FROM THE FIELD

HRSA’S Home Visiting Program: Supporting Families Impacted by Opioid Use
HRSA has released a new resource for Maternal, Infant, and Early Childhood Home Visiting Program awardees and their state partners in early childhood, public health, and substance misuse and mental health treatment. It provides essential information about the opioid epidemic, opioid use disorder, and neonatal abstinence syndrome.
It includes relevant research; offers strategies; and highlights promising efforts underway in Maine, Colorado, West Virginia, and Massachusetts.

The Opioid Epidemic and Maternal Health: Three Opportunities for Change 
Opioid use disorder in pregnancy has increased dramatically across the country in the last decade, bringing with it increased health risks for mothers and babies. Health professionals can help change these statistics by making the most of every interaction they have with new mothers, from prenatal care to building postpartum supports. New insights from NICHQ provide advice from experts in the field.

Opioid-Affected Births to Rural Residents Increasing
According to a study in NRHA’s Journal of Rural Health, pregnant women with opioid addiction may have particular challenges receiving the care they need in rural areas. Both maternal opioid use disorder and neonatal abstinence syndrome are increasing faster in rural areas than urban.

Family Physicians Offer Solution to Rural Maternity Care Crisis
Family physician John Cullen recently wrote about the erosion of obstetric care in rural communities. According to a recent report, more than one-third of Illinois counties qualify as maternal care deserts, and rural communities across the country face equally dire circumstances as distance to care grows. A recent NRHA blog outlines efforts underway to resolve the crisis.

Recommendations for Rural Health Equity
For the 1 in 5 people who live in rural America, choosing to live there should not present barriers to living a long and healthy life. But too often, it does. The Robert Wood Johnson Foundation presents key research, emerging insights, and resources to help transform rural health.

Improving the Lives of Young Children Through Data
A new brief from the Early Childhood Data Collaborative highlights projects implemented in three states to integrate education, health, and/or social services data in order to inform policies that influence the lives of young children and their families. The Annie E. Casey Foundation funded KIDS COUNT organizations in the states of Mississippi, Minnesota, and Rhode Island, supporting each state in its use of integrated data to address one pressing early childhood policy question.

Early Childhood Data in Action: Stories from the Field
Early childhood data can help states and communities identify needs, track improvements, and spread and scale successes. NICHQ has shared its Early Childhood Data in Action case studies, which show how three communities are leveraging data as catalysts for early childhood improvement. These communities have used data to align stakeholders around a common goal, support quality improvement and make critical decisions on resource allocation. Case studies feature:

  • Indianola, MS, where the community has organized around a collective goal and increased kindergarten readiness by nearly 25 percent
  • Ventura County, CA, whereby putting family-needs first, data were used to improve the quality of the services and supports offered to families
  • Philadelphia, PA’s integrated data system, which helped identify children in high-risk neighborhoods most in need of pre-kindergarten support

Supporting CQI in Early Care and Education & Home Visiting
A new installment in a Child Trends blog series dedicated to examining knowledge-sharing across early care and education (ECE) and home visiting (HV) describes how continuous quality improvement principles are being tested and applied to HV and ECE programs and services in new and innovative ways that allow for shared learning between these sectors.

Strong Start for Mothers and Newborns Model Evaluation
The Centers for Medicare & Medicaid Services, in conjunction with the Center for Medicare and Medicaid Innovation, has announced the final evaluation of the CMMI Strong Start for Mothers and Newborns model, including an overview of the findings and key Medicaid covered services. As an effort by the Department of Health and Human Services, the Strong Start for Mothers and Newborns initiative aimed to reduce preterm births and improve outcomes for newborns and pregnant women. 

Scaling for Systems Change: Rethinking Planning & Evaluation
As change makers, we are not always clear on what scaling means nor how efforts to scale should be properly evaluated, and because of this successful approaches to change have seen limited impact. A new article from the Tamarack Institute encourages evaluators to widen their gaze on what activities, results, and learning should be tracked when providing social innovators with feedback on their efforts and offers five things to keep in mind when thinking about scaling your social innovation.

Three Principles to Improve Outcomes for Children and Families
The science of child development and the core capabilities of adults point to a set of “design principles” that policymakers and practitioners can use to improve outcomes for children and families. In turn, these principles point to a key set of questions:

•  What are policies, systems, or practices doing to address each principle?
•  What could be done to address them better?
•  What barriers prevent addressing them more effectively?
 
Learn more about the application of scientific principles for early childhood outcomes from The Center on the Developing Child at Harvard University.

State and Federal Movement to Advance Trauma-Informed Care
Over the past year, the Center for Health Care Strategies has been monitoring state and federal policymakers’ interest in addressing early adversity, toxic stress, and trauma to promote overall health and wellbeing. To date, states and the federal government have employed a variety of policy levers to prevent and address trauma experienced by children, adults, and communities, and to encourage the adoption of trauma-informed approaches to care. A new blog post highlights continued efforts by state and federal policymakers to address adverse childhood experiences and trauma, and promote trauma-informed care.

A Sourcebook on Medicaid’s Role in Early Childhood
The October 2018 report by Charles Bruner and Kay Johnson, A Sourcebook on Medicaid’s Role in Early Childhood: Advancing high performing medical home and improving lifelong health, describes opportunities under state Medicaid programs to finance more preventive, developmental, and family-centered services for young children. It is designed for use by a broad audience that includes primary care child health practitioners and champions, state Medicaid and child health program staff, child health policy advocates, other health and social service professionals engaged with young children, and state policymakers.

Equity, Inclusion, and Collective Impact
What does collective impact look like when it is grounded in Equity? The Collective Impact Forum is sharing video from the keynote at its April 2018 Collective Impact Convening in Austin. Watch Beyond Seats at the Table: Equity, Inclusion, and Collective Impact as presented by Vu Le from Rainier Valley Corps, with introductory remarks by Sheri Brady from Aspen Forum for Community Solutions.

Resources to Help States Improve Integrated Care for Children
Integrating children’s care improves early identification and treatment of health issues that can improve children’s well-being and avoid costly medical, special education, foster care, and criminal justice expenses. This Issue Hub provides valuable resources for states interested in the Integrated Care for Kids (InCK) Model and others working to implement payment, coverage, and cross-agency strategies to improve for integrated care coordination of behavioral, physical and health-related social needs for children eligible for Medicaid or the Children’s Health Insurance Program. For more on the InCK model opportunity and its alignment with Help Me Grow, review this post on the HMG National Center’s Funding & Capacity Building Bulletin. 

THIS MONTH ON THE FUNDING & CAPACITY BUILDING BULLETIN (FCBB)

Check out the new opportunities from national partners, shared this month to the FCBB on the affiliate side of the HMG National Center website:

 
For continuing updates on opportunities like these, visit HMG National ‘s Funding & Capacity Building Bulletin

HMG NATIONAL CENTER RESEARCH REVIEW

How Early Head Start Prevents Child Maltreatment
Recognizing that most research is geared toward understanding near-term impacts on children and families, this study sought to identify the role of Early Head Start (EHS) in reducing child abuse and neglect. Specifically, investigators looked at whether EHS prevented children’s involvement with the child welfare system. Children were observed to be at reduced risk for child maltreatment when EHS generated the following program impacts and short-term outcomes: greater parental responsiveness and supportiveness, lower levels of parenting stress, less family conflict, more supportive home environments, and improved cognitive development, engagement, and attention during play. Reductions in maltreatment were not observed in response to increases in knowledge of infant development or improved family economic stability. “These findings underscore the potential for programs serving infant and toddlers to improve critical long-term outcomes for children by connecting with and supporting parents and families – even if preventing child maltreatment is not an explicit goal… Studies that focus solely on outcomes, without attending to key mechanisms of change, are likely to miss important lessons about how these programs create foundations for positive change”.

NATIONAL CENTER NEWS AND RESOURCES

Forum Save the Date!
Save the Date for the 10th Annual HMG National Forum in Buffalo, New York on May 6-8, 2019. Join us for three full days of shared expertise, best practices, and inspiration.

HMG National Forum Call for Proposals Now Open
The Help Me Grow National Center is excited to announce that the 2019 HMG National Forum Call for Proposals is now open. Applications are open to affiliates, as well as local and national partners, and will be reviewed by the Forum Planning Committee according to relevance, level of anticipated interest, and practical application. Please complete one online application for each session that you would like to submit. Submissions are due by January 11th, 2019.

Follow Help Me Grow National on Facebook! 

 

HMG COMMUNITY OF PRACTICE CORNER

New Affiliate Partners
The HMG National Center kicked off its New Affiliate Partners Community of Practice (CoP) at last year’s Forum in Seattle and has continued its work together since. Comprised of affiliates that are exploring the HMG model and planning their installation strategies, this CoP offers a supportive space for affiliates joining the National Network to identify learning objectives and participate in ongoing virtual sessions coordinated by the National Center that aim to bring valuable content to this onboarding group. The current CoP is comprised of seven affiliates in similar stages of HMG start-up and to date, the group has focused on prioritizing near-term learning objectives to which the National Center has matched content. Enrollment into this CoP is rolling and open to all affiliates in start-up, refresh, and re-start phases of HMG implementation. To learn more about this CoP and how to join, please contact Sarah Zucker at szucker@connecticutchildrens.org.

AFFILIATE NETWORK NEWS AND RESOURCES

HMG Alameda & San Francisco Present at ACEs Symposium
On October 15th, HMG Alameda and San Francisco showcased the HMG vision for prevention and early intervention to pediatricians from across the country attending the 2018 ACEs Conference and Pre-Conference Pediatric Symposium. As part of the Symposium’s Intervention Modality Expo, Angelina Montgomery (HMG Alameda Prevention Manager), Nadia Thind (HMG San Francisco Coordinator), and Theresa Zighera (First 5 San Francisco Program Officer) introduced attendees to the HMG Core Components and their intersection with Adverse Childhood Experiences (ACEs). Attendees from HMG Affiliate States were provided with information about how to access HMG in their area.

As is true across HMG Affiliates, HMG initiatives in the San Francisco Bay Area seek to fundamentally shift education and health care systems toward greater attention to prevention and early intervention; partnership is a key element of this shift. The benefit this partnership holds for influencing ACES within the pediatric community is two-fold:

  1. By helping pediatric health care professionals understand their critical role in identifying early warning signs in children, HMG hopes to increase receptiveness to universal developmental and ACEs screening within health care settings, and foster an overall culture where screening is fully embraced and institutionalized within the broader context of prevention.
  2. HMG aims to serve as a referral center for pediatricians and any non-medical concerns they might encounter that could jeopardize the healthy development of their young patients. HMG will take responsibility for ensuring that children and families are connected with the right programs and providers, putting them on a brighter, healthier path.

“Participation at this national conference reminded me of the tremendous power we hold to change the developmental trajectory in a young child’s life, when we come together across service sectors, break down systemic barriers and leverage one another’s assets,” said Theresa Zighera, First 5 San Francisco.

 

Promoting ASQ Developmental Screening through HMG Michigan
HMG Michigan (HMG MI), with its nine affiliate counties, uses the Great Start Collaborative as the foundation for system building. Each affiliate county in Michigan assesses the needs of its community and builds organic systems to support those needs. Utilizing many partners and community organizations to support the use of developmental screening, Oakland County has set an ambitious goal in working toward universal access of developmental screening using the ASQ-3 within HMG MI.
 
Due to its exceptional success in systemically embedding ASQ screening within the community and a resulting high number of screens conducted, HMG Oakland County was invited to participate in a national webinar through the Build Initiative entitled, Using the ASQ-3 and ASQ:SE-2 in Early Learning Quality Initiatives. The Build Initiative works at a national level to support early childhood leaders with avenues to impact the success of children. This webinar highlighted screening measures used in Oakland County and the systematic approach used to reach families through their developmental screening project.
 
HMG Oakland provides cross-sector partner sites (child care centers, medical professionals, family service providers, home visiting) with financial support, training, and resources to support their use of the ASQ with the families they serve. HMG Oakland County has a robust care coordination system in place in which a team of three HMG Care Coordinators collaborate efforts to respond to ASQs from the community. Parents receive a phone call with their child’s summary of results along with learning activities and resources to support the family in their home environment. Children who score in the monitoring or below cutoff are provided with connections to local agencies for further, more in-depth evaluation. The central access phone line is fielded by the HMG Care Coordinators as well, who provide support around a wide variety of needs coming from parents, providers and local agencies.

HMG Long Island Presents at AAP National Conference
Docs for Tots presented their work on developmental screening and maternal depression screening interventions in pediatric primary care during the American Academy of Pediatrics 2018 Annual Expo. A key finding of their work was the fact that screening alone was not enough; without referrals, care coordination and linkage to services, screening did not achieve its intended result. While children and parents were being identified in the doctor’s office, referrals would fall through the cracks as families struggled to navigate complex and fragmented systems. This realization led to the implementation of Help Me Grow Long Island (HMG LI) to assist in community systems change across early childhood fields. HMG LI brings together organizations across the island to collaborate on innovative strategies for early childhood developmental support for families from the prenatal period through age 5. This includes a centralized access point where families may be referred after a screen is completed in a doctor’s office and the provider wants to assure the family gets linked to the appropriate service; or families can access a developmental screen through HMG LI, with subsequent care coordination and linkage to services. HMG LI Family Resource Specialists are additionally trained on addressing social-emotional issues for caregivers with connection to behavioral health or social support resources, as well as concerns regarding social determinants of health. HMG LI further involves a level of physician and community outreach with the collaborative efforts of all partner organizations working to spread the word about how communities and providers can help foster a culture of developmental health with the lens of prevention and early intervention.

Assessing the Early Childhood System in One Vermont County
One goal of developing an early childhood system of care in a community is that different services will be integrated and coordinated with one another, creating a more seamless experience of support for families. In Vermont’s Lamoille Valley, the community has operated on that basis for many years, and it is one of Building Bright Futures’ principles as well: success comes when systems work in a coordinated fashion. As the designated Vermont Early Childhood Advisory Council to the Governor, Building Bright Futures is the statewide nonprofit, public-private partnership focused on improving the well-being of young children and families by improving the system that serves them.
 
So, what does “integrated and coordinated” look like in practice? A new blog by Steve Ames, the Lamoille Regional Coordinator for Building Bright Futures, describes the county’s experience determining a set of standards that describing aspirational practices, testing a new tool to assess progress towards those standards, and, more importantly, to guiding an improvement path towards those ambitious goals. 

BROADCAST YOUR NEWS IN THE NEXT HMG E-NOTE!
Log on to the affiliate dashboard and click ‘Share Your News’ or send directly to szucker@connecticutchildrens.org   

AFFILIATE RESOURCE EXCHANGE
Check out this new resource shared to the affiliate side of the HMG National website:

Implementing Standardized Developmental Screening in Pediatric Primary Care – This presentation is used by Alameda County, CA to educate community pediatricians on the MCHAT screening tool. This resource serves as an example of how physician trainings can be organized and what information on the MCHAT could be shared with physicians and service providers.

SHARE HMG RESOURCES WITH YOUR AFFILIATE PARTNERS
HMG leads may log on to the affiliate dashboard and click ‘Post a Resource’ or send directly to szucker@connecticutchildrens.org