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Home My WebLink About2016 Family Health ServicesJEFFERSON COUNTY PUBLIC HEALTH – PLANNED PERFORMANCE MEASURES 2016 REPORT COMMUNITY HEALTH - FAMILY HEALTH SERVICES PROGRAM [1] `PROGRAMS: Family Health/Maternal Child Health (MCH) including Breast Feeding Support, Maternity Support Services/Infant Case Management, Nurse-Family Partnership (NFP), Children with Special Health Care Needs (CSHCN), Women Infants and Children (WIC), and the Child Protective Services (CPS) Contract Programs: Early Family Support Services (EFSS), Early Intervention Program (EIP). MISSION: The mission of the Family Health Services is to offer health education and support to all Jefferson County pregnant women and families with young children as they build a secure foundation for a lifetime of health, learning, and community contribution. Goal 2: Improve children’s health, safety, and development by helping parent’s provide competent and sensitive care giving. Educate parents on how to support their infant/child’s health, development and learning. Promote and refer to well child care, immunizations, dental care, and childcare resources. Number of all Family Health encounters recorded in Nightingale Notes, Electronic Medical record system (home visits, office visits and phone calls) 697 506 544 522 550 577 Screen children’s developmental growth using standardized tools and refer to community providers for specialized services. Number of children with special health care needs Birth through age 18 referred for Public Health Nurse Case Management. 67 94 147 121 100 104 Goals Objectives Performance Indicators: 2012 Actual 2013 Actual 2014 Actual 2015 Actual 2016 Planned 2016 Actual Goal 1: Improve pregnancy and birth outcomes by helping women improve prenatal health. Provide comprehensive education, risk reduction strategies, and referrals to community services to pregnant women and families about the health risks of: substance use including tobacco, alcohol, prescription narcotics, and illegal substances; domestic violence; mental illness; and adverse childhood experiences. Number of comprehensive health screenings completed (includes ACES Questionnaire and Mental Health Screening) 77 41 39 47 Prenatal History Questionnaires completed, 37 ACE Questionnaires completed 60 43 Prenatal History Questionnaires completed, 15 ACE Questionnaires completed Nurse Family Partnership, evidenced based nurse home visiting program Number of visits provided in NFP 323 249 304 280 300 295 Number of referrals from NFP to community resources 156 145 256 179 175 330 JEFFERSON COUNTY PUBLIC HEALTH – PLANNED PERFORMANCE MEASURES 2016 REPORT COMMUNITY HEALTH - FAMILY HEALTH SERVICES PROGRAM [2] Goal 3: Improve overall nutritional health in order to prevent long term chronic diseases Educate pregnant women and families about the benefits of breastfeeding and healthy eating habits Total number of women infants and children served by WIC in Jefferson County (from CIMS report) 857 826 812 663 800 655 Breastfeeding initiation rate in WIC mothers 89% 93% 97% 91% 90% 93% Breastfeeding at 6 months rate in WIC mothers 57% 62% 59% 64% 60% 63% SUMMARY OF KEY FUNDING/SERVICE ISSUES FOR 2016 JCPH Family Health Programs address local, state and federal public health goals through intervention, treatment and prevention services. JCPH entered a regional partnership with Kitsap Public Health District and Port Gamble S’Klallam Tribe in 2012 to expand Nurse Family Partnership (NFP) services to Kitsap County. JCPH’s 16 year experience with NFP has provided infrastructure support, nurse home visiting expertise and mentoring to nurse home visitors in Kitsap County through weekly individual and team meetings. Two NFP-trained nurse home visitors currently share a caseload to offer NFP services in Jefferson County. While the NFP program is growing strongly as a regional program, fewer families were seen in JCPH Family Health Services programs than in previous years. This reflects a similar statewide trend of decreased enrollment in MSS and WIC services. JCPH Family Health Services Programs will continue outreach and recruitment of programs to families and also review agency service component to improve program delivery. Public Health Nurses received continuing education on ACEs, breastfeeding, perinatal mental health, parent-child relationships, and domestic violence, in order to increase their knowledge and skills in providing comprehensive services to clients. The WIC Programs continues to offer services in Port Townsend, Quilcene (weekly) and Tri-Area (bi-monthly). Breastfeeding education and support is provided through individual client contact in WIC, Maternity Support Services and NFP client visits, and the Breastfeeding Tea. Family Health Services Team regularly collaborates with Jefferson Healthcare medical providers and the Family Birth Center to provide breastfeeding and maternal-child health services. In past years, CPS managed two contracts with JCPH to offer public health nursing intervention with families in the Early Family Support Services (EFFS) and Early Intervention Program (EIP). As in 2014, only one of the contracts remained, and the number of services to families served through Children’s Services remained low. JCPH, CPS and Jefferson Healthcare Primary Care providers plan to continue to meet monthly to address intervention and care of families involved with all three agencies. Goals Objectives Performance Indicators: 2012 Actual 2013 Actual 2014 Actual 2015 Actual 2016 Planned 2016 Actual JEFFERSON COUNTY PUBLIC HEALTH – PLANNED PERFORMANCE MEASURES 2016 REPORT COMMUNITY HEALTH - FAMILY HEALTH SERVICES PROGRAM [3] Study/Analysis of 2016 Family Health Services Program Results The programs affiliated with the Family Health Services Program include Nurse-Family Partnership (NFP), Maternity Support Services (MSS), Infant Case Management, WIC, Early Intervention Program (EIP) and Children with Special Health Care Needs (CSHCN). The primary focus of Family Health Services programs are pregnant women and families with young children aged birth to five. Overall enrollment in Family Support Services programs remained stable from 2015-2016. Participation with the CPS contracted Early Intervention (EIP) program was reduced in 2016 due to very few referrals from the local CPS office. Staffing changes for the team occurred in 2016 with the retirement of the EIP Public Health Nurse (PHN) and additional changes are anticipated in 2017 when the CSHCN PHN retires in 2017. Sustainability and continuity of programs with accompanying staff replacement will need to be considered in 2017. WIC served a total of 655 individuals in 2016 compared to 663 in 2015; 46% of county infants were served by WIC in 2016 compared to 43% in WA state. In Jefferson County, 69% of working families with at least one working adult were enrolled in WIC and 66% were families living in poverty (100% or less than US Federal poverty guidelines). Consistent and frequent outreach and recruitment are important and necessary in maintaining Family Support Programs in the forefront of the community awareness. An outreach plan to increase East Jefferson County WIC participation included 1.JCPH continuing to offer WIC clinics in Port Townsend, Chimacum and Quilcene, 2.changing Quilcene clinic hours in 2016 to accommodate community use, 3.adding evening hours to Port Townsend clinic twice a month to accommodate working families (2017), 4. Increasing outreach to potential referral agencies, and 5. Expanding public marketing through media advertisements, window displays, and community postings (2016-17). CQI process will be considered in 2017 to evaluate this outreach plan. The JCPH WIC program is striving to achieve breastfeeding friendly clinic status through WA WIC program and will follow the recommended 10 steps to become a breastfeeding friendly clinic 2016-17. These steps include having organizational policies and procedures that address breastfeeding and having educated providers, resources and services to support breastfeeding.. Nurse-Family Partnership and Maternity Support Services offer education, guidance and support with health parenting, and linkages to community resources to pregnant women and families with young children. In 2016, 52 women were enrolled in MSS and 14 first time mothers enrolled in NFP. Of the 14 NFP new enrollees, 8 remain active and six were dismissed from the program because of personal choice (2), moving out of county (2) and inability/lost to contact (2) at the end of the year. The National NFP office is addressing client retention as an important area of focus and has developed new strategies to engage and support clients in the program. Our Regional NFP team will consider these new strategies, including offering telehealth visits (phone, skype) to clients in 2017. The NFP regional team and Bridge Partnership NFP Community Advisory Board will also focus on client recruitment, retention and attrition in 2017. The MSS providers participated in a presentation and follow-up on the NEAR (Neuroscience, Epigenetics, ACEs and Resiliency) Toolkit. These sessions were facilitated by Quen Zorrah and helped provide additional information, guidance and support on addressing these important topics with clients. While the number of ACE questionnaires administered in 2016 were lower than the previous year, providers addressed NEAR topics with a trauma informed approach in pregnancy and parenting discussions. JEFFERSON COUNTY PUBLIC HEALTH – PLANNED PERFORMANCE MEASURES 2016 REPORT COMMUNITY HEALTH - FAMILY HEALTH SERVICES PROGRAM [4]