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B’More for Healthy Babies Home Visiting (Baltimore City FY17 Annual and Beyond)


Story Behind the Curve

FY23: Our Healthy Families America Programs (HFA) were below target on the following measures: For How Much measure #1, # of families participating in home visiting services during the reporting period, we fell below the target of 380 and served 305 unduplicated families this year. Staff vacancies and transitions account for the shortfall in participating families so far this year. In Q4, all three HFA sites were open for referrals and new enrollments. We have already seen growth since Q3 and anticipate an increase in the number of families receiving home visiting service as a result of new home visitors being onboarded and slowly growing their caseloads. We have learned that the HFA model provides a good structure for service delivery, which is a positive component, but it also includes many requirements that can overwhelm staff. We are continuing to support the funding partners with implementation of the Home Visiting Strategy to layer in support for the Home Visitors, but the salary is a contributing factor in the site's ability to staff the vacancies. As a result, our FY24 annual target will be reduced, it will be set at 340. For Better Off measure #2, #/% of parents enrolled in home visiting prenatally or within 30 days after delivery who received a postpartum visit with a healthcare provider within 8 weeks (56 days) of delivery, the combined total of the three sites fell below the Target of 75%, with only 66% of eligible parents meeting the measure. We know that challenges meeting this measure relate to transportation issues, childcare coverage for additional children in the household, being unable to get a postpartum visit scheduled in the window, and missing appointments.

FY21: Home visiting programs enroll women during pregnancy and provide intensive home-based services through the child's third birthday. Home visitors help ensure mothers have a healthy pregnancy and assist families in addressing social, economic, educational, and parenting issues that influence child health and education outcomes. The services are provided using the evidence-based Healthy Families America (HFA) model. This reporting period, 312 families were served, and 2592 home visits were conducted through the three HFA programs in Baltimore City. 

Although we greatly exceeded our annual target for number of home visits conducted (4864/3350), we did not reach our target for number of families served (335/380). The number of families participating in home visiting did not meet the target of 380 for various reasons. First, while the programs have been able to retain most of their existing families despite continued challenges associated with the COVID-19 pandemic, engaging new families while limited to virtual home visiting sessions has been challenging. Programs continue to brainstorm innovative outreach techniques and gain insight on techniques that other programs have successfully implemented during monthly HFA Home Visiting and Babystat meetings. Next, one site discharged a larger number of families who were on creative outreach or no longer eligible to receive services. Finally, staff turnover continues to impact the number of families each site can serve.  

Dru/Mondawmin Healthy Families (DRUM) was unable to report on the new opportunity measures during this reporting period. They have onboarded a Youth Opportunity Specialist who manages this work. Family League will continue to support the specialist with project implementation. 


What Works

Action Plan

Program Summary

FY23: Funding will support the evidence-based, two-generation Healthy Families America (HFA) home visiting strategy. This strength-based, trauma-informed strategy works to support positive outcomes for children and families. In FY23, this strategy will continue to have an increased focus on supporting the needs of those at risk of becoming or who have become Opportunity Youth, removing systemic barriers participants have faced/continue to face.

FY21: Home visiting programs enroll women during pregnancy and provide intensive home-based services, through the child’s third birthday. Home visitors help ensure mothers have a healthy pregnancy and assist families in addressing social, economic, educational and parenting issues that influence child health and education outcomes. The services are provided using an evidence-based model, Healthy Families America (HFA). 

Target Population

FY23: Across Baltimore, the Healthy Families America (HFA) home visiting strategy serves people with a previous poor birth outcome, medical condition, or the presence of psychosocial risk factors. DRU/ Mondawmin (DRUM) Healthy Families, the funded partner, is one of Baltimore’s HFA home visiting programs. Traditionally, DRUM serves families from select west and northeast Baltimore communities. In FY23, DRUM will continue to have an Opportunity Youth Coach who will be supporting the needs of HFA home visiting participants and their families who are at risk of becoming or who have become Opportunity Youth.

FY21: Home visiting programs serve women who are at the highest risk of experiencing a poor birth outcome.  The target population is identified through HealthCare Access Maryland (HCAM), which serves as Baltimore’s central intake system into pregnancy and early childhood services, including evidence-based home visiting. HCAM uses a carefully researched vulnerability index to assess each pregnant woman, identify risk factors, and triage each high-risk woman to the appropriate home visiting model that most effectively meets her needs. 

Local Highlight

FY23: In the second half of the year our Healthy Families America Programs have had tremendous success with their families. All sites are currently staffed and open to referrals. One example of success is a mom who had trouble getting to appointments and work due to lack of reliable transportation. Because she is receiving housing support, she saved up additional funds and purchased a vehicle for her family. She is now better connected to health care, work, learning, social activities, and civic engagement opportunities. In addition, one site has graduated 10 families, and 3 of the parents they have been working with graduated from College in Nursing in Q4. Additionally, one of their parents graduated from high school.

FY21: Home visiting sites continue to serve families virtually and have placed a great emphasis on quality improvement to ensure that families are receiving effective supportive services and connection to resources. There has been a high number of depression, substance use, ASQ, and ASQ-SE screenings amongst all sites during this period. Additionally, due to the relationships that staff have with the families that they serve as well as the creative strategies for engagement implemented by the programs, sites have exceeded their target for the number of expected home visits that are completed.  

Despite the pandemic, families continue to see success. Families have found employment, achieved educational goals, purchased homes, and gotten married. 

Family League continues to support DRUM with implementation of the Opportunity Youth project by providing technical assistance regarding data collection and referral process.  

Data Discussion

FY2021 Jan-Jun:

#/% of participants not working or in school who report a connection to work/school 

#/% of participants at-risk of disconnection who report maintaining the connection 

DRUM was unable to report on the new opportunity measures during this reporting period. They onboarded a Youth Opportunity Specialist who manages this work who started in April. Family League will continue to support the specialist with project implementation and expects to report on the project in the next reporting period.  


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