vendornet.state.wi.us/vendorn et/asp/BidDetail.asp?Systembidnumb er=16173&LegalNoticeReferal=16173
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HomeVisitinginWisconsin Resources
LinktotheEarlyYearsHome VisitationOutcomesProject http://www.chw.org/display/PPF/Do cID/45172/router.asp

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HomeVisitinginWisconsin ContactInformation

JenniferHammel ChildAbusePreventionFunddirector ChildrensHospitalandHealth System 4142314877 jhammel@chw.org Capfund.org

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SelfAssessmentof HomeVisitingin Maine

May5,2011

MaineFamiliesHomeVisiting
Statewidehomevisitingprogram Statefundedprofessionaldevelopment
INstatePATandTouchpointsTrainingTeams

StandardsofPractice Ongoingqualityassuranceandevaluation Fundedsolelybytobaccosettlementmonies

MaineFamilies
Networkinall16counties Primarilyruralgeography Uniquepartnershipswith othercommunity providers Corepublichealthhome visitingdeliverysystem

OtherHomeVisitingPrograms
PublicHealthNursing/CommunityHealth Nursing EarlyHeadStart Nonstatefundedprograms

FederalMIECHVNeeds Assessment
Isolatedfamiliesinrural communities Risingtrendofdrug affectedbirths Poverty Substanceabuse Gapsininfrastructure Needforstakeholder buyinandinput

MIECHVNeedsAssessment
Communities definedatcounty level Threecountieswith significantlyhigher needsandfewer resources Opportunityfor programreplication fromProject LAUNCH

ProjectLAUNCH

StatePlanDevelopment
PublicHearingonNeedsAssessmentfindings throughtheMaineChildrensGrowthCouncil StakeholderMeetings FocusGroupswithunderservedpopulations Intenttobuildontheresourcesalreadyin placeandrewardauthenticcollaboration locally

StakeholderMeetings
HeldtwodaylongmeetingsinFall2010 FacilitatedbyZerotoThree Revealedsomeplacesofcommoninterest:
DataCollection/Evaluation ProfessionalDevelopment DefiningHomeVisiting(andcontinuum) CoordinatedReferralsystem

SelfAssessmentFindings
CollaborationMeasurerevealedsomedistrust oftheprocess Conflictingmessagesfromvariousstate agencies Increasingsenseofselfprotectionin dramaticallychangingpoliticalenvironment Unrealisticexpectationofstatefunds

ChangeinPlan
Selfidentifiedstakeholdergroupstomeetto developworkplansthatwouldaddressthe issuesoftheSelfAssessment ReleaseofGovernorsBudgetshowed proposaltoeliminateallfundingforMaine FamiliesHomeVisiting Redirectionofstakeholderenergy UncertaintyaboutMIECHV

StakeholdersUnite

MovingForward
UsetheMIECHVNeedsAssessmentandState Plantoinformwhere/howstateandfederal fundsshouldbeallocatedbyatieredsystem Continuepurposefulsystemsworkonsmaller scale(dependingonfinalstatebudget)using prioritiesidentifiedfromtheZTTSelf AssessmentTool

ForMoreInformation
SherylPeavey,MaineFamiliesAdministrator
Sheryl.peavey@maine.gov

MaineMIECHV
http://mainecgc.org/miechv.html

MaineFamilies
www.mainefamilies.org