20031 Outcomes of Minnesota’s Statewide Family Home Visiting Program Family Home Visiting Team Minnesota Department of Health

Junie Maureen Nancy Junie

20033 SFYTANFGeneralTotal 01$7,000, $11,000, $11,000,000$756,000$11,756,000 04?$4,000,000$1,044,000$5,044,000 05?$4,000,000$1,044,000$5,044,000

20034 FHV Programs Statewide 2001  67/87 counties 19 did not enroll any families (start up) 36/67 enrolled & exited families 31/67 enrolled with no exits 2002  86/87 counties (CHBs) 75/86 reported data (enrolled, exited or both)  7/11 tribes contracted 3/7 reported data (enrolled, no exits)

& 2002 FHV Enrollees 2001  Enrolled ~4,702 persons (45% MFIP) 2,702 children (0-19 years) 2,000 primary caregivers 505 (20%) pregnant  79% of families remained from ’01 & ’02 2,078 children 1,619 primary caregivers 2002  Enrolled 7,420 persons (44% MFIP) 4,126 children (0-19 yrs) 73% 0-3 years 3,294 primary caregivers 1,196 (38%) pregnant  Served in ,266 children 4,956 primary caregivers 11,222 total

State-wide Outcomes Self-Sufficiency  82% had identified goals before exiting at 0-3 months  80% had achieved at least one goal before exiting at 4-12 months  91% had achieved one or more goal before exiting at 13+ months Goals = education, employment, health, child care, housing, safety, etc.

State-wide Outcomes Health  94% of children (0-6 years) had health insurance (exited at 0-3 months)  95% of children (0-19 years) had health insurance (exited at 4-12 months)  85% of primary caregivers had health insurance (exited 4-12 months)

State-wide Outcomes Health  91% of children (0-6 years) had a well-child examination within one year of enrollment (13+ months exit) State rate: 55-65% [C&TC = 70%]  44% of children (7-19 years) had a well-child examination within two years of enrollment (13+ month exit) State rate = 30-35% [C&TC = 48%]

State-wide Outcomes Injury Prevention  21% - 47% - 56% of families with a child 0-6 years completed Home Safety Checklist (0-3 mos – 4-12 mos – 13+ mos exit) Home Safety Checklist is a parent education tool used by PHNs and home visitors to assess with the parent the living environment room by room to identify possible home injury hazards for families with children (0-6 yrs). The minimum requirement for completion is to assess the 18 critical (starred) items.

State-wide Outcomes Teen Parents (19 Years and Under)  Did not have subsequent births92% State data for 2002* = 82% National data for 2000 = 79%  Followed school attendance plan80% * Preliminary data from the MN Center for Health Statistics for the State Fiscal Year 2002 (July 1, 2001-June 30, 2002)

Stories  Optional  78 stories from 59 programs (counties and tribes)  Major story themes of families and nurses centered on: Working with Families at Risk Assisting with Basic Needs

Story Themes Families at Risk  Single parent  No support  Teen pregnancy, teen parents  MFIP/TANF  WIC, breastfeeding

Story Themes Families at Risk  Children with special health needs  Mental illness  Domestic abuse  Chemical dependency  Parent incarcerated

Story Themes Basic Needs  Housing  Transportation  Child Care  Employment (finding a job)  Education  Housekeeping

Sample.. Wadena Story  Connected family to other resources Single mother with 4 children Children with developmental delays Inadequate housing – safety issues Inadequate child care Financial and budgeting issues No work history Lack of use and knowledge of resources History of abuse and neglect History of unstable relationships

Sample.. Wadena Story “The parent…had many of the above issues resolved. She has adequate housing, a job, improved parenting, and is using community resources both for herself and for her children. This occurred through a partnership between the nurse and the client…(and) partnering with (other community agencies).”

State Highlights – What works!  Teamwork (public health nurse, parent aide, other home visitors, etc.)  Interagency collaboration (public health, social services, education, etc.) Less duplication; more supportive services for families  Partnering with job counselors and financial workers (economic assistance)

State Highlights – What Works!  Community outreach through social services, hospitals, WIC clinics, schools, Workforce Centers, etc.  Outreach to various racial/ethnic groups (especially tribal groups in 2002)  Training bilingual interpreters & home visitors “It was delightful to hear enthusiasm from community agencies wanting us to assist, support, teach and ultimately decrease the numbers in this target population….”

State Highlights & What works!  Providing services to adolescents “TANF has provided [us] with a fresh outlook on our HV program. We have purchased a new teen pregnancy/parenting curriculum and have trained staff on Partners in Parenting Education System parenting activities.”

State Barriers & Challenges  Completing Home Safety Checklist Mobile families; not in own home, in shelters How to introduce without being a threat  Short time frame for program start-up  New program that views “families” as “client” (billing, charting/legal, data)

State Barriers & Challenges  Income & citizenship validation (MFIP)  Reaching high-risk families  Staff shortages, inadequate funds  Increasing immigrants; lack of interpreters Limitations  Data only on exited families; none on enrollees!  No individual data

Future Challenges!  Budget deficit  Data reporting system that is ‘user friendly’ Currently have ACCESS; multiple ways to send data to MDH  Working with public health nurses on data issues (data collection & entry, QA)  Financing/reimbursement for home visits & related services: C&TC, WIC, mental health

Contact Information Family Home Visiting Program Minnesota Department of Health/MCH Section P.O. Box St. Paul, MN Tel: Fax: