Collaborative Home Visiting
HINDSIGHT IS 2020
- Wi-fi hotspots obtained and distributed to families so that parents could more easily connect directly with their home visitor, obtain community resources, and access schooling for their children
- Masks obtained and distributed to home visiting agencies for staff and families
- Digital thermometers given to families and to be used during any resuming home visits
- Paperwork-free enrollment and documentation due to technological adaptions
- Adapting to ongoing virtual home visits. Home Visitors report that many times there is more frequent contacts with parents due to the ability to check in more often.
- Monthly parent engagement groups hosted on virtual platforms
- Graduation car parades
- Porch drop-offs to leave resources and socially distanced porch visits with families
- Some agencies resuming limited in-person home visits or porch visits utilizing full PPE
- Marketing blitz with social media and website to increase communication about COVID-19 facts and myths and vaccine availability
- Ongoing reassessments each month with agencies to determine what new supports are needed
Fiscal Sustainability Summit
Translating Outcomes to Dollars: Sustainability for Early Childhood Interventions
Using a regional home visiting collaborative, www.promise1000.org as an example, this September 29, 2020 summit explored ways that early childhood interventions can leverage improved outcomes demonstrated through valid data outputs to create value-based payment mechanisms that allow for scaling of interventions. Attendees left with an understanding of the process for a transition from 'fee-for-service' to 'value-based funding', the data requirements, and the role of collective impact in such a transition; and, most importantly, how this work can benefit children and famlies.
Speakers provided examples, ideas, and possibilites for organizations engaged in funding, administering, collaborating with, and directly providing early childhood interventions targeting improved equity, school readiness, health, well-being, safety, and resilience.
These dynamic speakers included:
- Jeanna Capito, facilitator of the National Alliance of Home Visiting
- Jeff Shumway, Antonia Esposito, and Storey Kloman with Social Finance, an organization mobilizing social investment using data and innovative funding mechanisms such as Pay for Success projects
- Dr. Anderst, a Child Abuse Pediatrician, Director of the Division of Child Adversity & Resilience, Professor of Pediatrics at Children's Mercy Hospital, and Director of Strategy and Innovation for Promise 1000
Visit here to watch the presentation video and slides
2020 Shining Stars!
Congratulations to our Kansas City, Kansas Parents As Teachers (PAT) program for receiving the 2020 LOSOS Prize for Innovation! This KCK PAT program practices fidelity to the PAT model, fulfills requirements of the Kansas Maternal, Infant, and Early Childhood Home Visiting grant (MIECHV), works in pediatric clinics helping with developmental screenings and enrolling families, and fulfills shared activities and requirements as part of Promise 1000 Collaborative Home Visiting. Additionally, the Promise 1000 home visitors work to accompany families on well-child visits collaborating with child pediatricans to support the family. Promise 1000 mothers experiencing maternal depression can also receive 15 weeks of free in-home weekly mental health therapy sessions with therapists trained in Moving Beyond Depression. The KCK PAT program was also awarded the Blue Ribbon status in 2019.
Additionally, at our Promise 1000 "Better Together" virtual event in October 2020, we celebrated the important work that home visitors accomplish every day and the positive impacts their work has on the children and families they serve. Annually, Promise 1000 recognizes a Home Visitor of the Year, Supervisor of the Year, and this year we recognized an agency for their Creative COVID-19 Strategies.
* Carron Miesner (Easterseals Midwest) received the Home Visitor of the Year award for her dedicated and direct advocacy work in ensuring children have access to needed immunizations at scheduled well-child checks at community locations that traditionally have not offerred this service.
* Amy Gorton (Easterseals Midwest) received the Supervisor of the Year award for her positive leadership and support of her program staff which has led to tenured long-term staff and willingness and adaptability of the ESMW home visiting program to expand services and test new innovations.
* Kansas Children's Service League (KCSL) received a special 2020 Creative COVID Strategies award due to their quick responsiveness in implementing creative and innovative strategies to engage families such as use of electronic documents that did not require face to face enrollment, strategizing how to best complete domestic violence screens when doing virtual visits, drive-through graduation parties and parades, getting resources to families in need, expanding interpreting services to home visiting groups being held virtually, and their supervisors support of staff during this challenging time for all.
Awards captured here @ https://www.promise1000.org/home-visiting-staff-recognitions.html
KCK PAT receives LOSOS Prize for Innovation
Home Visitor and Supervisor of the Year Awards
Carron Miesner - Home Visitor of the Year (Easterseals Midwest)
Amy Gorton - Supervisor of the Year (Easterseals Midwest)
KCSL receives Creative COVID Strategies award
Capacity Building and Coordinated Home Visiting Systems of Care
- Participating locally with Missouri Department of Social Services-Jackson County to discuss planning and future implementation of Families First
- Planning with Kansas City Perinatal Recovery Collaborative (KCPRC) to ensure access to services for parents participating in home visiting services that are impacted by substance use
- Partnering with Missouri Children's Trust Fund (CTF) to provide technical assistance for collective impact home visiting hubs acress the state including collaboratives developed in the Columbia area (Brighter Beginnings), Springfield area (Greene County Home Visiting Network), and St. Louis (Generate Health).
- Following the Missouri Department of Elementary and Secondary Education (DESE) Preschool Development Grant (PDG) which is assessing the need for a more integrated, coordinated, and data-informed approach to ensure that Missouri's children have equitable access to high-quality, comprehensive services, Promise 1000 staff provided data consultation to the NGA Prenatal to Three group supporting and informing this work.
- Partnering with the Missouri Department of Health and Senior Servivces (DHSS) & Missouri CTF to develop a REDCap electronic home visiting database that replicates the Promise 1000 home visiting database formatting and structure and provides staff with a user-friendly database that was built for home visiting, aligns data metrics, and is easily adaptable to their needs.
Promise 1000 connects this region’s most vulnerable families to supports that optimize the beginning years of life for young children prenatal to three – the first 1,000 days of life. A collaborative initiative founded by United Way of Greater Kansas City, Children’s Mercy Hospital and the Health Forward Foundation, Promise 1000 includes 9 home visiting provider agencies utilizing evidenced-based models that are participating in funded shared activities to implement a structured, collaborative home visiting network for at-risk children under 3 years old and their parents to:
- Improve maternal and child health and well-being
- Reduce the incidence of child maltreatment and intimate partner violence
- Promote child development and school readiness, and
- Improve family resilience and safety of participating families
An addiitonal 8 local home visiting agencies are collaborative members with a total of 17 home visiting agencies involved in expanding home visiting to more families in the KC metro region through the Promise 100 centralized referral and intake system. All of these collaborative members meet on a quarterly basis alongside early childhood resource providers to discuss home visiting and learn from one another.
Why It Matters
The centerpiece of the collaborative is home visitation, guided by scientific research confirming that a stimulating and nurturing environment is essential for optimal brain development, which in turn leads to readiness for school and good health. Home visiting is also among the few evidence-based interventions recognized to prevent child abuse and neglect and other adverse childhood experiences that not only negatively impact the child’s physical and mental health but also become a major risk factor for the leading causes of illness and death as adults.
A network of metropolitan Home Visiting Agencies (HVAs) has collaborated over the past 8 years and launched Promise 1000 in May 2016. This network is part of a coordinated system of care for early childhood, encompassing young child health and well-being, family well-being and stability, school readiness, and the medical home for stronger health results.
The target population for Promise 1000 is low income families with children from pregnancy to 36 months of age and parents with at least one risk factor associated with poor health outcomes. Through data collection and continuous quality improvement, the collaborative seeks to ensure that home visiting is delivered by highly qualified, trained and committed home visitors who seek to establish a trusting relationship with parents at a critical time. Home visitors teach and support parents on topics related to child safety, parenting practices, health care and early intervention as a means of prevention to reach healthy childhood and family outcomes. This work can strengthen the emotional bond between parent and child and provides information and skills that help children reach their full potential. With the help of United Way 2-1-1, home visitors also link families to community resources, emphasizing the important role communities play in helping parents raise healthy and successful children.
Outcomes and Partnerships
- 1,054 children and 1,024 caregivers served
- The infant mortality rate is 2.9 per 1,000 (<1%) for all children enrolled
- 93% of infants are born weighing at least 2,500 grams
- 91% of infants reach 37 weeks or more gestational age
- 91% of adult household members read, sing songs, or tell stories to their child every day
- 90% of families have had guidance related to appropriate healthcare utilization, and 86% have established ongoing healthcare goals for their child over the most recent fiscal year
- The average duration for breastfeeding is 11 months, almost 2x longer than the desired norm (6 months)
- 85% of mothers with major depressive disorder recover with significant drops in parenting stress and substantial increase in social supports over time following In-Home Cognitive Behavioral Therapy treatment through Moving Beyond Depression (MBD) offerred by The Family Conservancy as contracted in its fourth year by Promise 1000 to treat maternal depression. MBD is designed for low-income mothers, packaged for delivery in the home, and emphasizes close coordination and collaboration with home visiting. This allows Promise 1000 to enhance availabilty and connection to a specific therapy service identified to meet needs of moms.
We anticipate that our collective metrics will, long term, be tied to additional positive health outcomes for children and families, including: increased birth spacing, reduced incidents of adverse childhood experiences and family violence, improved positive parenting practices and parental engagement in child development, increased school readiness, decreased healthcare utilization/costs, and ultimately demonstration of these outcomes will facilitate long-term fiscal viability of Promise 1000.
HOME VISITING 2020-2021 FUNDED GRANTEES
- Child Abuse Prevention Association (CAPA) - Healthy Families America
- Children’s Mercy Hospital - Healthy Families America
- Easterseals Midwest - Nurturing Parenting
- Kansas Children’s Service League (KCSL) - Healthy Families America (Johnson Co)
- University of Kansas Medical Center Research Institute: Project Eagle - Early Head Start Home Visiting
- Front Porch Alliance - Parents as Teachers and Early Head Start
- Turner, Kansas USD 202 School District - Parents as Teachers
- USD 500 Kansas City, Kansas Public Schools - Parents as Teachers
- Great Circle (KC region) - Healthy Families America
- The Family Conservancy - Moving Beyond Depression (MBD) Therapy
The pace of 2021 has increased with many ongoing projects from above as well as educational and engagement opportunities.
National Home Visiting Virtual Summit, hosted by Start Early - All funded Home Visiting Agencies received scholarships to attend this virtual event in February, along with Promise 1000 centralized staff, which included five days of live sessions that brought together systems leaders, practitioners, advocates, and decision makers in a collaborative pursuit to advance the home visiting fields and systems of care to increase service quality and improve outcomes.
Sessions included lightening talks, storytelling presentations, podcasts, collaborative learnshops, facilitated community discussion VR roundtable talks, panel presentations, community of practice groups, and poster presentations. Collaborative members focused on many sessions pertaining to equity and social determinants of health, resilience, the tool of storytelling with families and programs, and much more.
Cross-Cultural Community Engagement Workgroup utilized Promise 1000 data and local community needs reports to evaluate areas of strength and areas of growth with recommended goals of increasing prenatal enrollment, which can directly relate to healthy birth weight and reduced motherhood morbidity, as well as ensuring access to home visiting services for all marginalized populations, ensuring availability of interpreting services, and improved equity in the Promise 1000 network. This workgroup is expanding to include increased community partner and family representation.
Virtual Training Platform - Typically Promise 1000 new home visitors and supervisors from funded agencies gather together multiple times per year for required core competency trainings. The pandemic provided a unique opportunity to create online training modules for all core competency topics. Approximatley 20 training topics have now been recorded via Storyline 360 and will soon launch on a Cornerstones virtual platform so that all new home visitors or home visitors wishing to refresh skills can still receive this required training anytime throughout the year. Additionally, three voluntary Professional Development trainings were scheduled including virtual 'watch' parties where home visitors may be in separate locations but able to watch and enjoy trainings together virtually.
National Family Support Competency Framework - all Promise 1000 home visitors are completing a comprehensive assessment through the Institute for the Advancement of Family Support Professionals which is a shared model of competencies and skills that are rigorous and relevant to the field and recommended that all home visitors obtain. This will assist in creating future 2021-2022 grant year training plans.