BUILD Initiative Blog | NCIT Spotlight: Tarrant County, TX
Strong Foundations For Our Youngest Children

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This community Spotlight features Faith Rivera, M. Ed., Community Alignment Coordinator at Help Me Grow North Texas, My Health My Resources of Tarrant County.

The Capacity-Building Hub, an effort of the National Collaborative for Infants & Toddlers (NCIT), offers consultation and support to assist Pritzker Children’s Initiative-funded state and community leaders and their coalitions to make the provision of PN-3 opportunities and services more equitable. The goal, by 2023, is to help states and communities reduce by 25 percent the gap between the children and families served by high-quality programs and the children and families who want the services but don’t have access to them. The Hub aims, by 2025, to help states and communities decrease the gap by 50 percent. The Hub will progressively grow its efforts to increase the knowledge of all state and community leaders by sharing promising strategies and resources other states are successfully using to improve maternal health, birth outcomes, and infant-toddler well-being.

The Spotlight feature is an ongoing opportunity to share the work happening at the state or community level and foster connections between grantees.


BUILD: What are the big prenatal-to-three goals in your community?

Faith Rivera, Help Me Grow North Texas, My Health My Resources of Tarrant County

Tarrant County is implementing the Help Me Grow system model within our community. We're implementing a region-wide approach across 18 counties in our major metropolitan area, with a population of over 8 million people. This fits in perfectly with our prenatal-to-three goals through our community innovation grant.

Our focus for the Pritzker grant is really two-fold. First, it’s about increasing access to essential support services for low-income infants and toddlers. Second is increasing access to high-quality childcare for low-income infants and toddlers. Our goal is to hit that 25 percent mark for our low-income infants and toddlers within three years. And then long-term, about five to seven years would be half of our community's low-income infants and toddlers. Help Me Grow is the overarching theme, the system model, the system approach with those two goals feeding underneath it.

BUILD: Can you tell us more about Help Me Grow?

Faith Rivera, Help Me Grow North Texas

Help Me Grow is an evidence based system model framework that was created through the Connecticut Children's Medical Center in the mid-1990s. It focuses on ensuring that families get access to the supports and services that they need early on, which falls right in line with our goals for our Pritzker grant and building out a coordinated community-wide or region-wide system of care for early childhood.

There are four core components of the system model. First is our Centralized Access Point which houses a call center, website, and resource database, where families and providers can access supports. Second is building out our family and community outreach, so making sure families know about Help Me Grow, that providers know about us, that the system is marketed. We locally are also working to build out family leaders as a piece of this core component.  Third is ensuring that all early childhood providers, including those on the medical side are connected to the system as that universal early identification access point for families if there are needs that have to be addressed. And fourth is collecting data to improve our system, to address gaps, to show where the gaps are in our community and kind of “advocate.” (We’re not an advocacy organization, but we share what those gaps are and figure out ways to address and inform our general community about what's happening.)

We actually found out about the Help Me Grow system model through the initial cohort of the Pritzker grants through the initial fellows’ cohort. One of the fellows from that cohort was implementing Help Me Grow as well. We talked about what that looked like in their community and what the model was and we realized it was what we were trying to build out in our local community. Help Me Grow just gave us the framework to actually implement as well as the technical assistance support from the national center to make sure that we are properly implementing this evidence-based model.

BUILD: What are your primary challenges in achieving your prenatal-to-three goals?

Faith Rivera, Help Me Grow North Texas

We are implementing Help Me Grow across 18 counties with a population of over 8 million people, and that is a big feat in and of itself. The agency that I work for, My Health My Resources of Tarrant County, is one of the three core leadership agencies for the initiative, and we service 12 of the 18 counties. Staffing and funding support for an initiative this big is a challenge - not just in the short term, but building that sustainable funding to make sure that the system is around for years to come - not just throughout the entirety of the Pritzker grant and other similar grants that we have.

Something that we are really working at is how COVID is affecting our families not just in terms of financial issues or access to food, but with regard to the long-term implications that COVID is going to have on our families, on our system, on the children that are developing right now. We want to ensure that as we're building out the system, not just because of COVID and all of the different stressors that families are experiencing right now, that we're ensuring equity and access to services and supports across all of our families.

DFW is a very, very diverse community with a lot of different languages, immigration statuses, and family needs. We want to ensure, through the lens of Help Me Grow, that our approach is universal. All families can benefit from support. We want to make sure we still have those very targeted programs and marketing strategies for the families that are very much in need of what we're doing. We also want to ensure that those families who are hardest hit by COVID and by the racial inequities in our system are able to access this system.

BUILD: Who makes up your coalition, including at the leadership level public, private partners, parents, etc.?

Faith Rivera, Help Me Grow North Texas

At the leadership level of our coalition are those three core agencies - My Health My Resources of Tarrant County (MHMR) - the local mental health authority for Tarrant County (our local health department), who was the recipient of the Pritzker grant, and one of our local early education coalitions called the Early Learning Alliance.

Those are the three core agencies that support the work, but our larger leadership team also includes some private funders including United Way and a private charitable foundation. We have some additional coalitions that are in some of our surrounding counties of Tarrant that join in on that meeting including local Part C providers and other service providers. We try to make our leadership team very diverse. Those same partners are at the general collaborative group just end up a larger quantity and also bring in healthcare, home visiting, and child welfare providers to that larger group.

Some of our local leadership also sit on the state leadership for the Texas grant. Our chief for our Early Childhood Services Division at MHMR is a part of the steering committee for the state to make sure that our plans were aligned when they were submitted, with very similar verbiage and focus areas, but ours was on a community context level versus the state level for Texas. Our local efforts are used for demonstration and replication across the state to see what implementing Help Me Grow looks like for a Texas community.

As far as parent engagement goes, we have a few individuals who, within their agency, serve in a parent liaison role. Over the next few months, we’re going to try to build out family leaders to be a part of our leadership team and subcommittees. Just like we are all paid for our time and expertise, so will they. We have to make sure that parent voice is really built into the system. We're pulling on some of our partner groups like parent leader boards. We're gauging some feedback from them on certain pieces right now. But as of right now, we really don't have that family voice or it's very minimal. It’s one of our big focus areas over the next few months.

The family leaders will be receiving stipends for their time. They'll also receive technology since everything is virtual right now to ensure that they can join in on the meetings. They'll receive some support from us just to make sure they're prepared for these meetings and in this role, as well as some learning or activity kits for their children to keep them occupied while they're engaging in these meetings.

BUILD: How are you supporting families of infants and toddlers and pregnant women who face significant barriers to supports and services?

Faith Rivera, Help Me Grow North Texas

We were fortunate that through our Help Me Grow affiliation, we were able to receive some emergency funding through the JPB Foundation for emergency diapers, wipes, and formulas just in the short term to make sure that some of our families who are in great need across our community have access to those. We're very fortunate that we are in the process of rolling that out just as some tangible supports and resources that those families can access now. We're partnering with some agencies that tend to work with higher-need families like our childcare subsidy agency, our WIC program, as well as others just to make sure, again, that these families have the diapers, wipes, formula that they need.

We also are hearing from families as they call in to the Help Me Grow call center to get connected to resources and services. If they are not able to connect with a specific program, we're asking them why they could not connect with it and what the barriers were so that we can collect the data and look at the problem on more of a systems level. We want to know in certain zip codes or in certain cities or counties what families' barriers are to accessing services, whether it's childcare, finding find food, et cetera. We're collecting data on that to really be able to look at our system and see how we can address those barriers. As providers, sometimes we may have preconceived assumptions about why families don't or can’t access services. We want to actually use data to inform those decisions moving forward.

Even though Help Me Grow is a universal model, we are creating very targeted marketing approaches and targeted supports. For example, in Fort Worth, the largest city in Tarrant County, there are certain schools in which upwards of 20 percent of children are not connecting with school at all, whether it's in person or virtually. In response, we're actually having staff go to the homes of these families, provide them with learning kits for their school school-aged children and also their younger children. Staff will talk to them about what are they experiencing and what supports they need. We get them connected to the Help Me Grow call center or whatever supports they need to make sure they have that wrap around service connection. Whatever their needs are, we're there to support them. Again, we’re just looking at that whole family, what are their needs, and how can we support them.

That's just one example of how we are looking at very targeted populations that have high needs right now and how can we best support them in this time of need given that COVID is not going away anytime soon. As time goes on, more and more families are hurting from a variety of different factors, whether it's financially, as a result of racial disparities that are happening, the political climate, et cetera. We want to make sure that we have those targeted approaches as well as build out these family leaders in our system, gauging their voice on how we are perpetuating these disparities with the system that we're creating, and how we can address them. We want to ensure that it's not us as service providers making those decisions for the families, but that we’re really hearing their voices about how we can as a system and as specific programs, better service them and better meet their needs.

BUILD: You touched on this earlier about being the replication and model between the community and the state, but can you elaborate or is there anything additional you would share on the relationship between state and community work?

Faith Rivera, Help Me Grow North Texas

Outside of just cross-pollination of people on the committees, as the state was developing its plan at the end of last year and earlier this year, we aligned our plans with similar verbiage and focus areas. So just in the context of Help Me Grow, we are the demonstration and replication site. We were the first affiliate in the state, but now there are five additional communities coming on board in other cities across the state. We serve as a support for those other communities so they can reach out to us and ask questions and we can share what we have done. We are helping to create those best practices, given that every state is different and Texas is very unique.

We also are working on aligning our communication strategies. After the election, the state Prenatal to Three Collaborative for Texas is going to be working on some strategies on communicating what we're trying to build out with the general public, as well as sharing information with our legislators. We're about to go into a legislative session in Texas. These happen every two years. They're also pulling on us at a local level to see what is working to share out across the state.

If you look at the verbiage of the state plan and the Tarrant County plan, a lot of the focus areas are very similar. We have our six key strategies that we are implementing. Those align directly with the three pillars or buckets that the state grant is also focusing on because we didn't want to build out a statewide plan and then as communities, start implementing the work on their own and creating these systems in silo. If we're really going to create a coordinated system, it can't just happen at the regional level. It has to also connect at a larger state level. Our hope is that if we have that bi-directional communication with the state and we have some of the same people focusing on the big initiatives that are happening. Then we can make sure that we're working on these agendas together and that we have similar messaging.

BUILD: Any recommendations that you would pass along to other communities or states just getting started?

Faith Rivera, Help Me Grow North Texas

I would say, look at what you're already doing and the strengths that your community has and build upon them. That's what we did that really propelled our work forward. We already had such strong community collaborations even before Pritzker came into the picture in 2018. That extra support and funding really just propelled us forward and allowed us to connect with other communities across the nation that were doing similar things. It’s really what gave us the idea for Help Me Grow and helped project us forward.

I would tell communities that progress can happen very quickly, even if it doesn't seem like it. We only started implementing Help Me Grow back at the very end of May of last year. Not even 18 months later, the state of Texas has adopted Help Me Grow as the model for early childhood. State agencies have bought in and five additional communities are on board.

Stay the course. You know what you're doing is evidence-based and is approved by an amazing funder like Pritzker that funded you because they believe in what you're doing. There are so many supports throughout this network, through NCIT, through the hub, through everyone that really wants to see you succeed. Don’t be afraid to reach out and ask for help. We definitely have and we're so grateful that we did because without the TA support and connecting with other communities, I don’t think we would have gotten so far in less than 18 months of Help Me Grow affiliation.

Even just the fellows’ community that I was a part of in the first grant - I learned so much from that. We're connecting with the second cohort very soon and it's ironic that my supervisor is the new fellow. Even just locally that communication and connection between the two fellows moves the work forward. Any kind of technical assistance support that has been brought to us, they've been nothing short of fabulous. Through our communication with other communities, we learn and create best practices.  

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