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Debbie Richardson Home Visiting Work Group Meeting February 25, 2011

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Presentation on theme: "Debbie Richardson Home Visiting Work Group Meeting February 25, 2011"— Presentation transcript:

1 Debbie Richardson Home Visiting Work Group Meeting February 25, 2011
Overview Supplemental Information Request (SIR) for the Submission of Updated State Plan (Released 2/8/11) ACA Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program Debbie Richardson Home Visiting Work Group Meeting February 25, 2011

2 Home Visiting Primary service delivery strategy
Offered on voluntary basis to pregnant women or children birth to age 5 Embedded in a comprehensive, high-quality early childhood system that promotes maternal, infant, & early childhood health, safety, development, and strong parent-child relationships

3 Updated State Plan Submission Date
days from SIR release date May 8 – June 8 Will be reviewed & approved on a rolling basis

4 Funding to State Will receive at least FY’10 allocation in FY’11-’15 ($936,464) Additional competitive funds beginning FY’11 Criteria to be provided prior to state plan due date

5 Maintenance of Effort As required in initial FOA:
Funds shall supplement, not supplant, funds from other sources for early childhood HV programs & initiatives Must maintain non-Federal funding (SGF) for grant activities at level not less than 3/23/10 Received clarification that state’s Tobacco Settlement $ will not be considered

6 Updated State Plan Content & Criteria
Identification of targeted at-risk community(ies) Goals & objectives Selection of proposed HV model(s) Implementation plan Plan for meeting mandated benchmarks Plan for administration Plan for continuous quality improvement Memorandum of Concurrence Budget

7 1. Identification of targeted at-risk community(ies)
Justify selection of the at-risk community(ies) from among those identified in the initial needs assessment For the targeted community(ies), update & provide a more detailed needs and resources assessment Specific community risk factors and strengths Characteristics and needs of participants Service systems for families including HV programs currently operating or discontinued since 3/23/10 Existing mechanisms for screening, identifying, referring to HV programs Referral resources available and needed

8 1. Targeted community(ies) - cont’d
Plan for coordination among existing programs & resources in targeted communities How program will address existing service gaps Local & state capacity to integrate proposed HV services into early childhood system List other communities identified in initial needs assessment but not being selected due to funding limitations

9 2. Goals & Objectives for State HV program
Clearly articulated goals & objectives How program can contribute to developing a comprehensive, high-quality EC system Strategies for integrating the program with other programs & systems in state related to MCH and EC health, development, & well-being Logic model

10 3. Selection of proposed HV model(s)
One or more evidence-based HV models should be selected Up to 25% of funds allowed to support promising approaches that do not yet qualify as EBM Can request consideration or reconsideration of other models as EB Engage targeted community(ies) in decision-making to assess fit of model and readiness to implement

Early Head Start - Home-Based Option Family Check Up Healthy Families America Healthy Steps Home Instruction Program for Preschool Youngsters (HIPPY) Nurse Family Partnership Parents as Teachers

12 Basis for State’s Selection of Model(s)
Selected HV model(s) match needs and address particular risks in targeted community(ies) Characteristics and needs of local families Target multiple risk factors to the extent possible Consider service gaps Model(s) will be complementary, not duplicative, of existing HV or other services for local families Capacity and resources of the targeted community(ies) to implement the chosen model(s)

13 Local RFP process State may request proposals for funding to provide services in state-identified communities and select strongest State may identify 1 or more HV models for which it seeks proposals If choose to use a competitive subcontracting process, must describe how RFP will be structured and meet federal requirements

14 Model Adaptations May adapt model to meet needs of targeted communities such as broadening population served, additions, subtractions, or enhancements Acceptable changes are those that have not been tested with rigorous research but are determined by the model developer not to alter the core components related to program impacts Adaptations that alter core components may be funded as promising approaches

15 Promising Approaches A HV model…
with little or no evidence of effectiveness, does not meet criteria for EBM, or modified version of EBM that includes significant alterations to core components Should be grounded in empirical work Must be developed by or identified with a national organization or higher ed institution Must evaluate with well-designed & rigorous process

16 Model Developers Must provide documentation of approval by developers of selected model(s) to implement model as proposed Verifying developer… has reviewed & agreed to plan as submitted proposed adaptations support for participation in nat’l evaluation state’s status to any required certification or approval process required Submit within 45 days (by 3/25/11) – may request extension

17 Other info regarding models
State’s current/prior experience with implementing and current capacity to support State’s overall approach to HV quality assurance Approach to program assessment and support of ensuring model fidelity Anticipated challenges & risks to maintaining quality & fidelity and proposed responses

18 4. Implementation plan for State HV Program
Process of engaging targeted at-risk community(ies) Approach to development of policy and setting standards Working with model developer(s); TA and support to be provided by nat’l model(s) If used, plan for recruitment of subcontractor orgs Timeline for obtaining curriculum & materials Types of and how initial & ongoing training will be provided for HV personnel Recruiting, hiring, and retaining staff

19 Implementation plan - Quality
Plan to ensure high quality clinical supervision and reflective practice for staff Operational plan for coordination among existing HV programs and other related programs/services in the community(ies) Plan for obtaining/modifying data systems for ongoing continuous quality improvement (CQI) Approach to monitoring, assessing, and supporting implementation with model fidelity and maintaining quality assurance

20 Implementation plan - Participants
Estimated # of families served and estimated timeline to reach max caseload Plan for identifying/recruiting participants, and minimizing attrition rates for enrolled participants Individualized assessments will be conducted of participant families and services provided according to the assessments

21 Priority to serve eligible participants
Low incomes Pregnant women < age 21 History of child abuse or neglect; or interactions with child welfare services History of substance abuse or need SA treatment Use tobacco products in home Have, or have children with, low student achievement Have children with developmental delays or disabilities Families with members who are serving or have served in armed forces

22 Research & Evaluation Participate in national evaluation
Not required to conduct any add’l evaluation, other than research on promising approaches May conduct research & evaluation outside of national evaluation – if so, must describe

23 5. Plan for meeting mandated benchmarks
Must collect data on: all benchmark areas and all constructs eligible families enrolled in program who receive services funded with MIECHV program funds Individual-level demographic & service-utilization data Must demonstrate improvements in: at least 4 benchmark areas by end of 3 years at least ½ of constructs under each benchmark area

24 Benchmark I Improved maternal & newborn health
Prenatal care Parental use of alcohol, tobacco, illicit drugs Preconception care Inter-birth intervals Screening for maternal depressive symptoms Breastfeeding Well-child visits Maternal & child health insurance status

25 Benchmark II Child injuries, CA/N, emergency visits
Visits for children and mothers to emergency dept – all causes Info/training provided to participants on prevention of child injuries Incidence of child injuries requiring medical treatment Reported suspected maltreatment (allegations screened but not necessarily substantiated) and substantiated maltreatment for children in the program

26 Benchmark III Improvements in school readiness & achievement
Parent Child support for children’s learning & development knowledge of child development of their child’s developmental progress parenting behaviors and parent-child relationship emotional well-being or stress communication, language & emergent literacy general cognitive skills positive approaches to learning including attention social behavior, emotion regulation, & emotional well- being physical health & development

27 Benchmark IV Crime OR Domestic Violence
Caregiver arrests & convictions Screening for DV Of families identified for presence of DV: # referrals made to relevant services # completed safety plans

28 Benchmark V Family economic self-sufficiency
Household income & benefits Employment & education of adult members of household Health insurance status

29 Benchmark VI Coordination and referrals for other community resources & supports
# families identified for necessary services # families that required services and received a referral to available community resources # of MOUs or formal agreements with other social service agencies in community # agencies with which HV provider has a clear point of contact that includes regular sharing of information # of completed referrals

30 Plan for benchmarks – cont’d
Recommended/strongly encouraged: standard measures for constructs across HV models utilize standard measures and other appropriate data for CQI to enhance program operation, decision-making, and to individualize services data collected across all benchmark areas be coordinated & aligned with other relevant state or local data collection efforts

31 Plan for benchmarks – cont’d
For each construct within each benchmark area: Specify proposed measure(s) with various details For use of administrative data, must include MOU from agency with responsibility/oversight Proposed definition of improvement for each element of construct

32 Data collection & analysis plan
Sampling may be used for some or all benchmark areas Schedule for collection & analysis of each measure Ensure quality – min. qualifications, required training for relevant staff, time estimated for data collection-related activities by personnel How data will be analyzed at local & state levels Using data for CQI at local program, community, state levels Data safety, monitoring, privacy, human subjects protections Anticipated barriers/challenges & possible strategies

33 6. Plan for Administration
Statewide administrative structure to support state HV program How HV plan and program will be managed and administered at state & local levels Collaborative public/private partners If support more than one HV program in community – plan for coordination of referrals, assessment & intake procedures across models Identify other related state or local evaluation efforts of HV programs (other than evals of promising approaches) Key personnel – job descriptions & resumes Organization chart

34 Coordination with Early Childhood System
Ensure Updated State Plan is coordinated with other state EC plans including State Advisory Council Plan and State EC Comprehensive Systems Plan Any strategies for making modifications needed to bolster the State administrative structure in order to establish a HV program as a successful component of a comprehensive, integrated EC system

35 7. Plan for Continuous Quality Improvement (CQI)
CQI – A systematic approach to specifying processes and outcomes of a program or set of practices through regular data collection and the application of changes that may lead to improvements in performance Address how CQI strategies will be utilized at local & state levels

36 8. Memorandum of Concurrence
Signed by required agencies signifying approval of Updated State Plan (1st four + 2): Director, State’s Title V agency (KDHE) Director, State’s agency for Title II of CAPTA (SRS) State’s child welfare agency (Title IV-E and IV-B), if not also administering Title II of CAPTA (SRS) Director, State’s Single State Agency for Substance Abuse Services (SRS) Administrator, State’s Child Care and Development Fund (CCDF) (SRS – who?) Director, Head Start State Collaboration Office (SRS) State Advisory Council on Early Childhood Education and Care authorized by Head Start Act (?)

37 Other State Agencies… Strongly encouraged to seek consensus from:
IDEA Part C and Part B lead agencies Elementary & Secondary Education Act Title I or pre-K program MCHIP and/or EPSDT programs Strongly encouraged to coordinate with: Domestic Violence Coalition Mental Health agency Agency charged with crime reduction TANF and SNAP Injury Prevention & Control

38 9. Budget Updated budget for use of FY’10 allocation
Funds awarded for FY’10 are available for expenditure thru 9/30/12 Budget period – 27 months Includes costs of statewide needs assessment, state plan, and initial implementation

39 SIR and related HV Program information
KDHE website HRSA website Home Visiting Evidence of Effectiveness (HomVEE)

40 Debbie Richardson, Ph.D. Manager, Home Visiting Program Bureau of Family Health Kansas Dept. of Health & Environment 1000 SW Jackson, Suite 22o Topeka, KS

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