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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
  1. Welcome Introductions
  2. Videoconference Objectives
  3. Context for HRSA HV Program
  4. Building a HV System
  5. Michigan HV Program Logic Model
  6. How Can Communities Begin to Participate?
  7. Expectations for each County
  8. Seed Funds to Support County Activities
  9. QA
  10. 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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