1. Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) Supplemental Information Request #2 ( SIR #2) Virginia Updated State Plan Regional Meetings March 21-30, 2010

2. Maternal, Infant, and Early Child Home Visiting Purposes: oto strengthen and improve the programs and activities carried out under Title V of the Social Security Act; oto improve coordination of services for at-risk communities; and oto identify and provide comprehensive services to improve outcomes for families who reside in at-risk communities

3. Application Process Step 1: July 2010 State applications Step 2: September 20, 2010 SIR #1 Statewide Needs Assessment Step 3: Supplemental Information Request #2 Updated State Plan Due June 8, 2011

4. Updated State Plan o Final designation of at-risk communities to be targeted by State HV Program o Detailed needs and resources assessment for communities o Plan for coordination among existing programs/resources o Assessment of local and State capacity to integrate the proposed home visiting services into an early childhood system o A list of “at-risk” communities not selected for implementation in FY 2010

5. Updated State Plan o Goals and Objectives of Updated Plan o Strategies for Integrating Updated State Plan into other early childhood programs and systems o Logic model for State HV Program

6. Selection of Model o Selection of the model(s) should be in response to the needs of the targeted at-risk communities o Select a model(s) that meets criteria for evidence of effectiveness o Propose another model not reviewed by HomVEE study o Request reconsideration of an already-reviewed model o Propose use of up to 25% of funds for a promising approach

7. Evidence-based (EB) Models (2/08/2011) http://www.acf.hhs.gov/programs/opre/homvee http://www.acf.hhs.gov/programs/opre/homvee oEarly Head Start- Home-based Option Only oFamily Check-Up oHealthy Families America oHealthy Steps oHome instruction Program for Preschool Youngsters (HIPPY) oNurse Family Partnerships oParents as Teachers

8. State Selection of Model o Within 45 days, States must secure approval by developer(s) to implement model(s) as proposed, including any acceptable adaptations o For the MIECHV program, an acceptable adaptation is one determined by the developer not to alter the core components related to program impacts

9. Implementation States must: oDescribe how the model(s) meets need of each community oDescribe State’s current and prior experience implementing model(s) oSubmit a plan for ensuring implementation with fidelity oDiscuss anticipated challenges to implementation

10. Implementation State must: oSubmit a plan for implementation of State HV Program and for ongoing monitoring of the quality of implementation at the community, agency, and participant level oSubmit required assurances oMust agree to the Maintenance of Effort

11. Maintenance of Effort (MOE) States must : Maintain the level of State General Funds As of March 23, 2010

12. Benchmarks o Maternal and Newborn Health o Child injuries; child abuse, neglect, or maltreatment o School readiness and achievement o Crime or domestic violence o Family economic self-sufficiency o Coordination and Linkages

13. Benchmarks State must : oCollect data on all 6 benchmark areas oCollect data for all listed elements under each benchmark area oShow improvement in at least half of the elements under each benchmark area oDevelop a continuous quality improvement plan oReport to HHS on benchmark progress at the 3-and 5-year points

14. State Home Visiting Plan oA description of the administrative structure in place to support the program oA description of staffing and administration oA description of efforts to coordinate the program with other State early childhood plans

15. Continuous Quality Improvement oCQI is an approach utilizing regular data collection and the application of changes that may lead to performance improvements oThe State must discuss a plan for CQI for their State HV Program oTechnical assistance will be provided as needed on CQI strategies

16. Technical Assistance oHHS intends to provide TA and training to States throughout the grant application process and implementation phase of the MIECHV Program oStates should provide a description of anticipated TA needs in the Updated State Plan State level Local communities

17. Memorandum of Concurrence Signed by : oDirector of the State’s Title V agency oDirector of the State’s agency for Title II of the Child Abuse Prevention and Treatment Act (CAPTA) oDirector of the State’s child welfare agency (Title IV-E and IV-B), if this agency is not also administering Title II of CAPTA oDirector of the State’s Single State Agency for Substance Abuse Services oState’s Child Care and Development Fund (CCDF) Administrator oDirector of the State’s Head Start State Collaboration Office and

18. Memorandum of Concordance (continued) oState Advisory Council on Early Childhood Education and Care authorized by 642B(b)(1)(A)(i) of the Head Start Act oThe State’s Individuals with Disabilities Education Act (IDEA) Part C and Part B Section 619 lead agency(ies) oState Elementary and Secondary Education Act Title I or State pre-kindergarten program and oState Medicaid/Children’s Health Insurance program (or the person responsible for Medicaid Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Program).

19. Additional Potential State Partners oState Domestic Violence Coalition oState identified agency charged with crime reduction oState Temporary Assistance for Needy Families agency oState’s Supplemental Nutrition Assistance Program agency oState Injury Prevention and Control (Public Health Injury Surveillance and Prevention) program

20. Federal Review oJustification of targeted communities at risk oHow the model(s) addresses specific community needs oPlan for meeting benchmarks and collecting data oOverall feasibility of plan oLevel of commitment and concurrence among required partners

21. Virginia Needs Assessment oInsufficient staff to provide for the unmet need for HV oServices for fathers oServices for teen parents oServices for diverse cultural populations oUnavailable mental health and substance use treatment resources for parents oInadequate domestic violence prevention and treatment oInsufficient parent support in crisis situations, especially to prevent abuse/neglect oIncreased need for education/training for parents so that they can be self-sufficient oAddition: Early and appropriate referral to Early Intervention

22. Virginia Plan oParallel the Federal Requirements oProvide Technical Assistance to all 38 “at-risk” communities oIntegrate Home Visiting Services into the Early Childhood system with staff training, data collection, evaluation oRequire local Data Collection in the state project system oDevelop Continuous Quality Improvement Plan (CQI)

23. Virginia Plan o Increase Quality, Effectiveness and Availability at the State and Local level oIncrease services by Evidence-based (EB) Home Visiting Models in local communities oShow Improvements in the Lives of Vulnerable Families and Their Children as measured by Progress toward the Benchmark Goals within 3 to 5 years

24. State Application Process oEligible Applicants: 38 “at risk” Communities or a zip code area or adjacent zip code areas which meet the same qualifications as the 38 “at risk” communities oRequirements: Still being reviewed oDue date: TBA

25. Virginia “at-risk” Communities Accomack County Bristol City Campbell County Charlotte County Cumberland County Danville City Emporia City Essex County Fredericksburg City Gloucester County Greensville County Halifax County Hampton City Henry County Hopewell City Lancaster County Lunenburg County Lynchburg City Montgomery County Newport News City Norfolk City Northampton County Nottoway County Orange County Patrick County Petersburg City Portsmouth City Radford City Richmond City Smyth County Southhampton County Staunton City Suffolk City Sussex County Warren County Waynesboro City Williamsburg City Winchester City

26. First Steps for Local Application oMeet with all local home visiting programs oInvite early childhood partners oMeet with the local Early Childhood Coalition (Smart Beginnings Coalition or others)

27. Identify Community Home Visiting Needs Use existing needs assessments to begin oCity/County Development Plan oLocal Dept of Social Services oLocal Health Department (MAPP) oLocal Community Service Board oLocal School System data or plans oHead Start Needs Assessment oJuvenile Justice Prevention Plan oEarly Intervention Office oEarly childhood Interagency Group oHousing Department oBoys and Girls Club; etc

28. Ask parents & other consumers Parents/Families oParents with children in Head Start and other early child education settings oWIC participants oNew Parent Classes/Childbirth Classes Community Advocacy Groups Professionals oLocal Obstetricians and Pediatricians; Providers in Medical Homes; Community health care centers oTeachers at early childhood centers oBusiness leaders oHospitals

29. Identify Gaps in Local Home Visiting Services (children ages 0-5 years old; families) oAge Group oRisk factors oNeighborhood oCultural factors

30. Identify Resources oCommitment to Improving Services oHistory of supporting Families oExperienced Staff oSuccessful Organizations oCommunication Networks oInteragency Collaborative History oRelationships with other “at-risk” Localities oCommunity Opportunities

31. Identify a Target Population Priority to Vulnerable Families oLow income oA Pregnant women who is less than 21 years old oA History of Child Abuse and Neglect oA History of Substance Abuse or in need of treatment oA History of using Tobacco products in the Home oLow achievement, or have children with, Low Achievement oThose with children with Developmental Delays oFamily members serving in the Armed Forces or on multiple deployments outside of the United State.

32. Selection of an Evidence-based Model oIdentify the Community Goals oReview Community Needs oConsider Community Gaps oIdentify Target Population oCommit Community Resources

33. In Selecting the Model(s) o Pay particular attention to the Target Population identified for each model o Review the Evidence-based Model report by Mathematica Policy Research o Review the HomVee website

34. Selection of the Model(s) There is not one “right” selection. A review of the Needs, Gaps, Resources, Community Experience and Target Populations could lead to the choice to expand an existing evidence-based program model or to add a new program model to the community continuum in order to best serve vulnerable families. Consider where the community is interested in making an effort. Make a clear logical explanation of the choice.

35. Local Community Applicant Each community is likely to be asked to demonstrate: oEvidence of Efficiency and Effectiveness in Plan oCost per Child / per Family oEvidence of Collaboration oEvidence of Experience and Solid Performance in providing HV services oConsumer/Community Interest/input/buy-in oEvidence of Commitment to Improvement on Benchmarks oLocal Opportunities for Broader Partnership

36. Home Visiting Consortium Ashley Barton - BabyCare, Department of Medical Assistance Services Mary Mitchell - Medicaid Managed Care, DMAS Johanna Schuchert - Healthy Families Ann Childress – Dept of Social Services (DSS) Lisa Specter-Dunaway - CHIP of Virginia Linda Foster - Virginia Healthy Start Initiative, Dept of Health (VDH) Wenda Singer - Head Start/Early Head Start Collaborative, DSS Phyllis Mondak - Special Education/Part B, Dept. of Education Mary Ann Discenza – Early Intervention/ Part C, Depart of Behavioral Health and Developmental Services (DBHDS) Martha Kurgans – Project Link, DBHDS Catherine Bodkin - Resource Mothers, BabyCare Liaison, (VDH)

37. Useful Websites www.homevisitingva.com www.homvee.acf.hhs.gov www.mdrc.org/project_12_104.html www.mchcom.com

38. www.homevisitingva.com www.homevisitingva.com See “Announcements” or “Resources/Virginia documents”

40. www.homvee.acf.hhs.gov

41. Click on “Models”

42. Outcomes by Models and Populations

43. www.homevisitingva.com www.homevisitingva.com Announcements and Documents are posted here. Contact: Any Member of the Virginia Home Visiting Consortium or Catherine Bodkin, LCSW, Chair of HVC MIECHV Project Director Virginia Department of Health Catherine.bodkin@vdh.virginia.gov 804-864-7768

44. QUESTIONS? Thank you for participating today.