Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program Benjamin Hazelton, Home Visiting Policy & Systems Coordinator Public Health Division Maternal & Child Health

Multiple Grant Applications – One Project – Two Core Components Expanding Evidence-Based Home Visiting Services Early Head Start (EHS) Healthy Families America (HFA) Nurse-Family Partnership (NFP) Developing the Infrastructure to Support Sustainability Coordinated Service Entry and Integration within a Comprehensive Early Childhood System Continuous Quality Improvement Workforce Development Evidence-base is determined at the federal level by the Home Visiting Evidence od Effectiveness (HomVEE), a partnership between ACF and HRSA There is an allowance for up to 25% of the funding to be dedicated to a promising practice; however, would have also required an evaluation beyond those required for the Competitive applications. These three models selected because of their “footprint” in Oregon – even NFP had an established bas in the state – and an appetite for expansion. Developed common entry tool to be used in assisting families to find their fit – and to connect them with other formal and informal services and supports. Recognizing that home visiting is one service strategy among the early childhood disciplines – with health and early care and education. Promoting a common set of metrics among home visiting – and connecting it to the comprehensive early childhood system – then supporting efforts through a culture of Continuous Quality Improvement (CQI). CQI is different from Quality Assurance (QA) that would be used to assure model fidelity and is focused on supporting programs to do their best work with families. Standardizing workforce through shared common competencies that are cross-walked with other early childhood disciplines and integrated within an early childhood training and education system. Emerging from the workforce development is the Infant Mental Health Endorsement (IMH-E®) Whereas the EBHV is limited to the three models identified and the 13 at-risk communities, the system development work can and is available statewide to the extent that the the MIECHV program has the resources. Maternal & Child Health

The Foundation for New Formula Funding Opportunity Services Program Capacity System Development Formula 2010 EHS 34 Framework for “no wrong door” Tool for coordinating referral HFA 56 Development 2011 NFP 207 Community development Project provided TA Data system development Workforce development Expansion 2013 151 Integration with early learning and health system transformation Strengthening workforce development to include shared core knowledge standards Family leadership and engagement in program operations and governance Robust implementation of Continuous Quality Improvement 150

Current Status In Oregon Enrollment Capacity of 805 families – distributed across 13 at-risk communities New Needs Assessment Changes to national benchmark measures – and Continuous Quality Improvement (CQI) Community tailored entry procedures Common Core Competencies Infant Mental Health Endorsement (IMH-E®) 185 families in EHS, 263 families in HFA and 357 families in NFP. Recent contracting reduced the HFA enrollment by 41 families – at the LIA request. Was helpful in funding the remaining caseload because of negotiated increases in funding at the state level. Clatsop, Jackson, Jefferson, Klamath, Lane, Lincoln, Malheur, Marion, Morrow, Multnomah, Tillamook, Umatilla and Yamhill. Guidance for the new Needs Assessment is anticipated in fall of 2017 and will be concluded in spring of 2018. The six benchmarks (maternal and child health, child injuries, maltreatment and neglect, school readiness, family self-sufficiency, crime or domestic violence, and coordination of services) are written into the authorizing legislation. The measures are at the discretion of HRSA – recently reduced from 36 measures to 19. Focused on sentinel measures that are associated with overarching progress. Common CQI activity beginning October first – Developmental Referral Completion. Chosen because of the connections to the comprehensive system. Examples of common entry include two communities you will hear from today. Common Competencies were released last fall. They have been used to review position descriptions, etc at the local level. Working over the next federal fiscal year and grant period to utilize the competencies to inform training – beginning with the Cultural and Linguistic competence of the programs. Seven endorsee’s this fall. Another 30 are in the process for subsequent endorsement. Those seeking endorsement reflect the diversity of the population, geography and early childhood workforce of the state. Has been a fantastic opportunity to partner with the Ford Family Foundation. Maternal & Child Health

Workforce Development Alignment with the existing early childhood education field Develop core competencies for Oregon’s Home Visiting programs Develop a comprehensive training plan Establish Infant Mental Health Endorsement Maternal & Child Health

Continuous Quality Improvement Process and data improvements A resource, not just a grant requirement Inclusive of programs outside grant funding Maternal & Child Health

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