Fall Quality Improvement Group: Program Acceptance. Background

Transcription

1 Background Fall 2014 Quality Improvement Group: Program Acceptance Every Healthy Families team member is valuable. The specific role of the FAW in the HFF model is a unique position that carries great responsibility. The professional in this role is the families very first contact and first impression. The FAW plays an instrumental role in ensuring that families have access to quality home visiting services that are proven to prevent abuse and neglect. Over the course of three months, the HFF Central Office organized a series of conference calls focusing on the importance of program acceptance. A group of program managers, FAWs, FAWSs, and other team members participated and shared challenges, as well as strategies, for improving program acceptance across projects and communities. Following is a high level summary of take-aways from these conversations and from other sources of information. Strategies listed below may not work for every project. This summary is meant to be used to assist in critical thinking around ways to improve program acceptance that meet the needs of each individual project. These ideas were provided by peers across HF projects and central office staff. We thank everyone who contributed both time and ideas to this effort. Please share this resource with members from across your teams. 1

2 Discussion Summary What are some inherent challenges with program acceptance in your local community? Time - trying to schedule assessments within one week to ensure less time between when a parent completes the screen and when the assessment occurs. Mothers/fathers who live with others (renting, sharing small space with multiple people, temporary living situations, grandparents, etc). o Sometimes the maternal grandmother wants the services for her pregnant daughter more than the daughter wants services for herself. o Fathers sometimes do not want services in the home. o Rent is expensive - serving many families that are couch surfing. The FAW engaged the family and the family accepted, however it ended up being the wrong FSW fit for the family. Teen mothers are a unique challenge. Working and going to school weekly is often times too much. Substance use, domestic violence and mental health issues. Cannot or difficult time making first contact with the family. Closed communities or communities where trust is hard to earn. Families move across state lines and seasonal working families. Transient population that travels between county lines because no available or affordable housing. Influx of families moving into the county and quickly learning that they cannot afford to stay seeing a recent trend of increased Moved Out of Service Area (MOOSA). 2

3 Consistency of receiving an adequate number of Healthy Start Coalition Prenatal Risk Screens and/or Healthy Families Record Screens. STRATEGIES: Host a bi-annual lunch-in as a way to stay connected with the local Healthy Start Coalition team. This potluck event can serve to bring staff together and strengthen the local relationship between Healthy Start and Healthy Families. Hold monthly Healthy Start provider meetings as a way to stay connected and share information. Have a team member from Healthy Start serve on the Advisory Board. Be very active in the community connecting with the local WIC office weekly, contacting local schools to be sure they are aware of Healthy Families (especially for teen mothers). Schedule time for FAW to spend time meeting with families and discussing services in DOH Clinics, Mid-Wife Clinics, and Birthing Centers. Invite mid-wife and/or doulas in the community to a local training, lunch or reception to explain HF and the benefits to families. Have the FAW frequent the local Early Learning Coalition as a service to families seeking child care assistance. Reach out to local Early Learning Coalition to ensure that your local Healthy Families program is included on the list of resources shared by the Child Care Resource and Referral (CCR&R) specialists. Work closely with local transitional shelters. Frequent local hospitals. 3

4 Selling the program to ensure buy-in and participation at assessment. STRATEGIES: Critical that the FAW sells the program, is excited about his/her work, and sets clear expectations about the next steps in the process. This can include talking up the FSW and his/her skills and discussing what the family will get in return for their time and effort. Critical piece that the FAW is the right person for the job this skill set is unique and their work is challenging - someone that can have a poker face and hold professional lines is important. Must have the right personality fit in this position including being energetic, kind, patient and compassionate. Many projects use a flip chart that walks a family through the pieces and parts of Healthy Families, should they be eligible. Helps keep the messaging about the program consistent across FAWs and families. Find this resource on the HFF resource library. Equip the FAW with actual pictures of FSWs on the team with five listed descriptions about each to help make the connection between the work of the FAW and the actual home visitation work. Link the HF program description to what specific needs/interests the family might have. FAW ends the assessment process with a question about what interests the family in the Healthy Families program. FAW ends the process with asking what might challenge you in participating? This type of feedback is extremely useful to the FSW. A folder is left behind with community resources as well as a hand-made baby blanket made by a volunteer for each family. Goodie bag cater the items in the bag to fit the unique needs of the family, to meet them where they are, including non-target children. 4

5 Selling the program to ensure buy-in and participation at assessment. STRATEGIES (CONTINUED): Present resources, conduct the assessment and use a flip chart to describe the program. At the end of the assessment, parents are asked if they would like to build a bigger bag of resources. After the HFFAT is scored make an immediate assignment to the appropriate FSW the less time between assessment and assignment, the better. We must remember that a lot can happen in a family s life in one week s time, enough so that interest could be lost. FAW can keep weekly contact with a family until an FSW is assigned as a way to stay connected and potentially keep interest. FSW will shadow the FAW when there is time in both schedules. Closed communities we rely on our partners in those areas to help get our foot in the door. Host baby showers and post flyers in grocery stores, food banks and other community organizations. FAW teaches parenting classes at a local High School. Focus on local Teen Parent Schools. Utilize text messaging. When approaching a situation where the mother lives with others, the FAW tries to find a time to conduct the assessment when everyone is home so she can leave an impression that she is not a stranger. Consider expanding zip codes. 5

6 Keeping FAW skills sharp. Administering the HFFAT is an art that requires practiced skill. STRATEGIES: The Supervisor will shadow the FAW soon after attending FAW Core Training to ensure bad habits are corrected quickly. Cross-training ensures that everyone understands the differences in work responsibilities and can connect as a team member better. During FAW supervision a focus on their skill development is critical. If the supervisor senses that the FAW is struggling, then the supervisor can schedule a shadow to observe and broaden the discussion to ensure the FAW is supported. HFF create a training video of a live assessment to use before, during and after FAW training. Practice and role play interviews and assessments for on-going skill development. Incorporate regular team building exercises. Do not start the assessment in order, beginning with basic needs. Start with the prenatal section because it is an easy way to connect with an expectant mother easily relatable before moving to more serious areas. Some FAWs struggle with asking about the significant other, substance abuse and mental health. On-going training is helpful to keep skills in these areas strong. Use the Probing Questions document (attached) during supervision to practice creative and conversational ways to gather data on the HFFAT. While the FAW waits to receive required trainings have him/her shadow other team members, practice the assessments, and begin making relationships in the community (especially with major referral programs). 6

7 Other Strategies to Improve Program Acceptance Use the Performance Management System to review data: In the Screens/Assessments Menu: o Use the Aggregate Report for Assessment Results report to analyze refusal at assessment versus refusals during creative outreach. This report can also be pulled by staff member. o Use the Participant Assessments by Result report and sort results by assessment result and compare these against HFFAT sores and by staff member. Regularly review related standards and polices including: o Policy #1-02 Screening and Assessing Families HFA Standards: 1-1.B-C, 1-2.A-E, 2-1.A, 2-2.A o Policy #3-02 Creative, Respectful Outreach and Voluntary Services HFA Standards: 3-1, 3-2, 3-3 o Policy #11-02 Promotion of Positive Parenting and Knowledge of Child Development HFA Standards: 6-4.A-B, 6-5.A-B o Policy #19-02 Screening and Selection of Staff HFA Standards: 9-1, 9-3.A-B o Policy #49-09 Serving Non-target Children o Policy #52-13 Providing Services to the Deaf and Hard of Hearing Retake as a refresher course the following training: o FAW Core o Motivational Interviewing o Assessment Strategies and Techniques for FAWs Review and revisit the Capacity Funnel (also on Resource Library) Review and incorporate the use of the HFF Probing Questions document (FAW Core training materials) Thank you. Healthy Families Florida s mission is to provide a statewide system of voluntary, community-based home visiting services that strengthens families, promotes positive parent-child relationships and optimizes a child s health and development so that child maltreatment and other poor child outcomes can be prevented. 7