Building a Prenatal and Early Childhood Home Visiting ...€¦ · Home Visiting Funding Estimates...
Transcript of Building a Prenatal and Early Childhood Home Visiting ...€¦ · Home Visiting Funding Estimates...
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Building a Prenatal and Early Childhood Home Visiting System in Los
Angeles County
Pritzker InitiativeDecember 2018
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• Understanding Why Los Angeles Matters• Demographics, Geography, Governance
• Existing Landscape of Supports• Initial System Building Efforts – Brief History• Universal and Targeted Expansion• Current Opportunity – Seizing Strategic Window• Vision – Integrated System of Progressive Universal Home Visiting• Conclusion and Implementation
Presentation Objectives
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Los Angeles County
• Size that is greater than Delaware and Rhode Island combined
• Population larger than all but 9 states
• About 224 spoken languages
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I forgot the titleHome Visiting Models in Los Angeles County:Intensity and Funding Source
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Home Visiting Models in Los Angeles County: Enrollment Periods
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Home Visiting Funding Estimates in LA County,
FY16-17
First 5 LA, $39 M
44%
Federal Administration for
Children & Families/Early
Head Start, $30M
33%
Dept of Children and
Family Services, State Re-
Alignment, $10.2 M
11%
Dept of Public Health, Net
County Costs and Title XIX
(TCM), $3.9M
4%
DPH, Maternal, Infant,
Early Childhood Home
Visting funds, $1.53M
2%
Dept of Mental Health,
Mental Health Services
Act, $4.7 M
5%
Federal
HRSA,Healthy
Start, $632K
1%
Private funding (LA PECHI)
& F5LA for the HV
Consortium, $166K
>1%
Note: Federal Administration for Children and Families/Early Head Start (EHS) funds is an estimate based on the volume of families served and approximate cost per family. EHS funds combine home and center-based services so this estimate is being further refined to represent the true cost of home-based services only.
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• Developed a Common Vision and Guiding Principles • Identified Common Data Collection Mechanisms • Establishing Target System Scale and Cost• Piloting New Referral Pathways (DMH, DPSS)• Improving Perinatal Mental Health Resources• Exploring Sustainable Funding Opportunities • Engaging the Private Sector• Fostering Cross-Departmental Collaboration
Our Vision for an Integrated System of Family Supports
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• Public Health Department• Office of Child Protection• Home Visiting Consortium• Children & Family Services Department• Public Social Services Department• Mental Health Department• Health Services Department• Probation Department• Libraries• Office of Education• Children’s Data Network
Los Angeles County Home Visiting Partners
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Home Visiting
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Home VisitingEvidence based modelRegularityOccurs in the home or where the family is parentingFocuses on the parent-child relationshipUses a unique caseload approach for a home visitor-family relationshipEngages home visitor in reflective supervision
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Defining Terms
Complex more than one source of funding is utilized to address the same issue
Restrictive control of: - administration of the funding- the population of children and families served- the eligible providers
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Cost Implications for ProgramsUnderstanding current costs for programs◦ What are the drivers?
Understanding the impact of multiple models◦ Negotiating different program
requirements◦ Variations across: Primary Service;
Eligibility and Target Population; Length of Eligibility; Length of Program; Ratio and Group Size
Exploring the revenue utilized by programs
◦ What is the administration structure programs have built?
◦ How do they manage the funding and reporting?
◦ What is the budgetary approach?
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Understanding Costs◦ Personnel
◦ Wages- Child Care Workers, Lead Teacher, Preschool Teachers,
Teacher Aides, Floaters, Substitutes, Assistant Teachers, Staff Supervisors
- Administrators, Child Care Center/Program Director, and Financial Manager
- Office and Administrative Support Workers
◦ Benefits
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Understanding Costs◦ Non Personnel
◦ Education Program for Children and Staff◦ Child - food/food related, classroom/child supplies,
laundry, tuition assistance, parent activities, field trips, family transportation, child assessment materials, ongoing costs of additional quality-related materials
◦ Staff - professional consultants, training/professional development/conferences, staff travel
◦ Occupancy: rent/lease or mortgage, real estate taxes, maintenance, janitorial, repairs and other occupancy-related costs
◦ Administration and Management: office supplies, telephone, internet, insurance, legal and professional fees, permits, fundraising, memberships, administration fees
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How Quality Affects the Cost1. Staff qualifications: Increasing qualifications
by level
2. Ratios: Reduced ratios for all, or for younger age children
3. Time: Staff time beyond what regulations require
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Potential Funding StreamsFederal
- Infant and Early Childhood Home Visiting (MIECHV), Affordable Care Act
- Early Head Start
- TANF
- Medicaid billing
- SAMSHA
- Project LAUNCH grant
- Title V MCH Block Grant
State
- General Revenue
- Tobacco settlement, lottery
- May allow Community Based Child Abuse Prevention funds, or other federal resources that go to states to be used to pay for home visiting
Private Investments (foundations, United Way)