When LA’s “Safer at Home” order was enacted, Ava Moten was gripped by anxiety. “The only thing I was thinking: ‘Oh my God, our parents.’”
Moten runs a home visiting program for at-risk families in South LA. It’s called Shields for Families, and it serves parents who’ve just had a baby, and who may be experiencing homelessness or poverty, or are recovering from substance abuse.
These professional visits can help vulnerable families in all sorts of ways. That includes making sure the baby gets regular diaper changes.
“Diapers [are] really expensive. So we make sure every single visit, we're taking diapers in the home or taking wipes in the home. We’re taking clothes in the home,” Moten says.
But her staff members are not considered essential workers, so typical in-person visits immediately stopped.
However, they could leave diapers in a safe spot for a family to collect.
Home visitors attend to other needs too. They help with Medi-Cal enrollment, check for warning signs of infants’ developmental delays, and make sure homes are free of hazards for small children.
How does all this happen during the pandemic? Virtual video chats.
“We were thinking about [using] FaceTime,” Moten says. “Then they were saying that it wasn't HIPAA compliant.”
The Health Insurance Portability and Accountability Act (HIPAA) concerns client privacy, and many video chatting platforms do not meet HIPAA standards.
“How can we make sure we [maintain] fidelity to our model, and at the same time fidelity to our families?” Moten says.
This scenario repeated itself around the country as social service organizations rushed to figure out how to keep providing services after stay-home orders were issued.
Angela Rau is an expert at doing home visits via video conferences. She works for Parents as Teachers, a national organization that connects families to professionals who help them during a child’s early years. She leads webinars to train people on doing virtual home visits.
“This type of technology is becoming a lifesaver for families, and for home visitors to be together and support each other through this crisis,” Rau says.
Yet prior to COVID19, it was hard to convince policy makers that this method worked, she says.
“It just didn't seem like people were … wanting to put money towards it, wanting to sustain the work,” Rau says.
That changed when COVID19 hit. Rau’s organization has received a $1.1 million grant by the Heising Simons Foundation to create free online home visiting resources.
Dorian Traube, an associate professor of social work at USC, has spent years trying to convince people that video home visits have many benefits. “Sometimes these policy makers take a very provincial approach,” she says.
Traube is convinced that using secure video chat platforms is comparable — and even preferable — to having someone visit the home. Video visits cost a lot less than in-person ones, and more families could be served than only the most at-risk, she says.
Video chats could happen more frequently, and professionals could be on call for crises, Traube adds.
Yet prior to COVID19’s spread in the community, federal, state and county funding agencies were unwilling to fund groups using a virtual visiting model.
Traube points out that new parents today are digital natives. “What they were asking for were digital solutions to parenting challenges, they didn’t necessarily want someone in their home,” Traube says.
Jennifer Rodriguez of South LA is sheltering in place in the Jordan Downs projects with her 1-month-old son, her mom and siblings. She does Zoom calls with her home visitor from Shields for Families. Over those video chats, community health educator Perla Montenegro talks to Rodriguez about her baby’s development and offers tips and advice, and checks for signs of infant developmental delays.
Ava Moten says that since her staff began virtual visits on March 17, they’ve conducted 126 video visits — compared to 53 in-person visits in February.
Dorian Traube of USC is not surprised.
“My hope is that we continue to offer virtual services after stay-at-home orders are lifted because I think this is a positive outcome of a terrible situation,” Traube says. “It has moved the needle in several industries that were really reluctant to offer virtual services to families.”
Child welfare was one place where home visits were rarely — if ever — done via video conferencing. Not anymore.
“This entire situation with the coronavirus pandemic has changed the way that we do a lot of the work,” says Bobby Cagle, head of the LA County Department of Children and Family Services (DCFS).
DCFS has moved quickly to make sure its 18,000 children in foster care — and the 6,000 pending cases — can continue check-ins via video chat wherever possible.
Cagle acknowledges a “technology divide” exists among foster families. For those who cannot video chat, monthly in-person visits by social workers still happen.
Parents who have had a child removed and are going through the process to reunify now almost always have to video chat with their kids as well.
Video chatting has been distressing for many parents, according to Sylvie de Toledo, an advocate for parents in the child welfare system. She’s with the group Alliance of Relative Caregivers. “This is hard for everybody because children can’t hug their moms or dad,” she says.
Los Angeles mother Cristina, whose child was taken away after she faced domestic violence, believes her four year old doesn’t fully grasp why she no longer visits, despite the foster family repeatedly explaining it to her. (KCRW cannot share Cristina’s last name because her case is pending.)
“Instead of a visit, we're replacing it with a Skype [three days a week],” Cristina says.
Video chatting with a 4 year old for hours is hard. “She can’t really engage for that long,” Cristina says.
Her daughter has a hard time saying goodbye, she gets pouty and sometimes has an “attitude,” Cristina says. This never happened during their in-person visits.
Cristina wishes she could have a video conference for her upcoming court date — originally slated for April — when she would have been granted back custody of her daughter. Now it has been pushed to May. After one year of separation, every day without her child feels excruciating.
Deepa Fernandes is a reporting fellow at Pacific Oaks College which is funded in part by First 5 LA.