1. Kent County Home Visiting Hub Michigan Home Visiting Conference August 6, 2014

2. Needs Assessment  Identified existing resources that could contribute to the development of a home visiting hub  Identified gaps and improvements that could be made to the systems and components already in place

3. Welcome Home Baby  Early childhood gateway for families with newborns in Kent County since 2010  Hub functions: coordinated outreach, intake, referral, and feedback loops  Referrals based on assessment and parent choice

4. WHB Opportunities for Improvement  Need for improved data definitions & collection for referral feedback  Need to quantify service capacity tracking  Limited population  Duplication of home visits

5. WHB Background: Objectives  Serve as a gateway into early childhood services for families with newborns  Impact newborn health outcomes (use of medical home, ED & hospital use, breastfeeding)  Track referral partner data and use for system improvement

6. WHB Background: Components  Hospital visit: introduction and consent  Scheduling: phone call  Home visit: assessment, education, referral  Follow-up phone call to client  Client satisfaction survey  Referral feedback from agencies

7. WHB Background: Home Visits 2013  4126 Eligible  3278 Offered (79% of eligible)  2364 Accepted (72% of offered)  1781 Completed (75% of accepted)  3495 Referrals to partner agencies (15)

8. WHB Referral Feedback  New data definitions in 2013  Collection of data 90 days after referral  MOU includes data expectations

9. WHB Referral Feedback  April- June 2013 Quarter:  Acknowledged referrals (appropriate) = 99.1% (n = 325)  Service delivery status: (n = 322)  Services in progress = 60.6%  Parent declined = 17.7%  Unable to contact = 19.6%  Waiting list = 2.2%

10. WHB Referral Feedback  July- September 2013 Quarter:  Acknowledged referrals (appropriate) = 97.7% (n = 396)  Service delivery status: (n = 387)  Services in progress = 64.1%  Parent declined = 12.4%  Unable to contact = 22%  Waiting list = 1.6%

11. WHB Capacity Data  Quantified data collection in 2014  MOU includes data expectations  Established referral distribution ratios in 2014 for programs with multiple providers  Based on open capacity; developed formulas with agreed upon caseloads with referral partner agencies

12. Home Visiting Capacity  July MIHP Report:  Slots available = 2676  Slots filled = 1913 (71%)  July IMH Report:  Slots available = 168  Slots filled = 129 (77%)  May Report for other home visiting:  Slots available = 1485  Slots filled = 1396 (94%)

13. WHB Expansion- Pilot  Establish a pilot in one area hospital in an effort to move toward universal outreach, screening and referral at birth  Universal touch  Risk screening  Appropriate referrals  Planned measures of success

14. WHB Prenatal Database  Reduce duplicative home visits for clients engaged prenatally in home visiting programs  Partner agencies submit active prenatal client lists (gathering first set of data currently)  WHB notifies agency of birth of their active client so that worker can schedule newborn home visit  Cost savings for WHB (offsets cost of pilot expansion to provide access to more families)

15. Role of Heart of West Michigan United Way 2-1-1 in the HV Hub  Will act as a primary portal into the HV Hub, responding to families’ needs with a wide array of resources, services, and information related to pregnancy and early childhood  Updating 2-1-1 database with home visiting program information  Will determine triage questions to make referrals or forward calls to WHB  Outreach campaign with one number to call

16. Future Developments  Further develop connections to healthcare hub and 2-1-1  Outreach to vulnerable populations, i.e. women not seeking prenatal care or unaware of pregnancy  Establish referral process to the Hub through emergency departments

17. Christina Pavlak, LMSW Program Manager, Welcome Home Baby Project Director, Kent County Home Visiting Hub cpavlak@firststepskent.org 616-632-1016 www.firststepskent.org