HomeMy WebLinkAboutAgenda - 04-07-1998 - 9fOrange County
Board of Commissioners
Action Agenda Item Abstract
Meeting Date: April 7, 1998
Action Agenda
Item No. 94
Subject: Intensive Home Visiting Grant and Establishment of New Time Limited Positions
Department: Health
Attachment(s):
1 - Executive Summary
2 - Grant Award Letter
Public Hearing: Yes No X
Budget Amendment
Needed: Yes x No
Information Contact:
Dr. Rosemary Summers, Interim
Health Director
Extension 2411
Telephone Number:
Hillsborough
732 -8181
Chapel Hill
968 -4501
Durham
688 -7331
Mebane
227 -2031
Purpose: To accept funding from the N.C. Division of Women's and Children's
Health, Department of Health and Human Services for an Intensive
Home Visiting Program and to establish 3.5 new time limited positions
in the Orange County Health Department to:
• Decrease child abuse and neglect,
• Improve parent -child interaction,
• Ensure adequate use of preventive family support services,
• Improve children's health and development and
• Improve the service delivery system in Orange County by
decreasing fragmentation and duplication.
Background: The North Carolina General Assembly has made funding available on
a competitive basis for seven intensive home visiting demonstration
projects. Orange County was among 24 Counties invited to submit
proposals for this funding.
Development of the grant proposal was a collaborative planning
process coordinated by the Orange County Partnership for Young
Children, our local Smart Start agency, with participation from a
2
number of health and human service agencies. The collaborative
group decided that an intensive home visiting program was a need in
Orange County and would be a very valuable addition to the
continuum of services available to families with young children 0 -5
years of age. The group also decided that the Orange County Health
Department was the most appropriate agency to administer the
program. The Attachment 1 Executive Summary from the grant
project proposal submitted to the State provides program details.
The Health Department has been notified of the State's approval of
this grant award. Funding awarded includes $105,000 for Fiscal Year
1997 -98 and $100,000 for Fiscal Year 1998 -99. Additional funding for
Fiscal Year 1998 -99 also will be requested from the Orange County
Partnership for Young Children in the amount of $41,900. Medicaid
reimbursement of $15,965 is projected for Fiscal Year 1998 -99 for a
total budget of $157,865 for Fiscal Year 1998 -99.
The grant proposal included three and a half (3.5) positions to
accomplish the following outcomes:
❑ Approximately 50 families in Fiscal Year 1998 -99 at highest risk of
child abuse and neglect will receive intensive, at least weekly home
visiting services and
❑ Approximately, 75 families in Fiscal Year 1997 -98 and 500 families
in Fiscal Year 1998 -99 will receive an assessment, triage and
referral to the appropriate service.
❑ 90 percent of families in the program will not have substantiated
cases of child abuse and neglect,
❑ 90 percent of children served in the program will be up to date on
well child care examinations and immunizations,
❑ 90 percent of families in the program will demonstrate improved
scores on a post test of parenting knowledge and skills,
Staffing will consist of:
❑ A Public Health Nurse and a Social Worker to carry out the
intensive home visits
❑ A Social Worker to accomplish screening, intake and referral and
3
❑ A part time 20 hour Office Assistant for scheduling, record keeping,
reporting and general office support for the home visiting program.
All positions are proposed as permanent time limited through June 30,
1999.
Recommendation: The Manager recommends the Board approve:
❑ Accepting the funding from the N.C. Division of Women's and
Children's Health, Department of Health and Human Services for
the Focus on Families Intensive Home Visiting Demonstration
Project and
❑ Establishing the proposed 3.5 new permanent, time - limited
positions through June 30, 1999, contingent on receipt of the
funding cited on page 2 of this abstract.
❑ At the end of the time - limited period, evaluating any
recommendation to continue these positions based on
achievement of the outcomes as cited on page 2 of this abstract.
f:\pers\elgin\classify\health\abstract.doc
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Attachment 1
Executive Summary*
Focus On Families: Intensive Home Visiting Program
The Orange County Health Department, in conjunction with numerous community agencies,
submitted a proposal to the Division of Women's and Children's Health, North Carolina
Department of Health and Human Services for $105,000 the first year and $100,000 the second year
to develop an Intensive Home Visiting Program. The total budget for the second year is $157,865
supported by $100,000 from the Division of Women's and Children's Health, $41,900 from the
Orange County Partnership for Young Children and $15,965 in Medicaid revenue.
Focus on Families which is based on the Healthy Families Model, will target families with children
ages three or younger who are at highest risk for child abuse and neglect because of either the
parent's or child's health or psychosocial problems. The project will increase the capacity of the
Orange County health and human service delivery system to identify and meet the needs of high -
risk families. Addressing child abuse and neglect and poor parenting are the top priorities of
various community groups including the Orange County Partnership for Young Children and the
county's Healthy Carolinians Task Force. The lack of comprehensive home visiting services is a
critical gap in the current service delivery system.
Focus on Families will provide intensive home visiting services including weekly home visits
focusing on family support, parent -child interaction and child health and development consistent
with the Healthy Families Model curriculum. Families will receive services on a voluntary basis
until the child reaches age three. For those families enrolled in the program, the goals will be to
improve parent -child interaction, ensure adequate use of preventive family support services, and
decrease child maltreatment. The program is based on a collaborative integration of multiple
programs that provide support services to families in Orange County. Key features include
universal support screening, a central portal for intake and referral and customized and integrated
family intervention services. An expanded Child Service Coordination system will provide
centralized family assessment and community coordination of services. A Home Visit
Collaboration Team will assure smooth transition and coordination of direct services for families.
With the family's interest and involvement, the most appropriate service provider(s) will be
determined and referral will be established. Any family identified as needing and wanting intensive
home visiting because of high -risk circumstances will be served by this project.
The project will be staffed by a project coordinator, a social worker, a nurse, an intake and referral
worker and a part-time office assistant. The project coordinator position will be funded by
amending the current grant from the Orange County Partnership for Young Children for
enhancement of the Child Service Coordination Program. Also, additional funds will be sought
from the Partnership for partial support of the Focus on Families Program. Universal support
screening of newborns not previously screened will be accomplished through a contractual
arrangement with UNC Hospitals. In addition, a team of volunteers will be recruited and trained to
provide a paraprofessional support team approach for these home visiting services.
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*From the grant proposal submitted to the N.C. Division of Women's and Children's Health
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North Carolina
Department of Health and Human Services. ._
Division of Women's and Children's Health
1330 St. Mary's Street - Post Office Box 29597 - R21eigh, North Carolina 27626 -0597
Courier 52 -01 -00
James B. Hunt Jr., Governor Ann F. Wolfe, M.D., M.P.H., Director
H. David Bruton, M.D., Secretary February 3, 1998
Eileen C. Kugler, Division Director
Nursing and Personal Health Services
Orange County Health Department
P.O. Box 8181, 300 W. Tryon Street
Hillsborough, NC 27278
Dear Eileen:
Thank you for submitting the Focus on Families: Intensive Home Visiting Program proposal for a Home
Visiting Demonstration Projects grant. Eighteen proposals were received and carefully reviewed. Each
proposal reflected a high level of interagency involvement and thoughtful planning. I am pleased to tell
you that Orange County's proposal has been selected for funding.
Because of the excellent quality of the proposals, the decision was made to fund seven. Each project will
receive $100,000 in grant funds for year two. We are able to award $105,000 to your project for year
one. Please prepare revised budgets for both years and fax them to Beverly Hester (919- 715 -3187) by
Monday, February 9 in preparation for your meeting with her, Jess Berman and Jo O'Keefe on
Wednesday, February 11 from 9:00 to 10:15 AM. The purpose of the meeting is to review your budget,
contract and technical needs. The meeting will be in Room 306 at 1330 St. Mary's St., Raleigh. A map
is attached.
The reviewers found many strengths in your proposal. Among these were the extensive history of home
visiting efforts in Orange County; the careful planning process, which included surveys of workers and
families; a triage process with services based on the family's needs; agreement from UNC Hospital for
universal screening; strong training and supervision components; good in -kind support; the use of
volunteers; and linkage with EMS Home Safety Visits.
We greatly appreciate the investment of time, effort and energy and the commitment to enhancing
services for families which your proposal represents, and we look forward to working with you. If you
have any questions, please call me (919- 715 -3808) or Beverly Hester (919 -715- 3905).
Sincerely,
Tom Vitaglione, Chief
Children and Youth Section
cc: Rosemary Summers Jo O'Keefe
Jess Berman WCH Regional Nurse and Social Work Consultants
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