Program shift means Portland will lay off nurses, in-home visits will change

Douglas Gardner, director of the Portland Department of Health and Human Services.
Douglas Gardner, director of the Portland Department of Health and Human Services. Buy Photo
Posted Feb. 05, 2014, at 1:05 p.m.

PORTLAND, Maine — The city of Portland and a local nonprofit are working toward as smooth a transition as possible as administration of a popular parenting program changes hands, officials from both sides said.

But despite those efforts, nurses employed by the city will be laid off and some parents, who have become accustomed to regular in-home visits by medical specialists, will no longer receive check-ins from visiting nurses.

“We are working really hard with the city of Portland employees, hand-in-hand together to ensure a seamless transition for families. But it’s a disruption,” said Louise Marsden, head of early childhood programs for Opportunity Alliance, which will take over administration of the in-home family education program in Portland.

“The reality is there’s going to be some displeasure about this,” she continued. “It’s unavoidable, even after everyone’s best efforts to hand [off] the wand responsibly. If you’ve had the same visitor in your home for nine months, and that changes, it can be difficult.”

Approximately five years ago, state government shifted from contracting with dozens of local-level service providers to administer its so-called Maine Families in-home parenting education program to a county-by-county model.

At that point, the state hired the Portland-based nonprofit collaborative Opportunity Alliance to administer the program in Cumberland County, and the organization subcontracted the work in Portland to the city, which had provided the service locally for years under the previous deal.

Now, in an effort to make delivery of the program less expensive and more efficient for the state, Opportunity Alliance is taking over delivery of the program in Portland. The nonprofit has been delivering the Maine Families curriculum to parents in other Cumberland County municipalities since its inception.

Douglas Gardner, director of Portland’s Department of Health and Human Services, said the transition means the city won’t receive the $64,000 it had annually been getting to deliver the program locally in the upcoming fiscal year 2015. And that will mean the city’s staff of four nurses involved with in-home visits will need to be reduced, although he wasn’t sure yet how many layoffs will be necessary.

Gardner said the city still receives state funding directly for nurses to make home visits as part of the Maternal and Child Health — or MCH — program, although he acknowledged changes may be made to that program at the state level as well.

“We’ve employed nurses for years,” Gardner said. “The visiting nurses program is one of the oldest services in the department.”

Because of the handoff of the Maine Families program from the city to Opportunity Alliance, Portland parents will experience some changes.

The MCH visits are only required to be offered to parents whose children show health risks and need the extra attention, Marsden said. There are no such eligibility requirements to receive visits through the Maine Families program, at least through the first three months of a child’s life.

Previously, because the same city nurses were conducting visits under both programs, they were largely indistinguishable to parents and combined to provide regular check-ins and long-lasting relationships.

With the change, parents whose children are older than three months and aren’t showing health risks will abruptly lose the nurse visits they’d become accustomed to.

One such Portland couple is Annie Leahy and Mike Carey, whose youngest child is 4 months old.

“Knowing that you have somebody like that available to you was really reassuring,” Leahy told the Bangor Daily News. “I suppose you could call it a luxury, but for us, it really seemed like it was really basic and valuable.”

Said Carey: “[The nurses’] ability to intervene, make suggestions or maybe catch something that wouldn’t have otherwise been caught is invaluable. There could be things going on with a kid that you just may not notice [as untrained parents].”

Marsden said her organization will hire two additional workers to join its staff to help pick up the Maine Families program work for parents who qualify, but acknowledged that there’s no requirement that those workers be certified nurses.

Marsden also admitted the change of faces — from the city nurses parents became familiar with to the nonprofit workers who will replace them — may be jarring. But she said the Opportunity Alliance staff members will be highly qualified and working hard to make the transition as easy as possible for the parents.

“My recruiting post will not say, ‘Must have a nursing degree.’ And from a financial perspective, recruiting a nurse compared to recruiting somebody with a bachelor’s degree in social work or early childhood education is not the same thing,” said Marsden, who noted that her workers will receive as much as two months of training before being allowed to make home visits. “There are parents who don’t want anybody else in their homes except for a nurse. But this is a highly qualified staff.”

Marsden called the program transition “challenging and sad.”

“For families, the disruption is ‘Who is the visitor?’ and that’s a serious disruption. We’re doing our best to mitigate those disruptions,” she said. “Once we’re over this hurdle, everything will settle down. I think the thing that’s most difficult is that the city of Portland is losing some funding, and there’s no way around that. That will have implications somewhere.”

 

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