Pennsylvania's Home Visiting Monitoring Tools Outline Expectations and Inform Continuous Quality Improvement
To improve home visiting service quality, the Pennsylvania Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program leaders set clear expectations and a plan for improvement.
A state mandated enrollment policy set a 95% enrollment benchmark. The policy provides guidance to help Local Implementing Agencies (LIAs) achieve that goal, defining essential terms, timeframes for review and the corrective action process. The Office of Child Development and Early Learning looks at a three-month enrollment average for the basis of determining compliance.
Modifying a Program Review Instrument (PRI) created for preschool reviews, the home visiting program version clearly defines expectations of LIAs and incorporates a continuous quality improvement (CQI) approach. Contracted Infant Toddler Specialists use the PRI to track compliance with requirements and identify areas where additional technical assistance strategies might be needed to enhance quality, thus ensuring LIAs have opportunity to create a plan of action to strengthen their practices. Since it was first used in 2013-2014, the PRI has been modified in an iterative process with feedback from the users.
In advance of a monitoring visit, each LIA is encouraged to gather documentation to provide evidence of compliance with the PRI. During the visit, the Infant Toddler Specialist engages the LIA leadership in a conversation to identify if the program meets, partially meets, or does not meet core requirements across 17 indicators. Where corrective actions are needed, the Infant Toddler Specialist works one-on-one with the LIAs to create targeted technical assistance plans to improve practices so that LIAs meet the expectations of the MIECHV program. While results are still being evaluated, one site shared that its enrollment met the 95% level for the first time as a result of the PRI. Staff have presented more creative ideas about outreach and created additional events for families. Management staff have strengthened community connections to increase referrals.
Through federal grants from the MIECHV Program, in fiscal year 2016, home visitors in Pennsylvania:
- Made 39,307 home visits to 6,574 parents and children in 3,282 families
- Enrolled 2,467 new parents and children to the program, or 38% of participants
- Served families living in communities in 47 counties across the state, or 70% of Pennsylvania counties
The MIECHV Program in Pennsylvania:
- Screened 97% of mothers who participated in home visiting programs for domestic violence
- Indicated that 95% of participants in home visiting programs who were enrolled for at least one year reported having health insurance
- Created a Policy and Procedure manual for the Home Visiting Program and State Funded Nurse Family Partnership LIAs. The manual is designed to support current LIAs and educate any individual looking to obtain information about program services and requirements
Reviewed May 2018.
One of the key features of the framework is a set of desired outcomes in health, education, well-being, and systems for children ages prenatal through three, their families, and their communities.