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Michigan Infant, Maternal and Early Childhood Home Visiting Program. Building County-Level Home Visiting Systems Videoconference for Teams from: Berrien, Calhoun, Genesee, Ingham,

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Michigan Infant, Maternal and Early Childhood Home Visiting Program

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michigan infant maternal and early childhood home visiting program

Michigan Infant, Maternal and Early Childhood Home Visiting Program

Building County-Level Home

Visiting Systems

Videoconference for Teams from:

Berrien, Calhoun, Genesee, Ingham,

Kalamazoo, Kent, Muskegon,

Saginaw, St. Clair and

Wayne Counties

December 16, 2010

  • Welcome & Introductions
  • Videoconference Objectives
  • Context for HRSA HV Program
  • Building a HV System
  • Michigan HV Program Logic Model
  • How Can Communities Begin to Participate?
  • Expectations for each County
  • Seed Funds to Support County Activities
  • Q&A
  • Next Steps

December 16, 2010

videoconference objectives
Videoconference Objectives

Update on current status of HRSA Home Visiting Program.

Ensure understanding of purpose of Home Visiting Program (HVP).

Describe Michigan HVP’s Logic Model development efforts.

Describe steps county HVP teams can take to prepare for response to HRSA guidance (Step 3).

December 16, 2010

objectives cont d
Objectives, cont’d

Describe state expectations for county HVP ‘teams’.

Discuss ‘seed’ funding to support initial work.

Conduct Q & A.

Identify next steps and future TA opportunities.

December 16, 2010


Policy Brief from The Future of Children:

“Social Science Rising: A Tale of Evidence Shaping Public Policy”


December 16, 2010

social science rising
Social Science Rising

Social scientists have taken a step toward the goal of getting policy makers to consider high-quality evidence when making program funding decisions.

President Obama put provisions in the budget to support home visiting programs that “will produce sizable, sustained improvements in the health, well-being, or school readiness of children or their parents.”

The resulting bill gives priority funding to programs that “adhere to clear evidence-based models of home visitation that have demonstrated significant positive effects on important program-determined child and parenting outcomes.”

December 16, 2010

social science rising cont d
Social Science Rising, cont’d
  • The Obama administration will evaluate as many programs as possible, cut off funding for those that are not working and expand those that are.
  • The administration endorses a two-tier approach of giving more money to the programs with the strongest evidence of success and less money to programs that have “some supportive evidence, but not as much.”
  • The federal policy process now hinges importantly on evidence, a clear sign that the administration and Congress want to do everything they can to fund successful programs.

December 16, 2010


We will be sending out:

  • An updated resource list of articles about evidence-based home visiting.
  • A list of webinars you may wish to view regarding home visiting models and systems.

December 16, 2010

affordable care act funding status
AffordableCare Act Funding Status
  • Michigan has received funding for FY 2010.
  • We have 27 months to spend the funds that we were awarded.
  • We are awaiting the next federal guidance for Step 3.
  • There is talk that Congress may repeal this legislation.
  • It is critical for our state need to think about what’s important with respect to a home visiting system regardless of federal funding.

December 16, 2010

hrsa funding can be used for
HRSA Funding can be used for…

Three major activities:

Develop a state Home Visiting System embedded in a comprehensive, high-quality Early Childhood System.

Develop local home visiting systems based on the state system.

Within the system, implement and evaluate evidence-based home visiting programs.

December 16, 2010

hrsa next steps
HRSA Next Steps
  • Step 3 guidance not yet available
    • We still need to move forward in anticipation of what HRSA will require:
      • Determine infrastructure priorities.
      • Revise logic model.
      • Bring all of the key participants to the table.
      • Inventory county-level data about target audiences.
      • Develop database of home visiting programs.
    • Once released, we likely will not have much time to complete our State Plan, which will build on the above.

December 16, 2010

building a home visiting system
Building a Home Visiting System
  • The Great Start System Team has appointed the Home Visiting Work Group.
    • Purpose is to guide the development of the state-level home visiting system.
    • The state-level system will guide and support the county efforts.

December 16, 2010

based on lessons from other states
Based on Lessons from Other States…
  • Michigan might choose to focus on one or more of the following system components:

Public Engagement Ongoing Professional Development/

Program Support Core Competencies of Staff

Governance Evaluation and Information Systems

Administration Needs Assessment and Planning

Coordination Centralized Point of Referral

Monitoring Early Childhood Partnerships

Funding Program Standards


Some of the 10 counties have already begun systems development work.

December 16, 2010

mi home visiting program logic model
MI Home Visiting ProgramLogic Model

The Home Visiting Work Group is working with Michigan Public Health Institute (MPHI) evaluators on a Logic Model.

The Logic Model will continue to be modified and expanded—may need to be revised based on Step 3 guidance.

This draft Logic Model represents the larger effort to build a home visiting system, and is not limited to just the ACA funding.

December 16, 2010


We welcome your comments or questions about the draft Logic Model. Please send comments to:


December 16, 2010

6 how can communities begin to participate in the hv program activities
6. How Can Communities Begin to Participate in the HV Program Activities?

December 16, 2010


6a. Local Governance Structure

  • A group or committee will need to provide leadership locally regarding this home visiting system building work.
  • You know your local structure and partners best; what will work for you?
  • Ideas: entire GSC, GSC subcommittee, other existing or new committee that will be affiliated with the GSC, etc.
  • The entity providing leadership might be different than the fiduciary.

December 16, 2010


Who must be involved?

  • Your Great Start Collaborative contract already includes a list of required partners.
  • The federal HV legislation identifies several required participants for HV planning:
    • Public Health (Title V)
    • Substance Abuse
    • Department of Human Services/CAN Council (CAPTA/CBCAP)
    • Early Head Start/Head Start

December 16, 2010


Additional key representatives for HV planning include:

    • Community Mental Health
    • Education community
    • Existing Home Visiting programs/providers, including those providing perinatal services (e.g. MIHP, Healthy Start)
    • Families

December 16, 2010

why substance abuse services are a fit
Why Substance Abuse Services Are a Fit

Addictive behaviors:



Being unreliable


Moods swings


Acting compulsively

Neglect of medical needs of both parent and child

Potential for poor or inadequate nutrition

December 16, 2010

family implications
Family Implications

Children often model parental substance using behaviors.

Sometimes develop self preservation skills (Hero, scapegoat, mascot and the lost child).

December 16, 2010


Often children of addicts are linked with:

Victimization (violent crime, sexual abuse, DV).

Serious school problems.

Drinking-related traffic crashes, vandalism, other delinquent crimes.

Youthful deaths by drowning, suicide, and homicide.

Exposure to media and movie messages that glamorize use.

Peers who drink/drug.

December 16, 2010

problems manifested in several domains
Problems Manifested in Several Domains





Social relationships

Social services

December 16, 2010

community wellness
Community Wellness

Prevention or early intervention, enhance

chances for family and community wellness:

Less ATOD use.

Fewer family problems.

More productive citizenry.

December 16, 2010

michigan structure for substance abuse services
Michigan Structure for Substance Abuse Services

Bureau of Substance Abuse and Addiction Services (BSAAS) oversees prevention, treatment and recovery efforts related to substance use disorders and gambling addiction.

16 Coordinating Agencies (CAs) who are under agreement with MDCH to ensure quality substance abuse prevention and treatment services.

December 16, 2010

examples of services
Examples of Services

Prevention – Underage Drinking & Tobacco Use, Adult & Senior Problem Use, Communicable Disease, Parenting Awareness, Prescription & Over-The-Counter Drug Abuse.

Treatment – Driving Under the Influence insight education (DUI), Interventions, Methadone, Women's Treatment Programs, Fetal Alcohol Syndrome Disorder Screening and referral, Co-Occurring Disorders.

Substance Use Disorder Recovery – Recovery Oriented Systems of Care (ROSC), Peer Coaching/Mentoring, Recovery Supports and Resources.

Problem Gambling – 24 hour Help-line, Assessment Questions, Treatment, Prevention, Speakers Bureau, Therapist Training.

December 16, 2010

regional substance abuse services representatives
Regional Substance Abuse Services Representatives

Kalamazoo and Calhoun - Kalamazoo Community Mental Health & Substance Abuse Services

Achiles Malta, Prevention Coordinator (269) 553-7076 amalta@kazoocmh.org

Berrien and Muskegon - Lakeshore Coordinating Council

Kori White Bissot, Prevention Coordinator (616) 846-6720 kbissot@lakeshoreca.org

Genesee - Genesee County Community Mental Health

Lisa Coleman, Manager S.A. Prevention (810) 496-5544 lcoleman@gencmh.org

Ingham - Mid-South Substance Abuse Commission

Joel Hoepfner, Prevention Coordinator (517) 337-4406 ext. 102 joel@mssac.com

December 16, 2010

regional sas representatives cont d
Regional SAS Representatives (cont’d)

Kent County - network180

Denise Herbert, Prevention Coordinator (616) 855-5245 deniseh@network180.org

Saginaw - Saginaw County Department of Public Health

Bryant J. Wilke, R.S., Interim Dir. of S.A. Serv. (989) 758-3684 bwilke@saginawcounty.com

St. Clair - St. Clair County Community Mental Health (DBA) Thumb Alliance

Andy Kindt, Regional Prevention Coord. (810) 966-4490 akindt@scccmh.org

Wayne - Detroit Department of Health & Wellness Promotion

Karra Thomas, CPC-M, Prevention Coord. (313) 876-0154 thomaskw@detroitmi.gov

December 16, 2010

services for pregnant women mothers of young children
Services for Pregnant Women& Mothers of Young Children

9 out of 10 counties have in-county women’s specific substance abuse programming available.

Some programs are residential and accept both women and their dependent children.

Three statewide residential treatment programs accept women and dependent children, and provide gender specific treatment.

Parent at risk of losing her children considered a priority with regards to Tx, and they are placed in treatment ahead of the general population.

December 16, 2010

6a next steps for local governance
6a. Next Steps for Local Governance

Identify your governance group.

Support each member to understand the purpose and scope of this program.

Ask each member to review:

The November 4, 2010 state Home Visiting webinar

This presentation/powerpoint

Ensure that all members agree to collaboratively build the county-level home visiting system.

December 16, 2010


December 16, 2010

6b data federal indicators
6b. Data/Federal Indicators
  • We anticipate that Step 3 will include a 2nd cut analysis of risk/need to identify the target audience in each county; who is it that is experiencing the high concentration of risk?
    • Geographic
    • Sub-populations
    • Other characteristics

December 16, 2010

data federal indicators cont
Data/Federal Indicators, cont.
  • We will have to provide data about these target populations and the system/services as part of the national cross-site evaluation of the project.
  • Access to this data is an important component of being 'ready' to participate in the project.
  • Data will be required for each of the 10 federal indicators.

December 16, 2010

6b next steps for data
6b. Next Steps for Data

Premature birth (%)

Low birth-weight infants (%)

Infant mortality

(rate/1,000 births)

Poverty (% below FPL)

Crime (rates/1,000 residents)

Domestic violence (rate/1,000)

High School drop-out (%)

Substance abuse (%)

Unemployment (%)

Child maltreatment (# reports)

Take inventory of what local data you have about sub-populations for each of the 10 federal indicators*:

*see HV Analysis tables for detailed information on indicators and sub-indicators

December 16, 2010

for the local data you do have
For the local data you do have:

How was each indicator measured; is it the same as the federal metric (e.g. % of premature births vs. rate)?

At what level do you have the data (e.g. zip code, census tract, city, county, etc.)?

Can you run analysis by sub-populations, (e.g. race, ethnicity, etc.)?

December 16, 2010

for the data you do not have
For the data you do NOT have:

How can you quickly begin to build this data collection into local projects and into existing local data systems?

December 16, 2010

We anticipate that the 2nd cut analysis will be a collaborative state-local effort.
  • We also anticipate having follow-up conversations with each county about the analysis work.

December 16, 2010


December 16, 2010


The state is developing a database with standardized definitions, that will capture information statewide and will be shared with local communities.

December 16, 2010

6c next steps for the database
6c. Next Steps for the Database
  • Review your county table of HV programs – are any missing (table is available on websites)?
  • Work with the state to assemble additional information.

December 16, 2010

existing system coordination
Existing system coordination

We would also like to identify efforts that have been undertaken to build a county-level HV system:

  • Coordinated enrollment?
  • Local database of programs?
  • Locally shared training across programs?

December 16, 2010


December 16, 2010


The State is still developing the process to determine which counties would receive first round funding, and for which activities.

We anticipate that funding will be utilized for both infrastructure building and some direct services.

It is possible that fewer than 10 counties will receive FY10 funding.

December 16, 2010


The process will likely take in to account:

A readiness assessment

Results of 2nd cut analysis of need

Follow-up discussions/meetings regarding readiness and analysis results.

  • The steps outlined above (for 6a,6b,6c) will help you prepare for this process.
  • The process will be finalized once the Step 3 federal guidance is released.

December 16, 2010

seed funds
Seed Funds

The State will offer each of the 10 counties $8,000 in seed funds to support participation in ‘Step 3’ activities.

This funding would help offset costs for activities we’ve discussed today, as well as:

Data gathering and reporting

Epidemiology support for data analysis and reporting

Parent involvement

Local participation in the development of the Step 3 response.

December 16, 2010

seed funds1
Seed Funds

MDCH will establish contracts with local public health, as that is the easiest mechanism for us to quickly distribute these funds.

We anticipate establishing contracts in early January, 2011.

December 16, 2010

seed funds2
Seed Funds

Once we receive the Step 3 federal guidance, we will prepare an addendum to the contract.

Each county will prepare a response to the addendum, explaining how they will use the funds to support ‘Step 3’ activities in their community.

December 16, 2010

9 questions answers
9. Questions & Answers

December 16, 2010

10 next steps
10. Next Steps

December 16, 2010

next steps state
Next Steps - STATE

Establish a contract with local public health to provide seed funds for ‘Step 3’ activities.

Send information regarding data needed for state database on HV programs.

Notify you when HRSA releases the ‘Step 3’ guidance.

Send an contract addendum for the seed funds, related to the federal guidance and analysis needed from local communities.

Conduct additional information sharing webinars/meetings.

December 16, 2010

next steps local
Next Steps - LOCAL

Begin working on the tasks outlined in this presentation:

Provide comments on the draft Logic Model

Identify and build your local governance group

Start an inventory of currently available local data

Begin to develop plans to collect/provide additional data that will be needed

Review and update information about existing HV Programs for the statewide database.

Participate in upcoming informational webinars/meetings

December 16, 2010

upcoming webinars meetings tentative
Upcoming Webinars/Meetings(Tentative)

Wednesday, January 19, 10:00-11:30am

Webinar regarding Lessons learned from Project LAUNCH (available statewide)

Thursday, February 3, 1:00-3:00 in Lansing

Meeting with 10 communities regarding next steps on Home Visiting program

December 16, 2010

Please continue to reference the following websites for additional information about the Home Visiting Program:

www.michigan.gov/mihp, see Important News

www.greatstartforkids.org, under Early Childhood Home Visiting Program

Contact: HomeVisitingProject@michigan.gov

December 16, 2010

thank you

We appreciate your interest and willingness to work through this process with us!

December 16, 2010