Th The e Ma Mate terna nal, l, In Infa fant nt, , an and - - PowerPoint PPT Presentation

Carlos

• s Cano,

, MD, MPM PM

Divis ision

• n of H

Home me Visiting ing and d Early rly Childhood ldhood Syst stem ems s Mater erna nal and d Child ld Heal alth th Bu Bureau reau Heal alth th Reso sources rces and d Serv rvices ices Administra inistration ion Departme partment nt of Heal alth h and Human man Serv rvic ices es

Th The e Ma Mate terna nal, l, In Infa fant nt, , an and d Ea Early ly Chi hild ldho hood

• d

Hom

• me

e Vis isiting iting Prog

• gram

ram (MIECHV): MIECHV): Tr Tran ansforming sforming Pr Prac actice tice

Decembe ber r 10, 2014

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Main in Po Point ints

• Why a National HV program was needed

and how it was created

• What has been the progress in

implementation to date

• Areas where a public-private partnership

can generate leverage

• Integrate data-based decision making and QI into
• ngoing program implementation

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Creating eating Connections

• nnections Fa

Fast

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Birth

Early Infancy Late Infancy Early Toddler Late Toddler Early Preschool Late Preschool

Age

6 mo 12 mo 18 mo 24 mo 3 yrs 5 yrs

Ready to learn

“At Risk” Trajectory “Healthy” Trajectory Parent education Emotional Health Literacy Reading to child Pre-school Appropriate Discipline Poverty Lack of health services Toxic Stress Health Services

Ch Chil ild He Healt lth and De Develo lopment ment Traject ectorie ries

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Why Do Do W We Ne Need a Na Nationa nal Ho Home Vi Visit iting ing Pr Program? gram?

• Early childhood is a critical time in a child’s life and brain development
• Evidence-based HV services have proven effective
• All parents can benefit from support around the time of birth and

during the early years of life

• The

e home me is the first st and most st importan portant lear arning ng envir vironme nment nt

• Benefits for at-risk populations
• HV reduces some barriers to service engagement
• Shapes the intervention to family’s specific needs
• Provides “window” into the child’s most proximate environment
• Models “relationship building”
• “Coaches” parent to enhance knowledge of child development,

parental skills and capacity to achieve economic or educational goals

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Legislative gislative Au Authority thority

• Affordable Care Act of 2010
• Amended Title V o

V of th the So Soci cial al Se Securi curity ty Ac Act

• Section 511: MIECHV
• $1.5 billion over 5 years
• $100M FY2010
• $250M FY2011
• $350M FY2012
• $400M FY2013
• $400M FY2014
• Sustainable Growth Rate (SGR) Legislation
• $400M FY2015

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Progress

• gress to

to Date te

• Formula/competitive grants in 50 states, DC,

and 5 territories

• Cooperative agreements w/ 25 tribal entities
• Locally designed and run by local
• rganizations in the community (LIAs)
• Preliminary data:
• Sustained increase from 2012 to 2014 in counties

covered, families served, home visits delivered

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Sta tate te MIE IECH CHV

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In Innovations novations

• Targeting direct service investments towards well-

researched and effective home visiting models

• HV not just a program but a means to strengthen early

childhood services in general (e.g., centralized intake)

• Extensive measurement across three areas to track and

improve outcomes : performance, evaluation and QI

• Articulating a set of common constructs within the six

programmatic benchmark areas and requiring grantee measures to assess progress

• Supporting ongoing program evaluation and research
• Supporting QI efforts to rapidly enhance practice and outcomes,

e.g., the HV Collaborative Improvement & Innovation Network

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Fo Focus us on Outco comes es: Pe Perfor

• rman

ance ce Measur ureme ment nt

Data Collection on Program Goals (Benchmark Areas)

1. Prenatal, maternal, and newborn health (8 constructs) 2. Child health and development, including the prevention

• f child injuries and maltreatment (7)

3. 3. School

• ol readin

ines ess s and acad ademic emic achie ieveme vement nt (9) 4. Crime (2) or domestic violence (3) 5. Family economic self-sufficiency (3) 6. 6. Refer erral rals/ s/pro provi vision sion of other r communi nity ty suppor ports ts (5)

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Re Researc arch h & Ev & Evaluati ation

• n Pr

Projec ects ts

• ACF
• Mother and Infant Home Visiting Program Evaluation

(MIHOPE)

• Mother and Infant Home Visiting Program Evaluation –

Strong Start (MIHOPE –SS)

• Home Visiting Evidence of Effectiveness (HomVEE)
• Design Options for Home Visiting Evaluation (DOHVE)

research, evaluation, data, and CQI technical assistance

• Tribal Home Visiting Evaluation Institute (TEI)
• Tribal Early Childhood Research Center (TRC)
• HRSA
• Home Visiting Research Network
• Investigator-initiated grants

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QI QI: : Cl Closing ing the Kn Know-Do Do Ga Gap

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LS – Learning Session AP – Action Period

Expert Support

18 months

Topic Areas

(Key constructs)

Planning Group Develop “Change Package” Recruit Participants (35 Teams) Pre-work LS 1

P S A D

Expert Meeting AP1 AP2 LS 2 LS 3

P S A D P S A D Spread – Holding Gains

Source: Adapted from Institute for Healthcare Improvement, BTS Collaborative.

May 2014 Nov 2014 May 2015

Ho Home Vi Visitin iting g Co CoIIN IN

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• Cov
• verage

erage of

• f at

at-risk risk ar area eas

• Standardized Measurement System
• HV Research Network
• QI

I Col

• lla

labo borative rative (HV V CoI

• IIN)

IN)

Opportu rtuni nitie ties s for Ph Philanth nthro ropi pic c Ac Actio ion

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Car arlos los Can ano,

• , MD

MD, , MP MPM

Senior Advisor Division of Home Visiting and Early Childhood Systems Maternal and Child Health Bureau, HRSA 301-443-8951 ccano@hrsa.gov

Contact ntact In Infor format mation: ion:

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