4,126 eligible births
72 percent of eligible new parents offered a visit accepted
1,781 home visits completed (average of 148 per month)
3,495 referrals made to partner agencies
GRAND RAPIDS – New parents in Kent County have many resources available to help give their babies the best start, but connecting to them and finding services that best match their needs can be daunting.
That problem was evident early in the planning stages of the Kent County Great Start Collaborative seven years ago and the community team behind the collaborative decided to take it on as a priority project, Kent Great Start Collaborative Director Judy Freeman said.
The result is Welcome Home Baby of First Steps serving as the gateway for new parents to early childhood services in Kent County.
“It really offers the initial support and triage for additional services families might need to provide for their babies,” Freeman said.
Families give high marks to their Welcome Home Baby experience. Data from surveys of 1,049 parents taken between January 1, 2012 and March 31, 2014 indicate the following:
Source: Welcome Home Baby parent survey
Since 2010, Welcome Home Baby (WHB) has offered eligible parents a home visit by a nurse and connection to ongoing supports and services. The program is free for parents of infants under 30 days old and meet one of the following criteria: first-time parents, 25 or younger, giving birth in the U.S. for the first time, or have a newborn in NICU at Mercy Health Saint Mary’s Hospital. About half of the county’s 9,000 births each year are eligible for the program.
In most cases, parents are visited a day after the birth by one of two social workers employed by Welcome Home Baby as hospital liaisons. The worker collects information about the baby and family and offers a home visit with a registered nurse. Those who decline are given a book about infant care and development along with a community resource list, others get the book at the home visit. Spectrum Health Butterworth, the area’s largest birthing hospital, provides its own staff as the program liaison.
Parents who choose to participate (72 percent in 2013) are visited in the first week after returning home by a registered nurse trained in maternal-child health. Parents can ask questions and discuss any issues they have experienced in those first days. The nurse completes a physical assessment of the baby and mom, assesses safety risks (smoking, safe sleep), and discusses infant care, child brain development and ideal spacing between pregnancies. The nurse also conducts a psychosocial screening of the mother, inquiring about her support system, any mental health concerns, postpartum depression, and risk of domestic violence or other social issues. Breastfeeding is consistently the top issue of parental concern and all of the nurses have gone through lactation counseling training and are able to support and encourage new mothers as they learn to meet their baby’s needs .
Depending on the needs of the family, the nurse might refer them to any number of resources, ranging from additional home visiting and on-going support to area playgroups or resources for basic needs such as diapers, formula, transportation, housing, food or counseling. Welcome Home Baby has agreements with 15 partner agencies that provide a variety of services, including evidence-based models such as Early Head Start, Healthy Families America, Nurse Family Partnership, and Parents as Teachers and the Maternal Infant Health Program (MIHP) for moms and babies covered by Medicaid.
Parents receive a follow-up call about 30 days after the home visit to see if there are any lingering or new questions, make sure they have connected with the agencies recommended to them, and to see if they might need additional supports. WHB results show that 89 percent of families visited accept at least one agency referral and of those, 64 percent end up participating in the services offered.
One of the most telling signs of success is parent feedback about the need for the program.
“We hear from parents over and over again who say ‘Oh man! I had no idea these services existed! No one ever told me about them!’ Other families who experience higher risks or low income are absolutely inundated with information about programs but how do they know which is the best for them? It’s all very overwhelming and they often choose none,” said program manager Christina Pavlak. “The purpose of Welcome Home Baby is to help families know what is available to them and what might be a good match.”
Sanda Omerasevic is one of those parents. The first-time young mom appreciated the help she received after her son’s birth on June 15, 2013. After her home visit, she was referred to MIHP, which gave her access to a nurse, social worker and dietician for her son’s first year.
“It was eye opening and helped me learn what I should be doing to help him along,” Omerasevic said. "When Lori (Heyboer, RN) comes, we sit down together and she evaluates how Koushi is doing. For instance, is he grabbing things, switching things hand to hand, how are his motor skills. She leaves me pamphlets with information. She answers a lot of questions."
Welcome Home Baby is funded partially through a new Maternal, Infant, and Early Childhood Home Visiting grant (MIECHV) developed as a national early intervention strategy designed to help at-risk mothers and families provide for their infants and children within healthy and nurturing home environments. MIECHV is a partnership of federal, state, and local government agencies, and community-based organizations. In Michigan, the initiative is an effort of the Departments of Community Health, Education and Human Services. Only 11 sites in Michigan received a MIECHV grant.
The initiative’s overall goal is to improve child and family outcomes by implementing evidence-based home visiting within the Great Start system that provides programs for pregnant women, parents and caregivers, and children from birth to 8 years of age.
Other Welcome Home Baby funding comes from the Douglas & Maria DeVos Foundation, MSJ Foundation, Heart of West Michigan United Way, Kent County, and state Medicaid Outreach funds in partnership with the Kent County Health Department.
Developing sustainable funding streams is a significant challenge for Welcome Home Baby going forward, as is capacity limitations of home visitation services, Pavlak said. Efforts in the past year to improve reporting on partner capacities have made a big difference. Now, service partners provide either monthly or quarterly reports showing capacity levels, which allows nurses to better coordinate referrals to minimize wait times, and gives administrators a look at where expansion may be needed, Pavlak said.
“As with any new venture, there have been challenges along the way but we’ve made a lot of progress in many areas,” Pavlak said. “From the families’ perspective, people really love Welcome Home Baby. People are accepting available services so we are matching families appropriately to services and they are participating. That’s the goal.”