Child First, Inc.

At a Glance

National Office: 
917 Bridgeport Avenue
Shelton, CT 06484
Phone: 203-538-5222

Darcy Lowell
People Served: 
985
Year Founded: 
2001
Tax ID: 
46-1272768

Focus area(s):

Early Education
Maternal & Child Health
Mental Health

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Description

Child First (Child and Family Interagency Resource, Support, and Training) is an intensive, early childhood, two-generation home visiting intervention that works with a community’s most vulnerable young children (prenatal to age six years) and their families. The goal is to identify children at the earliest possible time to decrease emotional and behavioral problems, developmental and learning problems, and abuse and neglect.

Impact and Outcomes

Results of a randomized, controlled trial demonstrated that at 12 month follow-up, Child First intervention families had strong positive outcomes, as compared to Usual Care control families:
Child First children were 68% less likely to have language problems and 42% less likely to have aggressive and defiant behaviors
Child First mothers had 64% lower levels of depression and/or mental health problems.
Child First families were 39% less likely to be involved with child protective services, which was sustained (33%) at 3 year follow-up.
Child First family members had a 98% increase in access to community services and supports.

Mission & Goals

Child First is an intensive home-based model that targets the most vulnerable young children and families to decrease the incidence of emotional and behavioral problems, developmental and learning disorders, and abuse and neglect. Child First is based on scientific research that demonstrates that environments in which there is major adversity - like maternal depression, domestic violence, homelessness, and substance abuse - lead to levels of stress that are toxic to the developing brain of the young child. However, a strong, nurturing parent-child relationship protects the brain from damage and prevents lifelong problems in mental health, cognition, and physical health.

Child First works collaboratively with community providers, identifying children from challenging environments or showing early signs of behavioral or developmental problems.  This intensive home visiting model connects the family to comprehensive community-based resources, while providing a two-generation, psychotherapeutic intervention. Together, stress is decreased, the brain is protected, and growth is enhanced.

Program

Child First is an evidence-based home visiting intervention that addresses the most challenged, hard to reach, and underserved families with young children, prenatal through age five. This includes families with poverty, maternal depression, domestic violence, homelessness, and substance use.

Child First promotes strong collaboration among community providers, recognizing that creating an early childhood system of care is necessary both to identify children and families in need and to connect them to the services and supports necessary for their long-term success. Children are frequently referred for behavioral problems, developmental concerns, and abuse and neglect.

Based on the latest scientific research, Child First uses a two-pronged, team approach:

  • a Masters-level Mental Health/Developmental Clinician provides a two-generation psychotherapeutic intervention to create a protective, nurturing relationship; and
  • a Bachelors-level Care Coordinator connects both children and their families with comprehensive community-based services.

This results in strong positive outcomes in child language, child and maternal mental health, abuse and neglect, healthcare utilization, and service access.

Given the difficulty of this work, Child First clinical teams have intense training through a year-long Learning Collaborative and are supported by intensive clinical supervision, technical assistance, and ongoing professional development. The program is data-driven, with continuous quality improvement.

Impact

The Child First intervention was evaluated with a randomized controlled trial. Children six to thirty-six months of age were identified through screening for both social-emotional concerns and familial psycho-social risk in Bridgeport, Connecticut. The population was 59% Latino, 30% African-American, and 7% Caucasian. Risk factors were extremely high: 93% receiving public assistance, 64% unemployed, 53% without high school diploma or GED, 67% unmarried, 54% with depression, 44% with a family history of substance abuse, and 25% with a history of homelessness.

Twelve month follow-up demonstrated very strong, statistically and clinically significant outcomes for families randomized into the Child First  Intervention in contrast to the Usual Care Control group:

  • Child First children:
         o   68% less likely to have language problems (Odds ratio (OR)=4.4).
         o   42% less likely to have aggressive and defiant behaviors (OR=4.7).
     
  • Child First mothers:
         o   64% lower levels of depression and/or mental health problems (OR=4.0).
     
  • Child First families:
         o   39% less likely to be involved with child protective services, by maternal self-report (OR=4.1),
               which was sustained at 33% at 3 year follow-up (OR=2.1).
         o   98% increase in access to community services and supports.
     

These results were published in the prestigious journal Child Development in 2011. A careful review of the research led the Health Resources and Services Administration (HRSA) to designate Child First as one of only thirteen “evidence-based home visiting models” nationally. The Coalition of Evidence-Based Policy recently determined that Child First  was Near Top Tier, one of only three early childhood interventions highlighted at this level.

Replication of Child First across Connecticut has continued to demonstrate highly statistically and clinically significant findings with 78% of children and families showing improvement in one or more areas, including emotional and behavioral problems (57%), social competence (67%), language development (73%), and maternal depression (82%).

Growth Plan

Growth Plan

 

PHI is forging a national strategy of systems change within the eldercare and disability services sector. The important changes taking place in New York’s health care policy have positioned PHI to leverage our expertise to shape health care and improve job quality for essential caregivers. As more states follow suit in the transition to managed care, PHI’s lessons learned in New York will produce meaningful outcomes across the country.

 

Within the next five years, we will:

 

Grow

PHI will significantly increase our measurable outcomes. As we do, we aim to demonstrate the feasibility of our caregiving and workforce innovations in the large-scale systems that dominate the healthcare landscape.

 

·         Coordinating care for 8,000 low‐income elders and people with disabilities, with our partnering managed care plan, Independence Care System -- keeping pace with New York State’s transition to managed long-term care

·         Employing 3500 home care aides at PHI’s partnering home care agency, Cooperative Home Care Associates -- the nation’s largest worker-cooperative

·         Each year, training 720 women facing long-term unemployment or newly entering the workforce -- offering them a chance to begin careers in healthcare

 

Leverage our Scale to Change a Field

With lead support from the John A. Hartford Foundation and the F.B. Heron Foundation, PHI is expanding our technical assistance and advocacy capacity through a multi-million dollar “Philanthropic Equity” campaign.

 

The resulting grant investment will allow PHI to expand our consulting, policy, and advocacy staff to 30 professionals, and to diversify our revenue base to a 50/50 blend of grant and fee-for-service income. We will leverage our practice and policy “lessons learned” to other large employers, training programs, and care coordination plans, and into research and advocacy for changes in public policy, on a much broader scale.

 

Maximize Impact

PHI will achieve large‐scale practice changes within major employers, managed care plans and direct‐care training programs—as well as system‐wide policy changes in federal and state legislation and regulations.

Location of Sites

National Office: 
917 Bridgeport Avenue
Shelton, CT 06484
Phone: 203-538-5222
List of locationsMap of locations

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Locations in the following states:

Connecticut

Financials

Most Recent Budget

Year Ended:

2014

REVENUE

Corporate Grants: 
$0
Foundation Grants: 
$1,220,222
Government Funding: 
$3,780,000
Contributions from Individuals: 
$5,000
Special Events: 
$0
Program Services Fees: 
$355,000
Membership Dues: 
$0
Other Earned Income: 
$0
Other Revenue: 
$0
Total Revenue: 
$5,360,222

EXPENSES

Salaries, Related Salaries & Professional Fees: 
$1,320,000
Occupancy: 
$35,558
Travel & Entertainment: 
$73,011
Office Supplies, Printing, Postage: 
$11,573
Telephone & Communications: 
$10,895
Payments to Affiliates: 
$3,059,716
Other Expenses: 
$475,000
Other Expenses (Description): 

Training of staff at affiliate sites, database hosting and maintenance, back office support contract. 

Total Expenses: 
$4,985,753

NET GAIN/LOSS

Net Gain/Loss: 
$374,469

Prior Year Actuals

Year Ended:

2013

REVENUE

Corporate Grants: 
$0
Foundation Grants: 
$783,281
Government Funding: 
$975,000
Contributions from Individuals: 
$12,233
Program Services Fees: 
$683,996
Membership Dues: 
$0
Other Earned Income: 
$0
Other Revenue: 
$0
Special Events: 
$0
Total Revenue: 
$2,454,510

EXPENSES

Salaries, Related Salaries & Professional Fees: 
$406,017
Occupancy: 
$4,060
Travel & Entertainment: 
$21,167
Office Supplies, Printing, Postage: 
$4,263
Telephone & Communication: 
$31,849
Payments to Affiliates: 
$1,269,566
Other Expenses: 
$87,430
Other Expenses (Description): 

Training of staff at affiliate sites. indirect costs (paid to fiscal sponsor).

Total Expenses: 
$1,824,352

NET GAIN/LOSS

Net Gain / Loss: 
$630,158

Major Funders

Major Funders

 

Foundations

 

The Achelis Foundation

Altman Foundation

The Atlantic Philanthropies

Booth Ferris Foundation

Capital One Bank

The Clark Foundation

The Ira W. DeCamp Foundation

Ford Foundation

The Bernard F. & Alva B. Gimbel Foundation, Inc.

The F.B. Heron Foundation

The John A. Hartford Foundation, Inc.

W.K. Kellogg Foundation

The Charles Stewart Mott Foundation

New York Alliance for Careers in Healthcare

The New York Community Trust

Pinkerton Foundation

Robin Hood Foundation

Eleanor Schwartz Foundation

The Starr Foundation

The Stavros Niarchos Foundation

Surdna Foundation

Henry and Marilyn Taub Foundation

Tiger Foundation

United Hospital Fund

The Harry and Jeanette Weinberg Foundation

The Woodcock Foundation

 

 

Key Contracting Organizations

 

New York State Department of Health

New York State Office of Temporary and Disability Assistance

Michigan Department of Community Health

Detroit Regional Workforce Fund

Center for Medicare and Medicaid Services (CMS)/ The Lewin Group

CMS/Health Management Solutions

UCSF – National Institute on Disability and Rehabilitation Research

Fairpoint Baptist Homes

Trinity Senior Living Communities