december 16, 2010 1 michigan infant, maternal and early childhood home visiting program building...
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December 16, 20101
Michigan Infant, Maternal and Early Childhood Home Visiting Program
Building County-Level Home
Visiting Systems
Videoconference for Teams from:
Berrien, Calhoun, Genesee, Ingham,
Kalamazoo, Kent, Muskegon,
Saginaw, St. Clair and
Wayne Counties
December 16, 20102
1. Welcome and Introductions
December 16, 20103
Agenda
1. Welcome & Introductions2. Videoconference Objectives3. Context for HRSA HV Program4. Building a HV System5. Michigan HV Program Logic Model6. How Can Communities Begin to Participate?7. Expectations for each County8. Seed Funds to Support County Activities9. Q&A10. Next Steps
December 16, 20104
2. Videoconference Objectives
December 16, 20105
Videoconference Objectives
Update on current status of HRSA Home Visiting Program.
Ensure understanding of purpose of Home Visiting Program (HVP).
Describe Michigan HVP’s Logic Model development efforts.
Describe steps county HVP teams can take to prepare for response to HRSA guidance (Step 3).
December 16, 20106
Objectives, cont’d
Describe state expectations for county HVP ‘teams’.
Discuss ‘seed’ funding to support initial work.
Conduct Q & A.
Identify next steps and future TA opportunities.
December 16, 20107
3. Context: HRSA Home Visiting Program
December 16, 20108
Context
Policy Brief from The Future of Children:
“Social Science Rising: A Tale of Evidence Shaping Public Policy”
http://www.princeton.edu/futureofchildren/publications/docs/19_02_PolicyBrief.pdf
December 16, 20109
Social Science Rising
Social scientists have taken a step toward the goal of getting policy makers to consider high-quality evidence when making program funding decisions.
President Obama put provisions in the budget to support home visiting programs that “will produce sizable, sustained improvements in the health, well-being, or school readiness of children or their parents.”
The resulting bill gives priority funding to programs that “adhere to clear evidence-based models of home visitation that have demonstrated significant positive effects on important program-determined child and parenting outcomes.”
December 16, 201010
Social Science Rising, cont’d
The Obama administration will evaluate as many programs as possible, cut off funding for those that are not working and expand those that are.
The administration endorses a two-tier approach of giving more money to the programs with the strongest evidence of success and less money to programs that have “some supportive evidence, but not as much.”
The federal policy process now hinges importantly on evidence, a clear sign that the administration and Congress want to do everything they can to fund successful programs.
December 16, 201011
Resources
We will be sending out: An updated resource list of articles about
evidence-based home visiting. A list of webinars you may wish to view
regarding home visiting models and systems.
December 16, 201012
Affordable Care Act Funding Status
Michigan has received funding for FY 2010.
We have 27 months to spend the funds that we were awarded.
We are awaiting the next federal guidance for Step 3.
There is talk that Congress may repeal this legislation.
It is critical for our state need to think about what’s important with respect to a home visiting system regardless of federal funding.
December 16, 201013
HRSA Funding can be used for…
Three major activities:
– Develop a state Home Visiting System embedded in a comprehensive, high-quality Early Childhood System.
– Develop local home visiting systems based on the state system.
– Within the system, implement and evaluate evidence-based home visiting programs.
December 16, 201014
HRSA Next Steps
Step 3 guidance not yet available
– We still need to move forward in anticipation of what HRSA will require :
Determine infrastructure priorities. Revise logic model. Bring all of the key participants to the table. Inventory county-level data about target audiences. Develop database of home visiting programs.
– Once released, we likely will not have much time to complete our State Plan, which will build on the above.
December 16, 201015
4. Building a Home Visiting System
December 16, 201016
Building a Home Visiting System
The Great Start System Team has appointed the Home Visiting Work Group.
– Purpose is to guide the development of the state-level home visiting system.
– The state-level system will guide and support the county efforts.
December 16, 201017
Based on Lessons from Other States…
Michigan might choose to focus on one or more of the following system components:Public Engagement Ongoing Professional Development/
Program Support Core Competencies of Staff
Governance Evaluation and Information Systems
Administration Needs Assessment and Planning
Coordination Centralized Point of Referral
Monitoring Early Childhood Partnerships
Funding Program Standards
CQI
Some of the 10 counties have already begun systems development work.
December 16, 201018
5. MI Home Visiting Program Logic Model
December 16, 201019
MI Home Visiting ProgramLogic Model
The Home Visiting Work Group is working with Michigan Public Health Institute (MPHI) evaluators on a Logic Model.
The Logic Model will continue to be modified and expanded—may need to be revised based on Step 3 guidance.
This draft Logic Model represents the larger effort to build a home visiting system, and is not limited to just the ACA funding.
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Home Visiting Program Logic Model
December 16, 201021
Comments
We welcome your comments or questions about the draft Logic Model. Please send comments to:
December 16, 201022
6. How Can Communities Begin to Participate in the HV Program
Activities?
December 16, 201023
6a. Local Governance Structure
A group or committee will need to provide leadership locally regarding this home visiting system building work.
You know your local structure and partners best; what will work for you?
Ideas: entire GSC, GSC subcommittee, other existing or new committee that will be affiliated with the GSC, etc.
The entity providing leadership might be different than the fiduciary.
December 16, 201024
Who must be involved?
Your Great Start Collaborative contract already includes a list of required partners.
The federal HV legislation identifies several required participants for HV planning:– Public Health (Title V)– Substance Abuse – Department of Human Services/CAN Council
(CAPTA/CBCAP)– Early Head Start/Head Start
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Additional key representatives for HV planning include:
– Community Mental Health– Education community– Existing Home Visiting programs/providers, including
those providing perinatal services (e.g. MIHP, Healthy Start)
– Families
December 16, 201026
Why Substance Abuse Services Are a Fit
Addictive behaviors:– Lying– Stealing– Being unreliable– Manipulation– Moods swings– Abuse – Acting compulsively– Neglect of medical needs of both parent and child– Potential for poor or inadequate nutrition
December 16, 201027
Family Implications
Children often model parental substance using behaviors.
Sometimes develop self preservation skills (Hero, scapegoat, mascot and the lost child).
December 16, 201028
Consequences
Often children of addicts are linked with:
Victimization (violent crime, sexual abuse, DV). Serious school problems. Drinking-related traffic crashes, vandalism, other
delinquent crimes. Youthful deaths by drowning, suicide, and homicide. Exposure to media and movie messages that glamorize
use. Peers who drink/drug.
December 16, 201029
Problems Manifested in Several Domains
Families Communities Schools Employers Social relationships Social services
December 16, 201030
Community Wellness
Prevention or early intervention, enhance
chances for family and community wellness:
Less ATOD use.
Fewer family problems.
More productive citizenry.
December 16, 201031
Michigan Structure for Substance Abuse Services
Bureau of Substance Abuse and Addiction Services (BSAAS) oversees prevention, treatment and recovery efforts related to substance use disorders and gambling addiction.
16 Coordinating Agencies (CAs) who are under agreement with MDCH to ensure quality substance abuse prevention and treatment services.
December 16, 201032
Examples of Services
Prevention – Underage Drinking & Tobacco Use, Adult & Senior Problem Use, Communicable Disease, Parenting Awareness, Prescription & Over-The-Counter Drug Abuse.
Treatment – Driving Under the Influence insight education (DUI), Interventions, Methadone, Women's Treatment Programs, Fetal Alcohol Syndrome Disorder Screening and referral, Co-Occurring Disorders.
Substance Use Disorder Recovery – Recovery Oriented Systems of Care (ROSC), Peer Coaching/Mentoring, Recovery Supports and Resources.
Problem Gambling – 24 hour Help-line, Assessment Questions, Treatment, Prevention, Speakers Bureau, Therapist Training.
December 16, 201033
Regional Substance Abuse Services Representatives
Kalamazoo and Calhoun - Kalamazoo Community Mental Health & Substance Abuse ServicesAchiles Malta, Prevention Coordinator (269) 553-7076 [email protected]
Berrien and Muskegon - Lakeshore Coordinating CouncilKori White Bissot, Prevention Coordinator (616) 846-6720 [email protected]
Genesee - Genesee County Community Mental HealthLisa Coleman, Manager S.A. Prevention (810) 496-5544 [email protected]
Ingham - Mid-South Substance Abuse CommissionJoel Hoepfner, Prevention Coordinator (517) 337-4406 ext. 102 [email protected]
December 16, 201034
Regional SAS Representatives (cont’d)
Kent County - network180Denise Herbert, Prevention Coordinator (616) 855-5245 [email protected]
Saginaw - Saginaw County Department of Public HealthBryant J. Wilke, R.S., Interim Dir. of S.A. Serv. (989) 758-3684 [email protected]
St. Clair - St. Clair County Community Mental Health (DBA) Thumb Alliance Andy Kindt, Regional Prevention Coord. (810) 966-4490 [email protected]
Wayne - Detroit Department of Health & Wellness PromotionKarra Thomas, CPC-M, Prevention Coord. (313) 876-0154 [email protected]
December 16, 201035
Services for Pregnant Women& Mothers of Young Children
9 out of 10 counties have in-county women’s specific substance abuse programming available.
Some programs are residential and accept both women and their dependent children.
Three statewide residential treatment programs accept women and dependent children, and provide gender specific treatment.
Parent at risk of losing her children considered a priority
with regards to Tx, and they are placed in treatment ahead of the general population.
December 16, 201036
6a. Next Steps for Local Governance
Identify your governance group.
Support each member to understand the purpose and scope of this program.
Ask each member to review:– The November 4, 2010 state Home Visiting webinar– This presentation/powerpoint
Ensure that all members agree to collaboratively build the county-level home visiting system.
December 16, 201037
Questions?
December 16, 201038
6b. Data/Federal Indicators
We anticipate that Step 3 will include a 2nd cut analysis of risk/need to identify the target audience in each county; who is it that is experiencing the high concentration of risk?– Geographic– Sub-populations– Other characteristics
December 16, 201039
Data/Federal Indicators, cont.
We will have to provide data about these target populations and the system/services as part of the national cross-site evaluation of the project.
Access to this data is an important component of being 'ready' to participate in the project.
Data will be required for each of the 10 federal indicators.
December 16, 201040
6b. Next Steps for Data
Premature birth (%) Low birth-weight infants (%) Infant mortality
(rate/1,000 births) Poverty (% below FPL) Crime (rates/1,000
residents)
Domestic violence (rate/1,000)
High School drop-out (%) Substance abuse (%) Unemployment (%) Child maltreatment (#
reports)
*see HV Analysis tables for detailed information on indicators and sub-indicators
Take inventory of what local data you have about sub-populations for each of the 10 federal indicators*:
December 16, 201041
For the local data you do have:
How was each indicator measured; is it the same as the federal metric (e.g. % of premature births vs. rate)?
At what level do you have the data (e.g. zip code, census tract, city, county, etc.)?
Can you run analysis by sub-populations, (e.g. race, ethnicity, etc.)?
December 16, 201042
For the data you do NOT have:
How can you quickly begin to build this data collection into local projects and into existing local data systems?
December 16, 201043
We anticipate that the 2nd cut analysis will be a collaborative state-local effort.
We also anticipate having follow-up conversations with each county about the analysis work.
December 16, 201044
Questions?
December 16, 201045
6c. Update information about existing HV Programs
December 16, 201046
Database
The state is developing a database with standardized definitions, that will capture information statewide and will be shared with local communities.
December 16, 201047
6c. Next Steps for the Database
Review your county table of HV programs – are any missing (table is available on websites)?
Work with the state to assemble additional information.
December 16, 201048
Existing system coordination
We would also like to identify efforts that have been undertaken to build a county-level HV system:
• Coordinated enrollment?• Local database of programs?• Locally shared training across programs?
December 16, 201049
Questions?
December 16, 201050
7. State Expectations for each County
December 16, 201051
Process
The State is still developing the process to determine which counties would receive first round funding, and for which activities.
We anticipate that funding will be utilized for both infrastructure building and some direct services.
It is possible that fewer than 10 counties will receive FY10 funding.
December 16, 201052
Process
The process will likely take in to account:
A readiness assessment Results of 2nd cut analysis of need Follow-up discussions/meetings regarding readiness and
analysis results.
The steps outlined above (for 6a,6b,6c) will help you prepare for this process.
The process will be finalized once the Step 3 federal guidance is released.
December 16, 201053
8. Seed Funds to Support County Activities
December 16, 201054
Seed Funds
The State will offer each of the 10 counties $8,000 in seed funds to support participation in ‘Step 3’ activities.
This funding would help offset costs for activities we’ve discussed today, as well as:
– Data gathering and reporting– Epidemiology support for data analysis and reporting– Parent involvement– Local participation in the development of the Step 3
response.
December 16, 201055
Seed Funds
MDCH will establish contracts with local public health, as that is the easiest mechanism for us to quickly distribute these funds.
We anticipate establishing contracts in early January, 2011.
December 16, 201056
Seed Funds
Once we receive the Step 3 federal guidance, we will prepare an addendum to the contract.
Each county will prepare a response to the addendum, explaining how they will use the funds to support ‘Step 3’ activities in their community.
December 16, 201057
9. Questions & Answers
December 16, 201058
10. Next Steps
December 16, 201059
Next Steps - STATE
Establish a contract with local public health to provide seed funds for ‘Step 3’ activities.
Send information regarding data needed for state database on HV programs.
Notify you when HRSA releases the ‘Step 3’ guidance.
Send an contract addendum for the seed funds, related to the federal guidance and analysis needed from local communities.
Conduct additional information sharing webinars/meetings.
December 16, 201060
Next Steps - LOCAL
Begin working on the tasks outlined in this presentation:
– Provide comments on the draft Logic Model– Identify and build your local governance group– Start an inventory of currently available local data– Begin to develop plans to collect/provide additional data
that will be needed– Review and update information about existing HV Programs
for the statewide database.– Participate in upcoming informational webinars/meetings
December 16, 201061
Upcoming Webinars/Meetings(Tentative)
Wednesday, January 19, 10:00-11:30amWebinar regarding Lessons learned from Project LAUNCH (available statewide)
Thursday, February 3, 1:00-3:00 in Lansing
Meeting with 10 communities regarding next steps on Home Visiting program
December 16, 201062
Please continue to reference the following websites for additional information about the Home Visiting Program:
www.michigan.gov/mihp, see Important News
www.greatstartforkids.org, under Early Childhood Home Visiting Program
Contact: [email protected]
December 16, 201063
THANK YOU!
We appreciate your interest and willingness to work through this process with us!