SHFP Annual Report

Annual Report
Fiscal Year 2016
Shawnee Healthy Families Program

The purpose of the review is to identify the program’s strengths and areas needing improvement in relation to performance measures, cultural competence, to inform staff, participants, community members and advisory council members about the work of the program and to seek suggestions.

Target Population
The Shawnee Healthy Families Program’s target population is as follows: First time, WIC eligible parents of any age in Jackson, Perry, Franklin and Williamson Counties, who screen positive using the HFI Eligibility Tool, with 90% or more delivering at Memorial Hospital of Carbondale. The target population is identified primarily through screening and assessment at Memorial. Families may also be referred for screening by the local health departments, Shawnee Health Service clinics, local community agencies, other area hospitals, other Healthy Families sites or they may refer themselves.

Service Area Description
The four county region served by Shawnee Healthy Families is largely rural. The largest community is Carbondale, with approximately 29, 000 people. Southern Illinois University at Carbondale and Southern Illinois Healthcare are the two largest employers in the four county area.
The racial/ethnic breakdown for each of the four counties is as follows:
Jackson County:
4% Hispanic/Latino (any race)
77.8% white
14.3% African American
.4% American Indian/Alaska Native
3.2% Asian
2.6% Two or more races
Perry County:
2.7% Hispanic/Latino (any race)
87.9% white
8.3% African American
.2% American Indian/Alaska Native
.4% Asian
1.4% Two or more races
Franklin County:
1.2% Hispanic/Latino (any race)
97.7% white
.3% African American
.3% American Indian/Alaska Native
.1% Asian
1.1% Two or more races
Williamson County:
2% Hispanic/Latino (any race)
92.7% white
3.8% African American
.4% American Indian/Alaska Native
.8% Asian
Two or more races 1.7%

The poverty rates for the four county region are among the highest in the state. The Kids Count Data Center data (2011-2013 figures from Voices for Illinois Children) shows:

Franklin County: 28.5% of children live in poverty
Williamson County: 23.7% of children live in poverty
Jackson County: 33% of children live in poverty
Perry County: 23.9% of children live in poverty
Statewide: 20.8% of children live in poverty

Indicated cases of child abuse and neglect in the four county region are as follows
lllinois Department of Children and Family Services, most current year: FY 15
Jackson County: 220(rate per 1000:18.3
Williamson County: 361(rate per 1000: 21.6
Franklin County: 209(rate per 1000: 21.4
Perry County: 58(rate per 1000: 11.7

According to the Illinois Department of Public Health 2014 statistics (most current available), the rates of teen births in the four counties are as follows:
Jackson: 7.3%
Perry: 11.1%
Franklin: 8.4%
Williamson: 7%
Statewide: 6.1 %

The predominant language in all counties is English. Southern Illinois University at Carbondale accounts for a number of international students residing in the area. These students typically deliver their babies at Memorial Hospital of Carbondale. To date language barriers have not been an issue in the screening/assessment process or in delivery of family support services, although the program typically has at least one family on its caseload to whom English is their second language. The changing nature of migrant labor has also seen an increase in the number of Latino families residing in the area full time. Currently, most migrant farm worker families still reside in neighboring Union County or further south, but some Latino families do reside in the Carbondale area.
Currently the program is serving two families with English as a second language for any parent, as well as one family where English is the primary language but parent is raising children bi-lingual.

Memorial Hospital of Carbondale delivers approximately 2000 babies each year. Memorial is one of only two regional hospitals that deliver babies in the four county Shawnee Healthy Families service area and delivers far more babies than the other regional hospital.

According to the Illinois Department of Human Services the number of live first time births to WIC parents for the four county region in 2015 (most recent data available) was 455.

Adult participants (mothers): Demographic Data for Current Participants, as of June 2016

38% White
51% African-American
0% Asian
8% Two or More Races
2% Hispanic/Latino Ethnicity* Hispanic/Latino Ethnicity may be of any race
1% African (Ethiopian)

Child Participants:
25% white
50% African American
24% 2 or More Races (13% white and Asian; 87% white and African American)
*3% Hispanic/Latino Ethnicity* Hispanic/Latino Ethnicity may be of any race*
1% African (Ethiopian)

Age distribution of parents (mothers):
9% are 15-18 years
73% are 19-25 years
18% are 26 or older

County distribution of families:
5% of Families reside in Franklin County
19% of Families reside in Perry County
5% of Families reside in Williamson County
71% of Families reside in Jackson County

Percent of families composed of teen parents (15-19) living with their parents/other relatives: 14%
Teen parents living on their own: 5%
Percent of families with parents with less than H.S. degree: 17%
Percent of low-income families (qualifying for Medicaid, LINK or other public assistance):96%
Percent of families with at least one parent employed at least part-time: 63%
Percent of families with parents with a diagnosed chronic illness (includes mh )or disability: 22%

Percent of non-married households: 90% (62% of these families have some FOB involvement) –all are female headed households
Percent of Families Who Experienced Housing Instability in FY 16: 15%
Primary Language at Home: 96% of Participating Families have English as the primary language at home; 4% have another language as primary at home (one family Spanish is primary at home; another family has Amharic is primary at home)

Program Financial Report, FY 16

The Shawnee Healthy Families program is funded by a grant from the Illinois Department of Human Services. The program’s FY 16 contract was for $285, 332. 72% of the program budget went towards personnel costs. The program was among the 10% of human service programs that was not reimbursed for its work during a year long state budget impasse. The program was supported by the parent corporation throughout the budget stalemate of FY 16.

Service Delivery

Screening and Assessment Process
The Shawnee Healthy Families program uses standardized screening and assessment tools to identify families most in need of intensive home visiting services.
The Program Coordinator uses the HFI Eligibility Tool to determine if a family is eligible for home visiting services.

If the potential participant’s HFI Eligibility Tool is positive, the home visiting service is offered. The Shawnee Healthy Families program uses the Kempe Family Stress Checklist to assess families once they are enrolled in home visiting. The FSW assigned to the family administers the Kempe and uses that tool to assist the family in developing goals as well as determining needs, strengths and building a relationship with the family.
The program enrolled 27 new families during FY 16.

Percent of Positive Screens
58 positive screens, 33 program offers made =66%

Positive Screens Engaging In Services: 27 Positive Screens enrolled-82% of those offered services

Reasons for Services Not Offered:
Of 58 Positive Screens, 11 could not be reached for follow-up; 2 were receiving other home visiting services, two did not reside within service area; 11 are still being pursued for follow up in early FY 17.

Enrollment Process

If the family screens positive and wishes to receive home visiting services, enrollment and rights forms are signed, typically prior to the first home visit, in an enrollment appointment with the Program Coordinator. Families are read every form, regardless of reading ability, so that staff can ensure rights and services are understood.
Prior to assigning a family to a Family Support Worker, the Program Coordinator considers a number of factors which may include: family’s needs and preferences, staff member’s experience, FSW current caseload size, cultural, ethnic, or linguistic considerations of importance to the family and/or personality match. Every effort is made to make the best match between FSW and participant. These considerations are established and expected by the Healthy Families America program model. Each FSW on the Shawnee Healthy Families team is well trained and has extensive experience in home visiting.

During FY 16, the program served three bi-lingual families. In two of the three bi-lingual families, a language other than English is the primary language in the home; although these families are able and wish to participate in home visits with the home visitor in English. The program has found that families with English as a second language find speaking in English and improving English conversational skills to be a perk of the visits from Shawnee Healthy Families staff. Staff encourages parents to speak in both languages to their children and support bi-lingual education goals of the families. The program does not currently have a bi-lingual staff person and works with the medical interpretation staff through the corporation’s Farmworker Program. Telephonic interpretation is available as needed as well. The program does not anticipate the need for a staff member fluent in any languages other than Spanish and English.

In the past, the program has successfully served deaf and/or hearing impaired families, by contracting with ASL interpreters to accompany home visitors. Currently, the program does not have any deaf or hearing impaired families enrolled.

First Home Visits by Baby’s 3rd Month:
97% of families received 1st home visit within 3 months of ba DOB
85% of families received 1st home visit with 1 month of ba DOB
The one family who received first home visit at 4 months was a self referral who referred herself when baby was 3 ½ months old. Program continues to maintain an excellent early engagement rate and FSW staff and supervisors work together well to make this happen.No improvement plan is needed.

Dropouts FY 16:
19 participants closed from the program before five years in FY 16. Of these, eight closures were due to known participant moves from the area. Three closures were due to loss of contact after three months of outreach efforts or suspend status. Four participants closed voluntarily. Two participants closed due to DCFS involvement with children no longer in their care. One participant was closed by the program due to extended stay in substance abuse in-patient rehabilitation outside the service area. One prenatal participant had a stillbirth and was offered grief support prior to closing. One participant closed voluntarily citing that our home visiting was not what she had expected. Participants in the program six months or less still tend to be the most likely to dropout or be closed for end of creative outreach period, with high mobility and transience rates a significant factor. A staff member specific engagement and retention trend has also been identified and a plan developed for further training and reflective support for this staff member around barriers to engagement. The program wide plan for improvement continues to include finding ways to be flexible with participants who report time constraints as their reason for closing from services and employing a variety of creative outreach approaches to attempt to re-engage families. Additionally, the program has refined and strengthened up its auditing and quality assurance efforts to ensure all program services are being delivered according to the HFA model and Shawnee Healthy Families/Shawnee Health Service standards and mission and home visit observations are done with direct service staff twice a year, for Quality Assurance purposes.

Retention Rate (using PCA-A HFA Retention Calculation Formula)
Volume Year January 1-December 31, 2014
19participants enrolled between January 1, 2014 and December 31, 2014
Using HFA Retention Formula for volume year 2014:
6 month retention rate: 79%
12 month retention rate: 68%
53% are still enrolled as of June 2016

Other Relevant FY 16 Statistics
Number of New Participating Families FY 16: 26 (1 additional family enrolled end of FY 16, began receiving services early FY 17)
Total Number of Families served FY 16:93
Total Number of Home Visits Completed, FY 16: 1066
Percent of new babies breastfed at least once: 77%

Total Number of Developmental Screens Completed FY 16: 199
Ages and Stages: 147; Ages and Stages Social Emotional:52

Total Number of Families “Graduated” from Shawnee Healthy Families
FY 16 (completed 5 years of participation):14

Curriculum
Shawnee Healthy Families uses several curricula resources. The program transitioned in FY 16 to using Partners for A Healthy Baby as the primary curriculum for families prenatal-age three. “Partners for a Healthy Baby is a nationally recognized, evidence-informed curriculum used by many home visiting models to improve birth outcomes, reduce rates of child abuse, increase intervals between pregnancies, strengthen families, enhance child health and developmental outcomes, and support family stability and economic self-sufficiency. The Partners curriculum was developed by a highly experienced multi-disciplinary faculty team at Florida State University and designed to support a systematic approach to planning and conducting effective home visits.” The Partners curriculum features handouts for families featuring color photos of diverse families. The program continued using Healthy Families San Angelo with families with target children ages 37 months -60 months.. During FY 16, the program staff received training on the Mothers and Babies curriculum and approach as well. Mothers and Babies is specifically designed as a home visiting approach for supporting mothers dealing with perinatal depression.

The program also has available for staff use a prenatal curriculum called Promoting Maternal Mental Health During Pregnancy and a curricula geared towards fathers, MAPS for Dads, produced by the Healthy Families San Angelo program. Other Books and Resources Available for Supplemental Use by Program Staff Include:
What To Expect the First Year
What To Expect When Your Expecting
Meld’s The Middle of the Night Book

Videos and DVDs:
Now I Can Potty
It Feels Good to Help Your Baby Learn
Domestic Violence and Children
The Happiest Baby on the Block
The Happiest Toddler on the Block
1-2-3 Magic

Brochures:
Noodle Soup brochures on parenting and child development topics
Prevent Child Abuse Illinois and Prevent Child Abuse America brochures including Shaking a Baby Can be Deadly in English and Spanish

The program continues to acquire more educational print and DVD material for parents in Spanish and is purchasing more children’s books in Spanish as well.

Maintaining a Medical Home: The program is charged with improving immunization and well child rates for participating children, as well as ensuring all participating children have a medical provider. The funding and data source, IDHS, has failed to provide 3rd or 4th quarter rates for to date. Internal tracking for June 2016 shows immunization rates at 94% and well care rates at 80%. DHS figures, if ever received, will show a higher rate of well care, because DHS bases only on children turning age one and two during each quarter. 100% of children had a medical provider.

Developing the Goal Plan
The Shawnee Healthy Families program believes in supporting families as they reach for and achieve their goals and their family’s goals. The Family Goal Plan is initiated by the FSW, but completed by the family based upon their vision and goals of the future for themselves and their child. The family decides what goals they would like to work towards based solely on their desires and needs. The Family Goal Plan supports the belief that all families have strengths.

In developing the Family Goal Plan, the family identifies its strengths as well as needs. The FSW may facilitate this identification of strengths and needs by discussion and using the IFSP worksheet and Family Resource scale. The worksheet and scale are designed to assist the family and FSW in area determining areas the family would like help or information. One of the responsibilities of the FSW is to coordinate services for the family. Utilizing the IFSP worksheet and Family Resource Scale, the FSW can discuss areas the parent checked and would like a referral for. Items noted in the worksheet or scale often are then turned into goals to work on by the family. FSW staff also use HFA’s Family Values Cards and Checklists as a tool to help families recognize their own priorities and values and incorporate those values into achievable goals.

Supervision
Supervisors use weekly supervision time with staff to ensure that staff is aware of and sensitive to cultural differences among families and to ensure that staff have the appropriate skills and approaches to use with each family. Supervisors formally review family support plans minimally every 4 months and discuss family and FSW progress towards Family goals monthly.

Participant Input
The Shawnee Healthy Families program seeks participant input annually through the Participant Satisfaction Survey, which is distributed each spring. The 2016 Participant Satisfaction Survey results are attached.

Program supervisors also observe staff on home visits twice times per year and during these observations supervisors have the opportunity to speak with participants about the program and assure that quality services are offered. Supervisors also fill in for staff that are sick or away and use this as another opportunity to get input from families about their relationship with staff and about overall program satisfaction.

The program has a formal grievance policy and procedure which is reviewed with all participants at enrollment and then participants are given a copy of the grievance procedures. The grievance policy is printed annually in a program newsletter as well. The program received no formal grievances in FY 16. Participants were given further opportunity to share any concerns or comments in the program’s annual participant satisfaction survey and in the evaluation forms the program used for each group activity.

Staff

Staff Selection
The following characteristics are sought in direct service staff:
Non-judgmental
Compassion, empathy
Insightful
Able to Establish Trusting Relationships
Problem Solving and crisis intervention skills
Child care experience
Infant experience
Knowledge of Parenting skills
Maturity, Emotional Well Being
Cultural, Racial, Ethnic Sensitivity
Knowledge of Community Resources
Listening Skills
Honesty
Strength based, family focused
Appropriate education: FSWs- at least high school degree, associates or higher degree preferred.

The following characteristics are sought in supervisory staff
1. Solid Understanding and experience in managing/motivating staff as well as providing support in stressful work environment.
2. Administrative experience in human services programs
3. Experience with family services that embrace the concepts of family centered and strength based service providers
4. Knowledge of maternal-infant health and concepts of child abuse and neglect
5. Experience in providing services to culturally diverse communities/families
6. Experience in home visiting with a strong background in prevention services to the 0-3 population
7. Master’s degree in human services preferred.

Staff Training
All staff is required to attend Healthy Families Core Training for their position within six months of hire. New staff must also complete basic training topics regarding infant care, child development and health, parental health, language development, the role of culture in parenting, family violence, substance abuse, parent issues, HIV/AIDs, and staff topics. After the first year, direct service staff must receive continuing education training each year.

Program staff is oriented to the different cultural aspects within the communities served by the program. Staff is offered opportunities to attend cultural competency trainings and other relevant trainings, as they become available. The program’s goal is for each staff member to attend or receive some form of cultural competency training annually. Staff and supervisor discuss cultural competence training needs and plan accordingly for training.

Cultural competence and Other Staff Development attended FY 16 included:
*indicates cultural competence component included
*Diversity in the Workplace (5 staff)
*Infant MH Learning Group (2 staff)
*Human Trafficking (2 staff)
*LGBTQ Issues and Language Inservice (5 staff)
Mothers and Babies Perinatal Depression curriculum training (5 staff)
*Mental Health First Aid (1 staff)
Reflective Strategies Mini Training (4 staff)
*Futures Without Violence (5 staff)
*Building Bouncebackability in Yourself and Families (2 staff)
*You Don’t Know My Life (2 staff)
*Role of Self in Helping Others (2 staff)

Staff Input

Staff input is sought on a regular basis regarding program materials, service delivery, budget expenditures etc. Monthly team meetings and weekly supervision sessions are the typical settings for this input and information sharing. A summary of staff questionnaire responses for FY 16 are attached.

Staff Demographics (as of June 2016)
• Program Coordinator, Caucasian, MA, 16+ years social service experience
• Family Support Worker, African-American, BS, parent and grandparent, 26 years + social service/education experience
• Family Support Worker, Caucasian, AA, parent, 16+ years education/social service experience
• Family Support Worker, Caucasian, BS, parent and grandparent, 16 plus years education, home visiting and social service experience
• Group Services Specialist , Caucasian, PhD., parent, 16 years education/social psychology and volunteer experience

Staff Turnover FY 16
There was no staff turnover in FY 16.

Annual Review
For the first time since FY 07, the funding organization Illinois Department of Human Services, began doing onsite program reviews. The program review identified the need for the Shawnee Healthy Families program to improve in monitoring and documentation of health topics covered, particularly reproductive health. The program staff have been working on best approaches for doing this systematically and for documentation. The program began using the CDC’s Reproductive Life Plan approach during FY 16.

Credentialing
The program was reaccredited in October 2013, following a year long self assessment process and an on-site visit in August 2013 from peer reviewers from Healthy Families America. The program is due for re-accreditation in spring 2017.

Advisory Council
Three Advisory Council Meetings were held in FY 16 (a fourth was planned for the last quarter of FY 16, but was cancelled due to lack of availability of Council members) . Members represent the local EI service coordinator and EI service providers, a local health department, a local Head Start program, another home visiting program, and an autism services provider. The SHF Coordinator also serves on the Advisory Councils of other home visiting and early childhood programs.

Community Relations
The Shawnee Healthy Families program collaborates with many area agencies serving children and families, including DCFS, SIUC Head Start, the Women’s Center, Centerstone, Carbondale Community High School Rebound program, Land of Lincoln Legal Foundation, Child and Family Connections and Good Samaritan House. Shawnee Healthy Families has formal working agreements with all three local health departments. These agreements are renewed annually. Shawnee Healthy Families continues its business associate agreement with SIH/Memorial Hospital.

Emerging Community Trends That May Impact Program and Participants
-ongoing impact of Illinois budget crisis/reduction in other community resources
-significantly higher use of ER for mental health care, compared to the state average
-unemployment trends continue to be a big concern in SI
-decline of the regional University and community colleges due to budget crisis—fewer affordable educational opportunities for young adults
-increased acceptance of breastfeeding and excellent promotion through various sources (hospital, WIC, doctors offices and home visiting)
-increase in human trafficking in the region—connection to sexual abuse, domestic violence, substance abuse
-anticipated improvements to regional transportation options and collaborations across counties for transit
-housing instability seems to be on the rise, per staff and community perceptions
-staff note availability of food resources for food insecure families is on the rise—both availability and public awareness of the resources

Program Trends For Further Analysis, Planning and Action
-aging workforce
-budget anxiety/ ongoing state budget crisis
-changing social service resource landscape
-opportunities with corporate focus on Patient Centered Medical Home
-uptick in teen parent enrollments after a few years of decline
-program serving significantly higher number of African-American families—enrolling and retaining longer

Program Strengths FY 16
• The program graduated 14 families during the fiscal year.
• Families found various core areas of home visiting to be beneficial to them, with education on infant/child development, bonding/nurturing child, improving parent life skills, goal setting and healthy relationships indicated as the most appreciated areas of education and support.
• Participant Satisfaction Surveys received revealed a great deal of participant satisfaction with the program and especially with participant’s own home visitors.
• Breastfeeding initiation for FY 16 was 77%, a 10% increase over FY 15.
• Continued collaborative relationships with other home visiting programs and some improvement in internal referral relationship with the corporation’s OB/GYN practice.
• Staff feel respected and supported and feel generally skilled with a variety of cultural factors/differences they may encounter with families. In FY 16, training was provided on LGBTQ issues, per staff request in the FY 15 staff questionnaires.

Outcomes of Program Goals That Were Set For FY 16 (Goals referenced in FY 15 annual report)

• Remain mindful of participant needs and interests in planning of group activities. Feedback received in group evaluations and in participant satisfaction surveys showed high satisfaction.
• Improve documented breastfeeding promotion efforts in effort to improve breastfeeding rates. –Rate increased to 77%!
• Continue fine tuning implementation of revisions to HFA Best Practice Standards, particularly around use of reflective strategies in home visits. Four Staff attended a refresher mini training on the reflective strategies and all staff continued to show steady improvement in use and documentation of strategies.
• Mail out Participant Satisfaction Survey earlier in Fiscal Year to allow for opportunities to resend if response rate is low. Surveys were mailed in April and then sent out again in May. Response rate improved to 55%.
• Address staff training needs throughout the year, utilizing local resources as available. –Staff were able to receive good quality relevant training, despite limited out of area travel opportunities due to state budget crisis.
• Provide additional guidance to families on importance of continuous well care and immunizations after the first year. Program began using Individualized CDC Immunization Tracking Schedules and continued regular promotion of well child care and immunizations. Without data from the state, it’s difficult to assess impact at this time.

Program Goals Set For FY 17

• Supportive training and supervision work with specific staff member around engagement and retention strategies. Targeted cultural competence training as a component.
• Continued work to build collaborative referral relationships, particularly within the corporation. Encouraging warm hand-off referrals, which tend to result in greater program acceptance.
• Re-Accreditation with Healthy Families America
• Increase bi-lingual resources
• Noting that education and support around healthy relationships is already an area of strength for the program, plan to implement Futures without Violence Healthy Moms/Happy Babies approaches into work in FY 17.
• Through a survey to parents, we will try to determine specific group activity interests and will assess whether we have other options for time and day of the week. We may not have other options because our meeting location has many other activities during the week. As it appears that a zoo trip will be out of reach financially again in FY 17, we will look at what other parent-child field trips might be more local and feasible, if the state budget crisis resolves. Building opportunities for new experiences for parents and children is important and often cited by parents as something very special about the SHF program.
• There is a need for better social skill building among parents and plan has been developed for ice breakers and introductions to become routine at group activities.
• Paperwork and procedure changes, additional mandates from state overwhelmed staff in FY 16. Program Coordinator plans to be more mindful of pace of change and roll out new or refined processes and paperwork more slowly for staff, to the extent this is possible.
• Continued work on community resource collaboration—particular interest from staff in building relationship and understanding of housing issues and resources and d.v. resources

Advisory Council Review and Guidance:

Reviewed on August 10, 2016. Concurrence on community trends. No other feedback offered at this time. Advisory Council members were asked to share any other feedback with the Program Coordinator if thoughts come up.

Governing Board Review and Guidance:

Reviewed on Sept. 1 2016 by the Shawnee Health Service Board of Directors. A board member submitted a question about whether grant monies can be used for family planning. Program Coordinator responded, via email to the corporate counsel, that this is not an allowed grant expense, but that the program does work to educate women on birth control options and helps them develop their own reproductive life plans. Question from another board member was submitted regarding breastfeeding initiation as a measure, vs breastfeeding duration. Program Coordinator responded, via email to the corporate counsel, that the state contract is specific to tracking breastfeeding initiation, but that in FY 17 the program will begin monitoring breastfeeding maintenance through our newly implemented health records compiled at 6-8 weeks postpartum, at 6 months and 12 months. The Shawnee Healthy Families FY 16 Annual Report was unanimously accepted by the Board.

Addenda 1: Participant Satisfaction Survey

2016 Shawnee Healthy Families Participant Satisfaction Survey
Please circle your choices. Feel free to write in comments.

1. How would you rate the quality of services your family has received from Shawnee Healthy Families?

Excellent (32)   Good   Fair   Poor   No Response (1)

2. Is your family support worker respectful of your family and family background, including your family’s race and ethnicity and your family’s values?
Yes, Always. (33)   Yes, most of the time   No, rarely No, never

3.Which information/discussions/supports has your home visitor provided to you? Please circle all that apply.

(31) Infant /child development and milestones
(29) Health and Safety
(29) Positive discipline
(30) Bonding With My Child/Nurturing Parenting
(29) Healthy relationships
(30) Improving life skills (budgeting, job search, education etc)
(24) Literacy and school readiness promotion for my child
(27) Mental health promotion for myself and my child (including stress management, depression etc).
(27) Referral to other community assistance
(29) Goal setting/helping me achieve goals

4. Of the areas noted in question 4, what information/discussions/support have been most helpful to you as a first time parent? You may list more than one if you wish.
_________________________________________________________
“Health & safety, improving life skills, achieving my goals, and bonding with my child.”
“All of it has been helpful to me!”
“Everything she does helps.”
“All of them.”
“Discipline”
“Healthy relationships, infant/child milestones”
“Bonding with my child”
“Not stressing about baby, bringing diapers.”
“Being positive and building healthy relationships”
“Improving life skills, infant/child milestones”
“Positive discipline”
“All”
“Support”
“All”
“Infant/child development and milestones”
“Child development & milestones, health & safety, goal setting”
“All of them”
“Bonding with my child and child development”
“Goal setting, it has really helped me get my goals achieved and set new ones.”
“Child development & milestones”
“Healthy relationships, child development”
“She has been helpful in all ways.”
“Positive discipline”
“Health & safety, bonding with my child, positive discipline”
“Healthy relationships, safety, positive discipline, developmental milestones”
“Bonding, literacy”
“Mental health, healthy relationships”
“Infant/child development”

5. My family support worker/home visitor brings pictures, books, and other materials that are easy for me to understand.

Yes, almost always (33)   Sometimes   No, almost never   Never

6. If you have a question, concern or are looking for more information about something, does your family support worker/home visitor provide you with this information, even if it is at your next home visit?

Yes always (32)   Sometimes   No, never   No response (1)

7. My family support worker/home visitor is easy to reach and lets me know if we will need to reschedule a visit.

Yes, always (32)   Sometimes   Almost Never   Never   No Response (1)

8. How would you describe your home visitor’s personality?

“Amazing, she is sweet and helps me a lot”
“Sweet, kind, loving and caring”
“I love her!”
“Outgoing, she has a bright personality”
“Amazing”
“Very kind”
“Nice, helpful, easy-going, open-minded”
“Very supportive and helpful”
“Genuine, nice and funny”
“Loving, caring, positive, smart, beautiful on the inside and out, also understanding”
“Amazing, we love her, she is always there when we need her”
“Bubbly, caring, loving”
“Beautiful and bubbly, very caring. FSW is such a sweet woman. ”
“Very helpful and nice”
“Excited, joyful, happy, fun person to be with”
“Very friendly, caring and helpful”
“Awesome! Very caring and sweet.”
“She’s friendly and caring”
“She is funny, happy, encouraging and hopeful”
“Awesome!! Loving.”
“Loving, caring and very respectful”
“Good”
“Very friendly, always positive and caring”
“She is very nice, easy to talk to, gives me good advice on things I need help with.”
“Caring, loving”
“Respectful, hard-working”
“Positive and uplifting, upbeat and awesome ”
“Happy, outgoing”
“Amazing, sweet, funny, caring”
“Very friendly, understanding, helpful”
“Very outgoing and very helpful”
“Bubbly & fun”

9. Have you attended any Shawnee Healthy Families group events in the last year?
Yes (22)   No (11)

10. If you have attended group events, what were they?-circle all that apply:
(19) Holiday parties
(9) Messy Play or Arts and Crafts nights
(3) Stress Management
(9) Active Play night
(5) Small Group Discussions
(5) Dental hygiene talk
(3) Bed Time Stories night
(6) Thanksgiving craft night
(7) Halloween costume and activity night
(4) Budget workshop
(4) Welcome Babies night for expectant moms
(4) Other?

11. If you have attended any of our group activities, did you enjoy them?
Yes (23)   No

12. What kinds of group activities for parents or parents and kids would you be interested in SHF offering in the future?

“Any as long as my son is learning and having fun at the same time”
“Food night”
“Wiggles & tunes”
“Parent/child pictures, parenting & life skills group meetings”
“Events outside would be nice”
“Parent & child fun and games”
“All the above”
“All kinds”
“Play dates”
“Spa day, no kids invited”
“Halloween party”
“Arts and crafts”
“All”
“Active play night”
“Zoo trip”
“Zoo trip”
“Zoo”

13. If you do not attend SHF group activities, why? Circle all that apply or list other reason

Do not interest me

Location of activities (3)

Timing of activities/schedule conflicts (17)

Other_________________________________
“Working”
“Sick”
“In treatment”
“Just started”
“Just enrolled”

14. Is there a group activity or workshop topic you would be interested in having Shawnee Healthy Families offer in the future? (please list)
“Connect with different animals”
“Zoo trip”

15. Have you been informed of the program’s grievance policy (your right to complain?)
Yes (32)   No (1)

16. Would you recommend Shawnee Healthy Families to other families, if they met our target population (first time parents-prenatal or within a few weeks after baby born in Jackson, Perry, Franklin, Williamson Counties)?
Yes (32)   No   Not sure   No Response (1)

Special Section only FOR FAMILIES WHO HAVE ENROLLED IN SHAWNEE HEALTHY FAMILIES IN THE LAST 12 MONTHS:

17. Thinking back to when you enrolled in the program:
-was the program’s enrollment paperwork explained clearly to you?  Yes (21)   No
-was the explanation of the program’s home visiting services explained well to you?  Yes (21)   No
-was the Program Coordinator respectful towards you during the enrollment visit?  Yes (21)   No

18. Thinking back to your first few home visits with your Family Support Worker:
–was the Family Support Worker easy to talk to about your life story (our assessment or parent survey process)?
Yes (22)   No
–Were you able to feel comfortable and share to the degree you felt comfortable during those early home visits?
Yes (22)   No

My Name (Optional) ____________________ Date:_________________ jj/revised 3/16
My Family Support Worker:__________________

Any Additional Comments You’d Like to Make About the Shawnee Healthy Families program and/or staff can be written below. Thank you for taking the time to complete the annual participant satisfaction survey.

“I really love your program, it is truly something. I would love to continue with your program till I no longer can. I just want to thank you truly. I would recommend it, it is a great way for first-time moms like me to enjoy raising our kids with help. You people are amazing at what you do.”

“We love our FSW!”

“Love seeing FSW. She always makes me smile. Too bad she can’t come more often, we miss her.”

“Please let my FSW know I want to continue services when I finish treatment. I’m doing well and miss her. Baby is with my family.”

“I love FSW! She’s absolutely amazing and this program has helped so much!”

“Shawnee Healthy Families program has been very helpful for me and my family. Thank you!”

“I love the group, I’m glad I got the chance to attend it. It’s been very helpful since day one. I enjoy every visit and group session. All the ladies are very nice and good to talk to!”

Analysis and Significant Findings:
60 Participant Satisfaction Surveys were sent out in April and surveys were resent in May, to those who had not yet responded. 33 were completed by families as of June 30, 2016. 55% response rate.

Families value the program and their home visitor and feel respected.

Families find the curriculum and other materials provided to be easy to understand. A note that for families prenatal to age 3 (for target child), the program began using Partners for Healthy Babies curriculum in FY 16, which is an evidence informed curricula that includes many activities, worksheets and full color handouts for families.

Families found various core areas of home visiting to be beneficial to them, with education on infant/child development, bonding/nurturing child, improving parent life skills, goal setting and healthy relationships indicated as the most appreciated areas of education and support.

Parents indicate that their home visitors are responsive to questions and concerns and easy to reach.

67% of respondents attended group activities during the fiscal year, with holiday parties being the most attended, followed by parent-child interaction groups. 100% of respondents enjoyed the group activities.

Families expressed interest in the program having a zoo trip again in the future. The program did not budget for a zoo trip in FY 16 due to the uncertainty of the state budget and concerns about the ongoing maintenance of the chartered transportation we had previously rented.

Families would recommend the SHF program to others.

64% of respondents assessed the program’s enrollment and assessment processes (the question was targeted to individuals who had enrolled in services in the last year). Of these, 100% of families indicated that the program’s enrollment process was clear and respectful. 100% of respondents indicated that their first home visits, including their parent survey experience (“the assessment”) was comfortable for them.

Planning for FY 17:

Noting that education and support around healthy relationships is already an area of strength for the program, plan to implement Futures without Violence Healthy Moms/Happy Babies approaches into work in FY 17.

Through a survey to parents, we will try to determine specific group activity interests and will assess whether we have other options for time and day of the week. We may not have other options because our meeting location has many other activities during the week. As it appears that a zoo trip will be out of reach financially again in FY 17, we will look at what other parent child field trips might be more local and feasible, if the state budget crisis resolves. Building opportunities for new experiences for parents and children is important and often cited by parents as something very special about the SHF program.

Will continue to promote participant satisfaction survey response, with early distribution and explaining the benefits to the program and ultimately families, of the feedback received.

Addenda 2

Shawnee Healthy Families Staff Questionnaire 2016

Analysis and Planning
Please make comments. If you need additional space, please use additional sheets of paper. Please return to Jess by June 30 You may complete electronically or with pen and paper.

Do you feel your work environment is supportive and conducive to doing quality work?

Yes 5   No 0

Any comments__________________________________________________________

Do you feel you are treated with respect by your colleagues and supervisor?

Yes 5   No 0

Any comments___________________________________________________________

Thinking about your current caseload (and families you have served in the last year), are there aspects of culture competency that you feel you could benefit from more training in to best serve your families?

Yes   No 4   N/A 1

Circle any that apply or add any not listed that you would find helpful

Race/ethnicity
Multigenerational families
Disabilities
Gender Identity and Sexual Orientation
Family Cultures
Youth Culture/Adolescent Development
Father Involvement
English as a Second Language/Bi-Lingual Households
Poverty
Other aspects of culture related to home visiting_________________________________

As we’ve begun using the Partners For A Healthy Baby curriculum, have you felt that clients have been responding positively to the new curriculum?

Yes 4   No 0   Haven’t Noticed 1

Do you feel the Partners curriculum is well suited to the families we serve (respectful of culture? At a literacy level that’s appropriate? With activities that the families understand? )

Yes 5   No 0

Comments____”Miss the SA “Activities To Do With Your Child” at the end of each section. It was more art/creativity based.”_________________________________________________________________

As you consider Parent Surveys you have completed in the last year, have there been areas of special challenge for you? (a particular section of the survey, approaches? Difficulty in engaging certain families with the Parent Survey? Etc)

Yes 1   No 3   n/a 1
If yes, please describe challenges you have encountered_______teens ___________________________________________________________________________________________________________________________________________

As you consider our enrollment and family assignment introduction process, do you think it’s generally working well for you?

Yes 5   No 0
Comments__________________________________________________________________

As you consider our enrollment and family assignment introduction process, do you think it’s generally been working well for families?

Yes 4   No 0   Sometimes 1
Comments___________”I feel family bias should be considered –race is sometimes an issue.” _____________________________________________________________

As you consider the group activities we have had for families this fiscal year, what do you think has appealed to families most? _
”messy play/build a snowman” ;
“hands on activities:;
“bonding and meeting each other.”
“hands on activities with their kids have been well received.”
“holiday parties and craft projects that parents and kids can do together”

Do you think there are any barriers to participation or enjoyment of group activities for families that we as a program can address?
Yes (please list) 2   No 2
“I would like to see introductions made at each group.”
“ice breakers with parents, introduce families.”
“we do need more icebreakers.”

In the next Fiscal Year, what training would you be most interested in receiving?
_”child abuse”
“connection between trauma, drugs or mental issues and baby’s activity level”
“”guiding staff through change.”

Thinking of the supervision sessions you have now, what aspects of supervision do you find most helpful to you in your work?
“Feedback-suggestions-additional information on certain subjects to educate myself as well as the family.”
“Being able to discuss difficult situations and get positive feedback.”
“open door policy”
:getting info for parents when needed.”
What aspects of supervision sessions could be more helpful to you?
“supervision and level change process”
“I may access more support from consultant around working with staff on challenging issues.”
“feedback on participants”
“reflective questions, positive feedback and reminders about deadlines.”

Are there aspects of new HFA standards that you would like more training on? (reflective techniques, CHEEERS, transition plans, goal plans, Parent Survey? Other?) Please specifiy if yes.

Yes _1___transition plans_____________________   No 3
Comment: “It might be easier to get on board with the continuing changes to CHEEERS if someone from the national organization could give an inspiring conference presentation or webinar or something about what exactly they are trying to accomplish with these changes.”
Are there aspects of your job you need/want more supervisor assistance with?
Yes=0   No=5   Sometimes=0
Comments:____________________________________________________________
_____________________________________________________________________

Do you have suggestions for how we can better serve families?
“continue to give them a voice”
“no, but if we transport families without a car, why can’t we give gas cards to families who drive? If they want it? Need it? “
“continue to keep visiting”

Looking toward FY 17, are there changes you would like to see in the structure and content of team meetings?
“no, they are what they have to be.”
“I think reflective activities have been helpful.”
“no”
“once our consultancy with Kathy (part of Mothers and Babies program), it would be good to continue that in-depth discussion of problems in team meeting.”
1 person gave no response.

Do you have suggestions for inservices that we could provide during team meetings?
“The webinars sound interesting.”
“no”
“Man Tra Con; Navigating BH services.”
1 person gave no response.

Assuming funds are available, what kind of participant workshops or family activities would you like to see us offer in FY 17?_
_”swimming passes, movie or video tickets”
“mom night out with a meal and no kids”
“Families would probably love to do family portaits again. If the current baby shower ends up being successful, it would be good to do that once a year.”

How have you grown in your abilities/knowledge etc. in the last year with Shawnee Healthy Families?_
“new experiences create more knowledge, growth and confidence in ourselves”
I’ve learned about depression and how to offer help to moms struggling with it.
“I’m continuing to grow in my abilities with reflective supervision. I’m also very glad I became a national peer reviewer-should help as we go through our next accreditation process in FY 17.”
“I have learned a lot and continue to learn each day.”
“I really enjoyed using my information/communications skillis in revising the health paperwork.”

How would you like to grow in your abilities/knowledge etc in the upcoming year with Shawnee Healthy Families?
“continue to be open to learn from participants, co-workers and new materials.”
“I would like to keep working on re-engagment and what works, what doesn’t”
“I like to improve in how I introduce changes to staff to help them feel prepared and not so overwhelmed.
“keep applying myself to get better”

What’s been particularly challenging or stressful for you in the work this year?
“all the changes this year. It has been a constant process. No time to familiarize with one new item, before more came along.”
“The massive changes in documentation and the never-ending paperwork changes. I realize it’s necessary but it is a little stressful at times.”
“The budget crisis has created a lot of anxiety for me as I’ve worked to be the best advocate I can. Staff feeling overwhelmed by changes to the model and from the funder—and stressed by how I have introduced them!”
“more and more changes and time”
“I missed doing regular home visitis with families-it made me feel kind of out of touch.” (Group Specialist comment)

What’s brought you the most joy in the work this year?

“When participants and babies show such growth, appreciation and joy in our visits.”
“The smiles of babies and becoming a small part of the journey of a mom to a competent, successful parent-it’s very rewarding to watch.”
“The staff’s work with families has moved me so often. I’m fortunate to work with such wonderful, skilled people.”
“My babies and moms”
“It made me very happy to see (client name) achieve so many of her life goals.”

FY 16 Analysis and Planning For FY 17:
Questionnaires were completed by all FSW staff, Groups Services Specialist and Program Coordinator.

Staff feel respected and supported and feel generally skilled with a variety of cultural factors/differences they may encounter with families. In FY 16, training was provided on LGBTQ issues, per staff request in the FY 15 staff questionnaires.

Supervision and team meetings are effective and supportive, meeting staff needs. Program Coordinator will create easy to follow template for transition planning and for level promotion process. Will complete these tools by Sept. 2016.

Program Coordinator and FSW staff are developing individualized staff development plans for FY 17 based on responses to Staff Questionnaire, evaluation goals, and home visitor self assessed competencies. Plans will be finalized by August 2016. (Note that Group Services Specialist transitioning to new role in corporation in July 2017, so no staff development plan being pursued with SHF program).

Staff and families adapted well to the new Partners for a Healthy Baby curriculum. FSW Staff need to know they can supplement with activities from other curriculum that they have found helpful.

Enrollment process is working. Will not change process, but supervisor will continue to work to make best matches between family and FSWs based on staff skill, family preferences, but caseload capacity is often a factor as well.

Parent Survey is generally an area of comfort and competence for staff. Program Coordinator will work with individual staff on areas for growth with the Parent Survey.

Group activities were well planned and well received in FY 16. There is a need for better social skill building among parents and plan has been developed for ice breakers and introductions to become routine. Group Services Specialist position is open (as of July 13), with transition of staff to another department of SHS. Program Coordinator will work to refine position job description prior to hire process roll out. Group activities will be planned by Program Coordinator with suggestions from the FSW staff until hire is made. Program Coordinator and FSW staff will develop group activity staffing plan for interim period—will do at July team meeting.

Paperwork and procedure changes, additional mandates from state overwhelmed staff in FY 16. Program Coordinator plans to be more mindful of pace of change and roll out new or refined processes and paperwork more slowly for staff, to the extent this is possible.

jj 8/08 revised 6/15; revised 6/16