INTEGRATING HOME VISITING AND FAMILY SUPPORT SERVICES INTO AN
EARLY CHILDHOOD SYSTEM OF CARE SIT/CHVP Workgroup November 6, 2014
Kiko Malin, Director Family Health Services Division Alameda County
Public Health
Slide 2
Overview Home visiting integration review and update Progress
towards an early childhood system of care Addressing the social
conditions that influence health Policy efforts at the county
level
Slide 3
Population Served 20,000+ Births in Alameda County Annually
6,600 Medi-Cal Births 1,500 Born Low Birth Weight At-risk African
American Families ~50% Experience Breastfeeding Problems 6,000
Children 0-5 Have Contact with CPS 1,500 Births to Teen Mothers ~
27% Postpartum Depression
Slide 4
Programs involved in HV integration ACPHD Family Health
Services programs Black Infant Health Alameda County Healthy Start
Initiative (ACHSI, formerly IPOP) MADRE Special Start Healthy
Families America (HFA, formerly Your Family Counts) Fatherhood
Initiative Nurse Family Partnership First 5 contracts Special Start
at UCSF Benioff Childrens Hospital Oakland Pregnant and Parenting
Teen Programs (TVHC, Brighter Beginnings) Other ACPHD programs
Asthma Start Public Health Nursing
Slide 5
Healthy Start (ACHSI) Update Awarded grant in late August for
Sept. 1 start ACHSI as component of a broader home visiting system
was a critical part of grant proposal Three main components:
Intensive case management for highest risk families (HFA) Family
Health Promotion (ClubMom, care coordination) Womens Health
Promotion (peer navigators, outreach) Will also take a place-based
approach
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ClubMom Goal To positively change the CONTEXT in which young
African American mothers make decisions around their health and
related behaviors so that it includes: Social SUPPORT Health
INFORMATION Knowledge of RESOURCES Health-seeking MOTIVATION
Slide 8
TRANSITION YFC and ACHSI case management staff to Healthy
Families America; HIRING new staff and supervisors BUILD OUT mental
health services unit CONNECT families in the Best Babies Zone with
home visiting services and other activities INSTITUTIONALIZE
reflective supervision
Slide 9
Current Focus REVIEW and OPERATIONALIZE evaluation framework
developed by outside evaluator DEVELOP common standards and
INCORPORATE into practice DESIGN and IMPLEMENT training and
professional development plan ESTABLISH Family Advisory
Committee
Slide 10
Ultimate Goal NEST DIRECT SERVICES within both a broader early
childhood system of care CONNECT families to supports and services
that address the social determinants of health ADVOCATE at county
level for support to sustain and expand home visiting services
Slide 11
Alameda County Public Health Department Home Visiting- Family
Support Steering Committe Family Advisory Committee Outreach and
Triage Committee Alameda County Family Support System of Care
Community Partnership ALAMEDA COUNTY HOME VISITING AND FAMILY
SUPPORT SERVICES SYSTEM OF CARE GOVERNANCE Maternal Child
Health/Early Childhood and Prevention/ Early Intervention Home
Visiting Programs BBZ HFA ACHS I NFP First 5 and MPCAH Contract
Coordination Executive Committee
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Current Focus of Community Partnership Developing position
description for early childhood mental health liaison(s) Exploring
possibility of dedicated benefits eligibility worker for home
visiting Members from: Social Services Probation Early Head Start
Alameda Health System First 5 Healthy Homes
Slide 13
Ultimate Goal NEST DIRECT SERVICES within both a broader early
childhood system of care CONNECT families to supports and services
that address the social determinants of health ADVOCATE at county
level for support to sustain and expand home visiting services
Slide 14
OAKLAND HILLS LIFE EXPECTANCY EAST OAKLAND LIFE EXPECTANCY
Compared to a White child born an African American child born in
East Oakland can expect to live 15 fewer years. in the affluent
Oakland Hills Photo Source: The California Endowment, Health
Happens Here
Slide 15
Source: Alameda County Death files, 2010-2012; Alameda County
Birth files, 2009-2011; American Community Survey, 2007-2011;
California Dept of Education, 2012-2013 Place, Income and Social
Inequality Affect Health Across the Lifecourse 2X more likely to be
born low birth weight 12X less likely to have a mother with a
college degree 21X more likely to live in poverty 3X less likely to
read at grade level 6X more likely to be unemployed 2.5X more
likely to die of stroke INFANT CHILD ADULT Cumulative impact: 15
year difference in life expectancy
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Best Babies Zone: Castlemont Neighborhood There is a 13 year
difference in life expectancy between a child born in Piedmont and
a child born in Castlemont.
Slide 17
Castlemont Best Babies Zone: Focus Areas Early Childhood and
Family Supports Room to Bloom Early Childhood Hub Home Visits
Community Engagement, Planning and Action Community Cafes East
Oakland Innovators Mini-grants Building a Local Economy Community
Market Youth Murals, Merchant Supports Foundational Work
Communication Evaluation Partner Engagement
Slide 18
Project HERA Overall Goal: Grow a unit in Maternal, Paternal,
Child and Adolescent Health (MPCAH) that that engages staff and
clients in developing solutions to the social factors that impact
the health of families receiving our services.
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Build capacity of MPCAH staff to address financial issues with
clients Advocate for low cost financial products for clients Engage
MPCAH staff in identifying and addressing housing issues that
impact their clients Develop a clear path for home visitors to
communicate about policy-related issues they face in their
work
Slide 20
Leverage existing County funds to expand credit and financial
opportunities Support small lenders in reaching underserved people
Reduce predatory lending and associated financial and health
consequences Remove the barriers to building wealth that
disproportionately impact communities of color Alameda County
Healthy Credit: Investing in Stability and Prosperity
Slide 21
Ultimate Goal NEST DIRECT SERVICES within both a broader early
childhood system of care CONNECT families to supports and services
that address the social determinants of health ADVOCATE at county
level for support to sustain and expand home visiting services
Slide 22
Financing the Home Visiting/Family Support System of Care
Existing Funding Streams: First 5 Alameda County ACPHD general
funds Title V dollars Healthy Start grantee MIECHV monies TCM/FFP
Funds are braided, in programs and positions Funding Opportunities
to explore: Cross agency funding and leveraging opportunities Title
IV-E Medi-Cal Managed Care Board of Supervisors investment
Slide 23
Birth to 8 Statement of Purpose The Alameda County Birth to 8
Initiative is a catalyst to improve childrens 3 rd grade success
and reduce health and education disparities. We work to improve
outcomes by partnering with policy makers, county agencies and
community stakeholders. Only 45% of kindergarteners in Alameda
County are kindergarten ready
Slide 24
Birth to 8 Recommendations to Improve Kindergarten Readiness
Increase the following existing, cross-systems efforts: Early
childhood home visiting Quality early care and education Early
identification Bridge transitions between age groups, programs and
systems and intensify mental health and parent leadership and
support. Present funding request to Board of Supervisors next
year
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Thank you! Questions? Kiko Malin, FHS/MPCAH Director
[email protected] (510) 208-5979 Anna Gruver, MPCAH Coordinator
[email protected] (510) 667-4334