HomeMy WebLinkAboutCA Dept of PHState of California-Health and Human Services Agency
California Department of Public Health
CJ. PH
RON CHAPMAN, MD, MPH
t)irecfor 8 State Health Otficer
April 17, 2012
Ann Dickman, PHN
MCAH Director
Butte Caunty Public Health Department
2491 Carmichael Drive, Suite 400
Chico, CA 95928
Dear Ms. Dickman:
0
s .~~r,
~...
EpMl1ND G. BROWN JR.
Governor
~~
'~~32D12
APPROVAL OF AGREEMENT FUNDING APPLICATION (AFA) FOR
AGREEMENT # 201104 -- Fiscal Year (FY) 2011-2012
The Maternal, Child and Adolescent Health {MCAH) Division of the California
Department of Public Health (CDPH) approves your Agency's AFA, including the
enclosed Scope of Work {SOW) and Budget far administration of MCAH related
programs.
To carry out the program outlined in the enclosed SOW, Attachment A Program
Operational Requirements for the California Home Visiting Program (CHVP) and
Budget, during the pre-implementation period beginning December 1, 2011, and
program implementation beginning February 1, 2012 through dune 30, 2012, the MCAH
Division will reimburse expenditures up to the following amount:
CALIFORNIA HOME VISITING PROGRAM .............$ 275,001
The availability of Maternal, Infant and Early Childhood Home Visiting {MIECHV)
TITLE V funds are based upon funds appropriated in the FY 2011-2012 Budget Act.
Reimbursement of invoices is subject to compliance with all federal and state
requirements pertaining to CDPH MCAH related programs and adherence to all
applicable regulations, policies and procedures. Your Agency agrees to invoice actual
and documented expenditures and to follow aEl the conditions of compliance stated in
the current CDPH MCAH Program and Fiscal Policies and Procedures manuals,
including the ability to substantiate all funds claimed. The policies and procedures
manual can be accessed at: httpalwww.cdph.ea.gavlservices/fundinglmcahlPagesl
FiscalPoliciesand ProceduresManual. aspx
Maternal, Child and Adolescent Health Division/Center for Family Health, MS 8340, P.O. Box 997420 Sacramento, CA 95899-7420
(916} 650-0300 (916) 650-0305
Internet Address: www.cdgh.ca.4ov
Ann Dickman, PHN
Page 2
April 17, 2p12
As stated in Attachment A Program Operational Requirements, please remember you
are required to secure a contract agreement or affiliation with national model Healthy
Families America (HFA)/Prevent Child Abuse America (PCAA) prior to CHVP
implementation. A copy of the most recent contract agreement or approved affiliation
agreement from the HFAIPCAA National Office (NO} must be received by CHVP
through the mail or electronic format, upon contract execution. Agreements with the
HFAIPCAA NO must meet the subcontracting requirements as defined in the MCAH
Policies and Procedures Manual. Please refer to the Subcontract Section of the MCAH
Fiscal Policies and Procedures manual for the subcontracting requirements that must
be adhered to by the Agency and any subcontractors.
Please ensure that all necessary individuals within your Agency are notified of this
approval and that the enclosed documents are carefully reviewed. This approval letter
constitutes a binding agreement. If any of the information contained in the enclosed
SOW and Budget is incorrect or different from that negotiated, please contact your
Contract Manager, Toni Ballenger, at (916) 65Q-0351 or by e-mail at
Toni,Ballenger[a~cdph.ca.gov within 14 calendar days from the date of this fetter. Non-
response constitutes acceptance of the enclosed documents.
Sincerely,
/////J ~ r
• f~v -
a bir Ahmad, DVM, M..S., PhD.
MCAH Title V Director
Maternal, Child and Adolescent Health Division
Enclosure(s)
cc: Mr. Bill Connelly
Chair Board of Supervisors
Butte County Health Department
2Q2 Mira Loma Drive
Oroville, CA 95965
Toni Ballenger, AGPA
Contract Manager
Maternal, Child and Adolescent Health Division
Robin Qualls, BSN, MPH, NC III
Program Consultant
Maternal, Child and Adolescent Health Division
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ATTACHMENT A
PROGRAM OPERATIONAL REQUIREMENTS FOR
CALIFORNIA HOME VISITING PROGRAM
Pu~ose
The California Home Visiting Program {CHVP) Local Health Jurisdiction (LHJ) sites must meet all
objectives and complete each of the required intervention activities stated in the Scope ofi Work
(SOW) in order to remain in compliance with the contract agreement. The Program Operational
Requirements outlines additional information and specifics to assist each LHJ site in completing
activities, meeting objectives defined in the SOW, and implementing program activities with quality
and fidelity to the home visiting model. The Program Operational Requirements should be considered
bath part of the 50W and a precursor to the forthcoming CHVP Policies and Procedures Manual.
The SOW contains federally mandated requirements. LHJ's ability to meet and maintain CHVP goals
and objectives will affect future LHJ funding.
Background Information
The delivery of home visiting services addresses the diverse needs of children and families in~
communities at risk and provides an unprecedented opportunity for collaboration and partnership at
the federal, state, and community levels to improve health and development outcomes for at-risk
children through evidence-based home visiting programs. The California Department of Public
HealthlMaternal, Child and Adolescent Health (CDPHIMCAH) Division selected two evidence-based
home visiting models for implementation in California: Nurse-Family Partnership {NFP) and Healthy
Families America {HFA). Selection of these models was based on findings from the Home Visiting
Evidence of Effectiveness Review (HomVee} Study that gave NFP and HFA the most favorable
ratings for primary and secondary outcomes in the benchmark areas. LHJ sites are responsible for
administering the CHVP in accordance with model fidelity, the requirements stated in the SOW, and
the CHVP Policies and Procedures Manual. LHJ site staff is responsible for having in-depth
knowledge of all CHVP program components and manuals, such as the Policies and Procedures
Manual for LHJ sites, the CHVP Standards, NFP model or HFA model, as well as the federal
benchmarks and constructs. This may include any future manuals.
CHVP PROGRAM REQUIREMENTS RELATED TO THE SCOPE OF WORK
1. Site Visits and Technical Assistance
CHVP will perForm formal and/or informal site visits at their discretion. LHJ sites are required
to participate in CHVP site visits and allow CHVP Quality Assurance {QA) Teams to access
program-related records, participant records, and observe home visiting activities.
2. Progress Reports
a. LHJ site shall submit Progress Reports postmarked no later than the due dates specified in
this SOW. Progress Reports are to be prepared in accordance with the information and
format provided by CHVP. Faxed Progress Reports will not be accepted.
b. LHJ site is required to follow all CHVP procedures for reporting information submitted in each
Progress Report.
Final 2.b.201.2 Page ~
c. Failure to submit an acceptable Final Progress Report may jeopardize future funding for LHJ
site.
d. LHJ site must submit one copy of Progress Reports in original fiormat to CHVP via certifed
mail, postmarked no later than 30 days after the period ending on Due Dafe. In addition, the
same Progress Reports must be submitted electronically at the Due Date stated below. LHJ
site's fiailure to submit Progress Reports in a timely manner may jeopardize future funding for
LHJ site. CHVP reserves the right to require additional components in the Progress Reports
such as:
Accomplishments;
Challenges; andlor
Plan for Improvement
The following schedule below must be followed for Progress Reports:
Reporting Period From To Due Date
1} First Report February 1, 2012 June 30, 2012 July 31, 2012
2) Second Report July 1, 2012 December 31, 2012 January 31, 2013
3) Third Report • January 1, 2013 June 30, 2013 July 31, 2013
3. Additional Reports:
a. For supervisor quarterly reporting, see 6.c. below.
b. LHJ site shat! comple#e CHVP evaluation requirements as directed by CHVP in accordance
with prescribed form and format.
c. LHJ site will be required to respond as necessary to any ad hoc andlor final reports as
designated by CHVP.
d. LHJ site shall submit "Staffing Report," to CHVP by May 31, 2012, andlor upon any change
in personnel. Prior approval from CHVP NFP State Nurse Liaison (SNL) /HFA Statewide
Nurse Consultant is required far changes in staffing patterns that deviate from the original
contract agreement.
4. Media Communication
LHJ site shall coordinate and collaborate with CHVP ar its designee in any focal or statewide
medialcommunication efforts, as directed and approved by CHVP. lfi media is involved in
communicating the program and its implementation to the public, proposed information must
be shared and approved by CHVP first.
v, CommunicationlTransmittal Process
a. Transmittal Process
CHVP transmittal form must be used by the LHJ site to send contract related documents
andlor to request CHVP approval for items identified in the SOW. Completed CHVP
communication fiom~s shall be electronically submitted to CHVP (See Attachment C}.
Fina12.6.~012 Page 2
b. Program Letter
Any clarification related to the SOW including this Program Operational Requirement will be
communicated to the LHJ site via a Program Letter.
c. Communication with SNL for NFP or Statewide Nurse Consul#ant for HFA
In order to establish a clear channel of communication and maintain model fdelity, CHVP-
related questions must be directed to the CHVP SNL for NFP or Statewide Nurse Consultant
for HFA first before involving the NFP or HFA National Office or staff. The following order of
communication is expected from LHJ sites:
1. LHJ site NFP Supervisors, under the direction of the local MCAH Director, must first
contact the CHVP SNL for NFP program-related questions.
2. LHJ site HFA Supervisors, under the direction of the local MCAH Director, must first
contact the CHVP Statewide Nurse Consultant for HFA program-related questions.
3. Home Visitors far both models must contact their immediate supervisors for program-
related issues.
4. CHVP NFP 5NL IHFA Statewide Nurse Consultant will regularly communicate with the
CDPHIMCAH Program Nurse Consultants overseeing Title V Block Grant Scopes of
Work.
6. Supervisor Quarterly Reports
LHJ site Supervisors are required to submit quarterly reports summarizing their successes,
challenges, and any technical assistance needs far that period to the CHVP HFA Statewide
Nurse Consultant or NFP SNL. This quarterly report may be sent via email and should also be
included in the biannual Progress Report.
The following schedule below must be followed for Supervisor Quarterly Reports:
Reporting Period From To Due Date
1) First Report February 1, 2012 June 30, 2012 July 31, 2012
2) Second Report July 1, 2012 September 30, 2012 October 31, 2012
3) Third Report October 1, 2012 December 31, 2012 January 31, 2013
4) Fourth Report January 1, 2013 March 31, 2013 April 30, 2013
5) Fifth Report April 1, 2013 June 30, 2013 July 31, 2013
7. Request for Adjustments
Requests regarding adjustments in Due Dates of deliverables must be submitted to CHVP in
writing via transmittal process.
Final 2.b.201.2 Page 3
$. Maintenance of Effort (MOE) Agreement
LHJ sites agree to abide by the MOE as defined in the Affordable Care Act Section 295:
"Funds provided to an eligible entity receiving a grant shall supplement, and not
supplant, funds from other sources for early childhood visitation programs or
initiatives. The grantee must agree fo maintain non-Federal funding (Stale
General Funds) for granf activifies at a level which is not less than expenditures
forsuch activities as of the date of enactment of this legislation, March 23,
2090."
Specific questions or proposals should be directed to the local county counsel.
Home Visiting defined by the Health Resources and Services Administration (HRSA):
"Home visiting is defrned as an evidence-based program, implemented in response to
frndings from a needs assessment, that includes home visiting as a primary service
delivery strategy (excluding programs with infrequent or supplemental home visiting),
and is offered on a volunfary basis to pregnant women or children birth to age 5
targeting the parficipant outcomes in the~legislatian which Include improved maternal
and child health, prevention of child injuries, child abuse, or maltreatment, and
reducfion of emergency department visits, improvement in school readiness and
achievement, reducfion In crime or domestic violence, Improvements in family
economic self-suffrciency, and improvements in the coordinafion and referrals for other
communifyresources and supports." (HRSA-10-275}
9. Performance and Accountability
LHJ site whose deliverables are not met, as outlined in the SOW, will receive technical
assistance from CHVP. In addition, CHVP reserves the right to require a Corrective Action Plan
from the LHJ site. LHJs must contact the CHVP HFA Statewide Nurse Consultant or NFP SNL to
request assistance from CHVP as soon as concerns regarding meeting deliverables are
identified.
CHVP PROGRAM REQUIREMENTS ON IMPLEMENTATION
The fo[lvwing actions are necessary to initiate, implement, and sustain CHVP. Additional
details regarding program operation will be discussed in the CHVP Policies and Procedures
Manual to be released soon.
Contract Agreements at the Local, State, and National Level
LHJ site must secure a contract agreement or affiliation with national models (NFP or HFA) prior to
CHVP implementation. Before LHJ approaches the national models for contract agreement, the site
is required to collaborate and receive approval from CHVP. In addition, a copy of the most recent
contract agreement or approved affiliation agreement from the NFP National Service Off[ce (NSO} or
the Prevent Child Abuse America (PCAA) National Office (NO), if any, must be received by CHVP
through mail or electronic format, upon contract execution. Copies of any signed affiliation or
contract agreements with the NSOINO after this contract execution must be submitted to CHVP
within 10 days of receipt. LHJ site must regularly inform the CHVP SNL for NFP ar 5tatewide Nurse
Final 2.b.20~.2 Page ~
Consultant for HFA regarding the status of contracting from NFP NSO or status of securing affiliation
from PCAA NO.
INITIAL IMPLEMENTAT[ON REQUIREMENTS
LHJ site must meet the initial certification or affiliation requirements of the national program model
(NFP or HFA). LHJ site organizational structure must be prepared to assume the capacity to house
the service and manage the hiring, supervision, and payment of all personnel and ensure general
fiscal stability. The following actions must be considered prior to initiation of services:
1. MCAH Director
The MCAH Director is required to devote a minimum of 0.15 Full Time Equivalent (FTE) to CHVP
oversight, fostering partnerships and collaboration within the LHJ, and directing the local CHVP
Community Advisory Board (CAB)_ These requirements are in addition to the Key Personnel
requirements for the MCAH Director as outlined in the MCAH Policies and Procedures Manual for
LHJs.
LHJ must meet the MCAH-LHJ FTE and credentialing requirements for the MCAH Director. LHJ
may not receive waivers for the MCAH Director FTE requirements; waivers will be considered for
credentialing only. !f total FTE {LHJ plus local MCAH} exceed 1.0 FTE, local MCAH may meet
staffing requirements utilizing a MCAH Coordinator.
MCAH Director will contact the CHVP-SNL before contacting the NFP-NSO.
MCAH Director will support the collaboration of the CHVP-SNL with the NFP designated Nurse
Consultant (DNC). The MCAH Director will include the CHVP-SNL's role in the LHJINF_P
Implementation Agreement (contract) which includes: '
1. Ongoing collaboration between SNL and NFP's DNC
2. Providing support to the MCAH director andlor their designee as specified in the
contract between the LHJ and NFP
3. Providing ongoing coaching and consultation, as well as conducting education sessions
as appropriate to help nurse supervisors and nurse home visitors improve their
knowledge skills and abilities to implement the program with high quality and with fidelity
to the NFP model in collaboration with NFP's DNC
4. Provide education and support to MCAH Directors, nurse supervisors, and nurse home
visitors on specific topics as reasonably requested by NFP from time to time in
collaboration with NFP DNC.
5. Monitor ongoing quality improvement to ensure LHJs enter timely and accurate data
into ETO.
6. Assist in delivering appropriate continuing education in collaboration with NFP DNC.
7. Continually assist MCAH director to help nurse supervisors meet NFP professional
development requirements as specified in the NFP Policies and Procedures (P&ps} in
collaboration with NFP DNC.
8. Assist NFP DNC in mentoring nurse supervisors in their administrative and clinical
roles.
iaina12.6.2012 Page 5
9. Foster communication of successful practices and mutual problem solving among nurse
home visitors at L.HJs.
10. Keep NFP informed of implementation issues that arise with any LHJ. Work with the
NFP DNC to facilitate visits, not Tess than quarterly, between NFP's DNC and nurse
supervisors. The NFP DNCs shall meet with nurse supervisors at least quarterly.
The above stated terms must be established in the contractual agreement between each NFP
LHJ and the NFP NSO.
2. NFP Staff Recruitment
CHVP will require two primary staff positions consistent with the national NFP recommendation:
Nurse Supervisor and Public Health Nurse Home Visitor (PHN-HV). The FTE Public Health
Nurse positions are based on the number of required caseloads. The FTE Nurse Supervisor is
based on the total number of PHN Home Visitors. Far example, a LHJ site with a caseload of
100 participants must have four FTE PHNs and one FTE Nurse Supervisor. CHVP NFP SNL
reserves the right to ask far additional information or justification for any identified staffing
deviations.
NFP Nurse Supervisor
Qualifications:
• Registered Nurse license in good standing
• Master's degree in Nursing or closely related field (must submit a request to the NFP SNL
for alternative degree approval)
• Public Health Nurse certificate
Three to five years of experience as a Public Health Nursing Supervisor
Responsibilities: .
Su envision Commitments
• Report directly to the MCAH Director
• Use reflective supervision with PHN-HV, demonstrate NFP theory integration, and
facilitate professional development essential to the PHN-HV
• Provide clinical supervision with reflection through the following activities:
a. One-on-one clinical supervision, including weekly one-on-one meetings with PHN-HV
for 1-hour duration;
b. Case conference with the team to review cases for professions! growth and problem
solving, twice a month for 1.5 to 2 hours duration;
c. Meetings with the team to discuss program implementation issues twice a month;
d. Field supervision with PHN-HV between 4 to 8 hours per nurse every 4 months or as
needed.
l;iria12.6.2012 Page 6
• Provide close oversight to PHN-HV when complex physical or mental health issues are
identified from selected clients who are case managed
• Ensure that PHN-HV is assigned a caseload of no more than 25 participants
• Provide supervision for FTE PHN-HVs. CHVP Branch prefers a ratio of one FTE
supervisor to four FTE PHNs, unless exception is granted by CHVP Branch Quality
Assurance team. Supervisor will dedicate a full time effort to CHVP. The team will
consist of not less than four PHN's nurse home visitors {PHN-HV).
Quail Assurance Commitments
• Support CHVP in the activities that will lead to success in achieving the benchmarks,
constructs, and operational component of the SOW
• Participate in a minimum of six one-to-one meetings with CHVP SNL to evaluate the
progress of CHVP and identify quality improvement activities as needed
• Serve as the LHJ liaison with the CHVP SNL, attend meetings required by the
NFP/CHVP SNL.
• Write protocols for quality assurance activities for the PHN-HV.
Training Commitments
• Attend manila#ory and recommended trainings identified by CHVP
NFP Public Health Nurse Home Visitor PHN-HV
Qualifications:
• Registered Nurse in good standing
• Bachelor's degree in Nursing
• Public Health Nurse certificate
+ Experience in public health and cultural competency
Responsibilities:
Home Visiting Commitments
• Carry a caseload of no more than 25 families
• Conduct home visits integrating use of required assessment tools and refer.clients to
necessary resources as appropriate
• Provide medical case management, as defined by the NFP model, to families identifed
as having complex physical or mental health issues, such as pregnancy with or without
complications, adolescent pregnancy, premature infants, or children with special needs
Final 2.b.201Z Page 7
• Provide a summary of case physical assessment, developmental and case
documentation during a reflective case conference with the supervisor
• Data entry is an optional responsibility for this position.
Training and Meeting Commitments
• Attend mandatory orientations and meetings required by CHVP announced through a
Program Letter.
NFP Administrative Assistant
Responsibilities:
« Data entry and other administrative tasks. The agency has the option to have their
nurses enter the data, but the expectation to have 0.5 FTE support staff remains.
• Minimum ofi 0.5 FTE support staff required per 7 00 clients
3. HFA Staff Recruitment
CHVP will require four primary staff positions consistent with the national HFA recommendation:
Program Managers/Supervisors, Family Assessment Workers (FAWs}, and Family Support
Workers (FSWs).
HFA Program ManagerlMCAH Director
Qualifications:
• Master's degree, preferably in a health science, human services, or behavior science,
such as psychology, sociology, or a related field;
OR
• Bachelor's degree, preferably in a health science or behavior science, such as
psychology, sociology, or a related field, AND a minimum of five years' administrative
experience in quality assurancelimprovementond program development.
Responsibilities:
• The MCAH Director may also act as HFA Program Manager. The percentage of
effort for combined position must be specified in the Staffing Report (A#tachment
B).
• Report directly to the MCAH Director {if not one and the same}
• Oversee program operations, funding, quality assurance, evaluation, and supervision of
staff
• Develop and implement policies and procedures related to focal CHVP
Final 2.6.2012 Page S
• Ensure accreditation and program standards are met as described in CHVP Policies and
Procedures and HFA Self-Assessment tool; and
• Establish and maintain agreement and effective partnerships with home-visiting-related
partner agencies and medical providers.
HFA Supervisor
Qualifications:
• Master's degree, preferably in a health science, human services, or behavior science,
such as psychology, sociology, or a related field;
OR
• Bachelor's degree, preferably in a health science or behavior science, such as in
psychology, sociology, or a related field, AND a minimum of three years' experience
working in a public health or community related setting in the clinical field with
experience in supervising health professionals and managing programs.
Responsibilities:
• Full-time supervisors are to have six or fewer direct services staff.
Spend a minimum of 1.5 to 2 hours per employee each week on formal supervision
using a reflective model of supervision. AIIow additional time to shadow the FSWs and
FAWs to monitor and assess their performance and provide constructive feedback and
development.
• Supervisors will serve as the liaison with the CHVP HFA Statewide Nurse Consultant.
.Supervisors are required to attend meetings required by the CHVP HFA Statewide Nurse
Consultant at designated times.
• Use a reflective supervision model in face-to-face supervision with FAWs and FSWs,
and facilitate professional development essential to the home visitor role.
Family Assessment Workers (FAWs)
Qualifications:
• Bachelor's degree in health science or behavioral science, such as psychology,
sociology, or a related field
• Experience working with clients in communities
• Experience in assessment process and scoring ,recording of information, conducting
patient interviews, implementing treatment plans, employing problem-solving
techniques, handling crisis intervention matters, and using proper case management and
referral procedures
• Ability to establish rapport easily, outgoing, friendly and non-judgmental, confident and
assertive
Fina12.6.2012 Page 9
• Cultural competence is preferred
Responsibilities:
• Conduct family and child assessments and screen families for enrollmen# in the
program
• Document and enter assessment data in CHVP database
• Refer families to appropriate resources based on assessment
• Communicate pertinent assessment findings to FSW
Family Support Workers (FSWs)
Qualifications:
• Bachelor's ar Associate's degree, preferably in health science, behavior science, or
general education courses in liberal arts, sciences, and the humanities, in areas such as
addiction or child protection.
OR
• Graduation from high school with a minimum of 5 years' experience providing services
to infants, children and families and ability to demonstrate extensive knowledge of
community resources verifiable through reference check. {Exemptions must be pre
approved by the CHVP HFA Statewide Nurse Consultant).
• Experience working with clients in communities
• Experience. observing patients/clients and recording information, conducting patient
interviews, implementing treatment plans, employing problem-solving techniques,
handling crisis intervention matters, and using proper case management-and referral
procedures
• Strong desire to help others, effective communication and interpersonal skills, sense of
responsibility, and ability to manage time effectively
• Attributes such as patience and understanding are highly valued
• Cultural competence is preferred
Responsibilities:
• Conduct home visits with families to include the following elements:
o facilitate the parent-child relationship
0 observe and listen to parental concerns
o respect family values and culture
o support parents in their role as advocates for themselves and their children
Final 2.6.2012 Page 10
o assess, facilitate, and promote positive child growth and development
o provide information and appropriate referrals to community resources
o maintain appropriate documentation that outlines the services provided to the family
and help facilitate quality management
o serve no more than 15 families at a time who are currently being seen weekly
o carry a caseload of no mare than 25 families
o caseload may need to be reduced to accommodate families with multiple needs or to
accommodate communities in which there are long distances between home visits
4. Other Staffing Requirements by CHVP
• LHJ site must adhere to the Core Competency Requirements specified by NFP, HFA and
CHVP Branch for hiring qualified staff. Applicants should demonstrate sufficient skills to meet
the 50W objectives and activities. CHVP Branch reserves the right to approve or disapprove
changes in key personnel positions that occur after awards are made.
• In order to ensure adequate funding of all contract deliverables, CHVP Branch reserves the
right to require the LHJ to reduce or eliminate any staffing position(s) in excess of the minimum
required staffing pattern as identified in the model or CHVP requirements.
• LHJ site shall submit "Staffing Report," to CHVP Branch b Ma 31 ZD'I2, andlor upon any
change in personnel. Prior approval from CHVP NFP SNL/HFA Statewide Nurse Consultant is
required for changes in staffing patterns that deviate from the original contract agreement.
Alternative patterns of staffing will need approval from CHVP Branch.
• All staff for each model must meet the Core Competency Requirements before providing
services to the families, (see the Policies and Procedures Manual for LHJ site). Exemptions
must be pre-approved by the CHVP NFP 5NL or HFA Statewide,Nurse Consultant before staff
recruitment.
• LHJ site will report #o CHVP Branch any changes in staffing or reduction in percentage of effort
(less than 100%) dedicated by staff to CHVP within seven days of the change, along with
plans for addressing these changes. The LHJ. site must contact the CHVP NFPSNL or HFA
Statewide Nurse Consultant any time there is a reduction in the percentage of effort dedicated
by staff to CHVP.
CORE COMPETENCY REQUIREMENTS
Additional core competency requirements for NFP and HFA positions are located in the CHVP
Policies and Procedures Manual.
CHVP MEETINGS AND TRAINING REQUIREMENTS
LHJ site is required to attend and participate in CHVP meetings, worlcgroups, and trainings directed
by CHVP. LHJ site is responsible for staff members' receiving core training on HFA and NFP
Final 2.6.2012 Page 11
models they are implementing and other CHVP required training to meet the program benchmarks.
The following describes required training for NFP and HFA staff.
NFP Training
The Nurse Supervisors and PHN-HV are required to:
• Attend core educational sessions and mandatory one week training; and
• Complete self-study materials as directed by NFP.
1. NFP Pro ram re wired trainin s
Keys to Care Giving
NCAST (assessment tools)
Ages and Stages (assessment tools)
Home Inventory
HFA Training
LHJ site must comply with the training requirements to ensure s#aff receive the training support and
have the skill set necessary to fulfill their job functions and achieve the program's goals with
families.
1. Orientation topics:
* Staff (assessment workers, Dome visitors, and supervisors) must receive orientation
{separate from intensive role-specific training} prior to direct work with families, to familiarize
them with the functions of the program. (For specific orientation topics, refer to HFA 2008-
2011 Self-Assessment Tool Updated 3-1-10, pp. 69-74. Please contact your Prevent Child
Abuse America (PCAA} National Office (NO) to obtain a copy of the 2D0$-2011 HFA Seif-
Assessment tool.)
2. ]ntensive Training
• All staff must receive in-person Core Training from a Certified HFA trainer in either Parent
Survey (Assessment) ar Integrated Strategies (Home Visitors) within six months of hire.
• Supervisors must receive in-person training based on the track (assessment or home
. .visiting} they supervise and administrative, clinical, and reflective practice training within six
months of hire or affliation of the site. In addition to both track-trainings, supervisors are afro
required to attend two days of supervision training.
3. Wraparound training
• Once affiliation is received from HFA, staff will be able to access the Wraparound training topics (HFA
standards 10-~ A-F and 10-5 A-F] available online, and must be completed within six and 12 months
of hire respectively prefer to HFA 2008 - 2011 Self-Assessment Tflol Updated 3-1-10, p. 113-116].
4. Ongoing training
• After year one of operation, LHJ site is required to provide to their staff ongoing training in
topics which take into account the worker's knowledge, skill base, and needs. CHVP will
collaborate with each LHJ site to determine needs and coordinate training.
Final 2.6.Z01Z Page 1Z
Note: For new and expansion sites, LHJ shall keep on file the proof of completion of all
required core and follow-up trainings, and CHVP-required trainings of employed staff along
with their curricula.
WORK SPACE AND EQUIPMENT
LHJ site shalt provide necessary equipment and establish an optimal work space for staff who will
be implementing CHVP, including:
• Appropriate telecommunication and computer equipment capabilities for staff use
• Access to a LHJ site Policies and Procedures Manual for easy reference
• Easy access to community resources or agencies either electronically or on paper
DELIVERY OF HOME VISITING SERVICES
1. Enrollment
Potential participants are enrolled only if the enrollment criteria specified in the mode[ elements
are satisfied.
2. LHJ Site Responsibilities During Home Visiting Implementation
In order to implement the program with fidelity to the models, LHJ site shall share experiences
learned and program improvement with other LHJ entities that are implementing the NFP or HFA
models through CHVP coordinated meetings and teleconferences. If issues or difi"iculties arise
regarding home visiting program implementation, the LHJ site must contact the CHVP SNL for
the NFP or the HFA Statewide Nurse Consultant model. Other responsibilities include the
following:
• LHJ staff shalt demonstrate a level of competence in the skills related to Home Visiting
including assessments, interventions,. referrals and follow-up.
• LHJ staff for each site shall ensure that the CHVP SNL far NFP or Statewide Nurse Consultant
for HFA is involved in the process of program implementation and accreditation.
. CHVP Home Visitors shall collect required data on client visits, and the Home Visiting
Supervisor will ensure that these data are entered into the database or data system required
by CHVP within 'I week of the client's visit, taking all appropriate steps to maintain client
confidentiality.
• LHJ staff wilt obtain agreement from CHVP Branch before reporting data outside of their own
program {this is to protect against inconsistencies in reporting coming from different sources}.
• LHJ will send copies to CDPH-MCAH of all reports submitted to NFP NSO or PCAA NO.
• LHJ shah implement the Home Visiting Program in accordance with program fidelity to the
models.
Home Visitation Guidelines
Final 2.6.202 Page 13
NFP Home Visitation Guidelines:
• Ensure that each full-time PHN-HV carries a caseload of not more than 25 active families.
• PHN-HV must maintain the established visit schedule.
• Ensure that the essential program content as described in NFP Home Visit Guidelines is
covered with clients by Nurse Home Visitors. (Refer to Policies and Procedures Manua! for
model visit schedule specifics.)
• All PHN staff visitation must be documented within 24 hours of visit.
HFA Home Visitation Guidelines:
• Ensure that each full-time FSW carries a caseload of no more than 15 active families seen
weekly or a weighted caseload of 26 to 30 points for Level 1 families or families seen weekly.
• Ensure that each fulhtime FSW carries an overall caseload of no more than 25 families.
• FAWs and FSWs must maintain the established visit schedule.
• Ensure that the essential program content as described in HFA Home Visit Guidelines is
covered with clients by the FSW. (Refer to Policies and Procedures Manua! for model visit
schedule specifics.}
• All Home Visitors' visitation must be documented within 24 hours of the visit.
• CHVP reserves the right to access all collected data and establishes CHVP ownership of
CHVP uniquely- defined data content and functionality.
CLIENT CONFIDENTIALITY AND H1PAA REQUIREMENTS
The Health Insurance Portability and Accountability Act (HIPAA) was passed by Congress in 1996;
and took effect in 2003. It establishes standards for Protected Health Information (PHI) from
disclosure and informs clients of how their information will be used. LHJ site must abide by stringent
rules and regulations related to HIPAA. This ensures that al[ communication of PHI is confidential.
LHJ site must establish and maintain appropriate administrative, technical and physical safeguards to
protect the confidentiality of the data, prevent unauthorized use of or access to it and obtain any
necessary written permissions ar agreements for data analysis or disclosure of PHI, including from
CHVP, and in accordance with HIPAA regulations including, but not limited to, authorizations, data
use agreements, and business associate agreements.
Appropriate safeguards include, but are not limited to, securing and maintaining all hard copy ar other
records containing participant infiormatian containing PHI {such as CD-ROM, diskettes, thumb drives,
etc.) in a locked file cabinet inaccessible to staff other than those directly involved in either the
delivery of service to the participant, supervision of these direct service-delivery staff, ar in data entry;
and securing a[I electronic records containing participant information containing PHf in password-
protected, encrypted files, with access only for staff directly involved in delivery of services to
participants, supervision of these staff, or data entry.
Final 2.6.2012 Page 14
Each 1.HJ site must have on file a Confidentiality Agreement signed by each staff memberwho has
the ability to view the raw data, either by collecting the data or by viewing it after it has been recorded;
these individual Confidentiality Agreements must be renewed annually.
All client-participants will sign an informed consent to have their information shared with CDPH for
purposes of aggregated, unidentifiable public health reporting.
Failure of LHJ site to comply with any applicable provision of H[PAA wilt constitute a breach of
agreement.
SPECIFIC REQUIREMENTS FOR COMPETITIVE GRANT RECIPIENTS
(Fresno; Los Angeles Communities; Merced; Nevada; Sacramento Communities; San Mateo; Solano;
and Stanislaus)
A. Activities Required for Competitive Grant Recipients
In collaboration with the CHVP SNL for NFP and Statewide Nurse Consultant for HFA and
Quality Assurance Team, and external evaluator, the following activities are required for counties
that received MIECHV Competitive Expansion Grant funding:
~. Provide a sample of community leadership, family members, and clinicians who will
participate in interviews and/or focus groups with external evaluators during fiirst two months
of clien# enrollment
2. Assist external evaluators with scheduling of focus groups with selected community leaders,
family members, and clinicians to develop appropriate measures and incorporate information
deemed important for formal Site Visits; these activities are to occur during the first three
months of client enrollment
3. Specific designees (including community leaders, home visiting, clinicians, family members,
and program administrators} participate in community focus groups during the first three
months of client enrollment
~. Assist with organizing and scheduling site visits with key informants in collaboration with
external evaluators during the first quarter of State Fiscal Year (SFY) 2012/2013
5. Work with external evaluator to setup locations and schedule of participants for site visit
during the first quarter of SFY 2012/2013
s. Participate in site visits with Evaluation Team Site Visitors during the first quarter of SFY
2012/2013
7. Receive feedback from evaluators regarding interview and site visit data before the end of
second quarter for SFY 2012/2013
s. Respond to survey toots fior key informants during the fourth quarter for SFY 2012/2013
9. Key program administrators to participate in phone interviews with external evaluators during
the fourth quarter fior SFY 2012/209 3
To. Enter additional data (type and frequency to be announced); this activity is ongoing
Fina12.6.2012 Page 1S
B. Deliveralales for Competitive Grant Recipients
The following deliverables are required from the Competitive Grant Recipients semiannually in a
progress report in accordance with the due dates indicated in the Scope of Work:
1. List of key participants including administrators, home visiting staff, supervisors, family
members, advisory board members, and local community leaders provided to external
evaluators; these activities are to occur during the first three months of client enrollment.
2. Schedule of focus group meetings during the first quarter of State Fiscal Year (SFY}
209 212013
3. Establishment of dates of focus group meeting participation and roles of participants during the
first quarter of State Fiscal Year (SFY) 20 1 2120 1 3
~. Site Visit schedule developed coClaboratively with external evaluators during the first quarter of
5FY 2012/2013
5. Agenda far site visits, provided by external evaluators with locations and participants, during
the first quarter of SFY 2012/2013
6. Summary report of site visits provided by external evaluators before end of second quarter for
SFY 2012/2013
7. Participation in oral feedback sessions at end of site visit; receive formal written report
highlighting key areas of discussion from external evaluators during quarter following site visit
before end of second quarter for SFY 2012/2013
s. Email of links to survey tools or mailing through U.S. Postal Service of hard copy of survey;
transmission of completed tools to external evaluators during the fourth quarter far SFY
2012/2013
s. Dates of scheduled interviews in annual reports during the third quarter for SFY 2012/2013
~o. Entry of additional data; this activity is ongoing
QUALITY IMPROVEMENT FOR ALL HOME VISITING NFP AND HFA SITES
Efforts to improve home visiting outcomes for home visiting sites are required through effective
collaboration with the model program consultant and State QA teams. CHVP requires the following
activities to facilitate and establish a high quality CHVP:
• Communicate Continuous Quality Improvement Program initiatives to CHVP
• Participate in MCAHICHVP workgroupslcommittees
* Collect consistent and accurate data for home visiting activities
• Maintain detailed supervisory guidelines and expectations
• Promote measures to improve the process of identifying and enrolling participants who reflect the
model's and the LHJ target population
Final 2.6.201.2 page x6
• Develop a Community Advisory Board with diverse representation to ensure broad-based
community support for LHJ's implementation of CHVP
• Participate in periodic assessment by NFP or HFA mode! to ensure LHJ implements the Home
Visiting Program with fidelity to the selected model
• Involve the CHVP SNL and Statewide Nurse Consultant in strengthening fidelity to the model for
improved results
• Periodically review and upda#e LHJ site-specifc Policies and Procedures Manual to improve home
visiting in#erventions, documentation, and data collection; CHVP reserves the right #o review LHJ
site's Policies and Procedures Manual and approve changes
• Ensure staff are trained in accordance with NFP or HFA model requirements, in addition #o CHVP
training requirements
• Adhere to the program components and requirements for each model, including CHVP protocols
• Consistently deliver home visiting services to families enrolled in services
Final 2.6.2012 Page 17