Family Connects Oregon Update

A look inside Oregon's universally offered home visiting program

About Family Connects Oregon The birth of a child is a big change for any family. It impacts a family’s social, emotional, financial and physical environment. A safe and healthy environment during early childhood forms the foundation for a lifetime of physical and mental well-being. Many parents need support at this critical time. The Family Connects Oregon Program will connect  families of newborns to services and support that address their unique needs. Offering brief home visiting services to all families is a cost-effective investment to promote community-level change and long-term population health improvement.

Background

Home visiting is an evidence-based prevention strategy that has been in use in Oregon since the 1980's to support parents in providing healthy environments for their children. There are existing traditional home visiting programs in Oregon that are designed to provide sustained support for families who might benefit from this service; however, they are neither designed nor funded for all families.

Senate Bill 526 was passed in the 2019 Legislative Session to meet the need for a short-term home visiting service that can connect new parents to resources they choose, including other home visiting services. The Bill directs OHA to design and implement a voluntary statewide evidence-based home visiting program for nurses to visit families with newborns up to six months of age. It includes families with adopted or foster newborns and coverage for commercial plans in addition to Medicaid, for coverage that is truly universal. This program will be rolled out incrementally over the next six years until services are offered and available to all families that have a newborn in Oregon, approximately 45,000 births/year.

Family Connects Oregon enhances the home visiting service system by assuring that all families who want one, receive a home visit. Further, that all families are introduced to parenting supports such as breastfeeding education, peer support groups, or mental health support and treatment.

Family Connects Oregon will bring existing programs together in each community to create a comprehensive, integrated system of support that is available for all families. Each family will be connected to resources that they choose, and each community can tailor the program to the needs of their residents. Families will be able to start their exciting journey with a new child on a positive path that can help prevent more costly medical care or adverse experiences down the road.

Key Points Participation is voluntary. If families chose to accept this service, they then receive 1-3 visits in their home by a registered nurse who can answer questions, assess the health of the parent and child, provide screenings, and help them get connected to services they feel like they need and want. The goal is to support healthy child development and strengthen families. Implementation in Oregon will roll out incrementally over the next six years. Family Connects will enhance existing services and does not replace existing programs. The Family Connects home visiting model is an evidence-based model that supports families with newborns and connects them to community resources.

Early Adopters of the Family Connects Model

The early adopters of Family Connects Oregon consist of eight communities (shown below on the map). These communities were chosen through an application process that determined their readiness to implement the model. This initial cohort is currently going through an extensive community alignment and planning phase to determine how best to implement the program according to their unique communities and circumstances. To assist the cohort in planning and preparation work, OHA is providing two noncompetitive mini-grant opportunities for community alignment and preparation for service delivery.

They will provide lessons learned and best practices for subsequent cohorts. The cohort includes a mix of single and multi-county communities led by Local Public Health Authorities or Early Learning Hubs from across the state.

Rulemaking

As required by legislation, Oregon Administrative Rules are being drafted to guide the implementation of Family Connects Oregon. The rulemaking process is being conducted by OHA in collaboration with the Department of Consumer and Business Services and with input from stakeholders. There will be a public hearing and comment period to gain public input.

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updates please email us at oregon.uohv@state.or.us We're also hosting quarterly update webinars for interested parties which will be announced through the mailing
list.

Frequently Asked Questions

What is Family Connects Oregon?

Family Connects Oregon is Oregon's universally offered home visiting program which uses the evidence-based model, Family Connects. Its purpose is to recognize that families, communities, and health systems can be strengthened by offering an opportunity for a nurse to come visit a family in their home shortly after the birth of their child. Family Connects Oregon will provide a means of connection, coordination and referral to services for all families of newborns.

Family Connects Oregon will enhance Oregon's current existing home visiting infrastructure by investing in an evidence-based, universally offered nurse home-visiting program that connects all Oregon families with the services they want. This is an upstream approach aimed to further the goal of improving the lifelong health of Oregonians.

What are the benefits of Family Connects?
This model creates or strengthens a local system of care and referral to support families with newborns. Evidence shows:

• Return on Investment: every $1 in program costs yielded $3.02 in savings in emergency health care costs
• Reduced ED Visits: Infants had 50% fewer emergency department visits in the first year of life
• Reduced Overnight Stays: Infants had 85% fewer hospital overnight stays in the first year of life
• Increased Community Connections: Families reported 15% more connections to community resources within the previous 3 month period

Why a nurse? (adapted from Family Connects International, 2019)

1. Timing: Family Connects home visits typically take place about three weeks after the birth of a child. Newborns and birth mothers in the immediate postpartum period are vulnerable to a range of health complications, some of which can be fatal if left undetected. Registered nurses are trained to carefully assess both newborns and birth mothers, to determine the appropriate level of care required and to educate families on emergency warning signs so that they know when to seek urgent medical care after the nurse has left the home.
   
2. Knowledge: The Family Connects home visit includes a detailed assessment of physical health,connection to health and community services, child care plans, infant attachment, intimate partner violence, substance use disorders, perinatal mood disorders, and more. Family Connects home visitors need a broad base of knowledge in all of these areas to make an accurate assessment of family need, provide specific instruction, and connect families to appropriate resources. The broad knowledge base that registered nurses already have, combined with the specialized, ongoing training provided by Family Connects International, means that families are getting expert advice and support delivered consistently through an evidence-based model.
3. Trust: Since 2002, Gallup’s annual survey has shown that Americans rank nurses as the most trusted of all professionals with the highest ethical standards. When a nurse knocks on the door, families are comfortable welcoming them into their homes — they understand that nurses provide non-judgmental care to everyone.

How is Family Connects Oregon funded?
In January 2019, OHA partnered with the Early Learning Division to explore the feasibility of implementing a universally offered home visiting program as a strategy to support local communities. Initial funding support for early adoption was provided by the Early Learning Division Preschool Development Grant Birth through Five.    

The Governor’s 19-21 biennium state budget and Senate Bill 526 were passed during the 2019 Legislative Session, establishing universally offered nurse home visiting and providing funding for OHA’s budget for the 19-21 biennium.

What is the relationship between Family Connects Oregon and the Universally Offered Home Visiting Initiative?
Family Connects Oregon is Oregon's adoption of Family Connects International's evidence-based universal home visiting model. 

When will visits start?
The eight Early Adopters communities began community alignment and planning in July 2019. The anticipated initial implementation of home visits for these is expected around July 2020. Because this planning is a local level community-driven process, each community is different so it is expected that some may start earlier or later than that date.