Transcript Click to add title - Nurse

The Newly Enacted
Maternal, Infant, and
Early Childhood
Home Visiting Program
A Primer
April 13, 2010
•Please mute your phone
•Please hold all questions until
the end of the presentation.
Health Care Reform
• March 23, 2010 – President Obama signed into the law the
Patient Protection and Affordable Care Act.
• This legislation provides $1.5 billion over five years in mandatory
federal funds to States for early childhood home visitation
services.
• Grants to States to implement evidencebased home visitation models that
improve maternal and child health,
development, education, and
economic self-sufficiency, among other
outcomes.
• Medicaid Option was not included within
the enacted health care reform legislation.
What We Know – the Basics
• Law: The new Home Visiting Program is authorized as a separate section
under Title V of the Social Security Act. The Home Visiting Program is
separate from the MCH Block Grant.
• Agency: The Health Resources & Services Administration (HRSA) is likely to
be the designated lead agency for the new Home Visiting Program, but
in significant collaboration with the Administration for Children & Families
(ACF).
• Funding: $1.5 billion in mandatory funds over 5 years.
– Mandatory funding is guaranteed for the 5 year period and is not subject to
the annual appropriations process.
– After the initial 5 years, this program will be subject to the Congressional
reauthorization process, similar to other block grant and entitlement programs
such as CAPTA, TANF, and the MCH Block Grant.
– Funding Allocations
FY2010 - $100 million
FY2012 - $300 million
FY2011 - $250 million
FY2013 & FY2014 - $400 million
What We Know: Eligible Applicants
• Who Applies: States, Native American Tribes, or Tribal Organizations
are considered “eligible entities” to apply for grant funding under the
Home Visiting Program. In FY2012, non-profit organizations may apply
for funding in States that either failed to submit an application and/or
whose application(s) were not approved.
• Three Categories of Eligible Home Visitation Models:
– Program models proven to achieve significant, sustained and
positive outcomes through randomized controlled trial research
and with results published in a peer-reviewed journal;
– Program models proven to achieve significant and positive
outcomes through quasi-experimental research studies; and
– Promising new approaches or initiatives that have been developed
or identified by a national organization or university that will be
rigorously evaluated. States may only use up to 25% of their
respective allocations to support this category.
What We Don’t Know
• Will grant funds be dispersed on a competitive or formula basis?
• How will States know which program models qualify for which
categories?
• Will HRSA issue guidelines or rulemaking?
• What types of evaluation will States be required to conduct?
• What technical assistance will HRSA and/or ACF provide?
• How will HRSA-MCH Bureau and ACF-Children’s Bureau divide
duties and administration?
• Will ACF grantees receive “stop-gap” funding under this
program for operations or evaluations?
• Will Governors have the authority to designate the administering
State agency?
What Should States Be Doing?
• Statewide Needs Assessment: 9/23/2010 deadline
– Must be completed within 6 months of enactment to be eligible to receive
funding under the MCH Block Grant in FY2011
– Must identify communities with concentrations of risk factors
– Should include existing capacity and quality of home visitation services in
the State
– Coordinated with other State assessments
• Quantifiable & Measurable State-Determined Benchmark Areas
– States must demonstrate improvements in 4 benchmark areas at Year 3 and
all 6 benchmark areas at Year 5.
– States much establish benchmarks to show improvements in the following
areas:
Maternal & newborn health
School readiness & achievement
Childhood injury & maltreatment
Family self-sufficiency
Coordination of community resources Crime or Domestic Violence
What Should States Be Doing?
• Prioritize services for high need, low income, or at-risk families
– Pregnant women under age 21;
– Families with a history of child abuse or neglect;
– Families enrolled in public assistance programs such as TANF or
Medicaid;
– Families with tobacco use in the home;
– Families with a history of substance abuse or need substance abuse
treatment;
– Families with children with low achievement or developmental
disabilities; and
– Families currently serving in the Armed Forces.
• Identify program model(s) that meet the needs identified in Assessment
– Program enrollment and services are voluntary
– Selected program model(s) are implemented with fidelity
– Agree to annual reporting requirements to HHS
What is Nurse-Family Partnership?
• Evidence-based nurse home visitation model serving only first-time, low
income mothers and their families
• Typical clients served by NFP are younger, living in poverty
• Frequent home visits beginning early in pregnancy through child age 2
• Maximum caseload of 25 families per full-time nurse
• Improves pregnancy outcomes, maternal/child health and
development, and family economic self-sufficiency
• Over 30 years of randomized controlled trial research demonstrates
effectiveness across diverse populations; urban and semi-rural settings;
longitudinal follow-up
• Outcomes strongest among higher risk families
• Currently operates in 31 states through State and local implementing
agencies who employ nursing teams and operate under a contract
with the Nurse-Family Partnership National Service Office
What is the NFP National Service Office?
• National non-profit organization supporting development of the
Nurse-Family Partnership model in community settings
• Provides NFP-specific planning, nurse home visitor and supervisor
education, practice consultation, web-based quality
assessment and evaluation system to assure model fidelity
• Provides marketing/communications, public policy, and
advocacy technical assistance and support
• Provides consultation to States for development of their own
Nurse-Family Partnership initiatives’ management and support
systems
Counties and States Served by Nurse-Family Partnership - April 2010
States that
NFP serves
States where
NFP is a state
initiative
#
Number of
counties NFP
is serving
How can the NFP National Service Office Help?
• State Grant Application Toolkit for Nurse-Family Partnership (under
construction)
–
–
–
–
Summary of published research evidence
Current service capacity and eligible population by State
Guidance for targeting services to areas of highest need
Suggested NFP-specific measures to accompany State’s plan for
demonstrating progress in benchmark areas
– Boilerplate language for State applications describing NFP relevance to
requirements
– Guidance for development of State level infrastructure
– Description of standard nurse education, consulting, and evaluation services
available through NFP for assuring program implementation fidelity.
• Regional and local orientation webinars or in-person meetings for States
interested in including NFP in their applications
• Individualized consultation from Program Developers and NFP experts
in nursing practice, evaluation, policy, and financing
Contact your Program Developer
Western Region
•
Kristen Rogers (Regional Manager) [email protected] AK, AZ, HI, IN, MT, NM, NV, OR,
UT, WA, WY
•
Trinh Hartney [email protected] CA
•
Laura Misuk [email protected] TX, OK
Midwest Region
•
Mary Jo O’Brien (Regional Manager) [email protected] IA, MN, ND, SD, WI
•
Jeanne Anderson [email protected] IL, KS, MO, NE
•
Kimberly Friedman [email protected] IN, KY, MI, OH
Southern Region
•
Veronica Creech (Regional Manager) [email protected] NC, SC, VA, WV
•
Julie Rainbow [email protected] AL, FL, GA, TN
•
Kimberly Williams [email protected] AR, LA, MS
Northeast Region (Public/Private Ventures)
•
Lisa Gale Reyes (Regional Manager) [email protected] DC, DE, MD, NJ
•
Jennifer Stavrakos [email protected] PA
•
Renée Nogales [email protected] CT, MA, ME, NH, NY, RI, VT
Colorado (Invest In Kids)
•
Michelle Neal [email protected]
Program Development Director: Erika Bantz, [email protected]