Summary of Pennsylvania Home Visitation Stakeholders Meeting June 4, 2013

Topic / Details
Welcome
Introductions
Opening / Mimi Gavigan read Stone Soup, a delightful children’s story that underscores the riches that come from collaboration. This was followed by a discussion of how the story relates to home visiting.
Camille Catlett shared a 5-minute video (Building Adult Capabilities to Improve Child Outcomes: A Theory of Change) to highlight the importance of everyone’s work in building the capacity of adults to support infants and toddlers. The video is available at
Updates
  • Sequestration
  • ZERO to THREE technical assistance
  • Building Bridges
/ Tracey Campanini provided an update on what is known about sequestration. She shared that Head Start is bracing for a 5.27% reduction in the federal grant but that less is known about the size and scope of reductions to other funding sources.
Tracey also mentioned that work is underway on a targeted technical assistance project related to providing quality services and supports for Pennsylvania’s infants and toddlers. A team from Pennsylvania (Tracey Campanini, Jim Coyle, Maureen Murphy, Cathy Palm) attended an initial planning meeting and will present ideas to the Early Learning Council regarding activities that will support infant-toddler workforce development.
Tracey also mentioned work that the Pennsylvania chapter of the American Academy of Pediatrics has been invited to roll out of Building Bridges, a program for establishing connections between pediatricians and targeted prevention efforts. Dr. Beth DelConte will be leading this work in Pennsylvania. Additional information is available at .
Work Group Updates / Work Group 1: Defining, Promoting, & Sustaining Home Visiting – This group, led by Cathy Palm,has worked to create a definition of home visiting for use in Pennsylvania. A draft was developed and sent out for input. The results, which reflect input from 29 organizations, are attached. Once a final draft has been recognized as an official product of the MIECHV stakeholders, Work Group 1 has identified a sequence for sharing the definition and its implications/uses with Deputy Secretary Minzenberg Secretary Mackereth, the Task Force on Child Protection, the Joint State Government Commission, and leaders in other state agencies.
Work Group 1 has respectfully asked for clarification from OCDEL on how a definition might be used to support work toward the attainment of Pennsylvania’s vision for home visiting. The group would specifically appreciate guidance from OCDEL leaders so they can better understand where and how the guidance they are working on might be used.Mimi and Tracey will get clarification and share it with Work Group members.
Topic / Details
Work Group Updates
(continued) / Work Group 2: Collaborating Among Home Visiting Partners – With leadership from Lee Sizemore, this group is working to create a visual representation of where and how home visiting fits within the constellation of early learning supports and services in Pennsylvania. A next step will be to gather sample graphics from other states for ideas.
This Work Group is also looking at mechanisms that can support and enhance collaboration including memoranda of understanding (MOUs), centralized intake, lunch and learns, and joint child find activities. Future home visiting meetings will provide opportunities to share promising practices with the stakeholders.
An additional area of deliberation for this work group is what to call the overarching system serving and supporting young children and their families. PA Early Childhood Care and Education System, PA Early Childhood Care, Education and Support System, and PA Child and Family Development Collaborative Network are three options that are under consideration.
Work Group 3: Professional Development/Competencies – Mimi Gavigan has led Work Group 3 in seeking a crosswalk between Pennsylvania’s Core Body of Knowledge and competencies for home visitors. They will be looking at competencies from other states to provide examples and plan to have competencies in place by June 2014.
Work group members also used priorities that have been generated by the home visiting stakeholders to identify topics for sessions at the October early childhood summit.
Centralized Intake
PowerPoint slides supporting this presentation are available at
unc.edu/presentations/pennsylvania-home-visitation-stakeholders-meeting-june-2013 / Colleen Masi of Erie County shared the process that they are using to create a centralized intake system. She shared both hopes and the challenges Erie County has faced and offered excellent questions that future designers of such systems will need to consider. These include:
  • Who hires the central intake person?
  • How do you train the central intake person to understand all the available models?
  • Who owns the system? Who guides the system? Who is accountable for the system?
  • What data needs to be tracked and how (e.g., format to screen for eligibility, flow chart, referral sources, timeliness of response)?
  • What should guide referrals – geography? Program specifics?
In addition, Colleen underscored how important it is to identify a neutral, unbiased agent to serve as the system administrator.
Topic / Details
Updates
Additional details are available in the PowerPoint slides supporting this presentation at

unc.edu/presentations/pennsylvania-home-visitation-stakeholders-meeting-june-2013 / Michelle Hill provided an overview of the efforts that are underway to evaluate Pennsylvania’s home visiting programs and progress. These include tracking of demographics, service utilization, and benchmark data through a data system that is in the final stages of design, CoPAM (Pennsylvania’s MIECHV evaluation, formerly known as Policy Lab), MIHOPE and MIHOPE – Strong Start (federal evaluation efforts).The PowerPoint presentation (see box at left) provides additional details about each of these components.
In addition, Michelle is also leading a Work Group that will focus on Continuous Quality Improvement.
Karen Seeber shared information about Guiding Parents Smoothly. Details are available in the PowerPoint slides and at
Camille shared new home visiting resources which are posted at the same URL as the PowerPoint slides.

RESULTS FROM THE SURVEY MONKEY

29 organizations responded (34 total individuals responded - some organizations had more than one person respond)

  • 33 agreed with the Vision (1 skipped the question)
  • 32 agreed with the core components of high quality home visiting, 1 said they didn’t know, 1 skipped
  • 29 agreed with the definition of evidence based/promising programs (2 said they didn’t know, 1 no and 2 didn’t answer)
  • 28 said having a consistent agreed-to vision and definitions would be helpful (5 said they didn’t know)

Pennsylvania’s Vision: A statewide system of high quality home visiting services that will, in partnership with families and communities, strengthen, support, and promote prenatal health, family well-being and early childhood health, safety, development and education.

Core Components of High Quality Home Visiting Services in Pennsylvania include:

  • Voluntary and delivered primarily within the home of the parent(s) and child.
  • Intentional in engaging, assessing and strengthening the capacity and confidence of a child's first protector and teacher - the parents;
  • Focused on the whole family to promote – across generations – improved prenatal health, positive maternal and infant birth outcomes, family well-being, early childhood health, safety, development and education;
  • Operates with fidelity to an evidence-based model or a research-based or evaluated assessment and curriculum that specifies the purpose, outcomes, duration, and frequency of services. ;
  • Employs well-trained, and culturally competent staff and provides continual professional development relevant to the specific program model or research-based curricula being utilized; and
  • Demonstrates strong understanding of and linkage to other community-based cross-systems services; and
  • Demonstrates effectiveness with a commitment to measure and report outcomes and continuous improvement.

High quality home visitation services are a core component of the Commonwealth’s early care and learning strategies across all child and family serving systems. Pennsylvania is committed to ensuring that existing or future public investments are intentionally targeted to highest risk families and most often into services that are evidence-based.

Evidence-based programs utilize a program based on a clear, consistent model as identified by the Home Visiting Evidence of Effectiveness (HOMVEE) review authorized by the United States Department of Health and Human Services. These models include a program that with fidelity provides research-based services grounded in relevant, empirically-based knowledge and operates within an organization that ensures compliance with well-established and tested home visitation standards.

Pennsylvania also recognizes that children and families also benefit from a fuller array of home visitation services that are of high quality, but have not secured the designation of evidence-based.

Promising programs follow with fidelity a singular research-based model or some combination of models or curricula that have demonstrated nationally recognized outcomes with regard to effectiveness, including participation in on-going program evaluation and outcome measurement

COMMENT: Change made to address this comment - The wording in the Promising programs line (... curricula that have demonstrated nationally recognized research with regard to effectiveness ...) seems a little awkward to me. Should it be nationally recognized "'outcomes?"

Do you support the Vision?

I think it is important that in trying to achieve this vision, the uniqueness of different programs/professionals/program goals and structure under the banner of the term "home visiting" are recognized.

in partnership with one another (models, systems, etc.)

Do you support the Core Components of High Quality Home Visiting Services?

slight concern with "evaluated assessment and curriculum"

Adding continuous improvement is good

I am not sure if this mirrors the federal definition of high quality home visiting services exactly. I have no issue with the content, but again, want to make sure there is consistency with MIECHV.

Do you agree with the following definitions of evidence-based and promising programs?

agree with definitions, but not fully supportive of targeting highest risk - others within eligible categories benefit as well

I currently run a program that is not evidence-based that I find to be of equal or greater value to the community than many programs currently considered more valuable b/w they are evidence-based.

I like how you separated the two programming types and how we are committed to including promising programs in PA.

I believe that we should use and be consistent with the federal definition and still struggling with the inclusion of language relative to language to support programs/models not included in the federal definition within the scope of work within the MIECHV stakeholders group. I see value in these services, but believe we need additional direction from OCDEL/system - to understand what the work of the group and vision is to carry out to support this definition.

I like the reference to HomeVee, but would prefer to see the exact language from the federal legislation for MIECHV since the state is implementing the MIECHV program and charged with operating under those definitions. Having a similar, but not exact definition will introduce confusion in the field between MIECHV grantees and others.

Do you envision that having a consistent agreed-to vision and definition of evidence-based and promising programs will be helpful to you in your work? If not, please indicate why and if yes, please share ways in which you envision it can be utilized/helpful.

To support sustainability and enhance funding; Also to credibly define our work in many settings

Our organization's mission is to advocate for increased public investments in evidence-based programs, so a consistent vision/definition could be useful in educating/persuading state legislators

In our work supporting Family Centers as well as county Children and Youth agencies.

financing, expansion of EBHV, targeting services to high-risk populations

As an evidenced based program, the definition reinforces our commitment to providing families with best program services we can and would help potential funders identify quality programs.

It is my hope that everyone will use this language when talking to legislators, funders and the community about the variety of high - quality home visitation programs in our state. That Promising Programs deliver the same quality of services as those on the federal evidence - based list.

For Title V-funded MCH and the Healthy Start programs, it will be useful to have guidelines to develop home visiting programs that might qualify as promising practices.

Help with funding as well as more recognition about positive outcomes in our EHS and healthy Family America programs

helps individual programs articulate their own missions; will certainly help with the moves toward centralization of intake efforts and coordination of HV services on a local as well as statewide level; hopefully will help the lay person/public better understand what HV is and what it provides

Can communicate with pediatric practices on what the consistent vision/purpose of HV is as well as what the key core content components are that parents will hear/experience. Intent would be support and collaboration from pediatricians for HV in the community.

Since a definition has been developed for states under MIECHV, suggest that a separate state definition is not needed and would introduce confusion. There is a need for consistency.

Please feel free to share any additional information, questions, ideas about home visiting in Pennsylvania.

Continuing report-out of benchmark data at regular intervals will also be important to support our conversations. Thanks for the great work of this group of stakeholders!

Good work. Sorry we weren't able to be at last week's meeting.

I feel that this work we are doing in the MIECHV Stakeholder group is very valuable in promoting the value of home visiting innurturing healthy children, families, and communities. I do think it is important that the PA Dept.of Health be an active partner in these collaborative efforts since they are funders/implementer of an array of MCH programs.

This committee has done an outstanding job of creating a succinct, clear and easily understood definition that I fully support. THANK YOU.

ORGANIZATIONS COMPLETING THE SURVEY

  1. Allegheny County Health Department
  2. Bethlehem Health Bureau
  3. Capital Area Head Start
  4. Center for Schools and Communities/ PA PAT State Office
  5. Chester County Health Department
  6. Community Prevention Partnership of Berks County
  7. Dauphin County MH/ID/EI Program
  8. Early Learning Investment Commission
  9. Erie Family Center for Child Development
  10. Fight Crime: Invest in Kids (note not a member of the MIECHV Subcommittee but shared w/them)
  11. Greater Harrisburg Healthy Start
  12. ICF International
  13. Maternity Care Coalition
  14. Nurse Family Partnership – National Service Office
  15. Office of Child Development University of Pittsburgh (note not a member of the MIECHV Subcommittee but shared w/them)
  16. Pennsylvania Chapter – American Academy of Pediatrics
  17. PA Child Welfare Resource Center
  18. PA Coalition Against Domestic Violence
  19. Pennsylvania Coalition Against Rape
  20. Pennsylvania Head Start Association
  21. PA Key
  22. Pennsylvania Partnerships for Children
  23. PA Perinatal Partnership
  24. Protect Our Children Committee
  25. The Guidance Center
  26. STEP, Inc.
  27. Snyder, Union, Mifflin Child Development
  28. TIU 11
  29. United Way of the Capital Region