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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 B. PROGRAM NEED STATEMENT Entire Section B not to exceed one page) 1 . a) What is the unacceptable condition requiring change ? b) Who has the need ? c) Where do they live ? d) Provide local, state or national trend data, with reference source, that corroborates that this is an area of need. a. What : Pregnancy and raising a child places many new or additional burdens and stressors on a family, including financial, emotional and even physical stress . Along with the joys of parenthood can be the realization of the major responsibilities of raising a child to be healthy and ready to learn by the time they enter their school years . HF focuses on families with risk factors for child abuse addressing parenting components that will improve parent/child interactions and enhance overall brain development. b. Who . Factors associated with increased risk for child abuse, poor birth outcomes and poor infant/child growth and development include: marital status, age of mother, moving three times in one year, alcohol or substance use, high stress level, not wanting the pregnancy, depression, history of mental health counseling, and partner being unemployed. In many cases, these risk factors are more prevalent for low income families. Indian River County residents had 1 ,056 births in 2002 . Of these births, 62 . 8 % were from white mothers, 15 .3 % black, 19 . 0% Hispanic and 2 . 9% "other" mothers. In 2002, almost half, or 45 % of all births are covered under Medicaid or indigent funding, which amounts to 475 babies being from low income families . Of all the births in 2002 (the latest year for complete birth data), 39 . 6 %, or 418 babies, were to unwed mothers, with black unwed births at 76 . 5 % . In terms of education status of the newborn' s mother, 28 .3 %, or 299 of the mothers did not have a 12'h grade education or GED . c. Where . Healthy Families — IRC serves families from the entire county, with 53 % served from south county, and 47% from the north county area. d. Corraboration of Area of Need : The HF program is modeled after the highly successful national HF America initiative that is based on critical program elements that have been defined by over 20 years of research and represent best practices in home visitation. Only three reported child abuse cases for families receiving HF-IRC services have occurred since 1999, which is noteworthy since these families are at greater risk for committing child abuse . 2. a) Identify similar programs that are currently serving the needs of your targeted populations b) Explain how these existing programs are under-serving the targeted population of your program. Healthy Start Care Coordination provides ongoing case management to high-risk families, placing emphasis on the pregnant woman to help ensure a healthy birth outcome, as well as pregnant women or infants with medical risk factors. Typical caseloads in the Healthy Start program are 50 pregnant women and/or infants per Healthy Start Care Coordinator. Statewide, the Healthy Start program is only funded at 47 percent of the true at-risk client needs. Due to the complex and labor intensive problems addressed, Healthy Start Care Coordination only provided 91 infants and their families ongoing care coordination in 2003 . This leaves almost 1 ,000 families with Uewborns that might be at risk for child abuse and could be eligible for Healthy Families . The program is designed to work on parent/child bonding and interaction with the target child until the child reaches age five . Healthy Families also requires that low caseloads be maintained at an average of 20 families per worker, but no more than 25 . The low caseloads and the extended duration of services greatly enhance the opportunity to positively impact families . Healthy Families-IRC is the only program in Indian River that is designed to stay with families for up to five years , 5