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Organization: Indian River County Healthy Start Coalition , Inc . Program: Healthy Families — IRC Program Funder: IRC Board of County Commissioners — Children 's Services Advisory Committee - 2004 Grant Application G. TIMETABLE (Section G not to exceed one page) 1 . List the major action steps, activities or cycles of events that will occur within the program year, New programs should include any start-up planning that may occur outside the funding year, In com l ting the timetable, review information detailed in prior sections. Month/ Activities Period Healthy Families — IRC is in its fifth year of operation, and has no start-up steps. The major steps for the overall program are : Pregnant women are offered the universal screen by the Screening Liaison at Partners in Women ' s Health. The voluntary screen looks at risks for child abuse. A consent form is also signed by the client if they have a positive score for Healthy Families on the universal Weekly HS/HF screen. Referrals can also come from the social worker at Indian River Memorial Hospital at the time of birth. Additional referrals can come from any agency in the community. Families can be eligible for assessment during pregnancy or up to two weeks after the birth of their child. The screen is sent to the Healthy Start Care Coordination office for processing. All screens are then forwarded to the Healthy Families Family Assessment Worker (FAW) for a face- to-face assessment to determine if they are eligible for Healthy Families. The FAW communicates with the HS Care Coordination team to determine the potential HF client' s status prior to performing the assessment. On-going After the assessment, if the family is eligible for Healthy Families, and is interested in participation, the Program Manager reviews the case with the FAW. The case (family) then goes to the HF Supervisor, who reviews the family' s needs and determines the best Family Support Worker (FSW) for case management assignment. The family is then assigned to a FSW. Phone contact must be attempted within 72 hours by the FSW. A subsequent home visit attempt must be completed within 5 days . Once contact is made with the family, initial goal(s) setting is done within one month of opening case. Supervision is conducted weekly with all FSW' s for a minimum of two hours, who review all cases assigned to the FSW. Goals are reviewed and updated with the family and Supervisor every 90 days. These goals can be modified during 90 days if needed. For pregnant women, the determination of weekly or bi-weekly visits during pregnancy is made . After birth, visits are weekly for a minimum of 6 months. Bi-weekly visits can be done if the mom returns to work, with phone contacts in between. Six to eight months after birth, the Supervisor and FSW will determine if the family can move to level two, which is bi-weekly visits . This determination would be based on the family' s progress in meeting their goals and well as overall family needs . The Ages and Stages child assessment tool is conducted every four months and goes all the way to 60 months . The Parent Child Assessment/Observation tool is done at one month, then every six months . Home Safety checks at one month then six months . The family and target child have goals and levels to achieve for program graduation, 11