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Michigan Infant, Maternal and Early Childhood Home Visiting Program


Michigan Infant, Maternal and Early Childhood Home Visiting Program Building County-Level Home Visiting Systems Videoconference for Teams from: Berrien, Calhoun ... – PowerPoint PPT presentation

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Title: Michigan Infant, Maternal and Early Childhood Home Visiting Program

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

  • Wayne Counties

1. Welcome and Introductions
  • Welcome Introductions
  • Videoconference Objectives
  • Context for HRSA HV Program
  • Building a HV System
  • Michigan HV Program Logic Model
  • How Can Communities Begin to Participate?
  • Expectations for each County
  • Seed Funds to Support County Activities
  • QA
  • Next Steps

2. Videoconference Objectives
Videoconference Objectives
  • Update on current status of HRSA Home Visiting
  • Ensure understanding of purpose of Home Visiting
    Program (HVP).
  • Describe Michigan HVPs Logic Model development
  • Describe steps county HVP teams can take to
    prepare for response to HRSA guidance (Step 3).

Objectives, contd
  • Describe state expectations for county HVP
  • Discuss seed funding to support initial work.
  • Conduct Q A.
  • Identify next steps and future TA opportunities.

3. Context HRSA Home Visiting Program
  • Policy Brief from The Future of Children
  • Social Science Rising A Tale of Evidence
    Shaping Public Policy
  • http//www.princeton.edu/futureofchildren/publicat

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
  • 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.

Social Science Rising, contd
  • 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.

  • 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.

Affordable Care Act Funding Status
  • Michigan has received funding for FY 2010.
  • We have 27 months to spend the funds that we were
  • We are awaiting the next federal guidance for
    Step 3.
  • There is talk that Congress may repeal this
  • It is critical for our state need to think about
    whats important with respect to a home visiting
    system regardless of federal funding.

HRSA Funding can be used for
  • Three major activities
  • Develop a state Home Visiting System embedded in
    a comprehensive, high-quality Early Childhood
  • Develop local home visiting systems based on the
    state system.
  • Within the system, implement and evaluate
    evidence-based home visiting programs.

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
  • 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.

4. Building a Home Visiting System
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.

Based on Lessons from Other States
  • Michigan might choose to focus on one or more of
    the following system components
  • Public Engagement Ongoing Professional
  • 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.

5. MI Home Visiting Program Logic Model
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
    expandedmay need to be revised based on Step 3
  • This draft Logic Model represents the larger
    effort to build a home visiting system, and is
    not limited to just the ACA funding.

Home Visiting Program Logic Model
  • We welcome your comments or questions about the
    draft Logic Model. Please send comments to
  • HomeVisitingProject_at_michigan.gov

6. How Can Communities Begin to Participate in
the HV Program Activities?
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.

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
  • Early Head Start/Head Start

  • Additional key representatives for HV planning
  • Community Mental Health
  • Education community
  • Existing Home Visiting programs/providers,
    including those providing perinatal services
    (e.g. MIHP, Healthy Start)
  • Families

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

Family Implications
  • Children often model parental substance using
  • Sometimes develop self preservation skills (Hero,
    scapegoat, mascot and the lost child).

  • 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
  • Exposure to media and movie messages that
    glamorize use.
  • Peers who drink/drug.

Problems Manifested in Several Domains
  • Families
  • Communities
  • Schools
  • Employers
  • Social relationships
  • Social services

Community Wellness
  • Prevention or early intervention, enhance
  • chances for family and community wellness
  • Less ATOD use.
  • Fewer family problems.
  • More productive citizenry.

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.

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
  • Problem Gambling 24 hour Help-line, Assessment
    Questions, Treatment, Prevention, Speakers
    Bureau, Therapist Training.

Regional Substance Abuse Services Representatives
  • Kalamazoo and Calhoun - Kalamazoo Community
    Mental Health Substance Abuse Services
  • Achiles Malta, Prevention Coordinator (269)
    553-7076 amalta_at_kazoocmh.org
  • Berrien and Muskegon - Lakeshore Coordinating
  • Kori White Bissot, Prevention Coordinator (616)
    846-6720 kbissot_at_lakeshoreca.org
  • Genesee - Genesee County Community Mental Health
  • Lisa Coleman, Manager S.A. Prevention (810)
    496-5544 lcoleman_at_gencmh.org
  • Ingham - Mid-South Substance Abuse Commission
  • Joel Hoepfner, Prevention Coordinator (517)
    337-4406 ext. 102 joel_at_mssac.com

Regional SAS Representatives (contd)
  • Kent County - network180
  • Denise Herbert, Prevention Coordinator (616)
    855-5245 deniseh_at_network180.org
  • Saginaw - Saginaw County Department of Public
  • Bryant J. Wilke, R.S., Interim Dir. of S.A.
    Serv. (989) 758-3684 bwilke_at_saginawcounty.com
  • St. Clair - St. Clair County Community Mental
    Health (DBA) Thumb Alliance
  • Andy Kindt, Regional Prevention Coord. (810)
    966-4490 akindt_at_scccmh.org
  • Wayne - Detroit Department of Health Wellness
  • Karra Thomas, CPC-M, Prevention Coord. (313)
    876-0154 thomaskw_at_detroitmi.gov

Services for Pregnant Women Mothers of Young
  • 9 out of 10 counties have in-county womens
    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

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.

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

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
  • 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

6b. Next Steps for Data
Take inventory of what local data you have about
sub-populations for each of the 10 federal
  • 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
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.)?

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?

  • 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.

6c. Update information about existing HV Programs
  • The state is developing a database with
    standardized definitions, that will capture
    information statewide and will be shared with
    local communities.

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

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?

7. State Expectations for each County
  • 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
  • It is possible that fewer than 10 counties will
    receive FY10 funding.

  • 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.

8. Seed Funds to Support County Activities
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 weve discussed today, as well as
  • Data gathering and reporting
  • Epidemiology support for data analysis and
  • Parent involvement
  • Local participation in the development of the
    Step 3 response.

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.

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

9. Questions Answers
10. Next Steps
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
  • Send an contract addendum for the seed funds,
    related to the federal guidance and analysis
    needed from local communities.
  • Conduct additional information sharing

Next Steps - LOCAL
  • Begin working on the tasks outlined in this
  • Provide comments on the draft Logic Model
  • Identify and build your local governance group
  • Start an inventory of currently available local
  • 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

Upcoming Webinars/Meetings(Tentative)
  • Wednesday, January 19, 1000-1130am
  • Webinar regarding Lessons learned from Project
    LAUNCH (available statewide)
  • Thursday, February 3, 100-300 in Lansing
  • Meeting with 10 communities regarding next steps
    on Home Visiting program

  • 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 HomeVisitingProject_at_michigan.gov

  • We appreciate your interest and willingness to
    work through this process with us!
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