Welcome Home Baby Report to the First Steps Commission July 31, 2014

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

WHB 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

WHB Eligibility  Welcome Home Baby is available to mothers and/or fathers who are Kent County residents and have an infant under 30 days old and are one or more of the following: First-time parents 25 years old or younger Giving birth in the U.S. for the first time Parents of a newborn in the Neonatal Intensive Care Unit (NICU) at Mercy Health Saint Mary’s Hospital

WHB 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

WHB Client Demographics  82% First-time parents  2% First U.S. birth  Mother’s age  49% 25 & younger  45% Infants on Medicaid 2014 Data

WHB Client Demographics  Mother’s language: 93% English, 4% Spanish, 3% Other  Mother’s race/ethnicity 2014 Data

WHB Client Demographics  Marital status  Mother’s education 2014 Data

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%

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%

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%)

Challenges  Hospital access  Data sharing/analysis of health outcomes, ED use, hospital readmissions  Sustainable funding  Data reporting (new database & reporting mechanism being developed)

System change affecting WHB  Timeframe of first medical home visit for newborn has improved  Parents perceive reduced need for WHB  CQI project to address acceptance rate

MDCH Home Visiting Hub  Home Visiting Hubs will streamline and coordinate outreach, intake, referral and feedback loops across home visiting programs at the community level, assuring equitable access to the most appropriate services for high risk families.  Target population: prenatal to age 5

HV Hub – WHB Role  Blend MDCH grant & WHB funding to further develop HV Hub and convene home visiting agencies- MOU’s in place with 15 partner agencies  Establish a pilot in one area hospital in an effort to test universal outreach, screening and referral at birth- Mercy Health Saint Mary’s

HV Hub – WHB Role  Reduce duplicative home visits for clients engaged prenatally in home visiting programs- prenatal client database, gathering first set of data currently  Outreach & marketing- additional funding opportunity through September 2014, promoting 211 as the number to call

WHB Lessons Learned  Time & persistence  Adaptation  More work to be done

Advocacy Needed  Physician champion  Evaluation/data analysis focus  Funding

Q & A