NORTH CAROLINA & HOME VISITING
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1 NORTH CAROLINA & HOME VISITING A Case Study of Evidence-Based Program Implementation in North Carolina s Maternal, Infant, and Early Childhood Home Visiting Program Laura Louison, MSW, MSPH NC MIECHV Program Director NC Division of Public Health
2 Home visiting Services provided by qualified professionals in the home to parents from pregnancy through birth and early childhood Outcomes supported by home visiting include: Maternal Health Child Health Family Economic Self-Sufficiency Positive Parenting Child Development & School Readiness Juvenile Delinquency, Family Violence & Crime Reduction Pew Center 2010
3 Home visiting pre-miechv Network of various home visiting models across North Carolina with varying funders, expectations, scaffolding and infrastructure Strong public and private support for home visiting programs NC DHHS The Duke Endowment Kate B. Reynolds Foundation Blue Cross Blue Shield Foundation North Carolina Partnership for Children Prevent Child Abuse North Carolina Office of Head Start The Alliance for Evidence-based Family Strengthening Programs 2008 commitment to funding Nurse-Family Partnership First vision of statewide infrastructure to support implementation
4 Federal Legislation Patient Protection and Affordable Care Act of 2010 (P.L ) funding creates the Maternal, Infant, and Early Childhood Home Visiting Program MIECHV Formula grant program designed to: Strengthen and improve Title V programs and activities Improve coordination of services for at- risk communities; and Identify and provide comprehensive services to improve outcomes for families who reside in at-risk communities. North Carolina formula grant awards ( ): : 2.2 million : 3.2 million Competitive application unfunded
5 Evidence-based home visiting Funding reserved for one or more evidence-based home visiting models. Evidence-based criteria determined by the Mathematica Home Visiting Evidence of Effectiveness (HomVEE) Project: North Carolina supports: Nurse-Family Partnership Healthy Families America Parents as Teachers Early Head Start/Home Based Option
6 North Carolina MIECHV Program Vision: All children will grow up in environments that are safe and supportive, and that promote each child s physical emotional, cognitive and behavioral health Goal: Coordinate an effective statewide planning and implementation system through a strong alliance with key partners Advisory Group: Use the Early Childhood Advisory Council to optimize strong leadership, coordination and implementation at state and local levels.
7 NC MIECHV: Implementation GOAL: Implement a strong support network to assist local community service providers in implementing evidencebased home visiting models Implementation Stages: Exploration & sustainability Installation Initial implementation Full implementation
8 MIECHV Timeline State Needs Assessment Updated State Plan Competitive Award submitted Sites fully funded September May June July October January RFA to identify local sites State Plan Notice of Formula Grant Award
9 9 NC MIECHV: Exploration & Sustainability Assessing feasibility and understanding need State: Home visiting within the state s comprehensive early childhood system? Sustainability Stakeholder input and feedback Local: RFP Process Site visits
10 MIECHV Funded Sites MITCHELL AVERY WATAUGA ASHE ALLEGHANY WILKES SURRY YADKIN STOKES FORSYTH ROCKINGHAM GUILFORD CASWELL ORANGE PERSON GRANVILLE VANCE FRANKLIN WARREN HALIFAX NORTHAMPTON HERTFORD BERTIE GATES C H O W PERQUIMAN A S N CURRITUCK MADISON YANCEY CALDWELL ALEXANDER DAVIE ALAMANCE DURHAM NASH EDGECOMBE BURKE IREDELL DAVIDSON WAKE MARTIN WASHINGTON TYRELL DARE HAYWOOD BUNCOMBE McDOWELL CATAWBA ROWAN RANDOLPH CHATHAM WILSON PITT BEAUFORT SWAIN HYDE CHEROKEE GRAHAM CLAY MACON JACKSON HENDERSON TRANSYLVANIA POLK RUTHERFORD LINCOLN CLEVELAND GASTON CABARRUS MECKLENBURG STANLY MONTGOMERY MOORE LEE HARNETT JOHNSTON WAYNE GREENE LENOIR CRAVEN PAMLICO UNION ANSON RICHMOND HOKE CUMBERLAND SAMPSON DUPLIN JONES SCOTLAND ONSLOW CARTERET ROBESON BLADEN PENDER Buncombe Nurse-Family Partnership expansion NEW Durham Healthy Families America expansion COLUMBUS HANOVER BRUNSWICK Gaston Nurse-Family Partnership start up Northampton, Halifax, Hertford & Edgecombe Nurse-Family Partnership start-up Toe River (Mitchell & Yancey counties) Healthy Families America start-up Robeson & Columbus Nurse-Family Partnership expansion Burke Healthy Families America expansion
11 NC MIECHV: Installation Selection Training Performance Assessment (Fidelity) Coaching Competency Competency Drivers Drivers Integrated & Compensatory Systems Intervention Organization Organization Drivers Drivers Facilitative Administration Decision Support Data System Adaptive Leadership Technical Fixsen & Blase, 2008
12 NC MIECHV: State Installation Consultation from the National Implementation Research Network & The Finance Project Challenges: Establishing a state-level Implementation Team Funding sites Developing an effective state-wide data system
13 NC MIECHV: State Implementation Team NC MIECHV Program Director Nurse-Family Partnership Healthy Families America NIRN The Finance Project Nurse-Family Partnership State Nurse Consultant Data Manager/ Quality Improvement Coach Program Consultant
14 NC MIECHV: Local Installation Site visits prior to contract initiation Mutual expectations Establishing communication mechanisms to ensure a policy practice loop Lessons learned (hiring, data system building) Training Focus on installation activities Site interest in selection
15 NC MIECHV: Local Case Study Multi-county rural implementation initiative Challenges Mutual expectations Workforce Scaffolding State TA Terms of reference Communication Community of practice
16 NC MIECHV: Expansion Prepared competitive expansion award (unfunded) Challenges: Envisioning expansion strategy that capitalized on existing programs without overburdening programs State sponsored teams Local expansions Creating infrastructure for home visiting models Compressed timeline
17 Contact Information Laura Louison, MSW, MSPH NC MIECHV Program Director Children & Youth Branch Women's and Children's Health Section North Carolina Division of Public Health (work)
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