February 21, 2012Harrisburg, PA

Home Visitation Stakeholder Committee Meeting

Write down a word or phrase that you see as an essential value of an effective home visiting

system

Introductions: Share name, role, & value

Maternal, Infant and Early Childhood

Home Visiting Program

Summary of Grant Requirements

Purposes To strengthen and improve the

programs and activities carried out under Title V

To improve coordination of services for at risk communities

To identify and provide comprehensive services to improve outcomes for families who reside in at risk communities

Statewide Needs Assessment

Each State shall, as a condition of receiving payments for fiscal year 2011:

Conduct a statewide needs assessment that identifies communities with concentrations of:• premature birth, low-birth weight infants, and infant mortality,

including infant death due to neglect, or other indicators of at-risk prenatal, maternal, newborn, or child health;

• poverty;• crime;• domestic violence;• high rates of high-school drop-outs;• substance abuse;• unemployment; or• child maltreatment;

Statewide Needs Assessment

Assess the quality and capacity of existing programs or initiatives for early childhood home visitation in the State including—• the number and types of individuals and families who

are receiving services under such programs or initiatives;

• the gaps in early childhood home visitation in the State;

• the extent to which such programs or initiatives are meeting the needs of eligible families; and

• the State’s capacity for providing substance abuse treatment and counseling services to individuals and families in need of such treatment or services.

Coordination with Other Assessments

The State shall coordinate with, and take into account, other appropriate needs assessments conducted by: Title V – Maternal and Child Health

Block Grant Head Start CAPTA Lead Agency (child welfare)

Program Models The program must be conducted using 1

or more of the evidence-based service delivery models, as defined by HRSA:• Nurse Family Partnership• Parents As Teachers• Early Head Start• Healthy Families America• Family Check-up• Healthy Steps• Home Instruction Program for Preschool

Youngsters (HIPPY)

Maintenance of Effort Funds provided to an eligible entity

receiving a grant under this section shall supplement, and not supplant, funds from other sources for early childhood home visitation programs or initiatives.

BenchmarksEstablishment of quantifiable, measurable 3- and 5-year benchmarks for demonstrating that the program results in improvements for the eligible families participating in the program in each of the following areas: Improved maternal and newborn health. Prevention of child injuries, child abuse, neglect, or

maltreatment, and reduction of emergency department visits.

Improvement in school readiness and achievement. Reduction in crime or domestic violence. Improvements in family economic self-sufficiency. Improvements in the coordination and referrals for

other community resources and supports.

Improvements in Outcomes for Individual Families

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

Improvements in child health and development, including the prevention of child injuries and maltreatment and improvements in cognitive, language, social-emotional, and physical developmental indicators.

Improvements in parenting skills. Improvements in school readiness and child academic

achievement. Reductions in crime or domestic violence. Improvements in family economic self-sufficiency. Improvements in the coordination of referrals for, and the

provision of, other community resources and supports for eligible families, consistent with State child welfare agency training.

Priority for Serving High-Risk Populations

The program gives priority to providing services to the following: Eligible families who reside in communities in need of such services, as

identified in the required statewide needs assessment. Low-income eligible families. Eligible families who are pregnant women who have not attained age 21. Eligible families that have a history of child abuse or neglect or have had

interactions with child welfare services. Eligible families that have a history of substance abuse or need

substance abuse treatment. Eligible families that have users of tobacco products in the home. Eligible families that are or have children with low student achievement. Eligible families with children with developmental delays or disabilities. Eligible families who, or that include individuals who, are serving or

formerly served in the Armed Forces, including such families that have members of the Armed Forces who have had multiple deployments outside of the United States.

Additional RequirementsThe program: Adheres to a clear, consistent model that satisfies the requirements of

being grounded in empirically-based knowledge related to home visiting and linked to the specified benchmark areas and participant outcomes.

Employs well-trained and competent staff, as demonstrated by education or training, such as nurses, social workers, educators, child development specialists, or other well-trained and competent staff, and provides ongoing and specific training on the model being delivered.

Maintains high quality supervision to establish home visitor competencies.

Demonstrates strong organizational capacity to implement the activities involved.

Establishes appropriate linkages and referral networks to other community resources and supports for eligible families.

Monitors the fidelity of program implementation to ensure that services are delivered pursuant to the specified model.

Reporting Requirements Not later than 30 days after the end

of the 3rd year in which the eligible entity conducts the program, the entity submits to the Secretary a report demonstrating improvement in at least 4 benchmark areas.

Pennsylvania’s Maternal, Infant

and Early Childhood Home Visiting Program

Evidence-based Practices and

Decision-making

Protective Factors

Continuous Quality

Improvement

Effective Collaboration

Quality Underpinnings of the Home Visiting Grant

A decision-making process that integrates the best available research evidence with family & professional wisdom & values3

Evidence-based Practices and Decisions

Protective FactorsConditions in families and communities that, when present, increase the health and well-being of children and families. Research has shown that the following protective factors are linked to a lower incidence of child abuse and neglect: Nurturing and attachment, knowledge of parenting and of child development, parental resilience, social connections, and concrete supports for families 4

Where do you go for resources to support your evidence-based

practices? At the national level? At the state level?

• Strong leadership at all levels to articulate a vision and inspire a lasting commitment

• A focus on the "clients" (infants, toddlers, families)

• Consistent attention to the study of work processes

• Information-based decision making

• Teamwork and team decision making leading to quality improvements

Trademarks of Continuous Quality Improvement (CQI)

Another foundational concept

Professional development is facilitated teaching and learning experiences that are transactional, collaborative and designed to support the acquisition of professional knowledge, skills, ethics/values and dispositions as well as the application of this knowledge in practice to benefit all children and families 5, 6

Possible Challenges to an Integrated System of Effective Home Visiting

4 evidence-based models 12 implementing agencies One large, complex statewith many early childhood efforts and initiatives

A commitment to work together across clearly recognizable sectors or subsystems to address a problem and achieve a goal that could not be accomplished by working individually7

Effective Collaboration

Scholars identify vision as an essential component in models of successful leadership.8,9,10,11,12

Importance of Creating a Shared Vision

Vision has been defined as “the ability to bypass the obvious and see opportunities that evade others – to see new ways of doing things. It enables effective leaders to see new and valuable relationships among many diverse ideas, events, things and people. Vision includes new discoveries as well as the rearrangement of long standing ideas.” 10

A vision has to have accuracy, and not just appeal and imagination. Articulating a vision has to start with an awful lot of listening, a lot of stimulating conversation, and then more listening – to distill and capture the values. 13

Creating a Shared Vision

The vision for Pennsylvania’s Maternal, Infant and Early Childhood Home Visiting Program needs to be equally relevant at• the individual family level• the county cluster level• the implementing agency level• the state level

Initial Draft

A statewide system of high quality, evidence-based home visitation services that will strengthen and support families and promote maternal, infant and early childhood health, safety and development

Creating a Shared Vision

1

•Read the draft vision (handout). Circle or underline words that you think are important to include in a vision for PA’s home visiting system.

2

•On the same piece of paper, write down any specific, important words or phrases that are missing.

3

•At your table, discuss what you came up with in Steps 1 and 2. PLEASE record your ideas.

• Network: an extended group of people with similar interests or concerns who interact and remain in informal contact for mutual assistance or support

• System: a group or combination of interrelated, interdependent or interacting elements forming a collective entity

Next Steps

1

•With the colleagues at your table, create a one sentence vision statement that incorporates your ideas

2

•Record your draft vision statement on a piece of paper or a flip chart

3

•Identify a spokesperson to share your draft vision statement

Values of Effective Home Visiting (from proposal)

Parents are a child’s first and most important teacher and home is the most influential learning environment.

Services that are• Strengths-based and build on protective factors• Relationship-based and family-focused• Evidence-based• Reflective of and responsive to the diversity of children, families, and communities

Service agencies that• Employ well-trained and competent staff• Engage families as partners• Use data to drive decision-making• Engage in continuous quality improvement

Communities that• Collaborate and coordinate to provide a seamless network of services and supports• Recognize the importance of the home visitor in the early childhood system

Creating Shared Values

1

•With the colleagues at your table, discuss additional values of Pennsylvania’s home visiting system that are not reflected in the draft

2

•Record your ideas about additional values on a piece of paper or a flip chart

3

•Identify a spokesperson to share your ideas

Toward a Shared Vision and Values

1

•All inputs will be integrated into a draft

2

•Within 1 week the draft will be distributed for your input

3

•Within 3 weeks a final vision will be available to guide your work

Small Group WorkEarly Head Start Parents as Teachers

Healthy Families AmericaNurse-Family Partnership

Small Group Work

With your colleagues, please discuss the following:• How will you incorporate the vision and values in the

daily work you do related to home visiting?• How will you ensure that your practices are reflective

of and responsive to the culture, language, and configuration of each family?

• How will you promote collaboration and linkages with other agencies and initiatives at the agency level? At the county cluster level? At the state level?

• What resources would help you to do these things?

Are these resources you could use in

your work?Suggestions? Resources?

What do you think about

the next steps?

So what do you think?

Next Steps

References

1 National Child Care Resource and Referral Agency. (n.d.) Infants and toddlers need quality care. http://www.naccrra.org/policy/background_issues/infants-and-toddlers-need-quality-care2 Schumacher, R., & Hoffmann, E. (2008). Build supply of quality care. Washington, DC: CLASP. http://www.clasp.org/admin/site/babies/make_the_case/files/cp_rationale13.pdf3 CONNECT http://connect.fpg.unc.edu4 Center for the Study of Social Policy. (2003). Protective factors literature review: Early care and education programs and the prevention of child abuse and neglect. http://www.childwelfare.gov/survey/disclaimerAskme.cfm?target=http://strengtheningfamilies.net/images/uploads/pdf_uploads/LiteratureReview.pdf&referrer=http://www.childwelfare.gov/can/factors/protective.cfm5 Pennsylvania’s Comprehensive Early Childhood Education Professional Development System http://www.pakeys.org/uploadedContent/Docs/PD/PQAS/Guiding%20Principles%20for%20Early%20Childhood%20Professional%20Development%20in%20Pennsylvania.pdf6 National Professional Development Center on Inclusion. (2008). What do we mean by professional development in the early childhood field? Chapel Hill: The University of North Carolina, FPG Child Development Institute, Author. http://npdci.fpg.unc.edu/resources/articles/NPDCI-ProfessionalDevelopment-03-04-08.pdf

References

7 Mattessich, P.W., Murray-Close, M., & Monsey, B.R. (2004). Collaboration: What makes it work: A review of research literature on factors influencing successful collaboration. (2nd ed.). St. Paul, MN: Amherst Wilder Foundation.8 Bennis, W.G., & Nanus, B. (1985). Leaders: Strategies for taking charge. New York: Harper & Row. 9 Koestenbaum, P. (1991). Leadership: The inner side of greatness. San Francisco: Jossey-Bass.10 Senge, P.M. (1990). The fifth discipline: The art and practice of the learning organization. New York: Doubleday.11 Nanus, B. (1992). Visionary leadership. San Francisco: Jossey-Bass.12 Lynch, R. (1993). Lead! How public and non-profit managers can bring out the best in themselves and their organizations. San Francisco: Jossey-Bass.13 Hegarty, C.J., & Nelson, P.B. (1997). 7 secrets of exceptional leadership. Mechanicsburg, PA: Executive Books.

Additional Resources

National Early Childhood Technical Assistance Center http://www/nectac.org

Early Childhood Learning and Knowledge Center (ECLKC) http://eclkc.ohs.acf.hhs.gov/

Pennsylvania Juvenile Law Center http://www.jlc.org

Pennsylvania Early Intervention Technical Assistance http://www.pattan.net (early intervention)

National Sexual Violence Resource Center http://www.nsvrc.org

National Online Resource Center on Violence Against Women http://www.vawnet.org

(ACE) Study http://www.acestudy.org/