Sonoma County Home Visiting Advisory Council Meeting Minutes The purpose of the Sonoma County Home Visiting Advisory Council is to provide community support and guidance promoting program quality and sustainability to improve the health of Sonoma County. Meeting Title: Sonoma County Home Visiting Advisory Council Facilitator: Pauline Richardson, MCAH Home Visiting Program Manager Recorder: Ulla Mast, PH MCAH Date/Time: Wednesday, December 10, 2014-8:30am Location: Lawrence Cook Middle School, 2480 Sebastopol Rd, Santa Rosa 95407 Distribution List Sonoma County Advisory Council Members & Supporters Meeting Attendance: Attended Organization 1 Pauline Richardson MCAH Home Visiting 2 Elisabeth Chicoine PH-MCAH 3 Jace Chalon PH-Field Nursing 4 Sheri Creekmore PH-NFP 5 Angie Dillon-Shore Human Services 6 Tracy Greenwald PH-NFP 7 Nancy Martin PH NFP 8 Kathryn Pack First 5 9 Jeanette Swanstrom 4 C s 10 Marta Tilling CAP 11 Michelle Whitman Representing Supervisor Shirlee Zane Meeting Minutes: 1. Welcome, Introductions and Overview The meeting was called to order at 8:30 a.m. by Pauline Richardson and introductions were made. Richardson announced plans for the meeting to include a presentation on the Nurse-Family Partnership Joint Visiting Observation tool, Protective Factors Survey scoring, Home Visiting Collaborative handout and a presentation on and tour of Via Esperanza, AVANCE and Pasitos. 2. a) Tracy Greenwald, Supervising Public Health Nurse with Nurse-Family Partnership explained how local NFP programs ensure fidelity to the national NFP curriculum by doing joint home visits with the home visiting nurses. These joint home visits provide the nurses with feedback on their uses of NFP model aspects, are one-on-one, and occur once every four months. Joint Visiting Observation The reflections prior to the home visit include what is being worked on, and how the whole program and current visit is being approached. During the visit the supervisor is: There to watch elements unfold Look for elements of NFP and how they are integrated Home visiting structures have a holistic view, inclusive of personal health, maternal role, environment, life course development, family and friends, health and human resources
Page 2 Aspects looked for in the nurse s parent-child intervention include: How the mother s self-confidence and self-efficacy in regards to parenting her child are built Are parenting concepts presented in an engaging manner? Does the nurse demonstrate how to engage the child? Does the nurse support the client in engaging her own child? Does the nurse help the client reflect on how interaction went? A major part of NFP is the tools that are used during client visits, which include motivational interviewing and client-centered principles (i.e. how does the nurse interact with the client): Guiding versus directing Asking open-ended questions Allowing space for the client to answer, reflect, talk Reflective listening Empathy Empowering the client Exploring the clients ambivalence Eliciting the change talk Summarizing what the client has said After the joint visit, the NFP Supervisor has a reflective one-on-one with the nurse, which includes: What the visit/experience felt like. Ensuring the nurse doesn t bring in personal issues, i.e. whether the nurse reacted to client, rather than addressing the client s needs. Where the nurse felt positive or had concerns and what she/he desires to work on. Developing goals based on experience and how they are to be accomplished. Monthly check-ins. Each review section also has a summary at the bottom with the different stages of where a nurse may fall within each section, ranging from one to three. These scores designate where the nurse is in development of her practice: emerging, integrating or intuitive. b) Kathryn Pack addressed the Strengthening Families Protective Factors Survey, which is currently being employed by a variety of home visiting agencies to help families assess their perceptions of how they are doing in the five Protective Factors. The intended use of the tool is to see how families are doing overall. It is not recommended to guide clinical practice. This survey and its usefulness for collective impact measurement will become part of the steering committee work plan for 2015. The Steering Committee Meetings will provide a forum for additional discussion on how agencies are using the tool and collecting data. c) Elisabeth Chicoine presented the Home Visiting Collaborative Handout and talked about the steering committee retreat in January. After months of development, the handout/flyer is now available and includes: A summary of the program Home Visiting Collaborative partners Guiding principles The flyer was put to good use at the State Interagency Team (workgroup of the State of California Home Visiting Program) meeting that Pauline Richardson and Angie Dillon Shore attended. Some of the agencies that participated are the California Department of Health Services, American Academy of Pediatrics, California Department of Social Services, Department of Healthcare Services, American Indian Health Initiative Managed Care Division, California Department of Developmental Services, and MCAH Action representatives from the local community. There was special interest in what Sonoma County is doing because of the collaborative, integrated work with community organizations.
Page 3 The steering committee will have a longer meeting in January to create a detailed work plan for the next year. The work plan will include: Developing systems of care that reduce gaps and duplication of services Strengthening coordinated referral processes Best practices for data sharing Promoting evidence-based programs Sharing supervision best practices Collecting data collectively through the strengthening families program Identifying home visitor core competencies Addressing training needs 3. Collaborative Updates None. 4. Community Announcements MIHA data is a statewide snapshot/survey of maternal and health assessments and is updated annually. Sonoma County is the smallest county included and the state only provides data for the 20 counties with the highest birth rates. Though the sample size for this state-level survey in Sonoma County was 210 participants, and therefore quite small, it is an opportunity to reflect on where Sonoma County excels and also where the County is not doing as well as the state. The data only reflects those areas where there are statistically significant differences. The MCAH epidemiologist is going to do a 3-year trend evaluate more effectively how Sonoma County is doing. This information will be available in 2015. Illustration of why it is important to see this data may be gained by looking at the example of infants sleeping on their backs: at 81%, we appear to be doing quite well because this is significantly better than the state; however, this means that one in five Sonoma County infants are still not being put to sleep on their backs! This is indicative of only one of the areas in which we have considerable work to do. Elisabeth Chicoine and Jenny Mercado will present findings from the CDRT five year report on January 14, 2015, at CPI s Prevent Child Abuse Sonoma County. There are free English as a Second Language classes at Santa Rosa Junior College. An updated brochure on the effects of marijuana is now available in Spanish. Contact Gabrielle Trubach at 707-565-4556 for copies. Additional educational handouts on protecting your family from e-cigarettes, which spell out definitively that e-cigarettes are harmful, are now available in Spanish and English. This information is downloadable at http://www.cdph.ca.gov/programs/tobacco/pages/ctcpfactsheets.aspx (scroll down to environmental exposure to find pdf of this in English and Spanish versions) and was recently included in the Latino Service Providers newsletter. Also, 100 English and 100 Spanish free color hardcopies (plus a very small shipping and tax fee, approx $7-8.00) can be ordered from http://www.tobaccofreecatalog.org/ This can be done annually. 5. Via Esperanza Today s meeting was held at Via Esperanza to see what is available to their clients and to talk about AVANCE, a program that includes a home visiting component. Via Esperanza began about 2.5 years ago by utilizing empty space at Cook Middle School for early childhood parent engagement. Community leaders worked with Santa Rosa City Schools and CAP, and built the program around a
Page 4 two-generation approach. The idea was to have AVANCE, Pasitos, Head Start, and a subsidized preschool all housed together. Via Esperanza was given five classrooms and put together a family resource center. First Five provided $1.3 million in seed money for the first three years. Nubia Padilla presented information on the Via Esperanza programs. All the classes and activities are popular because free child care is offered. Subjects include: English as a Second Language (ESL) English conversation AVANCE Pasitos Padres Unidos Abriendo Puertas / Opening Doors Triple P Group and Individual Counseling Mother s Club Grupo Luna Counseling Groups Individual Counseling Cal-Fresh and Medi-Cal PiYo Conflict Resolution Citizenship Classes NEW (to be added): Financial classes through North Bay Organizing Project Information about the programs and classes will be sent to the HV Collaborative electronically. Marta Tilling from CAP presented information on AVANCE and Pasitos. AVANCE is in its fifth year and serves approximately 140 families with children up to three years old. This evidence-based program was developed in Texas and chosen by First Five as part of their strategic plan for family/parent engagement. It is a nine-month program that meets one morning a week for three hours. Parents have a required number of classes to attend (75%) in order to graduate. Parent education classes are in Spanish and include: Toy making classes, including a possibility sheet Parenting education sessions, including a comprehensive child development class Early Childhood Education Resource hour that speaks to the topic presented in the parent education classes Home Visitation Advocacy Monthly home visitation looks at how the family is functioning across a broad range of health and social issues and answers questions such as: Is the parent emotionally connecting with the child, making play fun or teaching something with a toy in a fun way? Is the child responding or reacting positively? Are sentences being used? Does the parent feel comfortable in the situation? All parents are videotaped and the video is shared with the group. This helps with self-confidence. There is approximately 20 staff on site. AVANCE is also located at Vineyard of Faith in Windsor, Lincoln School, and SCOE s Amorosa Continuation School. Pasitos is for three and four year olds and is constructed as play groups. The self-confidence that parents gained in AVANCE can be seen in this program. There are discussions pending with school districts to track how AVANCE graduates are doing after Pasitos as they move through the educational system. Today s meeting concluded with group tours of each of the programs on site.
Page 5 Remember Our Focus for 2014-15 Growing the home visiting collaborative and spreading the word! Adjournment: Meeting was adjourned at approximately 10:00 a.m. Minutes prepared by: Michelle Denham/Public Health Program Support Administrative Aide Minutes Approved: Pauline Richardson Time & Date of Next Meeting: February 25 8:30-10:00am - CAP 1300 N. Dutton Ave, Santa Rosa