CI&R Pilot Recognized As Promising Practice

Efforts by FL MIECHV to pilot Coordinated Intake & Referral (CI&R) using the state’s universal prenatal and infant screening process were recognized recently as a Promising Practice by the Association of Maternal and Child Health Programs (AMCHP).

The national organization, which represents state Title V programs, reviewed CI&R pilot activities and evaluation results, and approved the project for inclusion in its Innovation Station database for potential replication by other states.

The CI&R pilot was launched in 2015 as part of systems building activities included in a competitive grant awarded to FL MIECHV by HRSA. Eight Healthy Start Coalitions – serving ten counties – participated in the Action Learning Collaborative (ALC) and worked to develop effective local systems for identifying at-risk families and connecting them with programs that best met both their needs and preferences.

Coalitions included Bay, Franklin, Gulf (Bay County); Jefferson, Madison, Taylor; Northeast Florida (Duval County); North Central Florida (Alachua County); Flagler-Volusia; Orange (Orange, Osceola & Seminole); Hillsborough, and Manatee.

Participating coalitions formed multi-agency teams and participated in monthly calls, webinars, and in-person statewide learning collaborative sessions. The project also incorporated Continuous Quality Improvement (CQI) principles and processes, including Plan, Do, Study, Act (PDSA) cycles and using data to drive system improvement at the community-level.

Each team developed decision trees that focused on areas of identifying families who may qualify for services, improving coordinated systems for referrals, effective engagement and enrollment of families, and providing services that align with families’ needs and preferences. The decision trees laid the foundation for focused areas to improve upon and ensure a more effective CI&R process. Community teams met regularly to review CI&R test results and refine their approaches as needed. Information was shared with state stakeholders, including Title V and home visiting model developers.

To facilitate engagement and involvement of these stakeholders, Florida MIECHV partnered with CityMatCH to design and implement an Action Learning Collaborative (ALC) framework to this pilot group. Community teams assessed the landscape and needs of the community. Coalitions were provided with resources to support their work, including a planning period for partnership development and discussion of and consideration for how key CI&R components work in their community. The evaluation was conducted by the Chiles Center at the University of South Florida.

Based on pilot results, CI&R is being scaled and implemented statewide in FY 2018-19 through Healthy Start Coalitions as part of their contracts with the Florida Department of Health, the state Title V agency.

2018 Florida County Child Well-Being Index Ranks Counties on Key Indicators

Nearly one-third of counties served by FL MIECHV are in the lowest quartile of Florida counties ranked on key measures of child health and well-being in the 2018 Florida County Child Well-Being Index.

The report, released today by Florida Kids Count, examines progress between 2011 and 2016 by the state and counties on 16 indicators. The index includes profiles of each of Florida’s 67 counties, as well as a county-by-county ranking. The report demonstrates that while many indicators have improved statewide, there is significant variation among counties.

Based on the national Kids Count Databook, an annual ranking of states published by the Annie E. Casey Foundation, the report offers both good and bad news for Florida kids. For the state overall, there have been improvements in the Economic domain.  Still 1 in 5 of Florida’s children lives in poverty.   In Education, there were improvements in math proficiency and graduation rates, but work remains in getting children enrolled in quality early childhood educational programs and in reading and language arts proficiency.  Among the Health indicators, there is continued progress in getting children insured and reducing alcohol and substance use among teens, but there has been no progress in helping youngsters achieve healthy weights or in the percent of low birthweight babies.  In the Family and Community domain, the rates of verified abuse and neglect have fallen over the past five years, as have contacts with the Juvenile Justice system. However, there are more children living in single parent households, an indicator of economic stability, and more children living in areas of concentrated poverty.

New Report Updates National Home Visiting Picture, Need

The National Home Visiting Resource Center recently released a new Data Supplement to the 2017 Home Visiting Yearbook providing updated data on early childhood home visiting, a proven service delivery strategy that helps children and families thrive.

The Data Supplement builds on an inaugural Yearbook, released last summer, which painted a first-of-its-kind picture of home visiting using the best available data from 2015. The National Home Visiting Resource Center examined publicly available data and collected new data—this time from 2016—to present a more complete and up-to-date look at home visiting in action. The supplement’s robust data reflect advancements in data collection. For example, the supplement includes service information from 14 evidence-based home visiting models, up from 7 in the 2017 Home Visiting Yearbook.

Among the highlights:

  • More than 300,000 families received evidence-based home visiting services in 2016 over the course of more than 3.8 million home visits.
  • About 18 million pregnant women and families (including more than 23 million children) could benefit from home visiting but were not being reached in 2016.
  • Evidence-based home visiting was implemented in all 50 states, the District of Columbia, 5 territories, 24 tribal communities, and 47 percent of U.S. counties in 2016.
  • From 2010 to 2017, the federal Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) strengthened home visiting by supporting services, research, and local infrastructure. MIECHV expired in September 2017 but was reauthorized in February 2018 for 5 more years.
  • In 2016, MIECHV helped fund services for 83,841 families in states, territories, and tribal organizations—a portion of the total families served by home visiting that year.
  • States supported home visiting by combining funds from tobacco settlements and taxes, lotteries, and budget line items in 2016. With limited resources, states are continually working to expand the reach of home visiting to serve as many families as they can in ways that make sense at the local level.

Florida’s updated state profile reports more than 15,500 families – including 15,200 children – received more than 154,500 home visits in 2016 from more than 102 agencies. Models implemented in the state included Child First, Early Head Start, Family Check-Up, Healthy Families America, Home Instruction for Parents of Preschool Youngsters, Minding the Baby, Nurse-Family Partnership, and Parents as Teachers. The report notes more than 980,000 families in the state with children under age six could benefit from home visiting programs. Detailed information on families and services provided through FL MIECHV is available in the 2017 FL MIECHV Demographics and Utilization Report.

First 1000 Days FL Summit – Registration is Open!

Registration is open for the 2018 First 1000 Days Florida Summit September 26-28 at the Palm Beach Convention Center. The summit features national, state and community experts on health, social and early learning strategies for supporting families with children age 0-3.

Keynote speakers for the cross-sector, multi-disciplinary event include: Sara Enos Watamura, director of the Child Health & Development Lab and co-director of the Stress, Early Experience and Development Research Center at the University of Denver; Kathryn Hirsh-Pasek, the Stanley and Debra Lefkowitz Faculty Fellow in the Department of Psychology at Temple University and a Senior Fellow at the Brookings Institution; and Kate Rosenblum, director of the Women and Infants Mental Health Program at the Department of Psychiatry at the University of Michigan.

The summit will feature more than 40 workshops, on topics including:

  • Opioids in pregnancy
  • Trauma-informed home visiting
  • Effective father engagement
  • Recognizing and addressing implicit bias
  • Strategies for serving dual language learners
  • Infant mental health consultation across disciplines
  • Using relationships to promote infant-toddler development
  • Improving outcomes through place-based initiatives
  • Using ACEs to build resiliency
  • Supporting contraceptive choice
  • Addressing perinatal depression
  • Child care information & referral
  • Recognizing Fetal Alcohol Spectrum Disorders (FASD) in young children
  • Strengthening family engagement & advocacy
  • Compassion fatigue & self care
  • Safe Baby: supporting safe sleep
  • Addressing social determinants of health
  • Human trafficking
  • Supporting breastfeeding mothers in child care
  • Reflective supervision & practice
  • Working with families impacted by IPV, trauma
  • And MUCH MORE!

The 2018 statewide conference will also highlight Best Practices from The Field, as part of a poster showcase and evening reception. Community service providers are encouraged to submit a poster abstract by May 1st for consideration. Awards will be given at the event for First, Second and Third Places, plus a People’s Choice based on votes by participants.

The Children’s Services Council of Palm Beach County and FL MIECHV are Marquee Sponsors for the event.

Check out the conference website to register or find out how to submit a poster abstract. Registration fee is $150 ($162, including CEUs).


MIECHV Reauthorized & Funded in 2018 Budget Act!

The federal Maternal, Infant and Early Childhood Home Visiting (MIECHV) program was reauthorized and funded for five years as part of the Bipartisan Budget Act of 2018 signed this morning by President Donald Trump.

MIECHV provides funding to states and territories to support the implementation of evidence-based home visiting programs in designated high-need communities. In 2016-17, the program provided more than 22,600 home visits to nearly 2,000 Florida families, including 1,950 children under age three in 25 high-need communities and four contiguous areas.  Communities are implementing one of three models proven to impact outcomes for children and their families: Nurse-Family Partnership, Healthy Families Florida and Parents as Teachers. Florida’s program is administered by the Florida Association of Healthy Start Coalitions.

The program has been in limbo since the end of September when its authorization lapsed. Despite widespread bipartisan support, interim short-term budget resolutions failed to include home visiting. It came down to a nail-biter this week with the addition of MIECHV, along with other key safety net and family-serving programs, in a bipartisan Senate budget proposal.

The final 2018 budget also included significant funding increases for the Child Care Block Grant and community health centers, as well as an additional four years of reauthorization for the state Children’s Health Insurance Program (SCHIP).

Thanks to all of our local, state and national advocacy partners, particularly the National Home Visiting Coalition and the Association of State and Territorial Home Visiting Initiatives (ASTHVI) for their hard work and support!

MIECHV, Other Programs Remain in Limbo

Reauthorization of the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, along with Community Health Centers and other health care programs, was not included in the short-term continuing resolution passed yesterday by Congress.  The continuing resolution includes six-year reauthorization of the Children’s Health Insurance Program (SCHIP) and ends the government shut-down through February 8th, providing time to consideration of legislation regarding the Deferred Action for Childhood Arrivals (DACA) immigration program.

Home visiting advocates continue to urge Congress to include MIECHV in any moving legislative vehicle.  At this point, with funding extended through February 8th, the next opportunity will be in early February. Over the next several weeks, home visiting advocates are urging supporters to contact their Congressional members and tell them to renew MIECHV now.

Home visiting, parenting programs critical to building strong foundation for children

Sustaining and expanding funding for evidence-based parenting programs and supports through the Maternal, Infant & Early Childhood Home Visiting (MIECHV) and other initiatives is critical to building strong foundations for children and their families, according to a new series of policy briefs developed by Zero to Three and the Center for Law and Social Policy (CLASP). In addition, use of innovative approaches, such as centralized intake to screen and refer families to the most appropriate services, are key to the development of coordinated systems of care in communities.

The recently released series, Building Strong Foundations: Advancing Comprehensive Policies for Infants, Toddlers, and Families, identifies 13 core policies required to support young children and their families on a path to healthy development. Such public policies address the comprehensive and interrelated needs of infants, toddlers, and families, ensuring access to mental and physical health care services; healthy food to eat; stable housing; good jobs with adequate benefits; and quality early care and learning programs.  The series includes a framework, overarching rationale, and 13 policy briefs that make the case for these essential core policies and identify action steps for federal and state policymakers to build and improve upon them.

The policy brief on Parent Support Services and Resources recommends parents of infants and toddlers have access to a full continuum of evidence-based parent support services that are appropriate to their needs. This includes information resources, evidence-based home visiting, parent education and peer support programs, and guidance in navigating other services available in the community. Development of the policy framework was supported by the W.K. Kellogg Foundation.