A National Resource to Support Excellence in Community Action
Last Revised: Feb 27, 2009 - Initial Posting: Sep 23, 2004
Purpose

The mission of CHIP of Virginia is to improve young children’s heath and promote wellness and self-sufficiency in low-income families, through partnerships with local communities.

Description

Overview of CHIP ModelCHIP of Virginia is a non-profit organization responsible for the development, implementation and maintenance of a statewide network of community-based child health and family support programs in Virginia.  Local CHIP (Comprehensive Health Investment Project) sites provide services through a home visiting model using a case management approach.  The CHIP model involves a team of a public health nurse and an outreach worker working in partnership with the family and service providers to help each family reach full potential.

The initial concept for CHIP was developed in 1988 through the leadership of Total Action Against Poverty (TAP).   Community Action Agencies are currently involved as lead partner agencies for two of the eleven CHIP sites.

To be enrolled in CHIP, a family must (a) be at or below 200% of federal poverty income level and (b) have one or more children between birth and six years old or be expecting a baby.  The three essential program components of CHIP are:

  • Medical Home – CHIP is committed to the philosophy that the promotion of wellness and the improvement of health for children begin with a medical home that provides accessible, continuous, comprehensive, family centered, coordinated, and compassionate health care to infants and children.  Traditionally, children from low-income families do not have medical homes, but instead receive fragmented, limited and sporadic services from clinics and hospital emergency rooms.  CHIP sites work with families and communities to ensure that each child (0-6) and their older siblings are able to access and use a medical home and a dental home.
  • Health Supervision – CHIP provides services to improve the health status of CHIP children through a home-based case management approach.  These services complement the efforts of the medical home and include but are not limited to:
    • Health assessments and early developmental screening of children
    • Development of comprehensive plans of care
    • Referrals and follow-up for primary and specialty care
    • Health education, including anticipatory guidance for child growth and development
    • Oral health assessments, instruction and application of dental varnish
  • Family Support – CHIP provides services to promote parental involvement and support the family’s ability to move toward self-sufficiency, including but not limited to:
    • Family needs assessment and facilitated family goal setting
    • Educational and support services to assist parents in acquiring parenting skills, learning about growth and development, and responding to the behavior of their children.  CHIP established a partnership with the Parent Educational Advocacy Training Center (PEATC) and Healthy Families to begin using the Parents as Teachers (PAT) curriculum in CHIP sites.
    • Outreach services to ensure that parents are aware of and able to participate in family resource and community service activities.
    • Community referral services to assist families in obtaining community resources, including health care, mental health care, FAMIS, FAMIS Plus, or other insurance, employment resources, and other social services.
    • Follow-up to ensure that necessary services are received by families and are effective in meeting their needs.
    • Transportation to services and appointments.

In order to ensure the ability to work with families from all cultures, CHIP established the CHICOS project.  CHICOS or Child Health Integrated Cultural Outreach Services has enabled CHIP to:

  • Train all staff in cultural competence and immigrant families’ rights to services
  • Assist sites in hiring bilingual home visitors
  • Translate CHIP home safety and outreach publications
  • Support the formation of parent education groups for Latino families
  • Provide parenting education materials to Spanish-speaking families in their own language
  • Train staff members in medical interpretation, and
  • Contract interpreters and telephone-based medical interpretation for CHIP sites across the state.

Partners in Pregnancy is a partnership between CHIP of Virginia and Optima Health Plan aimed at improving health outcomes for high risk pregnant women and their infants. In Virginia, 10,300 babies born each year are low birth weight, and 3,000 of these are Medicaid births. Partners in Pregnancy provides high-risk pregnant women and their infants with the care they need to survive and grow up healthy. The program involves home visits and case management by CHIP nurses and outreach workers, in combination with a medical home and regular nurse consultations provided by Optima.  The Association of Maternal and Child Health Programs has recognized CHIP of Virginia’s Partners in Pregnancy program as one of the top Promising Practices in the field of Maternal and Child Health - see press release.   Evaluation results have shown a major cost-savings and improved health outcomes for the women and their infants. Babies who received CHIP services in addition to health plan benefits spent 44% fewer days in the hospital than a similar insured control group throughout the first year of their life, and the net savings from pregnancy to age one was $2,287 per child. This is a return on investment of 1.26 - see Partners in Pregnancy Return on Investment Report.

Finally, CHIP of Virginia acts as the voice and face of the local CHIP sites at state level policy and practice discussions.  CHIP of Virginia staff are members of statewide boards and coalitions, and educate members of both the Executive and Legislative branches of state government about CHIP and about children’s health issues.  CHIP is also represented on a number of national organizations and acts as a liaison between those organizations and local CHIP personnel.  Various program highlights have been covered in CHIP of Virginia annuals report and fact sheets.

Outcomes

CHIP uses a comprehensive process and outcome evaluation system.  Evaluation forms mirror overall program objectives and use a variety of indicators to track changes in child health and family self-sufficiency.  Four key program success indicators have been established:

  • Outcome indicators: immunizations, health insurance, and use of medical homes
  • Process indicators: delivery of core servicesCHIP Annual Report - 2008

The CHIP Annual Report 2008 includes a series of charts showing a broad range of program outcomes. A total of 2,871 families were served in FY08, including 3,827 children and 582 pregnant women.

Outcomes based on families enrolled after November, 2005:

  • Children with Health Insurance 88% vs. 93% one year after enrollment.
  • Children with Medical Homes 91% vs. 99% one year after enrollment.
  • Immunizations up to date or on track 86% vs. 95% one year later.
  • One or both parents employed 36% v. 46% one year after enrollment.
  • Children ages 3-5yrs enrolled in preschool or early care setting 38% vs. 66% one year later.

CHIP has also published a series of Fact Sheets that focus on specific issues including Dental, Parents as Teachers, CHIP Saves Money, School Readiness, Asthma, Prenatal Care, and Child Health.

CHIP Dental Fact Sheet       CHIP Parents as Teachers Fact Sheet      CHIP Saves Money Fact Sheet      CHIP School Readiness Fact SheetCHIP Asthma Fact Sheet      CHIP Prenatal Care Fact Sheet      CHIP Child Health Fact Sheet
Contact

Lisa Specter-Dunaway, President & CEO
804-783-2667