FY23: One of the Covid-19 pandemic impacts affecting the Healthy Families program was the loss of staff. The program is now fully staffed enabling the number of families served to increase. Additionally, the Healthy Families program is working with a marketing professional to develop a plan for increasing referrals from sources other than the County Health Department. Challenges: Referals to the Healthy Families program dropped significantly during the pandemic. The program is working hard to increase those referrals and is currently working with a marketing firm to develop an action plan. The Healthy Families Baltimore County program is now providing a hybrid version of the Healthy Families model that includes both in-person and virtual services. The program has developed protocols for implementing a progam delivered in two different formats.

Previous Narrative:

Baltimore County is experiencing a rising trend line for the rate of unduplicated children with indicated*/unsubstantiated* child abuse/neglect findings over the past 4 years.  The County rate from 2015 through 2018 ranged from a low of 5.4 in 2015 to a high of 6.4 in 2017. The 2018 rate was 5.7 and represents 1,322 indicated and unsubstantiated findings for completed Child Protective Service investigations.

*Indicated Cases of Maltreatment:  Child Protective Services investigation of a report of child maltreatment where the finding concludes that there is credible evidence, which has not been satisfactorily refuted, that child abuse did occur.

*Unsubstantiated Cases of Maltreatment:  Child Protective Services investigation of a report of child maltreatment where the finding concludes that there is an insufficient amount of evidence to support a finding of “Indicated” or “Ruled Out*.”

*Ruled Out Cases of Maltreatment:  Child Protective Services investigation of a report of child maltreatment where the finding concludes that child abuse did not occur.

The term “intergenerational transmission of child abuse and neglect” refers to the theory that parents who were abused as children have a greater tendency to abuse their own children. For a variety of reasons related to research methodology, the evidence supporting the theory of an intergenerational transfer of child abuse and neglect remains a work in progress. However, several strong studies have identified factors supporting intergenerational patterns of maltreatment including maternal substance use, depression, anxiety, and experiences of victimization, as well as parents’ experience of intimate partner violence and history of mental illness (U.S. Department of Health & Human Services, Child Welfare Information Gateway, 2016).  All of these factors have been identified as, or associated with, Adverse Childhood Experiences (ACEs).  Adverse Childhood Experiences (ACEs) is the term given to describe traumatic experiences that occur to children and youth under the age of 18.  These traumatic experiences include emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, mother treated violently, household substance abuse, household mental illness, parental separation or divorce, and incarcerated household member.

An overarching Goal of the Healthy Families program is to reduce the incidence of child maltreatment in Baltimore County as well as the out-of-home placements occurring as a result of child maltreatment.  The program Objective to attain this goal is to cultivate and strengthen nurturing parent-child relationships.

• Baltimore County Department of Health
• Baltimore County Department of Social Services
• Franklin Square Medical Center
• Baltimore County Public Schools

Healthy Families is a home visiting program that optimizes child health and development by encouraging early prenatal care, promoting the health of mothers before and between pregnancies, reducing unintended pregnancies through education on the benefits of child spacing and referral for family planning services, promoting positive parenting skills and supporting positive parent-child interaction. Services are provided to families prenatally through age two of the target child*.

*Target Child: The target child is the child that is initially the focus of the parent-child relationship and who the program intends to serve. 

The Target Population for the Healthy Families program is pregnant women and parents facing challenges such as:

1. single parenthood
2. low income
3. childhood history of abuse and other adverse childhood experiences
4. current or previous issues related to substance abuse, mental health issues, and/or domestic violence.

Adverse Childhood Experiences (ACEs) is the term given to describe traumatic experiences that occur to children and youth under the age of 18.  These traumatic experiences include emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, mother treated violently, household substance abuse, household metnal illness, parental separation or divorce, and incarcerated household member.

FY23: Healthy Families Baltimore County recently received re-accreditation with Healthy Families America. The Healthy Families Baltimore County program recently received approval from Healthy Families America to deliver the Healthy Families Child Welfare model adaptation in partnership with the Baltimore County Department of Social Services. Among other unique aspects, the Child Welfare model enables the program to accept focus children up to 24 months of age. Healthy Families Baltimore County, in collaboration with the Baltimore County Health Department, provides families with direct access to a public health nurse to address identified health needs. This unique model has generated interest from other Healthy Families programs from around the country. The program is currently working with a California-based Healthy Families program to replicate the Baltimore County model.