Introduction to the Model

1. Introduction to the Model Lynn H. Kosanovich, HFA Regional Director

2. Presentation Overview History Rationale for Healthy Families America Model: Goals 12 Critical Elements Our Philosophy Strengths of the Model Affiliation and Accreditation

3. History • 1970s - HI Healthy Start designed to prevent CAN based on Dr. Henry Kempe (Battered Child Syndrome) work in CO • 1992 – PCA, HI Healthy Start and Ronald McDonald House Charities • Developed 12 Critical Elements based on HI Healthy Start Model & Literature Review • 1995 – Accreditation and formal affiliation • 1997 – Accreditation of Multi-Site Systems • Training, TA, P&P, Data, Evaluation • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation

4. Child Welfare Gateway: In 2006 CAN rates were highest among children under 3 44.2% of fatalities in 2006 were children under age one 78% of fatalities occurred under the age of 4 76% of fatalities were committed by one or both parents Rationale for HFA • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation

5. Rationale for HFA (cont.) • More than a decade and more than 17,000 individuals • CDC & Kaiser Health Plan’s Department of Preventive Medicine in San Diego, CA • Connection between ACE & physical and mental health of adults including the major causes for adult mortality in the United States • Early childhood trauma clearly contributes to serious health issues later in life ACE Study (Adverse Childhood Experiences)

6. Vision-Mission-Goals • Our Vision: All children receive nurturing care from their family essential to leading a healthy and productive life. • Our Mission: To promote child well-being and prevent the abuse and neglect of our nation’s children through home visiting services. • HFA Program Goals: • Build and sustain community partnerships to systematically engage overburdened families in home visiting services prenatally or at birth. • Cultivate and strengthen nurturing parent-child relationships. • Promote healthy childhood growth and development. • Enhance family functioning by reducing risk and building protective factors. • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation

7. 12 Critical Elements • Service Initiation (CE 1-3) • Linking, assessing and reaching out to families • Service Content (CE 4-8) • What happens during a home visit • Staff Characteristics (9-12) • Hiring, training & supervising staff • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation

8. Critical Elements: Service Initiation • Initiate Prenatally or At Birth (CE #1) • Target population • Relationships in the community • Standardized Assessment (CE #2) • Used to identify those most in need and those most likely to benefit • Offer Services Voluntarily & Creatively Reach Out (CE #3) • Families more likely to participate • Working with participants who need us to build their trust

9. Critical Elements: Service Content • Offer Intense, Long-term Services, Criteria for Increasing & Decreasing (CE #4) • Must be offered three to five years • Leveling system to determine intensity of services & family progress • Culturally Sensitive Services (CE #5) • Training on unique characteristics • Staff-participant interaction • Sensitivity toward family values, beliefs & customs • Appropriate materials

10. Critical Elements: Service Content (cont.) • Focus on Parent as Well as Child (CE #6) • Review issues on assessment • Develop Goal Plans – about the process • Curriculum – PCI, Child Development, Health & Safety • Developmental Screens – ASQ • Follow-up with children suspected or identified with delays • Linked to Medical Provider & Other Services (CE #7) • Medical Home • Immunizations • Referrals • Limited Caseloads (CE #8) • Sufficient time to connect with families

11. Critical Elements: Staff Characteristics • Personal Characteristics, Skills & Knowledge (CE #9) • Important for staff to build relationships with diverse populations • Basic Training & Role Specific Training (CE #10 & #11) • Orientation, role specific, wraparound & ongoing • Supervision (CE #12) • Ongoing & effective, develop realistic & effective plans to empower families, & express concerns & frustrations • Reflective, Clinical and Administrative • Governance & Administration • Not a Critical Element

12. Early nurturing relationships are the foundation for life-long healthy development. Infant Mental Health Strength-based Parallel Process Family-Centered Culturally Sensitive Valuing Fathers Reflective Practice Our Philosophies • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation

13. Strengths of the HFA Model Flexibility: • Target population • Child development & parent-child interaction curricula • Staffing requirements Comprehensive Assessment Services: • Determine families most likely to benefit • Refer families to community resources • Used as Single Point of Entry Creative Outreach • Focus on building trust • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation

14. Strengths of the HFA Model (cont.) Service Intensity: • Weekly for a minimum of six months after birth • Decreases as family competencies increase • Offered three to five years Focus on Parent as Well as the Child Comprehensive Training: • Parent Survey • Integrated Strategies for Home Visitors • Wraparound Training – Distance Learning Accreditation State Systems

15. Suggested criteria: Ability to access parents prenatally or at birth Experience with home visiting Infrastructure to support HFA best practice standards Physical space to house program Affiliation: Complete application and implementation plan Send, with $500 fee, to Chicago address listed on application Complete phone call with Lynn Kosanovich, HFA regional director Affiliation & Accreditation • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation

16. Implementation & Accreditation Accreditation: • 1st time within 2 years of affiliation (every 4 years after that) • Based on 12 Critical Elements • Self-study • Site Visit • Panel response

17. Contact Info: • Lynn Kosanovich • Healthy Families America Regional Director • lkosanovich@preventchildabuse.org • 703-888-3135