MEMORANDUM OF AGREEMENT BETWEEN THE CHILDREN’S TRUST FUND and
HARTFORD NURTURING FAMILIES PROGRAMS
This agreement is between the Children’s Trust Fund, Saint Francis Hospital and Medical Center, Hartford Hospital, Catholic Charities Asylum Hill Family Center, Catholic Charities El Centro Family Center, and Catholic Charities Southside Family Center, City of Hartford- Health and Human Services Department (Maternal Infant and Outreach Program), Family Life Education, Inc., Hispanic Health Council Center for Women and Children’s Health (Comadrona Program), Trust House Inc., The Village for Families and Children Rambuh Family Center, and The VNA Healthcare, Inc..
Purpose: The purpose of this agreement is to facilitate the coordination of services and establish the screening, referral and enrollment protocols for all * first time mothers who live in Hartford.
For the purposes of this agreement *first time mothers are defined as women who are pregnant for the first time and have made a decision to parent their unborn child or who have given birth to their first child and the child is less than 90 days old at the time of program enrollment. All forms referred to in this agreement are Nurturing Families Network approved forms.
We agree:
The Nurturing Connections Coordinators (NCC) at Hartford Hospital and Saint Francis Hospital and Medical Center will:
I. Complete the REID and intake for all first time mothers* who come to their attention through the clinic, outreach activities or a hospital admission.
II. If the REID score is:
A. Positive and the mother agrees to participate in the KEMPE assessment:
1. Obtain the mother’s signature on the Release Of Information (ROI) form, as needed, granting permission to disclose her identifying information to a NFN neighborhood site.
2. In the following order-forward the intake and the ROI form to:
- A NFN site using the Rotational Referral System or based on the mother’s preference.
- NFN MIOP or the NFN Women’s and Children’s Health Program when the program indicated in 2a is at capacity.
- Traditional MIOP or Comadrona program services when the programs indicated in 2a and 2b are at capacity.
B. Positive and the mother does not agree to participate in the KEMPE assessment, document:
1. The efforts to engage the mother and the outcome of the engagement process including:
a. Attempts made to refer the mother to the NFN home visiting program and/or to other specific services, including traditional MIOP and Comadrona ,or resources.
b. Offer the mother Nurturing Connections services delivered by the Nurturing NCC or another agency staff.
c. Inform mother of the option to participate in a Nurturing Parent Group (NPG) that provides services within her neighborhood or based on her preference.
- Negative and the mother agrees to services:
1. Accept mother into the Nurturing Connections program.
2. Inform mother of the option to participate in a Nurturing Parent Group (NPG) that provides services within her neighborhood or based on her preference.
3. Secure the mother’s signature on the ROI form, as needed, indicating her agreement to participate in the program.
- Negative and the mother does not agree to services:
1. Provide the mother with the information regarding the Nurturing Families Network.
2. Inform mother that she can contact the NCC at any point prior to the child’s 90th day of birth to enroll in the program.
3. Inform mother of the option to participate in a Nurturing Parent Group (NPG) that provides services within her neighborhood or based on her preference.
4. Keep on file mother’s intake form.
- Follow the Nurturing Family Network policy to inform referrals for families with acute problems.
IV. Maintain a computerized record of all mothers screened in the hospitals or referred from other sources per the information on the intake form.
The Hartford NFN sites Family Assessment Worker (FAW) will:
I. Inform the Nurturing Connections Coordinators (NCC) atHartford HospitalandSaint Francis Hospital and Medical Center,via email, when they are accepting and /or available to accept new families into their home visiting program.
II. Complete the intake form for first time mothers* that come to their attention as a result of outreach efforts, referrals from clinics, schools, or other sources.
III. Upon completion of the REID and intake form if the score is:
A. Positive and the mother agrees to participate in the KEMPE assessment and she lives within the site’s service area
1. Obtain the mother’s signature on the ROI form granting her permission to disclose personal information to the identified NCC. This information will only be used for tracking of referrals and service delivery.
2. Complete the KEMPE assessment and inform the mother of her eligibility for the home visiting program.
a. If the mother is eligible, document the results on the intake form and follow protocols established for timely case assignment.
b. If the mother is not eligible, document the results on the intake form and inform her of the option to participate in Nurturing Connections and the Nurturing Parenting Group.
3. Forward the ROI and intake forms to the NCC atHartford HospitalandSaint Francis Hospital and Medical Center indicating where she anticipates delivery or has delivered.
4. Inform the NCC atHartford Hospitaland Saint Francis Hospital and Medical Center of the service(s) the mother will be receiving at the notifying site or other site based on her preference.
B. Positive and the mother agrees to participate in the home visiting program and she does not live in the site’s service area:
1. Obtain the mother’s signature on the ROI form granting her permission to disclose personal information to the identified site and the NCC at Hartford HospitalandSaint Francis Hospital and Medical Center. This information will only be used to complete the referral, case assignment and to track service delivery.
2. Contact the identified site to ensure there are openings within the home visiting program.
3. Forward to the accepting site the ROI and the intake forms.
4. Forward to the NCC atHartford Hospital andSaint Francis Hospital and Medical Center the ROI and the intake form, indicating the hospital of delivery, the site and services the mother agreed to receive.
C. Negative and the mother agrees to participate in the NC service:
1. Obtain the mother’s signature on the ROI form indicating her agreement to participate in the NC program and permission to disclose personal information to the NCC atHartford HospitalorSaint Francis Hospital and Medical Center. This information will only be used to complete the referral and case assignment.
2. Inform the mother of the option of participating in a Nurturing Parenting Group at that provides services within her neighborhood or preferred site.
3. Forward to the NCC atHartford HospitalandSaint Francis Hospital and Medical Center the ROI and the identifying information recorded on the intake form where mother anticipates delivery or has delivered.
4. Inform the NCC atHartford HospitalorSaint Francis Hospital and Medical Center of the outcome of hospital referrals forwarded to sites.
D. Negative and the mother does not agree to participate in NC service:
1. Request the mother’s signature on the ROI granting her permission to disclose identifying information to Nurturing Connections.
a. If the mother signs the ROI, forward the intake form to the NCC atHartford HospitalandSaint Francis Hospital and Medical Center indicating where mother anticipates delivery or has delivered.
b. If the mother refuses to sign the ROI the site will keep the completed Intake form on file until the child would be three months old.
2. Inform mother of the option to participate in a Nurturing Group that provides services within her neighborhood or preferred site.
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IV. Inform the NCC atHartford HospitalorSaint Francis Hospital and Medical Center hospital of the status of referrals within the program.
V. Notify the Nurturing Connections Coordinators (NCC) atHartford HospitalorSaint Francis Hospital and Medical Center if a prenatal mother stops participating in the home visiting program as indicated on the ROI.
The City of Hartford and the Hispanic Health Council will:
I. Provide traditional MIOP and Comadronaprogramservices to mothers pregnant with their secondor subsequent child.
II. Provide traditional MIOP and Comadrona program services to mothers when the NFN sites are at capacity.
Each party agrees that this document will be reviewed every two years from the date the MOA is finalized. Interim modification to this process can only be implemented when parties agree to develop new protocols to successfully implement the screening and referral process of the Hartford Nurturing Families Network.
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Anyango Smith, Program ManagerRose Alma Senatore, CEO
Asylum Hill Family CenterCatholic Charities
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Ara Gena Martinez, Program ManagerRose Alma Senatore, CEO
El Centro de Desarrollo y Reafirmacion FamiliarCatholic Charities
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Joyce Bosco, Program ManagerRose Alma Senatore, CEO
Southside Family CenterCatholic Charities
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Laura Verbarg, NCCJohn Biancamano, Vice President of Finance
Hartford HospitalHartford Hospital
Women’s Ambulatory Health Services
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Grace Damio, Program ManagerJeannette DeJesus, Executive Director
Hispanic Health Council Hispanic Health Council
Center for Women and Children’s HealthCenter for Women and Children’s Health
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Leticia Marulanda, Program ManagerMayor Eddie A. Perez
City of Hartford Health Dept.City of Hartford
Maternal Infant and Outreach Program
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Ramon Rojano, Director
City of Hartford
Health and Human Services Dept.
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Evelyn Rodriguez, Program ManagerBeverly Ryan, Executive Director
Parkville Family CenterFamily Life Education, Inc.
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James Lane, Program Manager Howard Garval, President
RAMBUH Family Center Village for Families and Children
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Jesusita de Pedro, Program ManagerChristopher Dadlez, President and CEO
Saint Francis Hospital and Medical CenterSaint Francis Hospital and Medical Center
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Anne Brown, Program ManagerJudith Green, CEO
Trust House Inc.Trust House Family Inc.
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Migdalia Belliveau, Program ManagerNancy Culos, VP of Clinical Operations
VNA Healthcare, Inc.VNA Healthcare, Inc
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Linda Harris, Program SupervisorKaren Foley-Schain, Executive Director
Children’s Trust FundChildren’s Trust Fund
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REVISED 10/20/05