Supporting Evidence-based Home Visitation Programs to Prevent Child Maltreatment Webinar Script:
Final 6/05/08

SLIDE 1

Hello and welcome to the pre-application webinar for funding opportunity number (FON): HHS-2008-ACF-ACYF-CA-0130: Supporting Evidence-based Home Visitation Programs to Prevent Child Maltreatment.

My name is Melissa Lim Brodowski and I work at the Office on Child Abuse and Neglect which is housed in the Children’s Bureau within the Administration for Children and Families at the US Department of Health and Human Services.  I am also the Program Contact for this grant announcement.

This webinar is being webcast at both 11:00am and 4:00pm Eastern time on Tuesday, June 10th, 2008.

SLIDE 2

This webinar is intended to provide prospective applicants with an overview of the program announcement that became public on May 22, 2008 and is currently available on www.Grants.gov and the Administration for Children and Families (ACF) Grants Opportunities webpage at www.acf.hhs.gov/grants.  To find the announcement go to www.acf.hhs.gov/grants and click on “Open Funding Opportunities.”  Then find the link for “Supporting Evidence-based Home Visitation Programs to Prevent Child Maltreatment.” The direct link to the announcement is also provided on this slide.
 
This webinar will attempt to clarify common applicant questions by highlighting information in the announcement.  All prospective applicants are strongly encouraged to read the announcement in its entirety and to refer back to the program announcement for more detailed information when preparing their applications. 

Page numbers in the PDF version of the program announcement, available at the ACF Grant Opportunities website, at http://www.acf.hhs.gov/grants/open/HHS-2008-ACF-ACYF-CA-0130.html, have been included on the webinar slides for your reference. 

SLIDE 3

Federal staff will not be responding directly to the questions of listeners during this webinar.  All participant lines will be muted.  Listening participants will, however, have the opportunity to send written questions to the Children’s Bureau by email during and after the webinar.  Potential applicants may submit questions in response to the webinar until 5:00pm Eastern on Friday, June 11th.  Questions should be sent to: cb@dixongroup.com  Please include the words “Applicant Question 0130” in the subject heading of the email, and please include your name, the name of your organization, and your telephone number in the text of the message.

All questions received prior to 5:00pm Eastern on June 11th will be reviewed by Children’s Bureau staff. A transcript of the webinar and a summary of the questions submitted by the deadline and the Children’s Bureau’s responses will be posted on the ACYF grant review webpage at http://www.acf.hhs.gov/grants/grants_cb.html as soon as they become available.  Webinar slides will also be posted on this webpage for applicants’ future reference.

Any questions that a potential applicant has prior to the first webinar or after the pre-application conference question period closes at 5pm on June 11th should be directed to the applicable program or grant contact person in the program announcement.

Again, this is the pre-application webinar regarding funding for the grant program ”Supporting Evidence-Based Home Visitation Programs to Prevent Child Maltreatment.” I will also refer to this as the “home visiting grant program” during the webinar.

SLIDE 4

The legislative authority for the home visiting grant program comes from two sources:
           
Section 105(b)(5) of the Child Abuse Prevention and Treatment Act, as amended; and
The Consolidated Appropriations Act, 2008, P.L. 110-161 which specifically added the funding to CAPTA Discretionary funds for this home visiting program.

Information about the legislation that authorizes and supports the home visiting program and other child welfare programs can be found on the Children’s Bureau website at:  www.acf.hhs.gov/programs/cb under Laws and Policies.
 
SLIDE 5
There will be up to 21 cooperative agreements awarded under this funding opportunity.  A cooperative agreement is a type of grant.  A cooperative agreement is a specific method of awarding Federal assistance where substantial Federal involvement is anticipated.  As described in the grant announcement under Section II “Award Information,” Federal involvement and collaboration includes:

• The Children’s Bureau review and approval of planning stages of the project activities before implementation begins;

• The Children’s Bureau involvement in the establishment of policies and procedures that maximize open competition, if applicable;

• Joint collaboration between the Children’s Bureau and the award recipient in the performance of key programmatic activities;

• Close monitoring by the Children’s Bureau of the requirements stated in this announcement; and

• Close monitoring by the Children’s Bureau during the project to ensure compliance with the intent of this funding.

To ensure that responsibilities of both parties are understood, a Cooperative Agreement document will be developed incorporating Legislative Authority, Federal regulations and terms and conditions.  The document will also identify the duration of the agreement, roles and responsibilities of the grantee and ACYF/CB, and reporting requirements.  The Cooperative Agreement document must be signed by the Authorized Official of the recipient organization and the ACYF/CB Program Official. 

Expectations for collaboration with Federal staff to successfully complete the goals and objectives of these projects are described throughout the program announcement.

SLIDE 6

The eligible applicants for the home visiting grant program include:

• State governments
• County governments
• Local governments
• City or township governments
• Regional organizations
• Public and State-controlled institutions of higher education
• Indian/Native American Tribal governments (Federally recognized)
• Indian/Native American Tribal governments ( other than Federally recognized)
• Indian/Native American Tribally designated organizations
• Public/ Indian housing authorities
• Non-profits with 501(c)(3) IRS status (other than institutions of higher education)
• Non-profits without 501(c)(3) IRS status (other than institutions of higher education)
• Private institutions of higher education
• Alaska Native and Native Hawaii Serving Institutions
• Special district governments

SLIDE 7

Collaborative efforts and interdisciplinary approaches are encouraged. Applications from collaborative groups must identify a primary applicant responsible for administering the grants.

Collaboration partners must include organizations with child maltreatment prevention and home visitation experience and expertise. Other mandatory partners include the State or county child welfare agency and the Community-Based Child Abuse Prevention Program.  This will be addressed in more detail in the later slides.

SLIDE 8

Eligible applicants may apply for a minimum of $100,000 and a maximum Federal share of 500,000 per budget period.

As mentioned in the previous slide, up to 21 cooperative agreements will be awarded under this funding announcement.

The cooperative agreements will be awarded for a project period of 60 months. The initial award will be for a 12-month budget period. Continuation of awards for subsequent 12-month budget periods will be subject to satisfactory progress on the part of the awardee and a determination that continued funding would be in the best interest of the Federal Government.  Continuation of awards is also subject to the availability of funds.

SLIDE 9

In terms of the match requirement, the grantee must provide at least 10 percent of the total approved cost of the project.  The total approved cost of the project is the sum of the ACF share and the non-Federal share.  The non-Federal share may be met by cash or in-kind contributions although applicants are encouraged to meet their match requirements through cash contributions.

For example, in order to meet the match requirements, a project with a total approved project cost of $555,555, requesting $500,000 in ACF funds, must provide a non-Federal share of at least $55,555 (10 percent of total approved project cost of $555,555.).  Please refer to p. 21 of the announcement to see how the 10% match is calculated.

SLIDE 10

The overall purpose of the home visiting grant program is to support the infrastructure needed for the widespread adoption, implementation and sustaining of evidence-based home visitation programs. Funds will be used for efforts to expand and enhance home visitation programs based on proven effective models. Funds will support:

• Collaborative planning efforts to leverage other Federal, State and local investments of existing funding streams into evidence-based home visitation programs and practices; 
  
  
• A range of activities needed to build infrastructure systems that can fully adopt, implement, and sustain high quality home visitation programs that have strong fidelity to proven effective models;
  
  
• Rigorous local evaluations which include process/implementation, outcome, and cost analysis components.

SLIDE 11

More specifically, Grants will be awarded for an initial planning phase in year 1 and, pending successful completion of that phase, approval from the Children's Bureau, and the availability of funding, funds for the implementation phase will be provided for years 2-5.

• During the planning phase, the grantees will engage in a collaborative process to develop a plan to build the infrastructure needed for the adoption, implementation and sustaining of the evidence-based home visitation programs.

• During the implementation phase, the grantees will implement their plan, conduct a rigorous local evaluation, and disseminate lessons learned to the field.

SLIDE 12

Now, we want to spend a few minutes on the home visitation research in general.

First of all, there is a sizable body of research, using both experimental and quasi-experimental study designs, that has evaluated the impact of a few nationally recognized home visitation programs.

This research points to the fact that not all home visitation programs have demonstrated positive impacts for all populations in preventing child maltreatment or improving parental capacity.

Several studies do point to a need to better address the needs of families with the highest risk factors for child maltreatment such as those with caregivers who have problems associated with mental health, substance abuse, and domestic violence.

SLIDE 13

We also know that many States currently are implementing various types of home visitation programs using Federal, State, local and private funding. These efforts do not all follow proven effective models. Some States have an infrastructure in place, but are implementing a model that has not been proven effective. Many States are implementing a range of home visitation programs and need support and guidance on identifying, selecting, and sustaining the most appropriate evidence-based program for their local community needs.

In addition, many Tribes have limited capacity and resources to implement evidence-based home visitation programs but have significant and unique needs for these services.  States and Tribes need guidance and support to maximize and leverage all other funding streams available so that investments in proven effective programs can be made. 

Finally, over the last several years, States have demonstrated an interest in implementing evidence-based programs and practices within their systems, but have been constrained by limited resources in their ability to develop the knowledge base of how such programs can fit within their systems.

SLIDE 14

One of the most important issues to consider is the criteria used to define what constitutes an evidence-based home visitation program.

The Consolidated Appropriations Act, 2008, P.L. 110-161 language states that:

“Funds are provided for a home visitation initiative to support competitive grants to States to encourage investment of existing funding streams into evidence-based home visitation models… The Administration for Children and Families shall ensure that States use the funds to support models that have been shown, in well-designed randomized controlled trials, to produce sizeable, sustained effects on important child outcomes such as abuse and neglect. Funds shall support activities to assist a range of home visitation programs to replicate the techniques that have met these high evidentiary standards. In carrying out this new initiative, the Department is instructed to adhere closely to evidence-based models of home visitation and not to incorporate any additional initiatives that have not met these high evidentiary standards or might otherwise dilute the emphasis on home visitation.”

SLIDE 15

Pages 6-7 of the announcement specifically list the criteria that we have used to identify Evidence-based Home Visitation Programs for this grant program.  These criteria include the following:

• First of all, there must be no clinical or empirical evidence or theoretical basis indicating that the practice constitutes a substantial risk of harm to those receiving it, compared to its likely benefits. 
  
  
• The program must articulate a theory of change which specifies clearly identified outcomes and describes the activities that are related to those outcomes.  This is represented through the presence of a detailed logic model or conceptual framework that depicts the assumptions for the inputs and outputs that lead to the short, intermediate and long-term outcomes.  The program must have a book, manual, training or other available writings that specify components of the program and describe how to administer it.

SLIDE 16

In terms of the evaluation data, the research supporting the efficacy of the program or practice in producing positive outcomes associated with reducing risk and increasing protective factors associated with the prevention of abuse or neglect must meet both of the following criteria:

• At least two rigorous randomized controlled trials (RCTs) (or other comparable methodology)  in highly controlled settings have found the practice to be superior to an appropriate comparison practice, and the RCTs have been reported in published, peer-reviewed literature.
  
  
• The program has been tested and replicated in other sites and settings.

SLIDE 17

In addition, the following criteria must be met:

• The program must demonstrate a sustained effect for at least one year beyond the end of treatment, with no evidence that the effect is lost after this time.  The program must also demonstrate a sizable effect which is a statistically significant difference between the treatment and comparison/control group. 
  
  
• The outcome measures must be reliable and valid, and administered consistently and accurately across all subjects.
  
  
• If multiple outcome studies have been conducted, the overall weight of evidence must support the efficacy of the practice.
  
  
• Finally, the program must be actively working on building stronger evidence through ongoing evaluation and continuous quality improvement activities. 

SLIDE 18

Applicants need to provide adequate justification and documentation within the application that the program meets the evidentiary criteria outlined in the announcement.  

Regardless of the evidence-based home visitation model selected, all applicants must show that the proposed programs are/will be appropriate for the target population(s). The applicant should provide information on research findings on the effectiveness and acceptability specific to the proposed target population, if available.

SLIDE 19

One of the important features of this grant program is that there are two very distinct phases (Phase I Planning and Phase II Implementation) in the work and the applicant’s plan for both phases must be included in the application.  I will provide a brief overview of these phases now and will go into more specific details about the tasks to be conducted in each phase in the subsequent slides.
I
Applicants must submit a design that clearly and concisely describes a strategy for a 12-month planning phase (Year 1).

Approximately 10 months after the award, the grantee must submit a draft Implementation Plan. Children’s Bureau (CB) will review the plan and the grantee must submit a revised implementation work plan incorporating the recommendations of CB staff, as needed. Continuation funding for Years 2-5 is contingent upon CB approval of this plan.

In the Implementation Phase (Years 2-5), the grantee will implement the various components of their plan and work closely with CB to share lessons learned along the way.

SLIDE 20

I will now review the specific activities that will need to be undertaken in Phase I: Planning (Year 1).

Grantees will be expected to initiate a 10-month collaborative planning process.   Applicants must collaborate with other relevant State and community agencies to plan the investment of Federal, State, local and private funding streams for evidence-based home visitation programs and to promote greater coordination of these related service delivery systems in order to expand and enhance the existing services. 

The overall purpose is to insure that all relevant programs and funding streams are identified and included in these coordination efforts.  The culmination of this process will be the development of an Implementation Plan to build the infrastructure needed for the widespread adoption, implementation and sustaining of the evidence-based home visitation program/s. 

SLIDE 21

The final plan should include, at a minimum, but is not limited to, the following elements:

• Identification of the lead agency that will be responsible for implementing the plan and coordinating with the other partner agencies, and a plan for providing management and oversight for this initiative as well as a plan for developing formal agreements with relevant agencies and service providers.
  
  
• A process for conducting a comprehensive inventory of existing and potential Federal, State, local, and private funding streams for home visitation as well as existing home visitation programs currently being funded and their evidence base.  The purpose of this inventory is to identify current and potential sources of funding for home visitation programs including, but not limited to: Title IV-B of the Social Security Act, Title V Maternal and Child Health Block grants, Temporary Assistance for Needy Families, Social Services Block Grant, Office of Juvenile Justice and Delinquency Prevention block grant, Child Abuse Prevention and Treatment Act funds, and other State and local general and private funds. 
  
  
• Timeline for implementing the plan. Applicants may choose to use a phased-in or pilot approach that starts with one local jurisdiction and then expands to other areas of the State once the initial efforts have proven successful. 
  
  
• Selection and identification process for the evidence-based home visitation model/s that the applicant has begun (or continue) to support. Where appropriate, a formal agreement must be in place to ensure that the original program developer will be supporting the replication effort. The application should identify the model/s selected and the plan submitted in Year 1 will confirm and document this process.  

SLIDE 22

Also, other components of the plan include:

• Fiscal leveraging plan and the mechanism for the disbursement of funds to support the home visitation programs. Plans also should include preliminary ideas for sustaining the programs beyond the grant period.  Funding provided through this program announcement will be used to support the overall planning and implementation of the selected programs.  The goal of the fiscal leveraging plan is to identify the other sources of funding that will be used to support the direct services provided to families.
  
  
• Plans for working with the local home visitation programs funded through this initiative in order to facilitate the successful adoption, implementation, and sustaining of the evidence-based programs. 
  
    
• Plans for linking and coordinating the State and local home visitation services with other health and human services and formal and informal resources offered that comprise the continuum of care for families.
  
  
• Systematic screening and assessment processes to identify parents and caregivers who need to be referred to these home visitation programs. This may include screening at hospitals to insure that pregnant women, especially those exhibiting risk factors, are referred to these home visiting programs. The proposed plan for these processes should justify how the target population being served is consistent with the target population for the selected home visitation program model. 
  
  
• Provision for comprehensive training and technical assistance and support to programs implementing the evidence-based home visitation programs. This technical assistance may be provided by the developer of the program and/or other personnel who have the specific expertise to assist local programs with implementing these types of programs. At a minimum, the evidence-based program selected should have the capacity to provide the initial technical assistance and support to teams that will be assisting the local programs in implementing the model. This technical assistance also must address ways to ensure the quality of the supervision and coaching of the home visitors and their supervisors.

SLIDE 23

And the last few elements of the plan should describe -

• Strategy for workforce recruitment and retention of the home visitors and other direct service staff who have the skills and capacity to deliver the high quality services to families.
  
  
• Plan for quality assurance systems to monitor the ongoing quality of various home visitation programs being funded and their fidelity to the original program. Plans also may support the development or enhancements of management information systems that can be used for quality assurance and oversight of programs.
  
  
• Plan for rigorously evaluating and testing the implementation of the various components of the initiative. The evaluation plan should include implementation (process), outcomes, and an economic evaluation component, with a cost analysis of this initiative being conducted at a minimum. Successful applicants will need to agree to collect common cross-site outcomes, measures, and cost data elements for a national cross-site evaluation.

SLIDE 24

CB is very interested in interagency collaborative efforts across various disciplines with common target populations and shared outcomes. As a result, applicants must collaborate with the following entities in the development of the plan and the subsequent implementation:

• State or local child welfare agency
• Designated lead agency for the Community-Based Child Abuse Prevention Program (see www.friendsnrc.org for a list of contacts). 

In addition, CB strongly recommends that applicants also collaborate with the following entities:

• Maternal and Child Health Early Childhood Comprehensive Systems grantees (see http://www.state-eccs.org/ for a list of contacts).

• Substance Abuse and Mental Health Services Administration (SAMHSA) funded Project LAUNCH grantees (a limited number of States, Territories, and Tribes will be funded to plan for comprehensive early child wellness programs and implement local pilots in FY2008. A list of these grantees will be shared with successful applicants).

SLIDE 25

As I mentioned previously, near the end of year 1, approximately 10 months after the initial award, the grantee will be required to submit their draft implementation plan for review and approval by CB. A revised plan that incorporates the recommendations of CB may be required. Continuation funding for years 2-5 will be contingent upon CB's final approval of the plan.
Once the approval is received, in years 2 through 5, the grantees will implement the various components of their Implementation plan and work closely with CB to share lessons learned along the way and disseminate best practices in their efforts to support evidence-based home visitation programs in their jurisdiction.  The application should describe the critical components of their proposed implementation phase. These critical components should include, at a minimum:

1. The administrative structure for the project, including the lead agency, the relevant partners, and the proposed contents of the agreements across agencies and service providers. 
   
   
2. The results of the comprehensive inventory of funding sources and existing home visiting programs to be used for replication and identification of resources for supporting service delivery efforts.

SLIDE 26

3. Arrangements for technical assistance to programs including collaboration with the original designer/developer of the home visiting model(s) selected to support the replication effort, ensure fidelity to the model(s) and provide for quality service provision. 
   
   
4. A process for instituting the selected approach (pilot or phased-in) to introduce the model(s) and expand and enhance services based on initial learning. 

SLIDE 27

And finally,

5. A strategy for information dissemination, including fostering and strengthening communication and coordination activities with other grantees and with CB's Training and Technical Assistance Network including CB's National Resource Centers, the National Data Archive on Child Abuse and Neglect and Child Welfare Information Gateway.
   
   
6. Identification of linkages with appropriate agencies, organizations, and resources on the local, regional, State, Tribal or Federal levels that address issues pertaining to the prevention and treatment of child abuse and neglect through the use of evidence-based home visitation programs.

SLIDE 28

Because this is a cooperative agreement, I wanted to spend a few minutes going over the expectations that the Children’s Bureau has for these Implementation Projects:

At CB, an implementation project is one that puts into place and tests new, unique, or distinctive approaches for delivering services to a specific population.

Implementation projects may test whether a program or service that has proven successful in one location or setting can work in a different context. Implementation projects may test a theory, idea, or method that reflects a new and different way of thinking about service delivery. Implementation projects may be designed to address the needs of a very specific group of clients or focus on one service component available to all clients. The scope of these projects may be broad and comprehensive or narrow and targeted to specific populations. For this announcement, an implementation project must:

1. Implement an evidence-based model with specific components or strategies that are based on theory, research, or evaluation data; or replicate or test the transferability of successfully evaluated program models;
   
   
2. Determine the effectiveness of the planning process and implementation strategies using a rigorous evaluation approach; and
   
   
3. Produce detailed procedures and materials based on the evaluation that will contribute to and promote evidence-based strategies, practices, and programs that may be used to guide large scale replication or testing, and to encourage the investment in these types of programs in other settings. 

ACF will expect grantees to engage in an evaluation of sufficient rigor to demonstrate potential linkages between project activities and improved outcomes.

SLIDE 29

ACF expects that projects funded under this program announcement will develop a knowledge base around successful strategies for the implementation, adoption and sustaining of evidence-based home visitation models.

ACF has a particular interest in projects that develop knowledge about:

• Factors associated with developing or enhancing the infrastructure to support and monitor the quality of evidence-based programs;
  
  
• Effective strategies for adopting, implementing and sustaining evidence-based home visitation programs;
  
  
• Effective strategies to encourage the investment of existing funding streams for evidence-based home visitation programs.
  
  
• The conditions under which evidence-based programs can be implemented with fidelity on a large scale (i.e., What are the types of providers, organizations, communities, or infrastructures that are most effective?); and
  
  
• The outcomes and cost-effectiveness of supporting evidence-based programs.

SLIDE 30

Since this is a discretionary grant, we expect all our discretionary grants to be involved in evaluation activities.  The Children’s Bureau requires an objective rigorous evaluation of this grant project.

Projects are expected to allocate a minimum of ten percent of the project budget each year to evaluation.

In order to compare outcomes, it would be acceptable for a grantee to test different implementation strategies. Examples of this could include testing different approaches for providing training and technical assistance on the evidence-based home visitation programs within different jurisdictions. Applicants are encouraged to propose and justify other methods of comparing outcomes produced by various combinations of implementation activities.

Funded programs will be asked to track the same/similar outcomes, using the same/similar tools as the evidence-based models being implemented, so it will be possible to compare the implementation and outcomes of the funded programs with the implementation and outcomes of these same models that have already been implemented and evaluated. In addition, CB anticipates funding a national cross-site evaluation contract for programs funded under this announcement and will work with the grantees to identify common cross-site measures for processes, implementation, outcomes, and costs.

SLIDE 31

All applications in response to this program announcement are due by 4:30pm, Eastern Time on July 21, 2008.  Applications submitted by mail must be received by 4:30pm, and electronic submissions must be submitted via www.Grants.gov no later than 4:30pm. Late applications will not be considered.  Applications that request amounts that exceed the stated ceiling of $500,000 for the first budget period will not be considered.  Application Submission Information, or Section IV of the announcement, and further details specific to submission due dates and times can be found on page 22 of the announcement.

The application limit is 75 pages. Pages over this page limit will be removed from the application and will not be reviewed. This page limit does not include Standard Forms (SF) 424, 424A, and 424B, certifications, assurances, third-party agreements, letters of commitment, job descriptions, resumes, and curriculum vitae.

SLIDE 32

We would also like to provide you with a couple of additional reminders regarding the submission of applications.

• The due date and time applies to all applications whether mailed, hand delivered or submitted electronically.
  
  
• Applicants are responsible for ensuring that applications are mailed, hand delivered or submitted electronically well in advance of the application due date and time; this does not mean the day before or the day of the due date. This should include enough time so that if difficulties are encountered there will be sufficient time to submit a hard copy via express mail.
  
  
• Electronic submission is voluntary, but encouraged.
  
  
• Applicants must have a D-U-N-S and register in the Central Contract Registry (CCR) to obtain the Authorized Organization Representative (AOR) electronic signature credentials for electronic submission. This may take up to 5 days.
  
  
• If you are experiencing any difficulty with electronic submission, you must contact the Grants.gov Help Desk (at 1-800-518-4726 or support@grants.gov)
  to receive a case number which documents your problem.

SLIDE 33

As a reminder, any questions about the information from this webinar should be sent to: cb@dixongroup.com  by 5:00pm Eastern on Friday, June 11th. 

All questions received prior to 5:00pm Eastern on June 11th will be reviewed by Children’s Bureau staff. A transcript of the webinar and a summary of the questions submitted by the deadline and the Children’s Bureau’s responses will be posted on the ACYF grant review webpage at http://www.acf.hhs.gov/grants/grants_cb.html as soon as they become available.  Webinar slides will also be posted on this webpage for applicants’ future reference.

Any questions that a potential applicant has prior to the first webinar or after the pre-application conference question period closes at 5pm on June 11th should be directed to the applicable program or grant contact person in the program announcement.

SLIDE 34

Finally, the Children’s Bureau strongly encourages a full and open competition.  All the applications that are submitted within the deadline and do not request more than the maximum award will be reviewed by an outside group of peer reviewers with expertise in this area.  We take pride in our objective peer review process and the integrity of our review process.  We wish all the prospective applicants well and good luck!