Connecting Families to Home Visiting in Rhode Island

Project Context: 

• In 2017, several high-profile child fatalities in Rhode Island brought urgent attention to the need to improve early childhood interventions and child maltreatment prevention across the state.
• The state already had a holistic short-term family home visiting program, “First Connections” to support families facing adversity.
  • Home visiting programs can help improve maternal and child health by identifying medical needs of families, identifying social needs, supporting family stability, and educating families on infant and child safety and care.
• In Rhode Island, 60% of the approximately 10,000 births per year were referred to First Connections following a newborn development assessment.
  • However, the large volume of referred families made it challenging for providers to find and prioritize the families that were most likely to benefit from extra help.

How the GPL Supported: 

• Aided RIDOH as they restructured the First Connections contract to focus providers on serving families most in need of help. This included: 
  • Helping to design a request for information (RFI) to generate ideas for adjustments. 
  • Helping to design a request for proposals (RFP) that reflected new program goals and payment structure changes. 
• Helped design a tier framework to more consistently identify families who might benefit from more intensive outreach. These were families with the highest likelihood of experiencing emergency department visits or child welfare investigations. 
• Supported First Connections providers rearrange staffing models, design warmer and more persistent outreach, and offer flexible meeting locations — efforts to build trust with families and increase program uptake. 

Results:  

• More families facing adversity were successfully connected to home visiting services. Across the state, First Connections’ take-up rates for families with four or more factors indicating adversity increased by 22% following the GPL’s support.