Lynn H. Kosanovich, HFA Regional Director

1
Introduction to the Model

• Lynn H. Kosanovich, HFA Regional Director

2
Presentation Overview
History Rationale for Healthy Families
America Model Goals 12 Critical
Elements Our Philosophy Strengths
of the Model Affiliation and Accreditation
3
History

• 1970s - HI Healthy Start designed to prevent CAN
  based on Dr. Henry Kempe (Battered Child
  Syndrome) work in CO
• 1992 PCA, HI Healthy Start and Ronald McDonald
  House Charities
• Developed 12 Critical Elements based on HI
  Healthy Start Model Literature Review
• 1995 Accreditation and formal affiliation
• 1997 Accreditation of Multi-Site Systems
• Training, TA, PP, Data, Evaluation

• History
• Rationale
• Model
• Goals
• Critical Elements
• Philosophies
• Strengths
• Affiliation

4
Rationale for HFA

• Child Welfare Gateway In 2006 CAN rates were
  highest among children under 3
• 44.2 of fatalities in 2006 were children under
  age one
• 78 of fatalities occurred under the age of 4
• 76 of fatalities were committed by one or both
  parents

• History
• Rationale
• Model
• Goals
• Critical Elements
• Philosophies
• Strengths
• Affiliation

5
Rationale for HFA (cont.)
ACE Study (Adverse Childhood Experiences)

• More than a decade and more than 17,000
  individuals
• CDC Kaiser Health Plans Department of
  Preventive Medicine in San Diego, CA
• Connection between ACE physical and mental
  health of adults including the major causes for
  adult mortality in the United States
• Early childhood trauma clearly contributes to
  serious health issues later in life

6
Vision-Mission-Goals

• Our Vision All children receive nurturing care
  from their family essential to leading a healthy
  and productive life.
• Our Mission To promote child well-being and
  prevent the abuse and neglect of our nations
  children through home visiting services.
• HFA Program Goals
• Build and sustain community partnerships to
  systematically engage overburdened families in
  home visiting services prenatally or at birth.
• Cultivate and strengthen nurturing parent-child
  relationships.
• Promote healthy childhood growth and development.
• Enhance family functioning by reducing risk and
• building protective factors.

• History
• Rationale
• Model
• Goals
• Critical Elements
• Philosophies
• Strengths
• Affiliation

7
12 Critical Elements

• Service Initiation (CE 1-3)
• Linking, assessing and reaching out to families
• Service Content (CE 4-8)
• What happens during a home visit
• Staff Characteristics (9-12)
• Hiring, training supervising staff

• History
• Rationale
• Model
• Goals
• Critical Elements
• Philosophies
• Strengths
• Affiliation

8
Critical Elements Service Initiation

• Initiate Prenatally or At Birth (CE 1)
• Target population
• Relationships in the community
• Standardized Assessment (CE 2)
• Used to identify those most in need and those
  most likely to benefit
• Offer Services Voluntarily
• Creatively Reach Out (CE 3)
• Families more likely to participate
• Working with participants who need us to build
  their trust

9
Critical Elements Service Content

• Offer Intense, Long-term Services, Criteria for
  Increasing Decreasing (CE 4)
• Must be offered three to five years
• Leveling system to determine intensity of
  services family progress
• Culturally Sensitive Services (CE 5)
• Training on unique characteristics
• Staff-participant interaction
• Sensitivity toward family values, beliefs
  customs
• Appropriate materials

10
Critical Elements Service Content (cont.)

• Focus on Parent as Well as Child (CE 6)
• Review issues on assessment
• Develop Goal Plans about the process
• Curriculum PCI, Child Development, Health
  Safety
• Developmental Screens ASQ
• Follow-up with children suspected or identified
  with delays
• Linked to Medical Provider Other Services (CE
  7)
• Medical Home
• Immunizations
• Referrals
• Limited Caseloads (CE 8)
• Sufficient time to connect with families

11
Critical Elements Staff Characteristics

• Personal Characteristics, Skills Knowledge (CE
  9)
• Important for staff to build relationships with
  diverse populations
• Basic Training Role Specific Training (CE 10
  11)
• Orientation, role specific, wraparound ongoing
• Supervision (CE 12)
• Ongoing effective, develop realistic
  effective plans to empower families, express
  concerns frustrations
• Reflective, Clinical and Administrative
• Governance Administration
• Not a Critical Element

12
Our Philosophies

• Early nurturing relationships are the foundation
  for life-long healthy development.
• Infant Mental Health
• Strength-based
• Parallel Process
• Family-Centered
• Culturally Sensitive
• Valuing Fathers
• Reflective Practice

• History
• Rationale
• Model
• Goals
• Critical Elements
• Philosophies
• Strengths
• Affiliation

13
Strengths of the HFA Model

• Flexibility
• Target population
• Child development parent-child interaction
  curricula
• Staffing requirements
• Comprehensive Assessment Services
• Determine families most likely to benefit
• Refer families to community resources
• Used as Single Point of Entry
• Creative Outreach
• Focus on building trust

• History
• Rationale
• Model
• Goals
• Critical Elements
• Philosophies
• Strengths
• Affiliation

14
Strengths of the HFA Model (cont.)

• Service Intensity
• Weekly for a minimum of six months after birth
• Decreases as family competencies increase
• Offered three to five years
• Focus on Parent as Well as the Child
• Comprehensive Training
• Parent Survey
• Integrated Strategies for Home Visitors
• Wraparound Training Distance Learning
• Accreditation
• State Systems

15
Affiliation Accreditation

• Suggested criteria
• Ability to access parents prenatally or at birth
• Experience with home visiting
• Infrastructure to support HFA best practice
  standards
• Physical space to house program
• Affiliation
• Complete application and implementation plan
• Send, with 500 fee, to Chicago address listed on
  application
• Complete phone call with Lynn Kosanovich, HFA
  regional director

• History
• Rationale
• Model
• Goals
• Critical Elements
• Philosophies
• Strengths
• Affiliation

16
Implementation Accreditation

• Accreditation
• 1st time within 2 years of affiliation (every 4
  years after that)
• Based on 12 Critical Elements
• Self-study
• Site Visit
• Panel response

17

• Contact Info
• Lynn Kosanovich
• Healthy Families America Regional Director
• lkosanovich_at_preventchildabuse.org
• 703-888-3135