Newborn Adaptation to Extrauterine Life and Newborn Assessment
Newborn Home Visiting program-Shelter Based Initiative
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Transcript of Newborn Home Visiting program-Shelter Based Initiative
Newborn Home Visiting program-Shelter Based Initiative
NYC Department of Health and Mental Hygiene Newborn Home Visiting
program-Shelter Based Initiative Beyond Housing 2016 Conference
January 15, 2016 Ericka Moore, MPH,CLC Bureau of Maternal, Infant
and Reproductive Health NYC Department of Health & Mental
Hygiene
Agency Mission To protect and promote the health of all New
Yorkers. Program Mission The Newborn Home Visiting Program (NHVP)
seeks to provide mothers with the tools needed to raise a healthy
child in a safe home environment. In the context of the Agency
mission to promote and protect the health of all New Yorker; Our
Program however, has a more narrow mission of supporting the health
and well-being of our Littliest New Yorkers. The Newborn Home
Visiting Programs mission is to provide mothers with the tools and
access to resources that will enable her to raise a healthy child
in a safe home environment. Program Rationale Giving birth is a
period of vulnerability and offers an opportunity to address health
and social issues Infancy and new motherhood are periods when
education and support can have lasting effects The Health
Department has unique access to this population and can assist
families in accessing information and resources to support
increases in health equity Newborn Home Visiting Program
(NVHP)
The Newborn Home Visiting Program (NHVP) is an agency initiative
which offerspost-discharge support to families with a new infant;
the Program provides topic specific education, assessments and
identifies health and social issues that require referral to
community-based services. NHVP is voluntary and free to the client.
Infancy and new motherhood or becoming the mother to another child
is a period when education and social supports can have a lasting
effect. The DOMHH has unique access to this population and can
assist families in obtaining information and resources that will
increase their opportunity to experience better health and social
outcomes. It important to understand that Home Visiting is an
evidence-based public health practice; these visits are conducted
by trained public health professionals who work as public health
advisors with the Agency. What is the Newborn Home Visiting
Program? NHVP Program Goals Knowledge and utilization of safe
infant practices Knowledge and breastfeeding practices among women
Environmental hazards in the living environment Awareness and
utilization of community-based services Early Childhood
Development/Language Development Identify social and mental health
needs of families and connect to appropriate services What are we
trying to accomplish with the women, babies and families? Through
this engagement which consists of two visits and a follow-up phone
call, we want to impact Inform Mom of appropriate practices in
caring for a new infant Some Moms know what they are doing and may
only need reminders/current information about such practices Ensure
that Moms who are breastfeeding get the often needed support to
continue; and education others on the value and benefit of
breastfeeding. Staff complete an environment assessment to ensure
issues like: peeling paint and missing window guards are
addressed.Additionally, issue like leaking pipes, mold and holes in
the wall are identified and communicated to landlords, HPD and
NYCHA. Many new moms are unaware of the services and resources in
the community that they can access at no cost.When interviews are
conducted home visitors can assess additional needs that the family
may have based on a conversation, even when Mom has not indicated a
specific need. The Newborn Program assesses other children in the
home to determine need or eligibility for early intervention
services, developmental monitoring, childcare services and UPK.We
also provide families with childrens books and encourage the family
to read, sing and talk to their babies to support early learning
and language development.Current research clearly indicates that
children in under-resourced environments enter school less ready
than their better resourced communities.This type of engagement
also support bonding, as does breastfeeding. Home Visitors also
assess for social needs for moms, babies and other family members
and work to make the connection to needed services. THESES GOALS
REALLY OUTLINE THE ESSENCE OF THE NEWBORN HOME VISTING PROGRAM Key
Health Messages Infant feeding, breastfeeding education and
assessment Safe Sleep and Injury Prevention Early Childhood
Development Early Intervention assessments and referrals
Immunization and Health Insurance enrollment Environmental
assessments Community resource connection NVHP Service Area NHVP in
DPHOservice areas: Bronx(Central/South) Community Districts:
Manhattan(East & Central Harlem) Community Districts:
Brooklyn(Bed-Stuy, Brownsville, Bushwick&East New York)
Community Districts:3, 4, 5 and 16 Newborns current services areas
are geographically located in the District Public Health Office
(DPHO) neighborhoods.Health data tells us that these areas have
some of the worst health outcomes in the City and need additional
resources to address those issues. We offer visits to women in the
following CDs represented on the map. The Program has partnerships
with (7) hospitals in these neighborhood where we recruit clientsat
bedsidefor participation in the Program. Manhattan: Harlem and
Metropolitan Hospitals Bronx: Lincoln Hospital Brooklyn: Woodhull,
Wycoff, Brookdale and Brooklyn Hospital Center Eligibility for the
Program requires that women give birth in a partner hospital, live
within the CD and have an intention to breastfeed (in Bronx and
Brooklyn);In Harlem, women who give birth in a partner hospital,
live within the CD and whether she breastfeeds or not is eligible
for this Program. Measuring Success Families Successfully Visited
in 2013: 2,023
DHS Families Successfully Visited: 38 DOHMH DHS Collaboration
NHVP/DHS Citywide Shelter Initiative Goals Strengthen support
provided to women giving birth in shelters Improve health of
mothers and their infants through education on key maternal and
infant health topics Increase access to support services through
linkages and referrals to governmental and community-based programs
Provide coordinated services to eligible DHS families The reason we
are here today is because our Agencies: DOHMH and DHS initiated a
conversation about how to better service women and families in
shelter and felt this Program would be a good match for addressing
some very specific types of supports that arent often obtained when
a woman is living in shelter and has an infant. For women,
pregnancy and childbirth are incredibly wonder and challenging
periods in her life.The added pressure of living in an unstable
home environment can have a negative affect on Mom and babys birth
and health outcomes. Earlier this year, DOHMH began discussions
with DHS leaders to address the need for and benefit of home
visiting services for women and babies who live inshelters
throughout New York City.From those discussions a set overarching
dual-agency goals were developed, that include Strengthening
support provided to women giving birth in shelters Improving health
of mothers and their infants:HOW? Through education on key maternal
and infant health topics Increasing access to support services by
connecting to governmental and community-based programs The idea is
to align our efforts to improve coordination of services to
eligible families living in shelter (primarily women and children)
And as Shelter Providers, you are key to our success in reaching
women/families with the supportive services provided by the Newborn
Program.You will be our first point of contactfor women and their
babies. DOHMH-DHS Initiative Eligibility Criteria
Who Will We Serve? Women who reside in shelter or present to
shelter with a baby 0-2 months of age. The Newborn DHS Shelter
Initiative will focus on this population.. DOHMH/DHS LAUNCH
TIMELINE
Program Implementation PHASE I- November 2015 Brooklyn Queens
Staten Island PHASE II- April 2016 Manhattan Bronx There will be
one team stationed in Brooklyn to support PHASE I of the initiative
and their catchment will be Brooklyn, Queen and Staten Island. Two
Teams will be stationed in the Bronx and will be responsible for
coverage in the Bronx and Manhattan. NHVP Shelter Initiative
Service Area
NHVP Serving Families in NYC Shelters Citywide PHASE I Brooklyn,
Queens, Staten Island PHASE II Bronx, Manhattan Visual to support
the prior slide NHVP Shelter Initiative Staffing Model
Initiatives Manager Team Supervisors Public Health Advisors Public
Health Assistants Social Workers Public Health Nurses City Research
Scientist Community Coordinator Admin Support Staff We are charged
with hiring 28 new staff to support the Shelter Initiative and this
slide outlines titles were hiring. We have identified 16 candidates
and continue to interview to try and meet the target. The public
health advisors and public health assistants will be the primary
home visitors; social workers and nurses will offer added support
for cases present with challenges or are complex and are beyond the
scope of practice for the home visitor. NHVP Shelter Initiative
VISIT STRUCTURE
Visit Timeline Visit I Occurs within 1st week of life Visit II
Occurs within 2nd week of life Visit III Occurs in weeks 4-6 of
babys life Follow-Up phone call week 7 or 8 of babys life Visit
Content Comprehensive maternal and infant health education Safe
sleep education and assessment/Environmental screening Infant
feeding education; breastfeeding support Developmental milestone
screening/education Medical Home assessment Resource review and
referrals initiated Modeling ECD/language development best
practices Breastfeeding support if needed Follow up on referrals
with client and/or DHS social service staff Prep for upcoming
medical appointments Maternal depression screening using PHQ 9
Reinforce key health messages Prep for upcoming medical
appointments Follow-up on outcome of medical appointments Reinforce
key health messages and referral follow up Positive affirmation As
outlined here there will be three separate visits at within
specific timeframes as part of the Shelter Initiative model. The
educational topics are divided between the visits.The goal is to
cover all topics relevant to the families expressed need. Quick
review of each Progress to Date Establishment of DOHMH/DHS Working
Group
Launched Phase I of Initiative in November 2015 NHVP model
revisions Two visits offered to all clients referred via shelter
based clients Facilitated Listening sessions DHS Path and Shelter
tours DHS Provider staff NHVP and Nurse Family Partnership
Listening Sessions To Date We have met and continue to meet
bi-weekly to establish/build the foundation for this initiative.
What weve termed Memorandum of Understanding (MOU) is actually a
data use agreement between Agencies. Reiterate definition of
collaboration Weve done the work of becoming informed about
families in shelter specifically women and children in shelter and
how their health can be impacted based on living in non-permanent
residence, stress and uncertainty has on health outcomes through
literature reviews. Weve completed several rounds of listening
sessions with internal staff (NHVP and NFP) as well as Shelter
Provider staff.Weve also complete a tour of PATH and several
shelters. Again, our goal is to assist Moms and babies while in
shelter. Strengthening support provided to women and babies in
shelters Improving health of mothers and their infants Increasing
access to support services by aligning our efforts to improve
coordination of services --primarily women and children KEY TO
MEETING THESE GOALS IS THE SHELTER PROVIDER WHO WILL SERVE AS OUR
1ST POINT OF CONTACT Next Steps DHS Client Listening Sessions
Additional listening Sessions with Shelter Providers NHVP Model
Enhancements Program Evaluation As the implementation of this
initiative moves forward, we will continue to work between agencies
to inform the Program model through what were calling listening
sessions.These sessions are designed to assist DOHMH staff in
understanding how to best focus the engagement with families and
ensure there is real benefit for the families in meeting their
identified needs around health issues. And we will, for the first
time, evaluate the Newborn Home Visiting Program based on this
initiative. NVHP Program Materials Thank You Question??? Libby
Carter-Otuya, MPA
NYC Department of Health & Mental Hygiene Director, Newborn
Home Visiting Program Ericka Moore, MPH Director, Maternal Child
Health Unit