Successes and a Silver Lining to Virtual Home Visiting in LA

By: Jess Berthold, Communications Director, First 5 Association of California

The nurses and caregivers of Welcome Baby, a voluntary home visiting program at Maternal and Child Health Access, in partnership with California Hospital Medical Center, are meeting the challenge of tele-visits in stride—and the program is seeing some unexpected silver linings to going virtual.

“The community needs us more than ever because of the isolation and the increased barriers to services, but we have seen a ton of success stories already,” says Lili McGuiness, program manager for Welcome Baby, which is funded by First 5 LA.

Lili McGuinness

One nurse, who has been with the program for 10 years, has identified situations from phone calls alone where medical care was urgently needed. In the first case, a mother told the nurse she was having trouble getting a mammogram appointment, despite finding a lump and having pain in her breast. “The nurse went hard for this woman to get a mammogram, calling the clinic herself with the mother on the line, until they agreed to see her,” Ms. McGuiness said.

In another instance, a few strategic questions led the nurse to identify a baby as having potentially high-risk medical needs, and she immediately advocated for the baby to be taken into emergency care. The nurse contacted medical providers in order to pave the way for the mother to bring the baby to the hospital—where, it turned out, the baby had a major medical issue that needed attention.

The Welcome Baby program has been helping families with linkage to medical care and health care coverage, ongoing parenting support, access to basic needs, and mental health services. The approach is very client-centric—based in relationships, emotional support, and meeting families where they are. The strength of this approach is especially apparent now, when families are experiencing increased anxiety and depression, and less access to prevention of family violence services.

“What helps with successful health outcomes is modeling reflective empathy and strengths within the family, and holding a space to be vulnerable,” Ms. McGuiness said. “Through that process we model how to tune into your baby’s needs. The process also may lead us to find that a family needs mental health or family violence resources, or more support for parenting.”

Welcome Baby families are experiencing a lot of stress due to financial struggles, multiple people in the home, and social isolation—and nurses and other caregivers have responded by touching base more frequently. Mental health challenges have intensified, and so have referrals to organizations for tele-therapy.

In many cases, virtual home visitors also are helping parents access services to obtain essential needs like food, shelter, and diapers. “Families are overwhelmed and they need someone to walk them through some of the processes, like how use their cash cards from the city or access other benefits,” Ms. McGuiness said.

A silver lining is that, for some parents, virtual visits are preferable— more convenient and more comfortable than having a visitor in the home. They can be beneficial to the home visitor, too—offering a way to continue providing services if the home environment is unsafe to enter, Ms. McGuiness said.

“These visits allow for more access for families, and more flexibility for our workforce. I actually think this experience will help us grow to become even more client-centered, by having an option whose potential we didn’t fully realize until now,” she said.