Building Successful Early Childhood Home
Visitation State Systems
Lisa Schreiber, Consultant
ZERO TO THREE Policy Center
June 22, 2010
Mike Schreiber
Overview of Webinar
•New home visiting legislation and application process
•ZERO TO THREE’s new self-assessment tool
•State panel discussion with four model states: CO, NJ, VA,
WA
•Q&A
•Update from Pew Center on the States’ Home Visiting
Initiative
The Patient Protection and Affordable Care ActA New Opportunity for Home Visitation Programs
•$1.5b in mandatory funding (5 years) for high quality, evidence-based,
voluntary early childhood home visitation
•Title V of the Maternal and Child Health block grant (Social Security Act)administered by DHHS (MCHB and ACF)
•Targeted to “at risk” communities/populations (e.g. low income, pregnant
under 21, history of child welfare/abuse, history of substance abuse,
children with developmental delays, military families)
•State assessment plan due 7/9/10, state needs assessments due 9/1/10,
final state plans due early FY2011
•Governor’s office to determine administrative agency
•Up to 25% of funds can be used towards promising models
The Patient Protection and Affordable Care ActFunding Breakdown and FY2010 Allocation
•$1.5 billion over 5 years:
$100M for FY2010
$250M for FY2011
$350M for FY2012
$400M for FY2013
$400M for FY2014
•Formula grant to all states based on:
LifeStockPhoto
-$500K base allocation to each state
-An amount equal to funds provided under the current EBHV ACF grant
(CA, CO, DE, HI, IL, MN, NJ, NY, OH, OK, RI, SC, TN, TX, UT)
-An amount based on children in families at/below 100% poverty
•Chart of FY2010 funding levels can be found at: grants.gov or hrsa.gov
The Patient Protection and Affordable Care ActFull Needs Assessment Requirements
•
Needs assessment plan due 7/9/10 (FOA on grants.gov)
•
Full needs assessment guidance published late June, due
9/1/10
•
Full needs assessment must include:
-Data identifying communities at risk
-The quality and capacity of existing programs for early
childhood home visiting
-State’s capacity for providing substance abuse
treatment/counseling
-Connection with other assessments/planning for the Head
Start Act, MCH Block Grant and CAPTA
The Patient Protection and Affordable Care ActCriteria for Model Evidence of Effectiveness
•Announcement to be published in
mid-August, response (“Updated State
Plan”) due early FY2011
•Will specify criteria for evidence of
effectiveness of home visiting models
that qualify for funding and what state
applications must include to meet the
evidence criteria set forth by HHS
Andrea Booher
•Proposed criteria available for public comment prior to issuance
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 system’s capacity
-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
State Panel Discussion
Panelists:
•Melissa Kelley, Executive Director- Colorado Parent & Child
Foundation
•Sunday Gustin, Home Visitation Program Manager- New
Jersey Department of Children and Families
•Catherine Bodkin, Chair, Home Visiting Consortium- Virginia
Department of Health
•Joan Sharp, Executive Director- Council for Children &
Families, Washington State
Colorado State Profile
Colorado’s Home Visitation Coalition
Models Being Implemented: Promotion: Colorado Bright Beginnings, Prevention: Family
Visitor Program, Baby Bear Hugs, HIPPY (Home Instruction for Parents of Preschool
Youngsters), Parents As Teachers (PAT), Nurse Family Partnership (NFP), Intervention:
Family Advocacy, Care, Education and Support (FACES)
Program Reach and Families Served: Over 20,000 families served last year with one of
the above programs
Administration and Funding:
1 Program Model (NFP) has a designated line item of State funding, which is administered
through the Colorado Department of Public Health and Environment
All other Programs/Models are administered through statewide or local/regional
organizations and receive funding from a variety of public and private sources
(foundations, state and federal government grants, local public monies, and individual
donors)
Colorado State Profile
State Systems Strengths:
Early Childhood Colorado Framework and Framework in Action State Plan that is
comprehensive and inclusive of home visiting
Active home visiting coalition, since the mid-1980s
Very strong spirit of collaboration amongst home visiting and early childhood programs
Continuum of models and programs to support a variety of families and their needs
Key Stakeholders:
Colorado Home Visitation Coalition, Colorado Early Childhood Partners (statewide/state
level early childhood groups), Colorado’s Early Childhood Funders, Office of the Lt.
Governor and Various State Agencies (Education, Health, Human Services)
State Systems Definition:
Colorado has an active early childhood systems building initiative that is guided by the
Early Childhood Colorado Framework. Home visiting is part of a broad continuum of
services working across multiple domains. System level work of the CHVC includes
advocacy for home visiting as an effective service delivery model; cross-program/model
communication; cross-program/model coordination as appropriate.
New Jersey State Profile
New Jersey Home Visitation Initiative
Models Being Implemented: DCF Funded: Healthy Families America, Nurse Family
Partnership and Parents As Teachers and Family Connections site (special needs
population), Non-DCF Funded: additional PAT, Parent-Child Home Program and HIPPY
Program Reach and Families Served: Approximately 3,200 this year. At least one
program in all 21 counties in the state.
Administration and Funding: Division of Prevention and Community Partnerships within
the Department of Children and Families (DCF)
•Federal: Title IVB, TANF, ACF, OJJDP; State Funds; and Local Leveraged Funds
•HV program/administrative oversight in collaboration with NJ EBHV model developers
– HF and PAT—Prevent Child Abuse New Jersey
– NFP—Public/Private Ventures and NFP National Service Office Nurse Consultant
New Jersey State Profile
State System Strengths:
Unified and committed state level leaders/advocates – early strategic planning
Broad-based state and local partnerships and collaboration
Stable core funding commitments – DCF (Title IVB), DHS (TANF)
Shared program goals and objectives across models
Strong model developer/training and technical assistance partnerships
Key Stakeholders:
DCF (Prevention/CBCAP, CPS, Child Behavioral Health), Health (MCH, Perinatal
Addictions/Depression, WIC), Human Services (TANF, Addiction Services, Medicaid),
Education (Early Childhood, Early Head Start), Juvenile Justice (Prevention), Regional
MCH Consortia, Funding Partners (United Way, Nicholson Foundation), State/National
EBHV Developers (HFA, PAT, NFP)
State Systems Definition: Prenatal/MCH Interagency Collaboration. Central intake with
links to: a) Home Visitation and/or b) Other services/supports. DCF and state partners
provide leadership, technical assistance and support. Six of 21 counties have a formal
HV System with lead agency for local collaboration.
Virginia State Profile
Virginia Home Visiting Consortium
Models Being Implemented:
National: Head Start/EHS; Healthy Families; Healthy Start; Early Intervention; Part B;
Parents as Teachers. State-Level: BabyCare (targeted case management for high risk
pregnant women and infants); CHIP of Virginia (nurse-chw team promoting family health
and medical home); Project Link (targeted care coordination for women at risk for
substance use); Resource Mothers Program (community health workers mentoring
pregnant teens); Medicaid Managed Care (care coordination and education)
Program Reach and Families Served:
•27,245 children ages 0-5 years old and their families (2008), 9 localities = no perinatal
programs
•128 of 137 Virginia cities and counties
Administration and Funding:
•Consortium Infrastructure Project- Consortium MOA with 5 state agencies, coordinated by
health department
•Funding Sources: Federal agencies, state general funds, local foundations, United Way,
Medicaid reimbursement, Medicaid Administrative, local governments
Virginia State Profile
State System Strengths:
•Shared vision for healthy child development in strong families and healthy communities
•Early childhood system public-private partners in diverse agencies and disciplines
•Core training topics for all home visitors identified
•Shared data indicators across programs
•Commitment to standardized screening tools
•Sustained energy; openness to new approaches and partners
Key Stakeholders:
•Home visiting program state managers and local program staff
•Early childhood professionals in education, health care and social services
•Virginia Early Childhood Foundation
•Early Childhood Advisory Council
•Communities, especially the 25 Smart Beginnings Early Childhood coalitions
State System Definition: A collaboration of state home visiting programs serving families from
pregnancy to age 5 as part of the overall state comprehensive early childhood system working
with families and communities to promote children’s health, and readiness for school and
readiness for life.
Washington State Profile
Washington Evidence Based Home Visiting System
Models Being Implemented: Nurse Family Partnership, Parents As Teachers, Parent
Child Home Program, Steps Toward Enjoyable Effective Parenting (STEEP), Early Head
Start
Program Reach and Families Served:
Approximately 4,700 families served annually
Administration and Funding:
•Historically,
•CAPTA Title
administered by a single state agency
II (CBCAP) lead/Children’s Trust Fund
(now in transition)
•State
funded (local match)- new funding in 2007
State System Strengths:
•Legislative
•Home
and philanthropic commitment
Visiting Coalition
•Evidence-based
approach
LifeStockPhoto
Washington State Profile
Key Stakeholders:
•Home
Visiting Coalition, state agencies (health, early learning, social services),
foundations/private funders (Gates, United Way of King County)
State Systems Definition:
Historically
• Established approach to build a “portfolio” of programs built on practice, programs and
community needs
• Conducted outreach and education
• Defined “evidence” – levels with criteria
• Co-learning around continuous quality improvement for program development and
building organizational capacity
• Evaluating and conducting advocacy on behalf of system
Currently
• Evolving (and expanding)
• Early learning, health, child welfare, economic services (TANF), Medicaid, behavioral
health, mental health
• Governance, accountability, standards, professional development, financing etc.
Coalition-Building and Collaboration
In your experience, what are keys to success and what are
the major challenges for coalition building?
Respondents: Melissa
Colorado
Coalition-Building and Collaboration
What are the goals for the coalition work in your state and
how are those goals actualized?
Respondents: Catherine
Virginia
Program Implementation
Much has been discussed about the “black box” of
implementation. How do we “unpack” the box and find out
what is really going on during an effective home visit and
inform the state system?
Respondent: Joan
Washington
Program Implementation
An innovation that seems to be bringing communities and
programs together is the concept of a centralized
intake/assessment system. How do these structures work
and how are they an example of systems integration?
Respondents: Sunday
New Jersey
Program Implementation
Training/professional development seems to be an area
where systems-wide collaboration is taking place
successfully. How has your state created efficiencies in the
training arena?
Respondents: Melissa and Catherine
Virginia
Colorado
Quality Assurance
How do you address issues of program quality system-wide?
Respondent: Sunday
New Jersey
Sustainability and Financing
How has your state approached the financing of the home
visiting field to ensure the sustainability of the programs and
state system?
Respondent: Joan
Washington
Early Childhood Partnerships- Maternal and Child Health
How have your state home visiting efforts connected with
maternal and child health services and systems?
Respondents: Sunday and Catherine
Virginia
New Jersey
Early Childhood Partnerships- Early Care and Education
How have your state home visiting efforts connected with
other early care and education services and systems?
Respondents: Melissa
Colorado
Evidence-Based Practice
How can evidence of home visiting’s effectiveness guide
decisions about strategic/program planning?
Respondents: Joan and Catherine
Washington
Virginia
Planning and Expansion
Given the tremendous opportunity afforded by the new home
visiting funds, how will your state approach the planning for
the grants in terms of determining needs, defining risk,
selecting models and distributing funds?
Respondents: Catherine
Virginia
Planning and Expansion
How will you expand home visiting for those most in need in
your state and what will be the challenges of expansion?
Respondents: Sunday and Joan
Washington
New Jersey
Planning and Expansion
What advice do you have for those viewing the webinar who
are coming from evolving states, where not much systems
development has taken place, about how to build and
sustain a strong home visitation system?
Respondents: Sunday, Melissa and Joan
Colorado
New Jersey
Washington
Contact Information
Lisa Schreiber
Lisaschreiber2@yahoo.com
Melissa Kelley
www.cpcfonline.org
Sunday Gustin
http://www.state.nj.us/dcf/prevention/
Catherine Bodkin
www.homevisitingva.com
Joan Sharp
http://www.ccf.wa.gov/funded-programs/ebp-home-visiting-funding
The Pew Home Visiting Campaign:
Webinar Series
A series of four webinars highlighting promising practices in administering
state home visiting systems:
•Using Evidence to Guide and Direct State Home Visiting
Investments: Leaders from three Pew campaign states—Washington,
North Carolina and Ohio—will discuss their experiences promoting
evidence-based policy and practice in home visiting.
•Implementation, Implementation, Implementation: Best practices and
strategies for monitoring implementation of state home visiting programs.
•Evaluating for Impact: State-sponsored efforts to evaluate home visiting
programs for process and outcome measures, as well as cost-benefit.
•Systems Coordination: Successful state efforts to centralize intake,
standardize policies and procedures, identify core indicators and
performance measures, and train home visiting professionals.
Resources
Link for ZERO TO THREE webinar information (including this
power point, self-assessment tool and state one-pagers)
www.zerotothree.org/policywebinars
Link to federal home visiting grant announcement:
http://www.grants.gov/search/search.do?mode=VIEW&oppId
=55133
E-mail for federal home visiting grant questions:
homevisiting@hhs.gov