1. TITLE IV-E WAIVER SITE VISIT
JULY 6, 2016
Birth & Beyond
Home Visitation Program
AmeriCorps Impact Evaluation |

2. Family Resource Centers9
Birth & Beyond
Family Resource Centers
Arcade Community Center
Firehouse Community Center
Folsom Cordova Community Partnership
La Familia Counseling Center
Meadowview Family Resource Center
North Sacramento Family Resource Center
River Oak Family Resource Center at Dunlap House in Oak Park
Valley Hi Family Resource Center
WellSpace Health’s North Highlands Multi-Service Center 2 1 3 6 7 4 8 5

3. Birth & Beyond Family Resource Centers
Sacramento County Child Protective Services
Walk-ins, Hospitals, Schools, Community Partners
Family Resource Center
Parenting Workshops
Crisis
Intervention Services
School Readiness
NPP Home Visitation
Differential Response and Aftercare for families with children 0-5 years
Parent Support Line

4. CPS Referrals by Zip Code
Sacramento County
CPS Referrals by Zip Code

5. Children Served by B&B Visitor (2013-15)
4,588
Children 0-5 years old served
B&B Families Served
24%
36%
42%
63%
Mother pregnant
at intake
First time
parents
2 or more children
0-5 years old
2 or more children
of any age

6. Parents Served by B&B Visitor (2013-15)
Race/Ethnicity
Age
Used a control group to compare 496 B&B parents who received B&B Home Visitation AND had previous CPS HX to 985 parents with similar CPS HX who did NOT receive B&B HV services
Non HV comparison group “matched” (using Propensity Score Matching ) to HV B&B parents using series of available indicators (ethnicity, age, language, children in household
This slide displays results for those families served by AmeriCorps Home Visitors partially funded by the Corporation for National and Community Service
Snapshot of demographics of parents served by AmeriCorps Home Visitors
Evaluation studied a parent’s changes in knowledge, skills, beliefs attitudes, and finally behaviors
Marital Status

7. Since 2001 B&B has had positive results in reducing referrals to CPS
Past Evaluation| Did Birth & Beyond Parents Have a Reduced Rate of CPS Referrals?
CPS ‘look up’ study conducted annually since 2001
Consistently positive results for CPS outcomes
Half of B&B parents had a prior history of CPS referral (including as victim)
However, all B&B parents with at least 8 hours of HV had a reduced rate of CPS contact one year after their case closure
Since 2001 B&B has had positive results in reducing referrals to CPS
Past Evaluations were an OBSERVATION STUDY and found that -
50% of parents served by B&B had prior history with CPS
ALL parents who received at least 8 hours of B&B home visitation services had reduced rate of CPS contact one year after closure from B&B home visitation

8. CPS Referrals for Birth & Beyond Parents
Past Evaluation|
CPS Referrals for Birth & Beyond Parents
Receiving 8+ Hours of HV Programming ( )
n = 2,512
Pre Program
Post Program
Substantiated
Inconclusive
Past Evaluation for B&B Parents
Evaluation looked at the
Pre/post referral history of 2512 parents who started B&B
PRE-PROGRAM (Prior to B&B services)
50% of parents had prior CPS history
POST-PROGRAM
ONLY 3.5% of parents with prior CPS history had any substantiated subsequent contact with CPS one year after B&B services ended
Nearly 97% had no substantiated referrals
Unfounded/unknown
No history

9. AmeriCorps Home Visitors Only
Current Evaluation| Will any parent participating in Birth & Beyond have a reduced rate of CPS referrals?
Quasi-experimental study includes all HV parents, with CPS history, who were ‘touched’ by AC member in program years
Impact evaluation allows for the direct attribution of positive changes to HV program (i.e., provides ‘higher-level of evidence’ of program effectiveness)
AmeriCorps Home Visitors Only
Answer the Question –
Will any parent receiving B&B home visitation services have a reduced rate of CPS referrals?
For this study conducted by external evaluators LPC Consulting Associates and JBS International
B&B used a quasi-experimental design that provides highest level of evidence possible (while not denying services as the higher rigor of Randomized Control Trials) given available data

10. Current Evaluation
Compares HV parents (n=496) with previous CPS history to non-HV parents (n=985) with similar CPS history
Controls for bias that some individuals are more willing/likely to participate in HV program
Accounts for rolling program entries and exits
Holds all demographic factors constant to compare CPS recidivism over time
Included all parents served by AmeriCorps members who exited B&B HV services from and had previously come to the attention of CPS
Identified a similar group of parents from child welfare records and used them to see if participating in B&B HV made a difference in the likelihood they would have a future SUBSTANTIATED allegation of maltreatment
Controlled for factors in the comparison group such as
number and severity of previous allegations,
time since eligibility for treatment and
parent demographics

11. Current Evaluation | Findings
All parents participating in HV were 41% less likely to have a substantiated referral over a four-year period than non-HV parents.
Parents with hours of HV were 173% less likely to have a substantiated referral over a four-year period than non-HV parents.
Parents with at least 8 hours of HV showed an average decrease in risk/increase in parenting skills as measured by the AAPI (statistically significant at p < 0.01)

12. Study went out to about 4.5 years – 1600 days – used real data in that it followed both B&B HV parents and the comparison group to track recidivism
Graph shows the llkelihood to recidivate generally increases over time AND how risk to recidivate is DIMINISHED with B&B HV parents
173% of HV B&B parents were less likely to have a future SUBSTANTIATED allegation than those who had not received services
This result applies to the end of the study period - is the DIFFERENCE in having a SUBSTANTIATED allegation after 1600 days between those parents who received B&B NPP HV services and those who had not received services
This is a SURVIVAL ANALYSIS model meaning
We can expect these results from ANY parentswho participates in B&B HV not just those parents who actually did participate

13. Current Evaluation | Summary
CPS Recidivism | All parents participating in HV have a reduced likelihood of new CPS referrals.
Optimal Hours | Those parents receiving hours of HV have the greatest reduction in the likelihood new CPS referrals.
Results indicate participating in B&B Home Visitation makes a statistically significant positive impact on parents risk of future child maltreatment
The findings of this study provide strong evidence that Birth & Beyond home visitation supports Sacramento County parents and their families by reducing the risk of child welfare referrals after participating in the program.

14. Birth & Beyond Home Visitation Return on Investment
Average cost of Birth & Beyond home visitation - $700 per parent annually.
Average cost per child protection case (Centers for Disease Control and Prevention 2011) - $210,000 annually.
Sacramento County saves significant dollars annually by keeping children out of the child protection system.