Home Visiting Consortium Meeting February 22, 2017 9:30 AM – 11:30 AM

Attendance: Linda Goodman (co-chair), Melissa Mendez (co-chair), Kareena DuPlessis, Linda Harris, Cathy Lenihan, Kathi Bleacher, Elisabeth Teller, Darcy Lowell, Lynn Johnson, Stephanie Luzack (for Faith Vos Winkle), Noraleen Dunphy, Deborah Buxton-Morris, Allison Logan, Kimberly Nilson, Jerry Reisman, Judith Meyers, Jennifer Hernandez, Merrill Gay, Laura Bengtson (for Mary Beth Kuzoian), Sondra Crute

The meeting was convened at 9:30 AM with a welcome from Acting Commissioner Linda Goodman and introductions.

November 30, 2016 Meeting Minutes: One correction noted on page one under Consortium Membership. Change from Nurse Family to Nurse- Family Partnership. Judith Meyers motioned to accept and Noraleen Dunphy seconded. Motion passed.

Updates: Legislative Session and Proposed Budget: Linda Goodman informed the group that Connecticut is in the middle of a legislative session and there are a lot of proposed bills, as well as the Governor’s proposed budget. Linda spoke about the possible impact of funding regarding The Office of Early Childhood (OEC), Birth to Three, Care 4 Kids, and Help Me Grow. The OEC testified yesterday (2/21/17) in Appropriations, as did unions and municipalities. All testimony is posted on the Connecticut Government website. A discussion ensued around funding. Kareena DuPlessis will email everyone a link for questions and answers regarding the Help Me Grow program for which funding is proposed for elimination.

Maternal Infant Early Childhood Home Visiting (MIECHV) Innovation Grant Award: Lynn Johnson announced that the OEC was awarded the Innovation Grant for $1,527,706. Lynn then turned the floor over to Cathy Lenihan for a report.

Cathy reported the CT application focuses on the target areas of Workforce Development and Retention of a Highly Skilled Workforce. OEC is in the process of developing MOA’s with Eastern Connecticut State University and UCONN Department of Human Development and Family Studies to design and evaluate the impact of 8-10 online training modules on staff retention and workforce development. The content of the modules will explore the following topics: child development, childhood obesity, safe sleep, trauma informed care, infant mental health and Parents with Cognitive Limitations.

Cathy distributed a hand-out that explained how the two versions of the intervention will be implemented and tested using a randomized control trial design. If the two versions of the intervention are shown to be effective, disseminating the findings and scaling up for widespread effective usage should be a straightforward process. Project goals are as follows:

 Standardize the knowledge and competencies of the home visiting workforce serving families in high need communities.  Increase the retention of home visiting staff by reducing the stress of working with high risk families, by increasing the knowledge and skill set among home visitors, as well as feelings of competence, and reducing isolation.  Carry out empirical, experimental or quasi-experimental evaluation of Goal 2 and its objectives.

The full application can be found on the OEC website under Collaborations and Initiatives date posted 5/29/16 or by using this link: http://www.ct.gov/oec/cwp/view.asp?A=4547&Q=580478.

1 On a related note, Linda Goodman asked if once the Innovation grant modules are developed— particularly, the one on safe sleep—could they be using it for child care providers; even though it is being developed for another purpose? Linda explained that the OEC Licensing staff are finding that despite providing and reviewing written materials on safe sleep, they are still finding non-compliance during inspections. Cathy Lenihan explained that these modules could be used by anyone, certainly by our home visiting program. In the application HRSA acknowledged that we’re building this for MIECHV, but it can benefit others in our state. Then, a discussion ensued around safe sleep, clients and culture.

Subcommittee Reports:

Infrastructure Workgroup: Linda Harris reported that discussion occurred within the workgroup on developing a mechanism that will allow providers and families to contact CDI to make referrals from home visiting services similar to that in Norwalk. Mary Kate Locke from Family & Children’s Agency shared how CDI is used as the central point of access which providers use to make and track referrals in Norwalk. The referrals are then forwarded to a Family & Children’s Agency designated staff who triages the referral and contact the agency which can best meet the family needs. There are many considerations. Some providers and families, especially those at higher risk may not use a central number. And there are staff in programs such as in the Nurturing Families Network whose role is to seek out and offer services to families. With additional funds Nurturing Connection staff in the NFN program responsibilities could be expanded to triage referrals for all programs in their community if they have the eligibility and enrollment information.

The group then discussed the idea of a continuum of services and the conversation developed into a discussion regarding the limitations of access and availability within some communities verses other communities. There was also a discussion around the level of intensity of the services being offered matching the level of need of the families. The goal is to have a fluid and flexible continuum of services available so that all families could have something and families could move between programs while also avoiding multiple programs working with the same families.

Darcy Lowell cautioned the group regarding a centralized intake system and shared her experience with this in Palm Beach, Fl. She shared from a quality standpoint it looks like it is working but when you look closer there are many problems and complaints with the system around delays in service, families being passed through many channels before settling into a service, lack of sensitivity of triaging, uniqueness of the models not being communicated, and lack of understanding of the models by the central intake staff.

Another speaker interjected that you could have a central access point but have other ways to go in. We could look to Norwalk as an example of this. In Norwalk, there is a hub of providers who work together within that community to determine the best fit for families.

Lynn Johnson added that she had a chance to sit in on the infrastructure group this last time and there was some really good discussion, and the bottom line is that we do have a centralized intake, CDI. We need to look at how it should be utilized. We can enter family referral information into a data system, with the concern around loosing families this would help to keep track of whether a family has been reached. Regarding the speed and the timing for high risk families, currently the Birth to Three programs are notified and make contact within 24 hours of referral.

Cathy Lenihan suggested that we look at some of the early work of MIECHV, several states used MIECHV money to build infrastructure and create a centralized intake system. Another member of the group shared that the National Evidence Based Home Visiting Alliance did a monograph on centralized intake. This was sent to all consortium members through email.

Quality Development:

2 Melissa Mendez reported that they had a small group but good discussion in their last workgroup. We continued to focus on identifying quality indicators across all programs. The workgroup focused on four specific areas and turned them into questions that will move the work forward. The questions are:

 How do Connecticut home visiting programs promote child and family health?

The question is inclusive of all kids in the family and looks at well child visits, up-to-date immunizations, adult sibling health care and family medical home connections. We are going to look at what tools, assessments and efforts are being used across programs. We have enough expertise at the table to look at and dig a little deep in that area. The idea is to really look at how some programs do these things in a very robust way while other programs may struggle with how to integrate this. We would like to see sharing of expertise to bring everybody up to a higher level.

 How do Connecticut home visiting programs promote and support child/caregiver interactions and attachment?

We know that for some programs this is a huge focus. So, what can we do across all programs to raise that level of support?

 How do Connecticut home visiting programs promote child development and school readiness?

All programs have this as a primary focus. We will be looking at how they do it, what they’re doing and best practices so we can raise the bar for all programs.

 How do Connecticut home visiting programs reduce risk factors and promote protective factors for kids and families.

We will be looking more closely at how programs screen for trauma, DV, tobacco use and what do they do with the screening information. Also to be considered are there best practices in one program or another that can be shared across programs?

In conclusion, the ultimate goal is to create a comprehensive system for early childhood (not home visiting). The focus of this first effort is to look at the four indicators noted in the questions above. Then, identify areas where we can share best practices across programs, develop a document that we can share with legislators and provide tangible examples.

Workforce Development: Lynn Johnson reported that they worked on three things:

 To conduct an analysis of the home visiting workforce  Develop core competencies, and  Create central training

The group has met three times. The first time meeting focused on who makes up the workforce. The group has moved beyond that to focus on the competencies. During their meeting they reviewed the Core Competency binder that was provided to all consortium members in November and began to look and explore the next levels. The group acknowledges that they might have to develop various levels because of the different models and focus of services within CT. Abby Alter did a lot of great research looking at other states competencies, summarizing that and sending to our current workgroup for home visitors. This included some recommendations that we might want to look at or borrow from as we develop the additional levels.

3 In conclusion Lynn Johnson said that as a consortium and within the OEC we need to think about how we are going to move forward with the development of the CKCs for home visitors.

Final closing questions and remarks:

School Readiness: Deborah Buxton-Morris asked a question about preschool slots and school readiness. At some point will the consortium be working with the State Department of Education and start looking at school readiness? Linda Goodman responded that they would love to do that, but it has been difficult. A discussion ensued about brain development and third grade.

SASID: Darcy Lowell inquired about the status of getting SASID numbers for all children in home visiting. Linda Goodman said that OEC is actively working on developing the Early Childhood Information System (ECIS) module for home visiting. This will connect up to the Department of Education SASID manager. As soon as the home visiting module is launched and people start enrolling their children SASID numbers will be assigned.

Next Meeting Date: The Home Visiting Consortium will meet quarterly on the 4th Wednesday of the month. Unless otherwise notified, the meetings will be held at the United Way of Connecticut at 1344 Silas Dean Highway, Rocky Hill from 9:30 AM to 11:30 AM. The following is the schedule for 2017:  February 22 2017  May 24, 2017  August 30, 2017  November 29, 2017

Workgroups meetings will be the last Monday of the month prior to the consortium meeting dates as follows:  January 30, 2017  April 24, 2017  June 26, 2017  October 30, 2017

Adjournment: The meeting adjourned at 11:30 AM.

Note: Mary Beth Kazoian needs a Core Competency binder.

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