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

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

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

Rationale for HFA  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 History Rationale Model Goals Critical Elements Philosophies Strengths Affiliation

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)

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

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

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

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

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

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

Our Philosophies 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 History Rationale Model Goals Critical Elements Philosophies Strengths Affiliation

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

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

Affiliation & Accreditation 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 History Rationale Model Goals Critical Elements Philosophies Strengths Affiliation

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

Contact Info:  Lynn Kosanovich  Healthy Families America Regional Director  