800 Participants, Early Childhood Experts Gather at 2018 First 1K Days FL Summit

More than 800 early childhood professionals in home visiting, infant mental health, early learning, and maternal and child health gathered recently in Palm Beach for the 2018 First 1000 Days Florida Summit. The highly-rated conference featured nationally recognized plenary presenters who provided the latest science on parental brain changes, making the minds of young children, the importance of social-emotional development, and early literacy. A luncheon plenary featured the moving perspectives of parents and their experiences in accessing services for themselves and their families. They reminded the audience that parent involvement requires authentic engagement and inclusion in decision-making.

The 2018 summit was sponsored by the Children’s Services Council of Palm Beach County, Florida MIECHV and a host of other state and local organizations committed to improving outcomes for families with young children.

Florida Representative Erin Grall (R-Indian River) joined Senator Bobby Powell (D-Riviera Beach) in welcoming participants and underscored the importance of advocacy to support state investments in early childhood programs.

Attendees had an opportunity to participate in more than 40 skill-building workshops on a wide range of topics from pregnancy to infant mental health, child safety and early learning. Workshops focused on providing practical information and strategies to front-line staff, including how to reduce their own stress and compassion fatigue.

In addition to the break-out sessions, the summit featured a Showcase of Best Practices highlighting innovations from the field. Awards winners included – First Place: Little TYKES-Teaching Young Children Emotionally & Socially – Tykes & Teens; Second Place: Promoting Social-Emotional Wellness in Infants & Their Parents Through Welcome to Our World – Forty Carrots Family Center; Third Place: The TEACUP Preemie Program: Maintaining Family Engagement through FirstPlay Infant Storytelling Massage – The Children’s Healing Institute. Health Choice Network’s NFP Program won the People’s Choice Award for its poster on the integration of FQHC and home visiting services. Twenty-six posters were featured in the showcase.

Participants also explored more than 25 vendor exhibits and displays during the three-day conference. The summit also celebrated the 25th Anniversary of Early Steps, the state’s part C early intervention program.

A special thank you to all of the 2018 summit sponsors whose support contributed to the caliber and success of the summit. In addition to Marquee Sponsors FL MIECHV and the Children’s Services Council of Palm Beach County, Gold Sponsors included the FL Department of Health – Family Health Services, Early Steps and Newborn Screening; the Early Learning Coalition of Miami-Dade/Monroe, FL Association of Healthy Start Coalitions, and Florida Campaign for Grade Level Reading. Silver Sponsors included the Charles & Mary Barancik Foundation—First 1000 Days Sarasota; Helios Education Fund; Children’s Services Council of Broward County, and the Quantum Foundation.

Bronze sponsors for the event included United Healthcare; the Healthy Start Coalition of Miami-Dade, Kaplan Early Learning, the Center for Child Counseling, the Florida Association for Infant Mental Health; the Ounce of Prevention Fund of FL and the Parent Infant Program—FL School for the Deaf & Blind. Summit supporters included the Association of Early Learning Coalitions and the National Fatherhood Initiative.

FL MIECHV Awarded $10.2 million to Support Home Visiting in FY18

The federal Department of Health & Human Services (DHHS) has awarded $10.2 million in funding to the FL MIECHV initiative to support continued implementation of evidence-based home visiting in the state. The FY18 award will maintain funding for sites in 25 high-need communities and four contiguous counties. FL MIECHV currently funds one of three evidence-based home visiting models in these communities – Nurse-Family Partnership, Healthy Families Florida, and Parents as Teachers. It will also support state and local activities around Continuous Quality Improvement (CQI), data collection and performance measurement, contract management and accountability, professional development, and the state evaluation. Additionally, the grant includes resources for updating the state home visiting needs assessment originally completed by the Florida Departments of Health (DOH) and Children & Families (DCF) in 2011. The needs assessment establishes communities that have priority for receipt of federal home visiting funding.

The Florida Association of Healthy Start Coalitions was awarded funding to administer the MIECHV program for the state in 2013. In 2017, FL MIECHV-funded programs provided more than 22,000 home visits to nearly 2,000 families, including 960 pregnant women. Federal legislation authorizing MIECHV funding requires that all programs collect data to evaluate program performance and outcomes across six benchmark areas for all enrolled families:

  • Maternal and child health;
  • Childhood injuries and abuse and neglect;
  • School readiness;
  • Domestic violence;
  • Family economic self-sufficiency; and
  • Coordination of services.

Across these six benchmark areas, there are a total of 19 performance measures for showing improvement over time.  Each of the measures addresses an important factor that can lead to improved health and development outcomes for at-risk children through evidence-based home visiting.

September is Infant Mortality Awareness Month

September is National Infant Mortality Awareness Month. Preterm birth— before 37 weeks gestation– is the leading cause of infant death in the first month of life. Babies born prematurely are at higher risk of mortality and morbidity, as well as developmental delay.

In 2017, Florida ranked 29th among states with an infant mortality rate of 6.1 deaths for every 1,000 live births. The infant death rates in the state have decreased 14% in the last decade but significant disparities persist for black babies compared to white babies.

Home visiting programs funded by FL MIECHV address infant mortality and preterm birth by focusing on key risk factors associated with prematurity and other poor birth outcomes. These risk factors include perinatal depression, intimate partner violence (IPV) and tobacco use during pregnancy. Performance on these measures by sites implementing one of three FL MIECHV-funded evidence-based home visiting models (NFP, HFF or PAT) is tracked annually and reported to HRSA.

Local Healthy Start Coalitions will join with community partners during September to raise awareness and promote strategies for ensuring every baby gets the best possible start in life.

 

Legisbrief Focuses on Home Visiting

A new brief by the National Conference of State Legislatures (NCSL) provides an overview of state and federal efforts to support home visiting, noting the strategy “enjoys mostly bipartisan support… due, in part, to the evidence behind the programs and the return on investment.”

Home Visiting: Improving Children’s and Families’ Well-Being describes home visiting as “a voluntary, two-generation (e.g., whole family) model that addresses issues such as health, child development, parenting, education and family violence.”

The brief reports that states have taken a leadership role in supporting the implementation of home visiting. “States have historically led public investment in home visiting. States started funding home visiting in the 1980s and continue to pass legislation to expand programming and increase accountability.”

According to the report, about 40% of counties in the U.S. had an evidence-based home visiting program in 2016.

The National Home Visiting Resource Center has identified Florida implementation sites for the following evidence-based home visiting programs: 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. Statewide, 102 local agencies operated at least one of these models, and provided more than 154,000 home visits to 15,000 families and young children in 2016. Healthy Families Florida is the only program available statewide. Home visiting programs are funded by federal, state and local sources, including FL MIECHV.

Triplets! Home Visiting Supports Breastfeeding Success

August is National Breastfeeding Month! Nearly 90% of families participating in FL MIECHV supported home visiting programs during pregnancy  in 2017 initiated breastfeeding and more than one-third continued for six months or more. Here’s a great success story on how home visiting encourages and supports breastfeeding families!

Amy and Daniel Vaknin and their 2-year-old daughter, Skylar welcomed triplets, Ava, Avi and Ari into their family on April 28, 2015. Amy was very intentional about making breastfeeding a priority.

The Vaknin family today (left to right) Mom Amy; triplets Avi, Ari & Ava; big sister Skylar, and Dad David.

While While still pregnant, Amy committed to breastfeeding her triplets as long as possible. They enrolled in the Alachua MIECHV program on July 16th, 2015. Parent Educator, Shannon Brandt was very impressed with how committed Amy was to breast feeding her sweet babies. 

“She was very organized with her feeding schedules and documented everything on a spread sheet.” “Her husband, friends and family were a wonderful support system for her.” Shannon supported Amy’s goal to breastfeed as long as possible, often completing home visits while mom was rotating the babies on her breasts or pumping.

Alachua PAT participant Amy Vaknin breastfeeding two of her three newborns in 2015.

“Many mothers struggle with the undertaking of breast-feeding a single child for 12 months, Amy succeeded at breastfeeding her triplets for 15 months!”   

Shannon continued working with the family for the next three years. She was instrumental in tracking their development through the Ages and Stages Questionnaire and linked the family to services through Early Steps when it was identified that additional interventions were needed. It was a bitter sweet moment when the family successfully graduated from the PAT program. Shannon was thrilled to be able to re-connect with them to document this story.

August is National Breastfeeding Month

August is National Breastfeeding Month! The U.S. Breastfeeding Committee (USBC) is coordinating a social media advocacy and outreach campaign to build support for the policy and practice changes needed to build a “landscape of breastfeeding support.”  The group has adopted a theme for each week: Policy Pulse (Week 1), Special Circumstances & Emergency Preparedness (Week 2), Call to Action (Week 3) and Black Breastfeeding Week (Week 4).

These activities build on the observation of World Breastfeeding Week (WBW), celebrated every year from August 1-7 to encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration signed in August 1990 by government policymakers, WHO, UNICEF and other organizations to protect, promote and support breastfeeding. This year’s theme is Breastfeeding: Foundation of Life, highlighting breastfeeding as a universal strategy that levels the playing field, giving everyone a fair start in life.

Breastfeeding has been a performance measure for MIECHV since the inception of the initiative. Performance Measure 2 tracks the success of home visiting programs in supporting mothers—who enroll as participants during pregnancy—in breastfeeding their infants during the first six months following birth.

In 2017, nearly 90% of new mothers participating in FL MIECHV-supported home visiting programs initiated breastfeeding after delivery, and 34% continued for six months or more.

FL MIECHV supports professional development for home visitors to build their skills in supporting breastfeeding mothers. Resources for home visiting staff include a 20-hour Breastfeeding Counselor Course. In 2017 more than 100 home visitors, nurses and community partner staff completed the training. Continuing education is also available through recorded webinars on the MIECHV Learning Management System (LMS) portal.

The American Academy of Pediatrics (AAP)  recommends exclusive breastfeeding for the first six months of a baby’s life, followed by breastfeeding with the introduction of complementary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby.

According to AAP, this recommendation is supported by the health outcomes of exclusively breastfed compared to outcomes for infants and infants who never or only partially breastfed. Breastfeeding provides a protective effect against respiratory illnesses, ear infections, gastrointestinal diseases, and allergies including asthma, eczema and atopic dermatitis. The rate of sudden infant death syndrome (SIDS) is reduced by over a third in breastfed babies, and there is a 15 percent to 30 percent reduction in adolescent and adult obesity in breastfed vs. non-breastfed infants.

Breastfeeding also provides health benefits for mothers. Mothers who breastfeed are at reduced risk for breast and ovarian cancer, type 2 diabetes, retention of pregnancy weight, and possibly hip fractures and osteoporosis in the postmenopausal period.

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.