Over nearly a decade, the Foundation has supported a growing movement to coordinate home visiting systems in Oregon. We are now at a pivotal moment.
Oregon’s Early Learning Council meeting in March marked a pivotal moment: Four state agencies – the Oregon Department of Education, Department of Early Learning and Care, Oregon Department of Human Services, and Oregon Health Authority – publicly stated their commitment to, and broad support for, home visiting system coordination. This milestone was seeded 8 years ago through Foundation engagements in five southern Oregon counties and Siskiyou County, California.
What is home visiting?
Home visiting is a proven strategy for strengthening families and improving the health and well-being of children and their parents. When a family opts into a home visiting program, a “home visitor” becomes their resource navigator – connecting them to a community of care. Home visitors help them find primary care providers, child care, mental health services, housing help, lactation support and more. Services are tailored to the unique needs of every family. Learn more about home visiting services in Oregon.
The challenge
Oregon has a wealth of home visiting programs for pregnant people and families with young children. These programs are designed to meet the different hopes and needs of families at different phases – offering support with prenatal care, infant care, child development and parenting skills. And each home visiting program is funded differently – through federal and state agencies (e.g. health, education) and/or private organizations.
Historically, and partly owing to these complexities, home visiting providers have faced significant challenges in offering these critical supports to families, including:
- Limited awareness of home visiting programs and how they can help
- No clear way for families to access the programs that are the right fit for them
- Lack of knowledge among doctors, OB/GYNs, pediatricians and other providers about how to refer families to these programs
- Competition among programs for referrals and funding resources
- A complicated intake system that lacked coordination in getting families smoothly enrolled in home visiting services
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The opportunity
Hearing from community partners about these challenges, program staff at The Ford Family Foundation began to look for ways to build relationships and connection. Starting in 2015, the Foundation began holding annual convenings among home visitors in Coos, Curry, Douglas, Klamath and Lake counties and Siskiyou County, California. We also supported full-time staff roles to support system coordination, regular ongoing training and support, and robust evaluation.
By surveying participants at the start of this coordinating effort, we learned that more than two-thirds (69%) of home visitors reported a sense of competition among the programs for resources and funding, about 1 in 4 (23%) agreed that families were aware of their home visiting programs and services, and only 1 in 6 (16%) used common referral forms to facilitate access to services.
As the work of building community among home visiting programs continued, however, remarkable results were achieved. In the most recent survey data available, only 1 in 4 (26%) home visitors now report a sense of competition among programs (vs. 69%), nearly half (47%) agree that families are aware of their services, and almost three-fourths (72%) are using common referral forms.
Over time, home visitors reported decreased feelings of competition for resources and referrals, increased awareness among families of home visiting services, and increased use of common/shared referral forms.
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The future of home visiting
Over the years, the home visiting coordination movement has grown, with Wallowa, Baker and Malheur counties joining the original six. Now, as a result of successes seeded in rural counties, the Center for Coordinating Oregon Home Visiting Systems (CCOHVS) is being established at Portland State University – with the full confidence and commitment of four state agencies to build on these efforts.
“We are at an exciting moment in Oregon. What we are embarking on—the coordination of the home visiting system—will be transformational for Oregon’s families. We all want Oregon families to be connected to the type of home visiting services they want when they want and need them.”
– Cate Wilcox, Oregon Health Authority, Maternal and Child Health
“The Center for Coordinating Oregon Home Visiting Systems will support better collaboration and coordination between Oregon’s various home visiting programs, ensuring they are knowledgeable about one another and can support families in accessing the program that best fits their needs and desires.”
– Lois Pribble, Oregon Department of Education, Inclusive Services
The Foundation’s support of home visiting system coordination is rooted in our experience and reinforced by the data. We applaud the establishment of CCOHVS and the ways in which home visiting has been elevated in Raise Up Oregon, the comprehensive state system plan for early childhood, prenatal to age five.
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During the Early Learning Council meeting in March, where the state agencies shared their support for CCOHVS, there were several myths that were dispelled concerning Oregon’s home visiting system:
Are there too many home visiting programs in Oregon?
No—in fact, we still have greater need than we have capacity. Fewer than 20 percent of potentially eligible Oregon families receive home visiting services. Moreover, a rich system full of many highly trained professionals provides something for everyone. Needs are unique to each family, so valuing family choice and best fit is a priority. Each model offers something different, which allows for families to get connect to the right services for them at the right time of need.
Are families having multiple home visitors coming into their homes?
No—this has been examined and it isn’t happening in the ways one might imagine. A coordinated home visiting system – as is CCOHVS’s charge – also guards against the duplication of effort.
Why are home visiting programs spread across so many different state agencies?
Oregon’s home visiting system has richness and strength because it benefits from a variety of approaches and perspectives that reflects the multiple needs of families for health, early education, family stability, etc. This wealth of programs can better ensure that families’ cultural, racial, linguistic and other needs are met effectively – there is not a “one size fits all” home visiting model. Moreover, the system is not housed exclusively in state agencies, but lives in community-based programs as well. This configuration allows home visitors to meet families where they are – increasing access points and open doors. It also means more people are invested in this work to support families.