Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV)

1. Maternal, Infant, and Early Childhood Home Visiting Program(MIECHV) Supplemental Information Request (SIR #2) Virginia Updated State PlanDevelopment Health Resources and Services AdministrationAdministration for Children and FamiliesU.S. Department of Health and Human Services

2. Maternal, Infant, and Early Child Home Visiting • Purposes: • to strengthen and improve the programs and activities carried out under Title V of the Social Security Act; • to improve coordination of services for at-risk communities; and • to 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 6, 2011

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

5. Updated State Plan • Goals and objectives for Updated State Plan • Strategies for integrating Updated State Plan into other early childhood programs and systems • Logic model for State HV Program

6. Selection of Model • Selection of the model(s) should be in response to the needs of the targeted at-risk communities • Select a model(s) that meets criteria for evidence of effectiveness • Propose another model not reviewed by HomVEE study • Request reconsideration of an already-reviewed model • 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 • Early Head Start- Home-based Option Only • Family Check-Up • Healthy Families America • Healthy Steps • Home instruction Program for Preschool Youngsters (HIPPY) • Nurse Family Partnerships • Parents as Teachers

8. State Selection of Model • Within 45 days, States must secure approval by developer(s) to implement model(s) as proposed, including any acceptable adaptations • 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: • Describe how the model(s) meets need of each community • Describe State’s current and prior experience implementing model(s) • Submit a plan for ensuring implementation with fidelity • Discuss anticipated challenges to implementation

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

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

12. Benchmarks • Improvements in maternal and newborn health • Prevention of child injuries, child abuse, neglect, or maltreatment, and reduction of emergency department visits • Improvements in school readiness and achievement • Reduction in crime or domestic violence • Improvements in family economic self-sufficiency • Improvements in the coordination and referrals for other community resources and supports

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

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

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

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

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

18. Memorandum of Concordance(continued) • State Advisory Council on Early Childhood Education and Care authorized by 642B(b)(1)(A)(i) of the Head Start Act • The State’s Individuals with Disabilities Education Act (IDEA) Part C and Part B Section 619 lead agency(ies) • State Elementary and Secondary Education Act Title I or State pre-kindergarten program and • State 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 • State Domestic Violence Coalition • State identified agency charged with crime reduction • State Temporary Assistance for Needy Families agency • State’s Supplemental Nutrition Assistance Program agency • State Injury Prevention and Control (Public Health Injury Surveillance and Prevention) program

20. Federal Review • Justification of targeted communities at risk • How the model(s) addresses specific community needs • Plan for meeting benchmarks and collecting data • Overall feasibility of plan • Level of commitment and concurrence among required partners

21. Federal Webinars: • February 24, 3-4:30 pm EST –Data systems • March 3, 3-4:30 pm EST –Benchmarks • Additional webinars will be announced on other topics related to sections of the SIR

22. Virginia Needs Assessment • Insufficient staff to provide for the unmet need for HV • Services for fathers • Services for teen parents • Services for diverse cultural populations • Unavailable mental health and substance use treatment resources for parents; • Inadequate domestic violence prevention and treatment • Insufficient parent support in crisis situations, especially to prevent abuse/neglect • Increased need for education/training for parents so that they can be self-sufficient.

23. Virginia Plan • Parallel the federal requirements • Provide Technical Assistance to all 38 “at-risk” communities • Integrate Home Visiting Services into the EC system • with staff training, data collection, evaluation • Require local Data Collection in the state project system • Develop CQI plan

24. Virginia Plan • Increase Quality and Availability • Provide 1-4 grants for Community Service Grants to provide Evidence-based Home Visiting models • Provide 1-4 Community HV System Project Grants • Expand Research on Promising Models • Resource Mothers Program

25. State Application Process • Eligible 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 • Requirements: Still being reviewed • Due date: TBA

26. 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 Virginia “at-risk” Communities

27. First Steps for Local Application • Meet with local coalition of Early Childhood (EC) Programs • Identify Community Home Visiting (HV)Needs • Identify Community Gaps in local HV and EC System • Select an Evidence-based Model which matches the community needs identified • Identify a Target Population

28. Local Community Applicant • Each community is likely to be asked to demonstrate: • Evidence of Efficiency and Effectiveness in Plan • Evidence of Collaboration • Evidence of experience and solid performance in providing HV model • Evidence of commitment to improvement on Benchmarks

29. Home Visiting Consortium • Ashley Barton- BabyCare • Mary Mitchell, Vivian Horn - Medicaid Managed Care • Johanna Schuchert- Healthy Families • Ann Childress - DSS • Lisa Specter-Dunaway- CHIP of Virginia • Linda Foster-Healthy Start • Wenda Singer - Head Start/EHS • Phyllis Mondak, Special Education/Part B • Mary Ann Discenza – Early Intervention/ Part C • Martha Kurgans – Project Link • Catherine Bodkin- Resource Mothers, VDH BabyCare

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