NFP_Community_Presentation PMCHNNJ

© Copyright 2011 Nurse-Family Partnership. All rights reserved.

HOME VISITATION AND COMMUNITY HEALTH NURSESWORKING TOGETHER

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The Greater Passaic Valley Public Health

Nurses' Association

MAY 28, 2015


HOME VISITATION: HELPING FIRST TIME PARENTS SUCCEED

Barbara L. Scanlon, MSN-NMNurse Family Partnership Program SupervisorTeam of 8 Registered NursesCovering Passaic & Bergen Counties

Program Administered by: The Partnership for Maternal and Child Health of

Northern New Jersey

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The Partnership for Maternal and Child Health of Northern New Jersey

•A non-profit 501(c )(3) organization of health care professionals and consumers dedicated to providing education and increasing community awareness by facilitating collaboration among the private sector, the public sector, and maternal and child health care providers for the delivery of high quality coordinated maternal and child health care.

MISSION: •To decrease the disparities in healthcare outcomes between

different socioeconomic, ethnic and racial groups •Eliminating the barriers to health care services for women

and children.•To intensify efforts toward the improvement and prevention of

adverse maternal and child health outcomes by addressing community risk factors.

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•The Improving Pregnancy Outcomes initiative addresses the medical, social, and mental health of the community through the use of Community Health Workers (CHW’s) and a Central Intake system: * funded by the New Jersey Department of Health

•CHWs conduct daily outreach in the community•Educating and assisting community members to access health care and social services by offering resources and case management.

•CHWs refer consumers to the Central Intake program.

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Improving Pregnancy Outcomes


Central Intake

•Central Intake’s role is to increase screening, referral and linkage of community members to needed services such as home visitation programs or to CHW’s for case management.

•Central Intake (CI) coordinates with outreach (CHWs) to locate women & families without telephones to connect to the health care system that fits their needs.

•Together, these programs are designed to have a significant and positive impact on the overall well-being of the county’s residents.

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Healthy Families / TIP Program

Program Overview

• The Passaic County Healthy Families / TANF Initiative for Parents (TIP) Program is a home visitation program that assists families in urban Passaic County. • The program guides and supports families by providing information on child development, parenting, & self care.• A home visitor will assess the needs of the family and will provide appropriate referrals to health and community services. •Visit’s are provided in the comfort of the family’s home for the child’s first three years.

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Healthy Families / TIP Program

Program Requirements

• Any pregnant woman of low income (WIC standards) in the service area – or before the baby is 3 months old.•IF the family is receiving TANF benefits in Passaic County: they can be enrolled before the baby is 12 months old.•The Family must reside in Passaic County (or the county of residence where the program is located.)•Services are free, voluntary and confidential.

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Parents as Teachers: Program Overview

•A home visiting program for first time parents.•Parent educators support parents to reach personal goals and assist them with parenting skills.

•The program provides information, guidance, support and referrals to community agencies.

- Services are free, voluntary and confidential. - Home visits can continue until the child turns 3 years old.

Program Requirements•The program welcomes first time moms or dads during pregnancy or have a baby up to 6 months of age.

•Parents must meet low income criteria (WIC standards).

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"They always say babies don’t come with instruction manuals, but if there was one, the Nurse-Family Partnership would be it."

Andrea, Mom from Pennsylvania

Cover this gray area with one of the 8 provided filmstrip photo JPG files.


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Nurse-Family Partnership is…• An evidence-based, community health program • Transforming lives of vulnerable first-time mothers

living in our community• Improving: - prenatal care - quality of parenting

and - life prospects for mothers … by partnering them with a registered nurse.

• Every dollar invested in Nurse-Family Partnership can yield up to five dollars in return.

Overview

Working Together to Ensure Healthier FamiliesNurse-Family Partnership Overview



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Program Goals

• Improve pregnancy outcomes

• Improve child health and development

• Improve parents’ economic self-sufficiency

• First-time, at-risk mothers of any age

• Registered nurses• Intensive services

(intensity, duration)• Focus on behavior• Program fidelity

(performance management system)

• Data Collection

• Knowledge, judgment and skills

• High level of trust, low stigma

• Credibility and perceived authority

• Nursing theory and practice at core of home visitation model

Key Program Components

Why Nurses?



•Program eligibility includes: –Clients must be first time moms–Clients must be enrolled by 28 weeks pregnant.–Clients must live in an area served by NFP Nurse Home Visitors.

–Focused on Low income families•Participation in NFP is completely voluntary.•There is no fee for participating in the program.

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•Duration: - visits start during pregnancy (by 28 weeks gestation)

- continue until the child’s 2ND birthday and graduates from the program.

•Visit schedule: - visits are weekly for the first 4 weeks, - then bi-weekly until baby is born. - weekly again for the first 6 weeks post-partum. - then bi-weekly until the baby is 21 months. - final 3 visits are monthly until graduation from the program at 24 months.



•Basic health assessments of mother and baby are completed.•NFP nurse home visitors work closely with community health care

agencies, physicians, social workers and other health care professionals to provide comprehensive nursing care and referrals.

• Visits are tailored to meet the learning needs of each individual client and to help ensure each mom delivers a healthy baby.

•From helping clients have a healthy pregnancy, to coaching them on child development, to empowering them to pursue their heart's desire, each nurse home visitor is there for the clients - so the clients can be the best moms for their babies.

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A home visit focuses on6 client centered domains

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Personal HealthHealth Maintenance PracticesNutrition and ExerciseSubstance Use Mental Health Functioning

Environmental HealthHome, Work, School, and Neighborhood

Life Course DevelopmentFamily PlanningEducation and Livelihood

Maternal RoleMothering RolePhysical CareBehavioral and Emotional Care

Family and FriendsPersonal network RelationshipsAssistance with Childcare

Health and Human ServicesService Utilization



Who does NFP serve:

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"The great thing about Nurse-Family Partnership is that it works. To put it simply…it decreases about everything you want to decrease and increases about everything you’d want it to increase."

Dr. Thomas R. Frieden, former New York City Health Commissioner (now Director, CDC, and Administrator, Agency for Toxic Substances and Disease Registry)



19Research


Evidence-Based Policy

20Research

The Coalition for Evidence-Based Policy

has cited Nurse-Family Partnership -

“as one of only two interventions meeting the Top Tier, - and if implemented more broadly, could help spark rapid progress against major national problems.”

“ This program saves money. It raises healthy babies and creates better parents.

It reduces childhood injuries and unintended pregnancies,

increased father involvement and increased women's employment,

reduced use of welfare and food stamps,

and increased children's school readiness."

Barack Obama, U.S. Senator (44th president )



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Nurse-Family Partnership is Cost-Effective

•The RAND Corporation estimates Nurse-Family Partnership can return up to $5.70 for each $1 spent on the program.*

Savings accrue to government from decreased spending on:- health care - criminal justice- child protection - mental health - education - public assistance

- And increased taxes paid by employed parents

•Nurse-Family Partnership returns more than $18,000 over and above program costs for each family enrolled.**

(Washington State Institute for Public Policy 2008)

Monetary Benefits to Society

* RAND Corporation 1998, 2005; return for highest risk families** Savings related to low birth weight, child injuries and immunizations not included



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Anticipated program effects per 100 participating families

•50% decrease in language delays at 21 months resulting in a savings of $133,000-$440,000*

•50% reduction in child abuse and neglect among children from birth to two years, resulting in a savings of $38,500*

•29% reduction in subsequent births within two years after the birth of the first child and a 14% increase in time between first and second births, reducing risk of premature delivery and saving $80,933 for every premature birth that was prevented*

*Source: New York City Department of Health and Mental Hygiene 2004




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Used with permission from the Prevention Research Center for the Promotion of Human Development/2005 data

Fayette County, PA

Number of families served 280

Benefit minus cost per family $37,367

Per dollar return on investment

$3.59

Total economic benefit for Fayette County

$10,462,707

State of PA

Estimated number of NFP programs statewide

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Estimated number of families served statewide

3200

Total potential economic benefit statewide

$119,574, 400




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Sources of Nurse-Family Partnership Funding

• Maternal, Infant and Early Childhood Home Visiting Program (Federal)

• MIECHV – Administered through DCF in NJ

How It Works

Over more than three decades, Nurse-Family Partnership has been developed, tested, and replicated in community settings.

NURSE-FAMILY PARTNERSHIP SNAPSHOT

* Nurse-Family Partnership® (NFP) is an evidence-based, community health program that helps transform the lives of vulnerable first time mothers.

* Each mother NFP serves is partnered with a registered nurse early in pregnancy and receives ongoing nurse home visits that continue through the child’s 2nd birthday.

* Independent research shows that communities benefit from this relationship — every dollar invested in Nurse-Family Partnership can yield over five dollars in return.

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IMPLEMENTATION OF NFP:

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•Number of families served since 1996: 212,289•Number of families currently enrolled: 31,284•Number of nurse home visitors: 1,832•Number of counties implementing the program: 560

•Number of states where the program is serving clients: 43 + U.S. Virgin Islands

April 2015



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Nurse-Family Partnership is a growing, national program

States that NFP serves

Number of counties NFP is serving

Where we work

560

Tribal agencies are denoted by Band

43 + U.S. Virgin Islands

Number of nurse home visitors: 1832



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The National Service Office

How It Works

Insert photos from office not nurse and mom

• Prepares communities and agencies to implement Nurse-Family Partnership model with fidelity

• Educates nurse home visitors and nurse supervisors• Provides ongoing clinical support• Provides ongoing agency management and operations support• Advocates for local political support and long-term resources • Provides resources/training for marketing and community outreach• Collects and evaluates data to ensure quality services and

to guide quality improvement



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Characteristics of Nurse-Family Partnership Implementing Agencies

•Strong reputation•Excellent working relationships•Committed•Flexible and supportive of nursing staff

•Financially stable•Effective•Mission driven•Focused on success

How It Works


Partnership for MCH of Northern NJ NFP Teams:

•NFP of Hudson & Union Counties has 5 full time nurses and the capacity to serve up to 130 families - 65 for Hudson and 65 for Union.

•NFP has been serving families in Hudson County since 11/2009 Union County since 2/2012.

•We have 4 bi-lingual (English/Spanish) speaking nurses.

•NFP of Passaic & Bergen Counties has 8 full time nurses and the capacity to serve up to 200 families - 150 for Passaic & 50 for Bergen.

•NFP has been serving families in Passaic County since 09/2007 Bergen County since 11/2013

•We have 3 bi-lingual (English/Spanish) speaking nurses.

•One RN - IBCLC Lactation consultant.

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Currently PMCHNNJ Implements 2 NFP Sites Serving 4 Counties… Hudson, Union, Bergen and

Passaic.

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"The Nurse-Family Partnership empowers first-time mothers with the resources and knowledge to provide an environment in which children can reach their full potential."

Former U.S. Senator Arlen Specter (R-PA)

"The success of the Nurse-Family Partnership is undeniable: this program should be expanded to every community in this country, not just a select few."

Ken Salazar, former U.S. Senator (now Interior Secretary)

"I am very proud that Milwaukee was chosen to be a Nurse-Family Partnership site because this is a proven cost-effective investment in the well-being of children and families."

Milwaukee Mayor Tom Barrett

Nicholas Kristof recognizes NFP in his column about looking beyond K-12 education for solutions: Beyond Education Wars

•“Growing evidence suggests what does work to break the poverty cycle: Start early in life, and coach parents to stimulate their children.

•Randomized controlled trials, the gold standard of evidence, have shown this with programs like Nurse-Family Partnership, Reach Out and Read, and high-quality preschool.

•These kinds of interventions typically produce cognitive gains that last a few years and then fade — but, more important, also produce better life outcomes, such as less crime, fewer teenage pregnancies, higher high school graduation rates, and higher incomes.”

•This column appears in print edition of The New York Times on page A27.

4-23-2015

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We want to especially thank Senator Cory Booker for his support and his recognition that investments in our youngest citizens are wise public investments...

at the Partnership for Maternal and Child Health of Northern New Jersey. 8/20/2014


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Nurse-Family Partnership is Endorsed as a Model Program by

National Institute on Early Education Research

World Health

Organization

Office of Juvenile Justice & Delinquency Prevention

Nurse-Family PartnershipNational Service Office1900 Grant Street, Ste 400Denver, Colorado 80203www.nursefamilypartnership.or

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“If there is any hope that Congress' new health care bill will put some restraints around the growth in medical costs, it rests in the part of the proposal that calls for rewarding programs that reshape how medicine gets practiced…the Administration has the chance to invest in one such program – the Nurse-Family Partnership – when it starts giving out $1.5 billion in home health care grants...” 5.25.10

Full coverage: www.nursefamilypartnership.org > About > News

“Infant development strategies, like other forms of social capital, are perversely distributed in America - fetishized in places where babies are fundamentally secure and likely to prosper, undervalued in places where babies are not. The NFP aims, in a fashion, at equalization.” Katherine Boo 2.6.06

“If you want to invest societal resources where they will have the biggest benefit for all of us, clearly the evidence is there now that protecting children from the worst kinds of deprivation in their youngest years will result in more functional, capable, prosocial citizens.” Martha Farah, director of the Center for Cognitive Neuroscience at the University of PA 3.2.09

“ We're all better off if we make the investment upfront. I would rather see us be involved early and have it be an educational situation, as opposed to no involvement and then become part of the criminal justice system.” Patrick Perez, sheriff of Kane County, IL and member of Fight Crime: Invest in Kids 4.14.10



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Contact Our Programs For More InformationBarbara L. Scanlon, CNM-MSNNurse Family Partnership Supervisor / Program ManagerPassaic & Bergen Counties1 Ottilio TerracePaterson, NJ 07502Cell Phone: (201) 321-7356Office Phone: (973) 904-0856Office Fax: (973) 942-5974Email: [email protected]

Sarah Bilyj RN, BSN, CLCNurse-Family Partnership Supervisor & Site Administrator Hudson and Union Counties65-67 Ruby Brown TerraceJersey City, NJ 07305Office Phone: 201-876-8900 Ext. 242Work Cell: 201-344-3092Office Fax: 201-204-4056Email: [email protected]

Partnership for Maternal and Child Health

of Northern New Jerseywww.partnershipmch.org

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