When the Rochester community focused on the health of low-income children, it devised a strategy that featured a local time-honored tradition: home visits. Starting in the first year of a child's life, the Monroe County Child Health Initiative provides weekly or biweekly visits by trained paraprofessionals who coordinate the health care of the mother and child, provide parenting education, assure that preventive measures are being followed, and arrange for services if problems arise. These paraprofessional home visitors function as part of a recently improved early intervention, the home visiting service program operated by the Monroe County Department of Health.
This strategy has proved so successful that it is being incorporated as a permanent part of the care at Rochester General Hospital and is beginning to receive reimbursements from managed care plans.
Who is served?
The initiative serves high-risk mothers, infants, and children up to age two who live in the northeast quadrant of Rochester, one of the poorest areas of the city, and who are patients of Rochester General Hospital's outpatient centers. The focus is on families with children who are at high-risk of developmental difficulties because of social and economic factors, but who do not have a documented disability or chronic condition.
The Child Health Initiative enables us to create the Child and Family Health grant from eight separate categorical programs. This will substantially improve the way maternal and child health services are delivered to families, and streamline health department administrative procedures. The end result will be better both for families and for the county."—Andrew S. Doniger, MD, MPH, Director, Monroe County Health Department