Family Connects International (FCI) is committed to strengthening bonds for families with newborns and linking them directly to supportive community care resources through universal newborn nurse home visiting.
Our vision is a world with equitable outcomes for each and every newborn.
The United States is facing a maternal mortality public health crisis.
The U.S. has the highest pregnancy-related death rate among developed nations and that rate rose a staggering 40% in 2021 compared to the previous year.
How is this happening in a country with one of the most advanced health care systems in the world?
Family Connects is a universal solution to a preventable crisis.
Our policy priorities for 2023-2024 include:
Maternal Mortality - The Fourth Trimester
Since 2018, the American College of Obstetricians and Gynecologists (ACOG) has recommended that postpartum clinical visits occur within the first three weeks. However, most of those giving birth in the UnitedStates navigate the fourth trimester (the 12-week postpartum period) independently, waiting until 4–6 weeks postpartum to visit their medical provider. As many as 40% of moms do not attend a postpartum medical visit at all, and attendance rates are even lower among those who face barriers to health care access.As part of its recommendations, the ACOG committee specifically mentioned nurse home visitors as alternative providers of this first postpartum visit during the fourth trimester, citing research on outcomes from the Family Connects model of universal newborn nurse home visiting.
Driving Sustainable, Innovative Investments in Family Connects
We collaborate closely with our community partners to advocate for local investments aimed at implementing, sustaining, and expanding the reach of the Family Connects. FCI places a high priority on establishing relationships with federal, state, and local policymakers to jointly develop funding sources for local programming that encompasses both traditional and nontraditional avenues. We emphasize the importance of a mixed funding model to ensure free visits for families as an integral component of a comprehensive range of family support programs, with the goal of improving outcomes for children and families. ACOG committee specifically mentioned nurse home visitors as alternative providers of this first postpartum visit during the fourth trimester, citing research on outcomes from the Family Connects model of universal newborn nurse home visiting.
Universal System Alignment
Our efforts in community alignment involve coordinating the organization and dissemination of resources, while also identifying gaps or deficiencies in resources, systems, policies, and processes to ensure improved accessibility for all families. We actively contribute to values of transparency and accountability through continuous quality improvement data reviews and discussions. We aim to collaborate across various systems within communities, including medical providers, doulas, lactation consultants, early childhood education professionals, and social services to achieve our shared goals. Public investments in Family Connects ensure that community resources are maximized. We emphasize the importance of a mixed funding model to ensure free visits for families as an integral component of a comprehensive range of family support programs, with the goal of improving outcomes for children and families. ACOG committee specifically mentioned nurse home visitors as alternative providers of this first postpartum visit during the fourth trimester, citing research on outcomes from the Family Connects model of universal newborn nurse home visiting.
Nursing Workforce Development
An essential service provided by FCI is the development of the nursing workforce. Through our programs, we create a pipeline of nurses and nurse supervisors, offering career opportunities and establishing a well-educated workforce that serves both urban and rural communities. In the FY 2022, we trained over 144 nurses within our network, and over the past five years, we have supported 629 nurses. FCI actively seeks innovative opportunities to advance investments in a robust nursing workforce to serve both urban and rural communities.
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FCI’s 2023-2024
Policy Priorities
Family Connects International is committed to strengthening bonds for families with newborns and linking them directly to supportive community care resources through universal newborn nurse home visiting.
Our vision is a world with equitable outcomes for each and every newborn.
Download the PDF
About
Family Connects
At FCI, we believe our Model can benefit each and every newborn. That's why we employ a universal approach to reach all families of newborns, including foster, adoptive, and bereaved parents, to offer a free, nurse home-visit for a maternal and child health screen and connection to local services to meet their unique needs.
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White Papers
White Paper; Keywords: ACEs, Social Determinants of Health, Whole Person Care
Authors: Debra L. Best, MD, FAAP and Kimberly J. Friedman, JD
Conclusion: “In conclusion, there is considerable opportunity for medical providers and community partners to work together to deliver whole person care that extends beyond the walls of the medical provider’s office and embraces community partners. These partnerships require collaboration and coordination between health care services and community programs and must be built with patients at the center. Innovative funding streams that incentivize partnerships and build bridges for data exchange must be developed. Public funds must be leveraged at federal, state and local levels, and the donor community must share a long-term vision and commitment to whole person care. By building and incentivizing an infrastructure that is founded upon a universal system of coordinated supports for all families and linking that system with the medical home, we ensure family-centered access to needed and desired referrals. We also move one step closer to connecting every caregiver and child to the healthy futures that they deserve.”
- Addressing Social Determinants of Health in the Postpartum Period Using Family Connects (2021) White Paper
Author: Family Connects International
Conclusion: “While screening and referrals in the postpartum period cannot resolve many of the complex and longstanding intangible and structural health inequities, the Family Connects model can help communities ensure that comprehensive care — care that encompasses the behavioral, emotional and social needs of families, in addition to physical health — is being addressed.”
Briefs
- Family Connects: A Prospective Economic Evaluation (2024) Springfield-Greene Health Department Family Connects Springfield-Greene County “Discounted at 3%, it is estimated that the cost savings of the Family Connects program will be $22.2 million. This includes the discounted present values of over $400,000 due to the reduction in ED visits, almost $16 million due to the reduction in inpatient visits, over $4 million due to the reduction in postpartum anxiety and almost $400,000 due to the reduction in CPS investigations. Based on a 7% annual discount rate, the cost savings are estimated to be over $20 million. The Family Connects program is expected to cost approximately $1.4 million annually. For every dollar invested in the Family Connects program, Greene County can expect approximately $4.08 in savings. This represents a 408% return on investment.”
- Family Connects: Washington State Department of Children, Youth, and Families (2022). Report.Executive Summary “In May 2021, Engrossed Substitute Senate Bill (ESSB) 5092 section 229 provided funding for the Washington State Department of Children, Youth, and Families (DCYF) to collaborate with a nonprofit in Pierce County to provide a brief voluntary newborn home visiting program. The agency was also directed to examine the feasibility of using different funding streams to fund this visitation model. This report should be viewed in conjunction with the earlier reports submitted in December 2019 and June 2020, which is included in the appendix. The earlier reports discussed in-depth specific broad funding strategies and are only referenced in this report. There are as many different ways to fund this type of visitation program as there are programs. In Washington, it could be feasible to fund a system of visitation utilizing Medicaid, private insurance, Title IV-E, and MIECHV dollars, in addition to partnerships with the public health sector to capitalize on any prevention dollars that exist outside of the social services and child welfare sector. Brief voluntary newborn home visiting is an evidence-based prevention technique. Any operation and expansion of the current pilot will require an explicit partnership between the three state agencies that govern these types of services: DCYF, the Department of Health (DOH), and Health Care Authority (HCA), along with an authentic partnership with local implementing agencies.”
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Family Connects: A Strategy to Improve Health During the Fourth Trimester (2021)
Brief on the Fourth Trimester: The three-month period immediately following giving birth. Author: Family Connects International
- A Paradigm Shift Toward Development of Equitable Population-level Solutions (2020) Brief Authors: By Kimberly J. Friedman, JD, and Krysta Gougler-Reeves, MSW, MPH “By incorporating an infrastructure that includes population-wide systems such as Family Connects, by building a strong and equitable public health system, and by encouraging flexibility for evidence-based home visiting programs during a crisis, we can carve a path forward that connects every caregiver and child to the healthy future that they deserve.”
Cristina Novoa is senior policy analyst for Early Childhood Policy at the Center for American Progress. Simon Workman is the director of Early Childhood Policy at the Center.
Conclusion
As policymakers and advocates seek to give all children and families a strong start in life, a universally available family support model should be part of their agendas. Family Connects provides an example of such a model, and its promising outcomes and potential for cost savings make it broadly appealing to communities ranging from large cities such as Chicago—which recently began a pilot program in four hospitals—to midsize cities such as Durham to small rural communities. It even appeals to states: In June 2019, the Oregon Legislature approved a bill to expand Family Connects throughout the state over the course of several years, becoming the first state in the country to expand home visiting to all families.
As communities consider how best to serve families with newborns, it is critical to recognize that all families could benefit from additional help. Stakeholders should use the myriad resources available to help communities understand families’ needs, the different models available, the costs and returns on investments, and the potential outcomes of investing early.26 While the results of statewide implementation of Family Connects remain to be seen, the model’s strong track record of improving child outcomes for entire communities is certainly promising.
One Pagers
One pager with an overview of the evidence.
Author: Family Connects International
One pager on the importance of nurses in the Model.
Author: Family Connects International
Additional Resources
Prenatal-to-3 Policy Impact Center: State Policy Level Checklists
The Prenatal-to-3 Policy Impact Center recently shared the newest State Policy Lever Checklists that provide a breakdown of the policy components state leaders should consider when setting priorities or drafting legislation. There is a checklist for Comprehensive Screening and Connection Programs that focuses primarily on Family Connects, DULCE, and Healthy Steps.
The Checklists include a comprehensive list of policy levers, from eligibility requirements to generosity of benefits, administration, and funding mechanisms. They also call out considerations to support equitable program implementation.
The Evidence
Family Connects is an evidence-based model that supports all families of newborns. Two randomized controlled trials of Family Connects were conducted in Durham, NC, when the model was formerly called Durham Connects. We continue to engage in high quality research to drive data-driven improvement of the Family Connects Model.
Read more about the evidence to support Family Connects on our research page.
Meet Melea
Melea Rose-Waters, MSW
Senior Policy Director
As a registered lobbyist, Melea develops FCI’s policy agenda on the local, state, and federal levels and coordinates policy outreach for local community partners.
