Introduction

Purpose of the Manual

The purpose of this manual is to provide a detailed program overview and resources for Public Health Nurses (PHNs), community health workers (CHWs), supervisors and administrators to use to support their work in the Babies First! and CaCoon Programs.

In 2023, the effort to combine the Babies First! and CaCoon manuals was undertaken to reduce burden on implementing staff, local agencies, and families. Across the state, the workforce for these programs is often the same or overlapping. For other agencies, they are only implementing one of the programs, usually Babies First!. It is important for programs to keep in mind that services should still be offered to those children (up to age 5) who would be eligible for CaCoon, although they will receive Nurse Home Visiting support from a Babies First! case manager. There are also some programs that work with Community Health Workers and others that do not. Differences in programs are referred to as “model variations". Approved model variations or general best practices are illustrated in tip boxes throughout the manual. 

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Overview of Public Health Nurse Home Visiting in Oregon

These programs are administered by Local Public Health Departments or partnering local agencies and are tailored to address specific community needs. This localized approach ensures that families are offered the necessary support and resources within their community. Please note, not all programs are available in every county (see map for details).

Babies First! (B1st!): B1st! serves pregnant people and families with babies and children up through age 4 (up to age 5) with an identified need. Program oversight and technical assistance is provided by the State Public Health Division. Local Public Health Departments determine whether they will administer this program and which target populations to prioritize based on community need. B1st! is available in most Oregon counties.

CaCoon: The CaCoon program serves children and youth with disabilities and special healthcare needs from birth through age 20 (up to age 21). The Oregon Center for Children and Youth with Special Health Needs (OCCYSHN) provides oversight and technical assistance for this program. OCCYSHN is housed at the Oregon Health and Science University (OHSU). Local Public Health Departments determine whether they will administer this program and which target populations to prioritize based on community need.  CaCoon is available in most Oregon counties.

Family Connects Oregon (FCO): The FCO program offers between one and three home visits to every family with a newborn beginning around three weeks of age. Eligible families may be transferred from FCO to B1st or CaCoon. Oversight and technical assistance are provided by the State Public Health Division and Family Connects International. FCO is currently available in eight Oregon counties with plans to eventually be offered statewide. 

Nurse-Family Partnership (NFP): The NFP program primarily serves low-income people who are pregnant for the first time. Families are visited from pregnancy until the child turns 2 years old. Technical assistance is provided by the State Public Health Division and the Nurse-Family Partnership National Service Office. NFP is currently available in nine Oregon counties. 

Funding to support these programs depends on the program and the local site but may include: Oregon State General Funds, county general funds, Medicaid reimbursement, federal funds (Maternal and Child Health Title V Block Grant, Maternal Infant Early Childhood Home Visiting), and commercial insurance reimbursement (FCO only).

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Babies First! and CaCoon Joint Vision Statement

Every family in Oregon with an identified need who wants a public health home visitor has access to one. Families served by Babies First! and CaCoon feel that their unique needs are being met and that they are supported in living healthful lives. By helping families thrive, we are supporting the well-being of our communities.

Babies First! and CaCoon Joint Values Statement

• We oppose all forms of oppression, including racism, classism, sexism, and ableism.
• We understand that individuals may face unique forms of discrimination, particularly if they belong to multiple oppressed groups.
• We work to remove systemic and social barriers to care.
• We support the inclusion of all parents, including fathers, mothers, non-binary parents, resource parents, grandparents, step-parents, adoptive parents, and all others who have taken on a parental role.
• We offer services that meet parents where they are, reducing life stressors and adding value to families' lives.
• We value lived experience.
• We believe that all home visiting services should focus on the needs of families and be sensitive to the cultural backgrounds of the individuals served.
• We believe that parent partnership is an essential part of home visiting programs.
• We believe that home visiting programs are most effective when they are designed to first and foremost meet the needs of families and children.
  

Mission 

Babies First!

The Babies First! Program is a relationship and strength-based public health nurse (PHN) home visiting program that partners with families to improve pregnancy, family and child health outcomes, and to connect to quality health care and the community supports they have a right to.

CaCoon

CaCoon is a relationship and strength-based public health nurse (PHN) home visiting program that partners with families with children and/or youth with disabilities or unique health care needs by supporting them to access and coordinate quality health care and the community supports they have a right to.

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Program Acronym List

CCO   Coordinated Care Organization
CDRC Child Development and Rehabilitation Center
CHN    Community Health Nurse
CHW  Community Health Worker
CSHCN           Children with Special Health Care Needs
CYSHCN Children and Youth with Special Health Care Needs
EI/ECSE Early Intervention/Early Childhood Special Education
EBP     Evidence-Based Practices
EIP      Evidence-Informed Practice
FOC    Father of Child
IFSP/IEP Individualized Family Service Plan/Individualized Education Plan
LHS     Legacy Health Systems
LHD    Local Health Department
MAC   Medicaid Administrative Claiming
MOC  Mother of Child
OCCYSHN Oregon Center for Children and Youth with Special Health Needs
ODDS             Oregon Developmental Disabilities Services
OHA   Oregon Health Authority
OHSU Oregon Health & Science University
OT       Occupational Therapist
PHN    Public Health Nurse
POC    Parent of Child
PT       Physical Therapist
RS       Reflective Supervision
ST        Speech Therapy
SSI      Supplemental Security Income
SSDI   Social Security Disability Insurance
TCM   Targeted Case Management
UCP    United Cerebral Palsy

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Self-Assessments of Learning Needs

Self-assessments are an important part of program orientation, on-going professional development, and quality improvement. Parallel to the program approach of family-centered and trauma informed practice, we acknowledge the diversity in staff and community needs across Oregon, which also applies to training needs. Only you can assess your individual learning needs: we encourage you to take the Babies First! Self-Assessment of Learning Needs annually. Additional program assessments are also available (see below).

Home Visiting Staff:

• Babies First! Self-Assessment of Learning Needs (this is a smartsheet that will require you to create a login password).
• Reflective Supervision self-assessment

Program Administration:

• Strengthening Families™ Self-assessment Tool for Home Visiting Programs
• Reflective Supervision program assessment
• 2SLGBTQ+ assessment
  

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