Introduction to the Model Lynn H Kosanovich HFA

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

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

History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation § 1970 s - 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 Mc. Donald 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

Rationale for HFA • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation § 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

Rationale for HFA (cont. ) ACE Study (Adverse Childhood Experiences) • 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

Vision-Mission-Goals • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation § 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.

12 Critical Elements • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation § 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

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 • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation 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

Strengths of the HFA Model • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation 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

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 • History • Rationale • Model • Goals • Critical Elements • Philosophies • Strengths • Affiliation 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

Implementation & 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 § lkosanovich@preventchildabuse. org § 703 -888 -3135