EOHHS / EOE Home VisitingReadiness Cabinet

August 23, 2010

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Component of Patient Protection and Affordable Care Act signed March 2010

Goals: Respond to the diverse needs of children and

families in communities at risk Improve health and development outcomes

through evidence-based home visiting programs Part of the Dept. of Health and Human Services’

effort to establish comprehensive continuum of services for pregnant women, parenting families, and children birth to 8 years

Creation of Maternal, Infant, Early Childhood Home Visiting Program

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Supports state-based maternal, infant and early childhood home visiting grant program administered by DHHS by amending Title V of the Social Security Act

FY2010: $100 MFY2011: $250 MFY2010: $350 MFY2013: $400 MFY2014: $400 M

$1.5 B in Funding Over 5 Years

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In FY2010, MA will receive $1,096,728

$500,000 awarded on July 15, 2010 for initial Needs Assessment completion planning for implementing evidence-based home

visiting program

Can access remaining $596,728 after the full Needs Assessment is submitted and approved

Massachusetts’ Share

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1 Improvements in prenatal, maternal, and newborn health, including improved pregnancy outcomes

2 Improvements in child health and development

3 Improvements in child school readiness including improvements in cognitive, language, social-emotional, and physical development indicators

4 Improvements in the prevention of child injuries and maltreatment5 Improvements in parenting skills6 Reductions in crime or domestic violence7 Improvements in family economic self-sufficiency8 Improvements in coordination of referrals for other community

resources and supports

Prevention of child injuries and maltreatment became own outcome

Changes to Outcomes Specified in Legislation

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Home Visiting Initiative Requirements

Healthy Families America (HFA)Nurse Families Partnership (NFP)Parents As Teachers (PAT)SafeCareTriple P

Evidence-based home visiting models represented:

External Engagement – Home Visiting Summit

Goal1)To learn about national evidence-based home visiting models2)To deepen understanding of home visiting model evaluations through an academic expert panel

Session information1 session held on June 15, 2010 at the Dept of Early Education & Care (Boston, MA)

Academic evaluator experts:University of Chicago: Dr. Deborah Gorman-SmithTufts: Dr. Francine Jacobs, Dr. Jayanthi Mistry, Dr. Jessica Goldberg

GoalTo gather firsthand knowledge of the state’s current home visiting capacity as well as statewide service gaps.

Session information3 sessions held with representatives of MA home visiting programs:

o June 29, 2010: Office of Health Care Quality (Boston, MA)o August 5, 2010: Dept of Public Health (Boston, MA)o August 6, 2010: Holyoke Health Center (Holyoke, MA)

A Helping HandBoston Home Visiting CollaborativeEarly ConnectionsEarly Head StartEarly Intervention Partnerships ProgramF.O.R. FamiliesFRESH Start

Healthy Baby Healthy ChildHealthy Families MAHealthy StartParent Child Home ProgramVisiting MomsWelcome Baby

Home visiting programs represented:

External Engagement – Public Listening Sessions

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Community Needs Assessment

Data Indicators Mapped to 9 Participant Outcome Domains:Example of Improvement in child health/development & Improvement in school readiness

# Outcome Domain Data Indicators

City/town level – included in needs assessment community ranking

Statewide –included in needs assessment narrative

2 Improvements in child health and development

Asthma hospitalizations per 100,000 X

Lead poisoning adjusted rate X

Rate of childhood obesity (selected school districts) X

Children’s Medical Security Plan (CMSP) caseload X

Infant and Early Childhood Mental Health X

Children’s Behavioral Health Initiative (screening rates) X

3 Improvements in child school readiness incl. improvements in cognitive, language, social-emotional, and physical developmental indicators* Although there is city/town data on these indicators, they are not included in the ranking of this domain.

% EI enrollment X

Rate of high school drop-outs X

Poor performing schools (levels 1-4) X

% of children waitlisted for an EEC subsidized childcare slot X

Rate of truancy* X

% of Special Education placement (students with IEPs)* X

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1 2 3 4 5

121

176

35

11 80

50

100

150

200

# ofCommunities

Composite Need Score Groups

Composite Need Score for All 351 MA Cities/Towns

Lowest Need/Highest Score

Highest Need/Lowest Score

1. Holyoke2. Springfield3. Chelsea4. Lawrence5. Lowell6. New

Bedford7. Fall River8. Lynn

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Next Steps for Task Force

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Identified Statewide Gaps in Home Visiting Services

• Maternal mental health

• Early childhood mental health

• Child health and development

• Immigrants

• Family economic self sufficiency

• Family violence and trauma

• Comprehensive system of care

• Non-traditional populations (i.e. fathers)

The Massachusetts state home visiting plan should –• Emphasize depth over breadth in order to maximize the

likelihood of achieving desired impact. • Focus on promoting collaboration with existing

services, including those outside of early childhood domain to create coordinated system.

• Promote sustainability through building community capacity for the post-grant period.

• Prioritize service delivery to vulnerable populations

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Principles Guiding State Plan Development

Aug Sept Oct Nov Dec

August 20, 2010 16

Taskforce(Matching Modelsto Needs; Narrow Model Selection)

Date TBD

Taskforce(Refine State Plan)

Date TBD

Map gaps vs. community needs Recs to Governor &

EOHHS Secretary

Governor’s Response

Taskforce(if needed)Date TBD

Taskforce(Finalize Model Recs.

for State Plan)Date TBD

NeedsAssessment

DueSept 20

UpdatedState Plan

? Early FY11

Taskforce(Needs Assess. Finalization &

Guiding Principles)8/20 12-2pm

Further review of HV models

Research and prepare Updated State Plan

Plan for evaluation strategy

MA Response to HV Legislation Timeline - Updated

Other tasks?

Map models to community needs

Refine needs assessment