Florida’s Home Visiting Coalition

By Annette Phelps, ARNP, MSN
Division Director for Family Health Services
Division of Family Health Services
Florida Department of Health 

Carol Scoggins, MS
Program Administrator, Maternal and Child Health
Infant, Maternal and Reproductive Health
Bureau of Family and Community Health 

Kris-Tena Albers, CNM, MN
Executive Community Health Nursing Director
Infant, Maternal and Reproductive Health
Bureau of Family and Community Health 
 

Florida’s Home Visiting Coalition shares a passion for and commitment to improving the well-being of Florida’s families and their children. The Coalition members recognize home visiting as a critical service delivery strategy and research-based approach for building trusting relationships with parents and other caregivers with the knowledge, skills and tools to assist their children in being healthy, safe and ready to succeed in school. The Coalition is committed to maintaining an on-going, direct and honest dialogue and improved communication among programs to ensure collaboration and coordination and an integrated system of care. Family Health Services, Florida Department of Health is a member of the Coalition’s Steering Committee. While each program is uniquely designed and has unique goals, all of the following have a valuable role to play in meeting the complex and diverse needs of families and communities across Florida: 

Healthy Start is a maternal and child health program funded with state and federal funds including Title V that has three distinct components: prenatal and infant risk screening, community-based coalitions and direct health-related services to pregnant women, interconception women and children birth to age 3. Through an allocation methodology developed jointly between the Florida Department of Health and the 31 Healthy Start coalitions, funds are distributed to the coalitions to support infrastructure building and the provision of services to the maternal child health population. Since Healthy Start started in 1992, the infant mortality rate has dropped 19 percent, and since 1997, there has been a leveling of infant mortality rates in Florida. 

Federal Healthy Start implements community-driven approaches to reduce infant mortality rates by affecting maternal behavioral and medical risk factors and promoting healthy outcomes for women and their families. Florida has six Federal Healthy Start programs across the state. Each community awarded funds assures the availability of a core set of services and activities for the perinatal population in their project area. These services include case management, home visiting and links to health care and other needed services for mothers and their infants. In addition, each Healthy Start project is required to have a community-based consortium composed of individuals and organizations that includes women and families served by their project. Additionally, the consortium is to collaborate with their state Title V (MCH) agency, and to implement a local health system action plan to improve the quality, cultural competence of and access to services and/or to address other problems in the local system of care. 

Early Steps serves children (under the age of 36 months) who have a physical or mental condition or has a developmental delay. There are no financial eligibility requirements. In 2009, the Early Steps program provided early intervention services to 37,691 children and their families in their natural environments.  

Healthy Families Florida is a child abuse prevention program that provides home visiting services to parents expecting a baby and to parents of newborns. The program delivers home visitation services to children up to age 5 in families who need long term intervention and targets the parent/child interaction to build parenting knowledge and skills. The program attempts to select and train staff that represent the cultural make up of the communities they serve and caseloads are capped. Healthy Families Florida is a uniform national model nationally accredited by Prevent Child Abuse America/Healthy Families America.  

Home Instruction for Parents of Preschool Youngsters (HIPPY) program is a home-based, family focused program that assists parents to provide educational enrichment for their preschool child. Because parents play a critical role in their children's education, the HIPPY program seeks to support those parents who may not feel that they have the skills to help their children prepare for school.  

Parents as Teachers program provides support to parents of children from prenatal to 3 years of age. The purpose is to help families prepare their children for school by providing home visitation by parent educators who are certified or meet the requirements of the Born to Learn Institute. 

Head Start program promotes school readiness by enhancing the social and cognitive development of children through the provision of educational, health, nutritional and social services to enrolled children and families. Head Start services are available in every county in the state and more than 40,000 children and their families are being served each year. Early Head Start services (birth to 3 years of age) are also available in approximately a third of the state’s counties. 

New Parent Support (NPSP) program was established by federal law in order to help build strong healthy military families and is a part of the Family Advocacy Program (FAP). The program benefits military families who are expecting a child, or who have children up to 3 years of age. The program includes home visits, and may also include supervised playgroups as well as parenting classes and resources.  

Nurse Family Partnership (NFP) is an evidence-based, community health program that partners vulnerable women pregnant with their first child with a registered nurse early in her pregnancy. Ongoing visits continue through the child’s second birthday. The program is administered in one site through the Children’s Services Council (CSC) of Palm Beach County which is a special district of local government that levies property tax dollars to provide funding for programs serving children and families. In the last few years, the pressure for no-nonsense spending has instigated the movement toward ensuring that funds are provided to primary prevention and evidence-based early intervention programs that demonstrate a return on investment. Out of this philosophy, the CSC has incorporated “The Journey to Evidence Based Programming: Changing the face of Social Services” – a focus on using research and data for continuous learning and improvement into its decision-making process for funding service delivery systems and systems of care. 

Federal Healthy Start Projects implements community-driven approaches to address infant mortality rates by reducing maternal behavioral and medical risk factors and promoting healthy outcomes for women and their families. Beginning with prenatal care and continuing through the infant's second year of life, each community awarded funds assures the availability of a core set of services and activities for the perinatal population in their project area. These services include case management, home visiting and links to health care and other needed services for mothers and their infants. In addition, each Healthy Start project is required to have a community-based consortium composed of individuals and organizations and that includes women and families served by their project, to collaborate with their state Title V (MCH) agency, and to implement a local health system action plan to improve the quality, cultural competence of and access to services and/or to address other problems in the local system of care.