lynn h. kosanovich, hfa regional director introduction to the model

Lynn H. Kosanovich, HFA Regional Director

Introduction to the Model

Presentation Overview

History

Rationale for Healthy Families America

Model: Goals

12 Critical Elements

Our Philosophy

Strengths of the Model

Affiliation and Accreditation

History

1970s - HI Healthy Start designed to prevent CAN based on Dr. Henry Kempe (Battered Child Syndrome) work in CO

1992 – PCA, HI Healthy Start and Ronald McDonald House Charities

Developed 12 Critical Elements based on HI Healthy Start Model & Literature Review

1995 – Accreditation and formal affiliation 1997 – Accreditation of Multi-Site Systems

Training, TA, P&P, Data, Evaluation

•History•Rationale•Model

•Goals•Critical Elements•Philosophies

•Strengths•Affiliation

Rationale for HFA Child Welfare Gateway: In 2006 CAN rates

were highest among children under 3 44.2% of fatalities in 2006 were children

under age one 78% of fatalities occurred under the age

of 4 76% of fatalities were committed by one

or both parents

•History•Rationale•Model

•Goals•Critical Elements•Philosophies

•Strengths•Affiliation

Rationale for HFA (cont.)

• More than a decade and more than 17,000 individuals• CDC & Kaiser Health Plan’s Department of Preventive

Medicine in San Diego, CA Connection between ACE & physical and mental

health of adults including the major causes for adult mortality in the United States

Early childhood trauma clearly contributes to serious health issues later in life

ACE Study (Adverse Childhood Experiences)

Vision-Mission-Goals

Our Vision: All children receive nurturing care from their family essential to leading a healthy and productive life.

Our Mission: To promote child well-being and prevent the abuse and neglect of our nation’s children through home visiting services.

HFA Program Goals: Build and sustain community partnerships to systematically

engage overburdened families in home visiting services prenatally or at birth.

Cultivate and strengthen nurturing parent-child relationships. Promote healthy childhood growth and development. Enhance family functioning by reducing risk and

building protective factors.

•History•Rationale•Model

•Goals•Critical Elements•Philosophies

•Strengths•Affiliation

12 Critical Elements

Service Initiation (CE 1-3) Linking, assessing and reaching out

to families

Service Content (CE 4-8) What happens during a home visit

Staff Characteristics (9-12) Hiring, training & supervising staff

•History•Rationale•Model

•Goals•Critical Elements•Philosophies

•Strengths•Affiliation

Critical Elements: Service Initiation

Initiate Prenatally or At Birth (CE #1) Target population Relationships in the community

Standardized Assessment (CE #2) Used to identify those most in need

and those most likely to benefit Offer Services Voluntarily &

Creatively Reach Out (CE #3) Families more likely to participate Working with participants who need

us to build their trust

Critical Elements: Service Content

Offer Intense, Long-term Services, Criteria for Increasing & Decreasing (CE #4) Must be offered three to five years Leveling system to determine intensity of services & family progress

Culturally Sensitive Services (CE #5) Training on unique characteristics Staff-participant interaction Sensitivity toward family values, beliefs & customs Appropriate materials

Critical Elements: Service Content (cont.)

Focus on Parent as Well as Child (CE #6) Review issues on assessment Develop Goal Plans – about the process Curriculum – PCI, Child Development, Health & Safety Developmental Screens – ASQ Follow-up with children suspected or identified with delays

Linked to Medical Provider & Other Services (CE #7) Medical Home Immunizations Referrals

Limited Caseloads (CE #8) Sufficient time to connect with families

Critical Elements: Staff Characteristics

Personal Characteristics, Skills & Knowledge (CE #9) Important for staff to build relationships with diverse populations

Basic Training & Role Specific Training (CE #10 & #11) Orientation, role specific, wraparound & ongoing

Supervision (CE #12) Ongoing & effective, develop realistic & effective plans to empower

families, & express concerns & frustrations Reflective, Clinical and Administrative

Governance & Administration Not a Critical Element

Our Philosophies

Early nurturing relationships are the foundation for life-long healthy development.

Infant Mental Health Strength-based Parallel Process Family-Centered Culturally Sensitive Valuing Fathers Reflective Practice

•History•Rationale•Model

•Goals•Critical Elements•Philosophies

•Strengths•Affiliation

Strengths of the HFA Model

Flexibility: Target population Child development & parent-child interaction

curricula Staffing requirements

Comprehensive Assessment Services: Determine families most likely to benefit Refer families to community resources Used as Single Point of Entry

Creative Outreach Focus on building trust

•History•Rationale•Model

•Goals•Critical Elements•Philosophies

•Strengths•Affiliation

Strengths of the HFA Model (cont.)

Service Intensity: Weekly for a minimum of six months after

birth Decreases as family competencies increase Offered three to five years

Focus on Parent as Well as the ChildComprehensive Training:

Parent Survey Integrated Strategies for Home Visitors Wraparound Training – Distance Learning

AccreditationState Systems

Affiliation & AccreditationSuggested criteria: • Ability to access parents prenatally or at birth• Experience with home visiting• Infrastructure to support HFA best practice

standards• Physical space to house program

Affiliation:• Complete application and implementation plan• Send, with $500 fee, to Chicago address listed

on application• Complete phone call with Lynn Kosanovich, HFA

regional director

•History•Rationale•Model

•Goals•Critical Elements•Philosophies

•Strengths•Affiliation

Implementation & Accreditation

Accreditation:• 1st time within 2 years of affiliation (every 4 years after

that)• Based on 12 Critical Elements• Self-study• Site Visit• Panel response

Contact Info: Lynn Kosanovich Healthy Families America Regional Director lkosanovich@preventchildabuse.org 703-888-3135