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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, Genesee, Ingham,

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Michigan Infant, Maternal and Early Childhood Home Visiting Program

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  1. 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, 2010

  2. 1. Welcome and Introductions December 16, 2010

  3. Agenda • 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 • Q&A • Next Steps December 16, 2010

  4. 2. Videoconference Objectives December 16, 2010

  5. 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, 2010

  6. 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, 2010

  7. 3. Context: HRSA Home Visiting Program December 16, 2010

  8. 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, 2010

  9. 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, 2010

  10. 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, 2010

  11. 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, 2010

  12. AffordableCare 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, 2010

  13. 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, 2010

  14. 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, 2010

  15. 4. Building a Home Visiting System December 16, 2010

  16. 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, 2010

  17. 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, 2010

  18. 5. MI Home Visiting Program Logic Model December 16, 2010

  19. 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. December 16, 2010

  20. Home Visiting Program Logic Model December 16, 2010

  21. Comments We welcome your comments or questions about the draft Logic Model. Please send comments to: HomeVisitingProject@michigan.gov December 16, 2010

  22. 6. How Can Communities Begin to Participate in the HV Program Activities? December 16, 2010

  23. 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, 2010

  24. 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 December 16, 2010

  25. 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, 2010

  26. 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, 2010

  27. Family Implications Children often model parental substance using behaviors. Sometimes develop self preservation skills (Hero, scapegoat, mascot and the lost child). December 16, 2010

  28. 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, 2010

  29. Problems Manifested in Several Domains Families Communities Schools Employers Social relationships Social services December 16, 2010

  30. Community Wellness Prevention or early intervention, enhance chances for family and community wellness: Less ATOD use. Fewer family problems. More productive citizenry. December 16, 2010

  31. 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, 2010

  32. 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, 2010

  33. Regional Substance Abuse Services Representatives Kalamazoo and Calhoun - Kalamazoo Community Mental Health & Substance Abuse Services Achiles Malta, Prevention Coordinator (269) 553-7076 amalta@kazoocmh.org Berrien and Muskegon - Lakeshore Coordinating Council Kori White Bissot, Prevention Coordinator (616) 846-6720 kbissot@lakeshoreca.org Genesee - Genesee County Community Mental Health Lisa Coleman, Manager S.A. Prevention (810) 496-5544 lcoleman@gencmh.org Ingham - Mid-South Substance Abuse Commission Joel Hoepfner, Prevention Coordinator (517) 337-4406 ext. 102 joel@mssac.com December 16, 2010

  34. Regional SAS Representatives (cont’d) Kent County - network180 Denise Herbert, Prevention Coordinator (616) 855-5245 deniseh@network180.org Saginaw - Saginaw County Department of Public Health Bryant J. Wilke, R.S., Interim Dir. of S.A. Serv. (989) 758-3684 bwilke@saginawcounty.com St. Clair - St. Clair County Community Mental Health (DBA) Thumb Alliance Andy Kindt, Regional Prevention Coord. (810) 966-4490 akindt@scccmh.org Wayne - Detroit Department of Health & Wellness Promotion Karra Thomas, CPC-M, Prevention Coord. (313) 876-0154 thomaskw@detroitmi.gov December 16, 2010

  35. 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, 2010

  36. 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, 2010

  37. Questions? December 16, 2010

  38. 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, 2010

  39. 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, 2010

  40. 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) Take inventory of what local data you have about sub-populations for each of the 10 federal indicators*: *see HV Analysis tables for detailed information on indicators and sub-indicators December 16, 2010

  41. 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, 2010

  42. 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, 2010

  43. 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, 2010

  44. Questions? December 16, 2010

  45. 6c. Update information about existing HV Programs December 16, 2010

  46. Database The state is developing a database with standardized definitions, that will capture information statewide and will be shared with local communities. December 16, 2010

  47. 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, 2010

  48. 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, 2010

  49. Questions? December 16, 2010

  50. 7. State Expectations for each County December 16, 2010

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