Home Visiting on the Front Lines
As part of an effort to show how home visiting is helping vulnerable families during this time, Families Forward Virginia is interviewing Home Visitors across Virginia. We're asking them how their programs have changed and what their families need.
Beverly McQuarry: Suffolk and Isle of Wight
Pregnancy and child rearing can be stressful in the best of times. Beverly McQuarry, Team Supervisor of a home visiting program called Healthy Families, helps new and expecting mothers in Suffolk and Isle of Wight. Home visiting is an evidence-based prevention strategy for delivering services that support parents and strengthen families.
Each year, Beverly and her team serve roughly 60 families. Home visitors help children receive nurturing care from their family so they can lead a healthy, long and successful life. Their services include vital mental and physical health screenings for both mothers and children, parenting support and education, and connections to services such as early childhood education, early intervention, health care, housing and food assistance.
Typically, the home visitors see new families to their program on a weekly basis for the first six months. Strong progress within the family yields to bimonthly visits for a period, then once a quarter. Healthy Families home visitors can keep seeing families until their children are 5 years old.
Beverly and her team haven’t slowed down since the pandemic began, but their methods have evolved to ensure the safety and well-being of both the home visitors and the families receiving services. The home visitors of Suffolk and Isle of White are now conducting their visits over the phone through telehealth and have enrolled nine additional families into their program since the pandemic began. Educational materials with Healthy Families curricula and activities for children are mailed or dropped off on the family’s front door. When needed, Beverly and her team are also dropping off supplies, such as pack n’ plays, diapers, and other necessary items.
Home visitors are continuing to make referrals to community resources. They’re also making sure families are going to the doctor for well checks and other preventative health care, such as immunizations. Beverly and her team were able to comfort and reassure many parents who were nervous about these appointments during a pandemic.
The strong relationships that home visitors build with the families have been challenging to maintain without the physical home visits they are accustomed to. However, Beverly and her team are dedicated to serving the most vulnerable parents and children in Suffolk and Isle of Wight.
Christine Shell and Jamie Sievers: CHIP of Roanoke Valley
CHIP of Roanoke Valley is an early childhood home visiting program. Case Managers, like Jamie and Christine, support families who wish to be more self-sufficient and confident in their parenting. CHIP pairs pregnant moms and low-income children with home visiting Case Managers to help parents reach their goals. Their services include assistance with accessing health care and managing chronic health conditions. They also provide child development education, school readiness, and child health screenings, assessments, and monitoring.
As an example of these services in action, Christine recently worked with a mom who was concerned about her husband’s health. She reported, “Things are not well,” while she discussed his diabetes and concern for hyperglycemic episodes. Christine was immediately able to connect her with a Nurse on the CHIP of Roanoke Valley team, who provided education on her husband’s condition and comfort for her concerns. Nurses can quickly answer questions about medication side effects, rashes, and other health issues before they escalate into more serious problems. During the visit, Christine also connected the mom with a local energy assistance program to repair her HVAC.
Help navigating services
Jamie a bilingual Case Manager, so her families speak little English and need extra assistance with acculturation. Jamie helps prepare her families for public school, which is something many of these parents did not experience in the county they grew up in. They may not know how to apply for pre-K or register for Kindergarten. Along with education, these parents often need assistance navigating the health care system. Jamie is a vital resource to help navigate services and remove barriers by ensuring that interpretation services are available for her families.
As families struggle to work, live, and care for each other during COVID-19, Jamie and Christine are on the front lines with families, helping them problem solve and connect to vital community services. Prior to the pandemic, Jamie and Christine were able to meet families in their homes, where they are most comfortable, to talk through their issues and concerns. Now, Jamie and Christine visit families virtually, utilizing devices and apps to video chat with families.
Pandemic adds additional challenges
Working with families has always been a challenge due to limited resources. Since the pandemic
began, this task has become even more difficult. Christine began working with CHIP of Roanoke Valley relatively recently, on March 9th. By her second week on the job, she was working from home and visiting families virtually. Christine excels in this role by being open and honest with her families and spending a lot of time listening to their concerns and questions. Christine has provided multiple referrals to mental health resources as her families struggle through this crisis.
Jamie is a veteran Case Manager. She has been conducting in-person home visits for years, which involves modeling parenting techniques and behaviors for families to learn. Children with behavior issues can benefit from effective de-escalation strategies, which are easier to learn from modeling rather than reading materials. Although these documents are always provided, they can be overlooked by parents due to the demands of parenting, maintaining a household, and often working. The relationship and trust between the parent and Case Manager is critical for delivering services to
improve the health and well-being of the family unit, as well as minimize future issues.
Heart of the work
This relationship between families and their Case Managers is the heart of how home visitors are able to help them. Parents feel safe sharing vulnerable or embarrassing concerns, such as health care struggles and difficulties with child discipline. Because of this strong relationship, Jamie has been able to successfully connect families to services for parents who have experienced intimate partner violence. Many moms struggle with maintaining healthy boundaries with ex-partners. For one family, the mom stated that receiving mental health services from CHIP’s Licensed Clinical Social Worker helped her recover and heal from past traumas along with improving her relationship with her husband and child. Another mom lived in a home with many cameras which the landlord had placed throughout the building. This mom told Christine she felt like her home was a prison. Once the mom confided this, Christine was able to refer her to CHIP’s Counseling Center where she received helpful mental health services. These are just a few examples of how home visiting can be transformative for the health and well-being of families.
When asked what their families need right now, Christine and Jamie both state that families need an emotional outlet. Having someone to talk through this challenging pandemic experience has been absolutely critical to helping parents’ problem solve and de-escalate issues. In this way, home visiting counteracts problems before they get bigger. Families often need assistance accessing to food
and new housing, as many have lost their jobs and are at risk of eviction. For Jamie’s English as a Second Language families, the local Legal Aid center does not have interpreter services at this time, so Jamie’s families cannot access their protection from landlords trying to evict. Case Manager can break down barriers when families aren’t hearing from landlords, doctors’ offices, and other essential resources and services. Helping the parents’ problem solve also empowers them to discover how resilient they are. This boost in confidence also empowers parents to resolve issues independently. This realizes the main goal of home visiting – Supporting families in becoming self-sufficient.
Access to technology
Jamie and Christine both wish they had more personal-protective equipment so they could conduct their home visits in-person. They also hope to find a better Telehealth platform than DOXY, which is not user-friendly. They are often forced to switch to another service, in the middle of a virtual visit, because DOXY is not reliable. The Case Managers wish they could provide smartphone with video and data access to their families. Sometimes families cannot afford their phone and data plan, and many families lack reliable access to broadband.
Jamie also wishes she could end the stigma of undocumented families, especially undocumented children who came to the US as infants and toddlers. They are significantly isolated and cut off from avenues to improve themselves and live up to their full potential. Many children do not realize their residency status until they turn 16 and are unable to obtain a driver’s license. These families live under a cloud of constant fear. Limited transportation options cause significant stress in completing day-to-day tasks such as grocery shopping and appointments.
As CHIP of Roanoke Valley continues to modify their services in response to the pandemic, Case Managers Jamie and Christine remain committed to providing the best services possible to families who are working towards self-sufficiency.