Virginia Home Visiting Updated State Plan

I. Project Narrative 

Sections 1 - 9 

II. Attachments 

VIRGINIA MIECHV HOME VISITING PROJECT 

July 15, 2011 through September 30, 2012 

A. Local Community Plans 

1) Danville 

2) Fredericksburg 

3) Montgomery-Radford 

4) Norfolk 

5) Suffolk-Southampton 

TABLE OF CONTENTS 

B. Logic Models 

1) Virginia’s Plan for Smart Beginnings 

2) Virginia Home Visiting Consortium 

3) MIECHV Logic Model 

C. Virginia Implementation Plan 

D. Virginia Job Descriptions 

E. Virginia Key Staff Biosketch 

F. Virginia Organization Chart for MIECHV Project 

G. Virginia Memorandum of Concurrence and Letters 

H. Letters of Approval from National Model Developer Partners 

1) Healthy Families America 

2) Nurse Family Partnership 

3) Parents as Teachers 

III. Budget 

A. Forms (424A) 

B. Budget Narrative 

C. Indirect Cost Agreement 

Virginia Department of Health 

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MATERNAL, INFANT, AND EARLY CHILDHOOD HOME VISITING 

Supplemental Information Request #2 

NARRATIVE 

Section 1: Identification of Virginia’s Targeted At-Risk Communities 

In September 2010, in response to the Maternal, Infant and Early Childhood Home Visiting 

(MIECHV) Project Supplemental Information Request #1 (SIR1), Virginia identified 38 at-risk 

communities out of the state’s 134 localities. In October 2010, the Virginia Department of 

Health (VDH), the lead agency for the project, titled Virginia MIECHV Project, announced the 

names of the at-risk localities to stakeholders statewide at the annual Smart Beginnings 

conference and by posting the full SIR1 Needs Assessment report on 

https:\\www.homevisitingva.com. 

Members of the Virginia Home Visiting Consortium (HVC) 

notified their local program sites, and the Virginia Early Childhood Foundation (VECF) alerted 

the 25 regional Smart Beginnings coalitions (SBCs). 

In February 2011, following the release of the Supplemental Information Request #2 (SIR2), 

VDH, in consultation with the state’s Administration for Children and Families (ACF) agency 

and the Virginia Department of Social Services (VDSS), announced and hosted two statewide 

webinars to review the federal requirements, announced the seven evidence-based (EB) models, 

provided a basic outline of the likely VDH Request for Proposals (RFP) process, and informed 

localities about ways to obtain technical assistance from VDH staff and from the HVC members. 

The SIR2, the link to the website defining the evidence-based models, and the webinar 

presentation were posted on the www.homevisitingva.com website along with the questions and 

answers provided during the two sessions. Following approval by the Health Resources and 

Services Administration (HRSA) of the Virginia RFP process for selecting communities for 

Virginia MIECHV Project funds, VDH conducted six regional technical assistance sessions. The 

regional meetings were intentionally located in Winchester, Christiansburg, Charlottesville, 

Danville, Richmond, and Portsmouth so that people from around the state would be able to drive 

two hours or less to attend. In addition to the regional meetings, technical assistance for the 

grant applications have been provided through email, phone, and other scheduled meetings. An 

enhanced PowerPoint presentation, the handouts of additional local data tables, and answers to 

the questions asked in the six sessions were posted on the www.homevisitingva.com website. 

Localities not originally identified as one of the 38 at-risk communities, but which decided in 

March to identify specific neighborhoods to meet the at-risk definition, were referred to VDH, 

Office of Family Health Services (OFHS), Division of Policy and Evaluation for state-level data 

and given recommendations about methods for obtaining local data (e.g., at-risk neighborhoods 

based on the location of domestic violence calls to local police departments). 

The VDH RFP was issued on April 15, 2011. Announcements were posted on the 

www.homevisitingva.com website, sent out to the “interested parties” email list used for the 

regional meetings, and sent out by other HVC and SBCs stakeholders. Technical assistance for 

completing the RFP was provided by VDH staff and the HVC by phone and in local meetings. 

To maintain the model fidelity, as required by the SIR2, all localities that were considering an 

application were encouraged to contact the national project developers of the seven evidence- 


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ased models or the evidence-based model state coordinator for assistance in creating their 

community proposal for implementation of one or more evidence-based models. Proposals 

submitted by May 2, 2011, were reviewed by a twelve-member panel, consisting of state agency 

and program representatives, on May 9, 2011. 

Based on the ratings by the RFP review committee, seven at-risk communities are included in the 

Virginia Updated State Home Visiting Plan. As indicated below, there is a variety among the 

five contracting agencies. 

At-Risk Community Applicant Agency 

Danville Community mental health agency 

Fredericksburg Community mental health agency 

Montgomery-Radford Community Action Agency 

Norfolk Private agency 

Suffolk-Southampton Local health district 

Each of these communities has provided information about their needs and gaps. These 

determined their model selection for expansion of home visiting services. (See Attachment A.) 

Based on the approved applications, Virginia’s Updated State Plan will include the following 

expanded models and new models shown in Table 2. 

Table 2: Community Selected Models, Funding and Service Expansion 

Community MIECHV 

Funding 

Existing 

Models 

New 

Models 

Home Visiting 

Expansion 

in Families 

Enrolled 

Danville $194,115 Healthy Families 25 

Fredericksburg $308,256 Healthy Families 60 

Montgomery- 

Radford 

$279,073 Parents as Teachers 60 

Norfolk $137,730 Parents as Teachers 50 

Suffolk- $193,319 Nurse-Family 75 

Southampton 

Partnership 

State Total $1,112,493 270 

Screening and Referral Procedures 

The Virginia HVC has promoted the concept of interagency collaboration on screening and 

referral processes, such as the centralized intake process or use of common forms so that families 

did not have to repeat application procedures. Some communities have developed a centralized 

intake process while others have not initiated the community discussion to support this practice. 

Working with the national model developers, the HVC will provide technical assistance in 

developing referral agreements and identification of tools. Virginia MIECHV Project activities 

will be shaped by each community’s current practice and future goals. 


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Table 3: Current Screening and Referral Procedures in Selected Communities 

Community Centralized Names of Standard Written Referral 

Intake? (Y/N) Screening Tools Used Agreements (Y/N) 

Danville N HF Initial Screen, ASQ 

Edinburgh 

N 

Fredericksburg foundation HF Initial Screen, ASQ 

Edinburgh 

N 

Montgomery-Radford foundation ASQ, Edinburgh N 

Norfolk N ASQ, Edinburgh N 

Suffolk-Southampton N Denver N 

There is a longstanding cooperative agreement between VDH and VDSS supporting the state’s 

information and referral system. The 2-1-1 VIRGINIA system provides information regarding 

statewide and regional services available to assist women in improving individual and family 

health across the lifespan. The HVC has provided training to all home visitors about 2-1-1 

VIRGINIA and encouraged them to teach their clients about this system. Recently, VDH 

received a grant (First Time Motherhood/New Parents Initiative) to establish a partnership with 

2-1-1 VIRGINIA call centers that should result in an increased usage of the 2-1-1 VIRGINIA 

system. Virginia was instrumental in the early promotion of Text4Baby, a free text messaging 

service for pregnant and/or parenting women. VDH currently is partnering with Healthy 

Mothers, Healthy Babies and Virginia partners—such as Medicaid, WIC, Association of 

Certified Obstetricians (ACOG), and American Academy of Pediatrics (AAP)—to market this 

nationally acclaimed service in the state. Information regarding the service will be provided to 

appropriate families. VDH will also pilot a new interactive mobile information service called 

TEXTFIT designed to educate pregnant women and new moms with the information they need 

to make the right nutritional choices for themselves and their children. The plan will include a 

list of available referrals to primary healthcare along with educational, social, and financial 

support. Members of the advisory group will be representatives from large healthcare systems 

within Virginia, Title V stakeholder groups, and members of the Virginia HVC. 

Virginia state resources—such as 2-1-1 VIRGINIA, Medicaid health insurance for pregnant 

women and children, WIC program services, child care, and food stamps—are available in each 

community for young vulnerable families. The home visiting programs will be tracking their 

families’ use of these services so that barriers and inefficiencies can be identified and appropriate 

system changes made. Each Virginia MIECHV Project community identified needed resources, 

gaps in services, and a plan for addressing these with local partners: 

• Danville: 

− Needs/gaps in resources: Insufficient services for pregnant teens and teen parents and 

lack of programs for parents who are not first-time parents but lack knowledge of child 

development and need parenting support. 

− Plan: Expand Healthy Families to reach out to these two groups. 


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• Fredericksburg: 

− Needs/gaps in resources: Insufficient staff to meet demand, high rates of teen pregnancy 

and lack of teen-focused services, and high number of non-English speaking families and 

lack of bilingual staff. 

− Plan: Expand Healthy Families to serve first-time pregnant teen parents and pregnant 

women with Limited English Proficiency. 

• Montgomery-Radford: 

− Needs/gaps in resources: Low referrals for developmental delays, lack of early 

intervention to decrease child abuse and neglect, goal to decrease child abuse and neglect 

and increase school readiness, difficulty reaching African-American population, too few 

preventative referrals, and lack of programs serving children older than 2 years of age. 

− Plan: Expand Parents as Teachers program. 

• Norfolk: 

− Needs/gaps in resources: Lack of coordinated intake process, parents without solid 

knowledge of child development, and restrictive eligibility for home visiting programs 

leaving some families without resources. 

− Plan: Expand small Parents as Teachers program. 

• Suffolk-Southampton: 

− Needs/gaps in resources: Low income pregnant women not participating in prenatal care, 

lack of parent support services, and lack of coordination of resources. 

− Plan: Initiate Nurse-Family Partnership program. 

For several years, through the public-private partnership of the Virginia Early Childhood 

Foundation (VECF) and the Early Childhood Advisory Council (ECAC), Virginia has been 

creating a strong interagency early childhood collaborative system. Goal 2 (Parent Education 

and Family Support) of the Virginia Plan for Smart Beginnings (SB Plan) identifies the HVC as 

a partner for enhancing home visiting as a strategy to promote healthy child development and to 

support families. The ECAC and its partner agencies are supportive of the integration of the 

home visiting strategy into the plan and will expect updates of the Virginia MIECHV Project 

activities along with other updates from the HVC. 

Through the HVC, all early childhood home visiting programs are participating in cross-agency 

initiatives under the SB Plan in the areas of professional development, data collection, and 

analysis. Common training needs have been identified and trainings have been offered to early 

childhood professional disciplines. 

The Virginia HVC, reporting to the ECAC, has a broad mission to enhance the efficiency and 

effectiveness of home visiting services across the state as part of the SB Plan. The HVC will 

continue to work with all Virginia communities, including those identified as at-risk by the 

MIECHV definition. Of the 39 potential community applicants, 7 were recommended for 

funding through five contracts. The following 15 communities applied but were not approved for 

funding under this RFP due to limitations on available 2010 funding or due to other factors: 

Bristol, Essex, Hopewell, Portsmouth, Newport News, Hampton, Patrick, Henry, Petersburg, 


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Orange, Richmond, Charlottesville-West Haven, Warren, Williamsburg, and Winchester. Four 

communities developed proposals but did not meet the deadline for submission: Lynchburg, 

Charlotte, Waynesboro, and Staunton. The remaining 13 “at-risk” communities expressed 

interest but chose not to develop a proposal at this time due to other local demands on staff time 

and community resources. 

Section 2: State Home Visiting Program Goals and Objectives 

The updated goals and objectives for the Virginia MIECHV Project plan are presented below. 

Goal 1: Improve coordination of early childhood services at the state level. 

Objective 1: Increase the degree to which state agencies collaborate to develop and 

improve home visiting programs. 

Objective 2: Enhance communication among state agencies, the HVC, and local home 

visiting programs. 

Objective 3: Increase capacity to provide technical assistance, training, resources, and 

data collection for early childhood home visiting programs. 

Goal 2: Improve coordination of early childhood services at the local level with priority in 

the identified at-risk communities. 

Objective 1: Increase the degree to which the local home visiting programs collaborate 

together and with formal and informal community leaders or groups in program planning, 

service delivery, and evaluation activities. 

Objective 2: Increase diversity of referral sources to home visiting programs. 

Objective 3: Increase linkages and referrals to community services. 

Goal 3: Increase the quality, availability, and effectiveness of early childhood home visiting 

programs designed to strengthen families in Virginia. 

Objective 1: Increase quality of home visiting programs. 

Objective 2: Improve access to the early childhood continuum of services ensuring 

appropriate and timely referrals and reduction or elimination of duplication across home 


Objective 3: Increase effectiveness of home visiting programs to improve maternal and 

child health, improve parenting behaviors and the parent-child relationship, and support 

children’s learning and development. 


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The Virginia MIECHV Project will contribute to developing a comprehensive, high-quality early 

childhood system that promotes maternal, infant, and early childhood health; safety; and 

development of strong parent-child relationships by: 

• Coordinating its data system definitions with the comprehensive early childhood data 

collection and evaluation system being developed by Virginia Polytechnic Institute and State 

University (Virginia Tech) for VDSS and the Virginia Department of Education (VDOE); 

• Coordinating professional development activities for home visitors and supervisors with the 

professional development activities designed by the Virginia Cross-cutting Professional 

Development Workgroup (VCPD); 

• Reporting progress at least annually to the VECF and the ECAC; 

• Participating in the SB Goal 2 Group meetings, which seek to provide access to information 

and services for all families; and 

• Sharing lessons learned with the HVC and local communities so that improved efficiencies 

can be gained across the state in home visiting programs. 

Strategies for integrating the Virginia MIECHV Project with other programs and systems in the 

state that are related to maternal and child health and early childhood health, development, and 

well-being include: 

• Partnering on grants and projects that explore how home visiting can be a strategy to improve 

the effectiveness or efficiency of other programs (e.g., increasing awareness of services such 

as 2-1-1 VIRGINIA, increasing oral health follow-up, improving medical homes outcomes, 

increasing early intervention referrals, and enhancing child care center family support); 

• Participating in university-sponsored research projects that explore quality improvements in 

home visiting and early childhood systems; and 

• Promoting health promotion information and practices that are congruent with the life course 

development and socio-ecological models (e.g., Bright Futures Anticipatory Guidance, 

breastfeeding duration, and healthy food choices). 

The Virginia Home Visiting Consortium Model was submitted in the response to the SIR1. The 

Virginia MIECHV Project Logic Model should be viewed as nesting within the Smart 

Beginnings Logic Model and the HVC Logic Model while focusing on the Virginia MIECHV 

Project plan. See Attachment B1 for the Virginia Smart Beginnings Logic Model, Attachment 

B2 for the Home Visiting Consortium Model, and Attachment B3 for the Virginia MIECHV 

Project Logic Model l. The Logic Model Attachment B3 will be revised as the Virginia 

MIECHV Project staff work with the identified national models as necessary in future planning. 


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Section 3: Selection of Proposed Home Visiting Model(s) and Explanation of How the 

Model(s) Meets the Needs of Targeted Community or Communities 

Virginia utilized a competitive subcontracting process to identify which communities would be 

awarded funding to expand the local home visiting services. The RFP followed the outline 

format, content, and the requirements of the federal SIR2. Only at-risk communities and 

neighborhoods that met the same criteria were eligible to apply. Technical assistance was 

offered to all at-risk communities. The RFP clearly stated that the communities must propose 

one or more of the seven identified evidence-based models in order to be awarded funding. 

Successful applicants met with key local early childhood partners to identify the community 

needs, gaps, resources, target population, and to select the model(s) for expansion or 

implementation. Local communities were asked to consider their continuum of early childhood 

home visiting services and the changing needs of vulnerable families from pregnancy to school 

entry and to determine whether to provide services that filled in gaps or increased the levels of 

service intensity. Successful applicants documented their meetings with local partners, presented 

the local model(s) selection in a clear and logical manner, and provided assurances about 

meeting the requirements of the national developer for quality and fidelity as well as the HRSA 

grant requirements. The Virginia RFP required that an applicant include a proposed budget, a 

budget narrative, a staffing and management plan, assurances about state data collection 

requirements for benchmarks and continuous quality improvement (CQI) processes, technical 

assistance needs, and an agreement to provide required reports. Per the authorizing legislation, 

at least 75 percent of the funds are dedicated to support local grantees for the development and 

implementation of evidence-based home visiting models. 

Local applicants were informed of the RFP through emails, website postings, webinars, Smart 

Beginnings local coalitions, and regional meetings. Each applicant was asked to notify Virginia 

MIECHV Project staff, the national model developer’s office, and any state-level model 

coordinators if a community was interested in proposing any of the seven models. The local 

applicants were urged to document this notification by email to the national developer and to the 

Virginia MIECHV Project Manager, who is referred to as the Project Manager throughout this 

document. 

The acting Project Manager has contacted all seven of the national developer offices and has 

requested and received a conditional letter of approval, pending the national offices receiving a 

final copy of the Virginia implementation plan. By April 25, these letters were provided to the 

HRSA project officer and uploaded to the HRSA website as required. 

For this SIR #2, Virginia has identified the following communities for funding: Danville, 

Fredericksburg, Montgomery-Radford, Norfolk, and Suffolk-Southampton. Each community 

has provided a diagram of their services, a list of the participants in creating the local plan, the 

identified local needs and gaps that lead to local community team’s selection of the particular 

model(s), the local Memorandum of Concurrence, and the local signed Assurances. (See 

Attachment A.) 

The committee that reviewed the proposals identified these communities as having the 

administrative capacity, staff experience, community commitment, and resources to implement 


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the plans. VDH has made it clear that local community involvement is expected to continue on 

an ongoing basis throughout the duration of the Virginia MIECHV Project. Each community site 

will have a local advisory committee composed of early childhood home visiting program 

representatives and other early childhood program representatives. 

State Experience With Evidence-Based Model Implementation 

Two evidence-based models have been implemented across the state for several years: Healthy 

Families (HF) and Parents as Teachers (PAT). Each of these models has a state office that 

provides technical assistance to local communities. All three models chosen by the selected 

applicants have met the national standards; Virginia’s Healthy Families has achieved state 

accreditation. The Nurse-Family Partnership® Program (NFP) model will be new to Virginia. 

This model has a southwest regional coordinator but no state technical assistance provider. All 

three of the national offices of all models were receptive to meeting the requests for technical 

assistance, training, and coordination with other models within the first 90 day period (July1, 

2011, to September 30, 2011). 

Ensuring Implementation Quality and Fidelity to the Evidence-Based Models 

Fidelity and quality assurance will be a shared responsibility of the Virginia MIECHV Project, 

the evidence-based model staff, and the local program stakeholders. VDH plans to work with 

the technical assistance providers, which include the peer reviewers in the state for HF and PAT 

models, and the regional coordinator for NFP. For each evidence-based model included in the 

awarded proposals, VDH will develop agreements that include quality assurance requirements, 

monitoring items and schedules, timeframes for program implementation, and reports. National 

technical assistance costs will be included in the local program contract and procedures for 

resolving differences that support the model fidelity. A key element in the state agreement with 

each evidence-based model developer will be the commitment to collaborate with Virginia early 

childhood system partners and develop strong interagency referral systems and linkages. During 

the first 90 days of their contract period, the local contractors and Virginia MIECHV Project 

staff will work with the selected national evidence-based model staff to create clear plans and 

agreements for implementation, staff training, reporting, data collection, and ongoing technical 

assistance. If a community has proposed a combination of the seven models, combined 

implementation plans will be developed and approved by all model developers as well as the 

local contractor and the Virginia MIECHV staff. These plans will be reviewed annually. 

Evidence-based model representatives will receive reports from the Project Manager at least 

semi-annually. 

While each community will be required to follow the administrative and program 

implementation standards of each of the national evidence-based models, there will be state and 

local challenges in coordinating the multiple evidence-based models. The challenge for 

communities may be integrating multiple models into a state and local continuum without 

duplicating current services and providing the models in a way that is helpful and accessible to 

vulnerable families. While some national models have worked together, others have not. The 

Virginia HVC has experience in working together across agencies and programs at the state level 

and, therefore, can provide a structured process for discussing implementation issues across 

models and for integrating collaborative work plans. As the HVC worked to bring together ten 

models five years ago, the Virginia MIECHV Project will develop written agreements at the state 


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and local levels among all home visiting programs regarding their common vision, values, and 

common work plans. While this process may seem time consuming initially, it will support 

effective work in the future years and establish methods for resolving differences that might arise 

at the state, local, and programmatic levels. Programs implementing evidence-based models new 

to Virginia will be invited to identify a state representative to be on the HVC. All Virginia home 

visiting programs will benefit from technical assistance from HRSA-ACF federal staff, the 

national evidence-based model developers, and from other MIECHV state projects in the areas of 

policy implications, data collection procedures, and staffing issues that result from coordinating 

multiple evidence-based models. 

Section 4: Implementation Plan for Proposed State MIECHV Project 

See Attachment C. The state-level structures will be mirrored in the local home visiting 

programs. The HVC will serve as an advisory committee to the Virginia MIECHV Project, and 

local communities will be encouraged to designate a committee of their SBC or another early 

childhood interagency group to serve in this capacity. Virginia has demonstrated the ability to 

work collaboratively across programs and agencies to develop home visiting policies and 

standards as shown in the agreement on home visiting core competencies and development of the 

www.homevisitingva.com website. It is expected that the HVC will include representatives of 

the national evidence-based models and use established procedures to develop necessary 

recommendations, policies, and standards for the Virginia MIECHV Project. Additionally, it is 

expected that such recommendations, policies, and standards will be implemented across the 

existing state continuum of home visiting programs, not just for the Virginia MIECHV Project 

sites. 

During the first 90 days, the Virginia MIECHV Project staff will meet with the national model 

developers representatives to schedule the required trainings of all staff, finalize the benchmark 

measurement tools, and reach an agreement about the processes and timetables for sharing of 

data from the models’ electronic data systems. In addition, the Virginia MIECHV Project staff 

will meet with each site individually to discuss their hiring and training plans for new employees, 

the initiation or improvement of centralized intake process, the development of local signed 

agreements between agencies, creation of their advisory group, and their system for MIECHV- 

required data collection and reporting to VDH. After these individual meetings and follow-up by 

the Evaluator and Project Coordinator, a state meeting will be held of all five sites, the HVC, and 

other partners to develop the project plans. 

VDH will continue to provide technical assistance to the identified at-risk communities through 

web-based trainings, community meetings, and responding to contacts from those communities. 

From a life course health development perspective and using techniques such as spatial analysis, 

Virginia MIECHV Project staff assisted communities in identifying local risk factors. Based on 

the federal definitions of evidence-based programs and the capacity of the community, Virginia 

MIECHV Project staff assisted localities in selecting home visiting models and strategies. 

Ongoing technical assistance will be provided to make progress on the identified benchmarks 

and to advance the development of a cohesive state network of home visiting services within the 

state early childhood system. 


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The Virginia MIECHV Project will collaborate with key stakeholders, such as the Virginia HVC, 

to develop policy. The Virginia HVC’s membership is composed of staff representing the Title 

V agency, state substance abuse agency, state child welfare agency, state child care and 

development fund, state Head Start collaboration office, state Part B and Part C agencies, and 

state Medicaid agency. Other stakeholders will be invited to participate as they are identified 

during the state agencies’ deliberations. The Virginia MIECHV Project staff will coordinate the 

effort to develop above. 

The evidence-based programs selected for funding will work closely with their national model 

developer to implement home visiting services based on that model. Technical assistance and 

support through the national models are described below. 

Healthy Families America (HFA): Technical assistance (TA) will be offered by the HF 

Virginia peer reviewers who have been trained by HFA to provide training and oversight to HF 

Virginia service providers. TA by the peer review team is provided to all HF Virginia sites in a 

variety of methods: email messages, telephone contacts, face-to-face meetings, trainings, and onsite 

visits. Topic areas that are included in TA are advisory board development and 

maintenance, assessment, credentialing, evaluation, family support, program management, and 

supervision. TA needs of a local site varies and is provided throughout the year based on 

identified needs. 

Parents as Teachers (PAT): TA is provided by the PAT National Center to state-level agencies 

regarding monitoring, assessing, and supporting implementation with fidelity to the model and 

maintaining quality assurance. The Comprehensive Health Investment Project (CHIP) is a nonprofit 

organization responsible for the development, implementation, and maintenance of a 

statewide network of community-based child health and family support programs in Virginia. 

CHIP of Virginia will use the PAT home visiting model to provide services within the Virginia 

MIECHV Project. All CHIP of Virginia program sites currently have the program 

implementation plan required by the PAT National Center. CHIP of Virginia’s Director of 

Training will provide ongoing TA developed by PAT within its network. 

Nurse-Family Partnership: TA is provided through a regional coordinator and contract 

consultant. This team has already worked closely with the Suffolk-Southampton site in 

developing their proposal, so NFP is very aware of this new implementation. The NFP regional 

coordinator has already provided materials to the Virginia MIECHV Project Manager and a 

working relationship has been initiated. 

Table 5: Timeline for Obtaining the Curriculum or Other Materials by Evidence-Based Model 

Program Obtain Training Beyond Timeframe 

Curriculum Orientation 

Healthy Families Summer 2011 Core Training Summer 2011 

Nurse-Family Partnership Summer 2011 Core Training Fall 2011 

Parents as Teachers Summer 2011 Basic 

Pre-3-year-olds 

Summer 2011 

3-K Training September 2011 


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Initial and Ongoing Training and Professional Development Activities 

The home visitors and supervisors in the five contracting agencies will be provided training on 

the tools selected for gathering benchmark data elements. During the first 90 days and prior to 

conducting MIECHV home visits, the staff will be trained on the ASQ, the ASQ-SE, the Virginia 

High Risk Behavioral Screen, and the Life Skills Progression assessment tools. The Project 

Manager will arrange contracts for these trainings. The Project Coordinator and Evaluator will 

monitor the use of the tools and the accurate recording of the resulting data. 

All Virginia home visitors are expected to complete the home visiting core modules by 

December 2011. Virginia MEICHV Project staff will review the professional development 

provided by each evidence-based module funded and, as appropriate, seek to have all Virginia 

MIECHV Project staff participate in the required trainings offered by any evidence-based model 

funded by Virginia’s grant. To meet the national grant requirements, all Virginia MIECHV 

Project staff will be trained on the concepts of the Life Course Development approach; basic 

CQI procedures; motivational interviewing; reflective supervision; and on the Benchmark data 

measures, data definitions, and data collection. These trainings will be provided by the state or 

the implementing local agencies or obtained from the national model developer. 

The Virginia MIECHV Project will continue to collaborate with the Virginia HVC to ensure that 

all home visiting service providers in Virginia receive training in their core curriculum. VDH 

contracts with James Madison University (JMU) to support the HVC training efforts, and 

through these contracts, JMU has developed a comprehensive web-based training data system 

that provides registration, course tracking and completion, and communication with all home 

visitors. The data system includes the opportunity for pre- and post-testing in topical areas, 

supervisory review of home visitor training activities, and management planning for needed 

modules based upon general state participation and completion. Each home visitor has an 

individual training documentation folder. The system allows the home visitor to register, report 

their participation in HVC-sponsored trainings as well as in college or other independent 

learning opportunities, and receive professional recognition for their efforts. The HVC core 

curriculum includes the following areas of training: Reflective Supervision, Bright Futures 

Concepts and Working with the Medical Home, Community Collaboration and Maximizing 

Resources Through Effective Referrals, Conducting Effective Home Visits, Confidentiality, 

Child Development, Developmental Screening, Creating Home Environments that Promote 

Healthy Early Child Development, Child Abuse and Neglect – Risks, Recognition and 

Reporting, Identifying Risks – Using Screening Tools, Mental Health – Adult and Child, Project 

Connect – Creating Futures Without Violence, and Substance Use: Risks, Effects in Pregnancy 

and Early Child Development. 

For all home visiting models, supervisors will work with each home visitor to develop a training 

plan and tracking log to chart individual trainee’s progress towards completion of required 

trainings, including both the state and home visiting model trainings. Within the first six months, 

the supervisor will work with home visitors to help them develop a professional growth plan 

using the core competencies as a framework. On an annual basis, service providers and their 

supervisors will re-assess staff competencies across the core areas and use this assessment to 

develop written professional development goals. Specific training opportunities or professional 

growth opportunities will be identified to meet these goals. Core training for specific roles 


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within each home visiting model will be provided by certified instructors within that model. To 

document fidelity to the evidence-based models and for future CQI processes, JMU will keep 

records about evidence-based model training for each home visitor. 

Basic training in the HVC core curriculum and the home visiting model will occur within the 

first year of hire. Ongoing training will be provided on a continual basis and, subsequently, 

charted on each service provider’s training tracking log. Each home visiting model will define 

the number of hours of continuing education required each year for service providers and 

supervisors. 

Recruiting, Hiring, and Retaining Appropriate Staff for All Positions 

The Virginia MIECHV Project has established five positions in VDH, OFHS that are responsible 

for providing management, coordination, administration, evaluation, and epidemiology activities 

for this project. VDH will recruit and hire the Project Manager, Project Coordinator, and Project 

Administrative Assistant, all of whom will be funded by Virginia MIECHV Project funds. VDH 

will post the Project Manager, Project Coordinator, and Project Administrative Assistant 

positions through the state employment system. The early childhood partner agencies will be 

notified of the positions and encouraged to recommend that appropriate candidates apply. The 

Project Manager, Project Coordinator, and Project Administrative Assistant positions are 

expected to be filled by June 30, 2011. The 0.5 FTE Evaluator will work under the VDH OFHS 

Policy and Assessment Division. The Epidemiologist is shared with other Title V-funded 

programs within OFHS and will be supported, in part, by Virginia MIECHV Project funds. 

VDH will subcontract with the approved local community applicants. Local communities are 

also expected to post local program job openings and include the Project Manager at some level 

in the local consideration of application (e.g., participating in the interview panel or, at a 

minimum, reviewing the application forms). The education and skills required for job openings 

will meet the standards of each evidence-based model. 

Staff Retention 

Hiring procedures are a first step to project success and to retaining staff. Factors that support 

staff effectiveness and their retention include clear work expectations, timely and clear 

communication, appropriate salary levels, adequate and relevant training, reasonable workloads 

and timelines, skilled and available supervisors, encouragement to discuss challenges, support 

for creative problem-solving, respect for expertise and consideration of recommendations, 

involvement in developing plans, clear roles for carrying out the plans, adjustment to work plans 

as justified by circumstances or data, support for innovative thinking and cross-system 

collaborative work, recognition of achievements, and opportunities for growth. In home visiting 

programs, the worker–family relationship is the key to the program’s successful outcomes; 

therefore, excessive staff turnover is undesirable and costly on many levels. Supervisors will be 

encouraged to recognize the dedication of the home visitors to supporting family progress. 

Annual training of supervisors and other methods will be utilized to strengthen supervisory skills. 

Through the Virginia HVC training system, most of the state’s supervisors of home visitors have 

participated in the basic Reflective Supervision course. VDH has provided technical assistance 

to the 38 at-risk communities as part of the subcontractor recruitment plan. Each community 


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was eligible to apply for funding to implement one of the evidence-based models based on their 

community need profile. VDH has released a process to apply for funding, screened applicants, 

and determined which communities will be funded. In the contract with these communities, it is 

specified that the subcontractor will recruit, hire, and retain staff to provide services funded 

through the Virginia MIECHV Project. Within two weeks of receiving a signed contract, all 

subcontractors will be expected to advertise for the new positions and initiate their hiring 

process. Recruitment of service providers is a shared responsibility of the local collaborative 

planning groups. 

Consideration of the following characteristics, in addition to formal education, is to be included 

when interviewing applicants for service provider positions: 

• Experience working with families with multiple needs and the ability to separate their 

professional and personal lives in order to reduce boundary issues; 

• Ability to comfortably interact with families within a broad range of racial, ethnic, and 

cultural groups (if possible, the staff should reflect the racial, ethnic, and cultural make-up of 

the community and families to be served); and 

• Ability to work comfortably with both male and female participants and with many different 

family structures (in communities where English is the second language, every effort should 

be made to hire a service provider who speaks the first language of the community). 

Some programs have found that incorporating group interviews and a home visit into their 

standard hiring protocols has improved staff retention. VDH will encourage all subcontractors to 

include these techniques when interviewing and hiring new staff. Staff will receive intensive 

orientation and training on the program model from each program’s certified trainers. Virginia’s 

existing home visiting models have found that mentoring and supervision are key components to 

retaining staff. 

Ensuring High Quality Supervision and Reflective Practice 

Supervisors are the key to a program that provides high quality services producing expected 

outcomes over time. All home visitors benefit from reflective practice and high quality 

supervision. The HVC has provided the basic Reflective Supervision training over the past year 

for supervisors of all ten program models. This module will be offered again this summer 

through the HVC training plan with a state university. Supervisors in the Virginia MIECHV 

Project will be given priority in enrollment. Each home visiting model has standards that define 

the number of service providers assigned to each supervisor and the frequency and amount of 

individual reflective supervision time spent. These supervisors also receive reflective 

supervision time with their immediate supervisor. 

Supervision is clinical in nature when discussing high-risk families, such as families who are 

experiencing domestic violence or problems with addiction. Supervision also provides the 

opportunity for the HV to reflect on his or her own experiences and feelings, and this allows 

learning from one’s own life circumstances. The following components of supervision apply to 

the supervisor and supervisee relationships: 

• A nurturing environment that provides opportunities for respite; 


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• Use of the parallel process, including communication strategies (i.e., critical thinking, 

problem solving, accentuating the positive, feel/felt/found, normalizing, wondering, 

curiosity), trust building, rapport building and reflective observation, building on strengths, 

and demonstrating respect; 

• Feedback that is supportive, strength-based, and reflective and recognizes the strengths of the 

supervisee; 

• Guidance on techniques and approaches; 

• Identification of areas for growth; 

• Identification of potential boundary issues; 

• Integration of quality assurance measures; 

• Exploration of the impact of the work on the worker; 

• Assistance in implementing new training in practice; and 

• Assessing cultural sensitivity and practices. 

Estimated Number of Families Served 

The estimated number of families served varies depending upon amount of funding and the home 

visiting model the community has chosen to meet their need profile. HFA standards allow a 

service provider to carry a minimum caseload of 15 families (all receiving weekly visits) and a 

maximum of 25 families (with a mix receiving weekly, monthly, and twice monthly or quarterly 

visits). The PAT standards allow each service worker to carry a caseload of approximately 25 

families. The NFP model standards require each home visitor to maintain a caseload of 25 

families per nurse. Determination of predicted caseload was a component of the procurement 

process and will be stipulated in the contract with each awardee. 

Table 6: Families to be Served in the Virginia MIECHV Project by Model and Community 

Community Model # of Families 

Enrolled plus 

Danville 

Healthy Families 

Screened/Assessed 

and Referred 

125* 

Fredericksburg Healthy Families 264* 

Montgomery-Radford Parents as Teachers 90 

Norfolk Parents as Teachers 75 

Suffolk-Southampton Nurse-Family Partnership 100 

Virginia Total 654 

*Does not include Healthy Families Program services of screening pre-and post-partum, which 

is estimated to be 100 for Danville and 200 for Fredericksburg 


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Plan for Identifying and Recruiting Participants 

The plan for identifying target population and recruiting participants depends on the model’s 

eligibility requirements by age of the child, income, and risk factors. The Project Manager will 

meet with the local program coordinators and the national developers to create a local work plan 

within the first 90 days of the contract. This will be listed as a deliverable from the 

subcontractor. 

The local program will develop a local advisory group and seek its advice and approval of an 

outreach plan. The Virginia MIECHV Project will develop local publicity about the new 

expansion and reach out to at-risk populations in local vulnerable neighborhoods. Recruitment 

will involve multiple partnerships with key early childhood partners such as obstetricians, 

hospitals, WIC offices, and child care centers that serve the same target populations. Parents in 

programs will be asked for suggestions about methods and locations to target recruitment. 

Identification and recruitment of participants is a requirement of each home visiting model 

funded through the Virginia MIECHV Project. It is expected that subcontractors will establish 

referral networks with a variety of local programs and agencies. These can include, but are not 

limited to, the following entities: hospitals, health clinics, doctors’ offices, WIC program, 

organizations providing diagnostic and early intervention services, social services agencies and 

organizations, schools, mental health agencies, domestic violence shelters, homeless shelters, 

child care programs, and other early childhood programs. 

Plan for Minimizing the Attrition Rates for Participants Enrolled in the Project 

To minimize attrition, the staff will discuss in the initial enrollment meeting the value, 

requirements, and limits of the local home visiting program to potential participants prior to 

enrollment. Consumer satisfaction will be measured annually, and suggestions from participants 

will be sought regularly. The local advisory group will review enrollments and feedback in order 

to suggest changes to the local home visiting program that might lead to better retention rates. 

Participants in other community home visiting programs will be asked for input about what is 

valued. 

Retention of participants is planned through delivery of home visiting services by highly trained 

service providers. Case management, education, and support services by staff increase retention. 

Staff will be trained to utilize Motivational Interviewing, which has been shown to increase 

successful program outcomes. Support services may include assistance in transportation to 

medical appointments, advocacy to assist with housing and enrollment in medical care, referrals 

to support programs, and follow-up to ensure completion of referrals. Establishment of a trusting 

relationship between service providers and participants through home visits and support services 

successfully retains participant involvement. 

Timeline to Reach Maximum Caseload 

It is estimated that all home visiting models funded through the Virginia MIECHV Project will 

reach maximum caseload in each location by the end of year-two. The targeted number of 

families served by each program is described earlier in this section. 


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Table 7: Plan for Meeting Enrollment Caseload by Community and Model 

Location Model Maximum Target date 

HV Case Load (month/year) 

Danville Healthy Families 25 March 2012 

Fredericksburg Healthy Families 60 February 2012 

Montgomery-Radford Parents as Teachers 60 June 2012 

Norfolk Parents as Teachers 50 December 2011 

Suffolk-Southampton Nurse-Family Partnership 75 December 2011 

Coordination Between Home Visiting Program(s) and Other Community Resources 

Virginia has experience coordinating across home visiting programs. With new models 

potentially participating, the Virginia MIECHV Project operational plan for coordination 

between the home visiting models and other existing programs and resources in local 

communities will be developed during year-one of the grant after communities and home visiting 

models are identified and funded. All funded sites will create and maintain a collaborative 

advisory board comprised of key community stakeholders during the site’s developmental phase. 

It is recommended that the advisory board include, but not be limited to, representatives from the 

following entities: business leaders, social services providers, faith communities, mental health 

providers, hospitals, public health providers, local governments, early intervention programs, 

other home visiting programs, substance abuse treatment providers, domestic violence 

prevention groups, United Way, cultural/ethnic groups, and parents. Members will collectively 

establish the mission, goals, and objectives for this community initiative and will establish 

memorandums of understanding that describe how they currently coordinate with other 

community services. A six-stage development process will be recommended to develop the 

plan(s). 

• Stage 1: Form a planning group 

• Stage 2: Build trust and ownership 

• Stage 3: Develop a strategic plan 

• Stage 4: Design the program structure (coordination is defined) 

• Stage 5: Program service provision (coordination process) 

• Stage 6: Promote and maintain the home visiting program 

State and local stakeholders will meet annually to review progress and to promote new 

connections of home visiting programs with other early childhood initiatives. 

Data Collection 

VDH, working with the existing sole source contractors, will plan for using data systems for 

CQI. The Resource Mothers and Healthy Start Programs within VDH are contracting with Go 

Beyond, LLC, which provides information management systems to maternal and child health and 

family health programs, to use their Well Family data system for case management monitoring 

of participants and performance reporting to state and federal funding agencies. A module will 

be added for home visiting programs to either download data from existing home visiting models 

or for service providers to enter data on each participant in the Well Family data system for 

home visiting. Both the Resource Mothers and Healthy Start Programs have used this data 

system for CQI activities for many years and can provide consultation as needed to the Virginia 

MIECHV Project’s efforts to use data for CQI activities. 


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HVC Review of Data Elements in All Programs 

Consistent data collection across multiple home visiting models for both the Benchmarks as well 

as the CQI will be a major challenge. Individual client-level data for Virginia MIECHV Project 

clients have to be tracked separately from other participants in the same model, and the data 

definitions and time table for data collection have to be congruent. Detailed planning sessions 

with Virginia MIECHV Project staff and local program staff will be conducted during the first 

90 days to design the agreements and to gain approval for the plans from the evidence-based 

model developers. 

Costs for expanding the data elements already collected by the models or to create reports 

necessary for the Benchmarks or the CQI reports will be funded by the local programs in the first 

year. 

Supporting Implementation With Fidelity and Quality 

The home visiting programs participating in the Virginia MIECHV Project will monitor, assess, 

and support implementation with fidelity to the chosen model(s). The state and local programs 

will maintain quality assurance through the continuous quality improvement process and as 

described by each model below. 

Quality Assurance Technical Assistance 

Healthy Families Virginia has state staff members who are trained as Technical Assistance and 

Quality Assurance Specialists. They provide ongoing TA and QA services to all HF programs 

throughout the state by continuously monitoring and recommending to sites HFA standards that 

support model fidelity. During annual QA visits, sites are reviewed on all topics of model 

fidelity. They include the areas of service initiation, service content, governance and 

administration, quality assurance, training, and staff characteristics. Sites are then given a 

written report showing their strengths and areas where improvement is recommended to better 

meet an HFA accreditation standard. Based on this report, a quality improvement plan is 

developed and technical assistance is offered to help remedy the areas where model fidelity can 

be improved. TA is a collaborative approach where program staff and the TA/QA Specialist 

work together to remedy programmatic issues. 

Initially, the PAT QA Guidelines help organizations that use this model to effectively plan their 

services, operations, and management. After affiliation with the PAT National Center, ongoing 

adherence to the QA Guidelines helps to ensure successful replication, model fidelity, and 

application of evidence-based practice. Ongoing compliance with the essential requirements is 

necessary for continued implementation of the PAT model. CHIP of Virginia will report on 

compliance with the essential requirements annually via the Affiliate Performance Report. In 

addition, affiliates engage in an expanded program assessment every four years, incorporating 

additional data, stakeholder input, and documentation review to support the findings of their 

assessment. Both the focused annual compliance assessment and the comprehensive program 

self-study result in action plans that help ensure high quality services to children and families. 

Ongoing affiliation with PAT requires regular program self-assessment. In addition, CHIP of 

Virginia, the Virginia PAT Affiliate, will provide ongoing TA and annual on-site monitoring. 


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At the current time, quality assurance for NFP will be provided through the regional coordinator. 

The NFP program has highly developed quality measures for implementation and on-going 

services; the procedures for quality assurance remain to be developed in the state. 

Virginia MIECHV Project staff will work with all of the three model programs to develop the 

quality assurance plans. In addition, Virginia MIECHV Project staff will develop plans for 

coordinating the requirements for quality assurance across the three evidence-based models 

being implemented and in coordination with the existing local home visiting models of the HVC. 

TA will be provided through meetings, video conferencing, and webinars with all sites. 

Quarterly meetings are planned for the Virginia MIECHV Project with all sites. 

Challenges to Maintaining Quality and Fidelity and the Proposed Response to the Issues 

The CQI process at the state and community levels will be used as a tool to monitor and respond 

to identified challenges. The most significant challenge in implementing the PAT model will be 

accessing training for new staff. Virginia has one certified PAT trainer in the P-3 Born to Learn 

curriculum. The trainer needs to finish the requirements to obtain certification in 3-K. CHIP of 

Virginia, the Virginia PAT affiliate, has identified an additional trainer who, if the person meets 

the PAT National Center requirements, will meet the need to provide staff with required training. 

Areas in which Healthy Families Virginia (HFV) programs are most likely to face challenges 

with model fidelity are in the following areas: reaching target populations, maintaining 

frequency and length of supervision standards, and developing quality assurance measures 

required by HFA. Collaboration between HFV’s TA/QA Specialists and local MIECHV Project 

staff will allow programs to identify and improve areas that do not meet model fidelity. The 

TA/QA Specialists will work with programs to develop plans to overcome identified challenges 

and monitor progress in achieving goals. 

NFP will have plans developed during the first phase of Virginia MIECHV Project 

implementation. Each of these national models will be coordinating a sharp rise in immediate 

demands for TA, training, and materials from all over the country. Virginia MIECHV Project 

staff will coordinate requests for TA and training for all sites in the state and serve as a liaison to 

the national models about quality issues. 

A schedule of reports and meetings will be established with each evidence-based model, the 

local site, and with Virginia MIECHV Project staff in order to focus on the implementation and 

practices for quality and fidelity requirements. Working together with the HVC, differences will 

be identified between models, concerns within communities will be discussed, and all parties 

will be expected to identify solutions that maintain fidelity and quality. 

Collaborative Public and Private Partners 

Collaborative public and private partners will include, but not be limited to, representatives from 

the following entities: business leaders, social services providers, faith communities, mental 

health providers, hospitals, public health providers, local governments, early intervention 

programs, other home visiting programs, substance abuse treatment providers, domestic violence 

prevention groups, United Way, cultural/ethnic groups, and parents. Identification of specific 

local partners was developed during the procurement process for selecting sites for funding. 


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Assurances 

In order for Virginia to meet the HRSA requirements, VDH required all applicants to sign the 

following assurances in the local RFP response: (1) the local home visiting program is designed 

to result in participant outcomes noted in the legislation, (2) individualized assessments will be 

conducted of participant families and services will be provided in accordance with those 

individual assessments, (3) services will be provided on a voluntary basis, (4) the locality will 

comply with the Maintenance of Effort Requirement, and (5) the program will give priority to 

serve eligible participants. The stipulated eligible participants include those who: 

• Have low incomes; 

• Are pregnant women who have not attained 21 years of age; 

• Have a history of child abuse or neglect or have had interactions with child welfare services; 

• Have a history of substance abuse or need substance abuse treatment; 

• Are users of tobacco products in the home; 

• Have, or have children with, low student achievement; 

• Have children with developmental delays or disabilities; and 

• Are in families that include individuals who are serving, or have formerly served, in the 

armed forces, including such families that have members of the armed forces who have had 

multiple deployments outside of the United States. 

VDH will keep the information on file necessary to document the Maintenance of Effort 

Sites have signed the assurances required for the federal funding (see Attachment A). 

Section 5: Benchmark Plan 

Proposed Measures for Benchmark Plan 

In developing the Benchmarks for Virginia, VDH staff has reviewed the measurements and 

assessment tools utilized by each of the national models and the ones utilized by the current 

Virginia sites. Table 8 shows the proposed measures for each construct within each benchmark 

area. The table includes the specific measure, definition of improvement, data source, 

population to be assessed, and data collection schedule. 

Improved Maternal and Newborn Health 

Prenatal Care 

Two measures were selected to measure the Prenatal Care Construct: (1) percent of prenatally 

enrolled women with first trimester entry into prenatal care; and (2) percent of prenatally 

enrolled women with adequate or better prenatal care utilization on the Kotelchuck Adequacy of 

Utilization Index. First trimester entry and adequate utilization of prenatal care are appropriate 

measures for prenatal care as they are standardized, well-known measures used as Performance 

Measures for Title V and other MCH programs. Biannually, local MIECHV programs will 

securely provide identifiable information for women who were enrolled in the MIECHV 

programs during pregnancy, and that information will be linked to birth certificate data from 

VDH. Linking participants to birth certificate data rather than relying on self-reported data will 

reduce the burden of data collection for the local MIECHV programs. Further, the Kotelchuck 


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Index involves multiple computations of data. By linking to birth certificate data, the 

computations of the Kotelchuck Index can be automated to minimize error and increase 

reliability. Improvement will be defined as an increase over time in the percent of prenatally 

enrolled women with first trimester entry into prenatal care and with adequate or better 

utilization of prenatal care. 

Parental Use of Alcohol, Tobacco, or Illicit Drugs 

Three measures were selected to measure Parental Use of Alcohol, Tobacco, or Illicit Drugs 

Construct: (1) percent of prenatally enrolled women drinking alcohol at enrollment who are still 

drinking alcohol at time of delivery, (2) percent of prenatally enrolled women using tobacco 

products at enrollment who are still using tobacco products at time of delivery, and (3) percent of 

prenatally enrolled women using illicit drugs at enrollment that are still using illicit drugs at time 

of delivery. Quarterly, local MIECHV programs will submit self-reported alcohol, tobacco, and 

illicit drug use for prenatally enrolled women to the State Office using Virginia’s Behavioral 

Health Risks Screening Tool for Pregnant Women and Women of Child-bearing Age. This 

standardized tool is used to screen for substance use, mental health, and intimate partner violence 

and was adapted from the Integrated Screening Tool developed by the Institute for Health 

Recovery (IHR). The tool incorporates the 5 P’S and the quantity/frequency of tobacco use. The 

5 P’S Screening Tool was developed by the IHR to help identify alcohol and other drug use 

among pregnant and postpartum women. The integrated IHR 5 P’S Behavioral Risk Screening 

Tool provides a relationally-based opportunity to identify risk and offer brief interventions 

and/or referral for specialist assessment. Virginia’s Behavioral Health Risks Screening Tool was 

developed by VDH, Virginia Department of Medical Assistance Services, Virginia Department 

of Behavioral Health and Developmental Services, and Virginia’s Home Visiting Consortium as 

part of the Assuring Better Child Health and Development Initiative Screening Project. Further, 

it follows Bright Futures Guidelines as a framework for prevention and use of standardized 

screening tools. Given that this tool was developed and is supported across multiple agencies 

and ties into Virginia’s Early Childhood System, it was selected as a source to measure this 

construct. 

Preconception Care 

Two measures were selected to measure the Preconception Care Construct: (1) percent of women 

participating in the program for at least one year who had a routine check-up in the past year and 

(2) percent of women participating in the program with an ongoing source of primary care. 

Women participating in the program for at least one year will be asked, “What kind of place do 

you USUALLY go to when you need routine or preventive care, such as a physical examination 

or check-up?” This standardized question is from the National Health Interview Survey (NHIS), 

which is a cross-sectional household interview survey that monitors the health of the civilian, 

non-institutionalized United States population through the collection and analysis of data on a 

broad range of health topics. From each family in the NHIS, one sample adult and one sample 

child (if any children are present) are randomly selected and information on each is collected 

with the Sample Adult Core and the Sample Child Core questionnaires. While this question was 

not designed for women of childbearing age, it was designed and field tested for the general U.S. 

population. 


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Inter-Birth Interval 

One measure was selected for the Inter-birth Interval Construct: percent of women having a live 

birth who had less than 18 months between their previous live birth and the start of the most 

recent pregnancy. Bi-annually MIECHV programs will report client-level data to the State 

Office for linkage to birth certificate data and analyses. Again, use of administrative data and 

data linkages were used as much as possible to reduce the burden of data collection in the local 

programs and improve reliability. 

Screening for Maternal Depressive Symptoms 

Two measures were selected to measure the Screening for Maternal Depressive Symptoms 

Construct: (1) percent of women who have been screened for maternal depressive symptoms and 

(2) percent of women who screened positive for depressive symptoms who were re-screened for 

follow up. Trained home visitors will screen for maternal depressive symptoms using Virginia’s 

Behavioral Health Risks Screening Tool for Pregnant Women and Women of Childbearing Age. 

There are two versions of the tool: one to be administered by the practitioner and the second to 

be self-administered by the woman to then be reviewed by the practitioner. This tool is meant 

for a brief screening for substance use, depression, and intimate partner violence and to help 

detect risks, not to assess the severity of the risks. The home visitor will be trained to determine 

the need for further review, referral and/or intervention necessary. For depression, the Edinburg 

Postnatal Depression Scale (EPDS-3) questionnaire was used. VDH, Virginia Department of 

Behavioral Health and Developmental Services, Virginia Department of Medical Assistance 

Services, and the Home Visiting Consortium developed the tool based on the Integrated 

Screening Tool developed by the Institute for Health and Recovery (IHR). Training modules are 

already designed for this tool. This tool was selected given its ties with Virginia’s existing 

system of care. 

Breastfeeding 

There were two measures selected for the Breastfeeding Construct: (1) percent of women who 

enroll prenatally, deliver a live-born infant, and initiate breastfeeding and (2) percent of women 

who enroll prenatally, initiated breastfeeding, and are still breastfeeding at six weeks postpartum. 

The Life Skills Progression (LSP) is a 43-item rating scale designed to assess family functioning 

of low income parents of children aged 0 to 3 years. Since it only takes 5 to 10 minutes to 

complete and score, the burden of data collection is minimal. Further, it has been tested by 45 

independent investigators and the inter-rater reliability runs from 78 to 90 percent. Construct 

validity calculated based on results from two pilot programs ranged from 64 to 99 percent. 

Under the Infant/Toddler parental life skills area, there is a breastfeeding domain that measures 

breastfeeding initiation and duration. The tool is administered at enrollment, every 6 months, 

and at closure. 

Well Child Visits 

Three measures were selected to measure the Well Child Visit Construct: (1) percent of children 

enrolled prenatally up to 3 months of age who are up to date for well-child visits at 1 year of age, 

(2) percent of children enrolled prenatally up to 3 months of age who are up-to-date for 

immunizations at 1 year of age, and (3) percent of children under 6 years of age and enrolled at 

least 6 months who have a regular source of health care with a primary care provider. Two data 

source are used for this construct. First, parents of children enrolled prenatally will be asked to 


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self-report on well child visits using the LSP Health & Medical Care domain. Second, 

immunizations records will be linked to program participants using VDH’s Virginia 

Immunization Information System. 

Maternal and Child Health Insurance Status 

Two measures were selected for the Maternal and Child Health Insurance Status Construct: (1) 

percent of prenatally enrolled women with health care coverage during pregnancy and (2) 

percent of prenatally enrolled women with health care coverage at delivery. Using the field 

tested, standardized questions from the Pregnancy Risk Assessment Monitoring System 

(PRAMS), women prenatally enrolled in the program will be asked, “How was your prenatal 

care paid for?” and “How was your delivery paid for?” PRAMS is a national cross-sectional 

survey of women who recently gave birth and provides information about a woman’s 

experiences before, during, and just after a pregnancy. Questions from the PRAMS survey have 

been field tested and found acceptable for this population. 

Child Injuries, Child Abuse, Neglect, or Maltreatment and Reduction of Emergency 

Department Visits 

Visits for Children to the Emergency Department From All Causes 

One measure was selected to measure the Emergency Department Visits for Children Construct: 

Rate of emergency department visits among participating children from all causes. Families 

participating in MIECHV programs will self-report on emergency department visits for their 

children. 

Visits of Mothers to the Emergency Department From All Causes 

One measure was selected to measure the Emergency Department Visits for Mothers Construct: 

Rate of emergency department visits among participating mothers from all causes. Mothers 

participating in MIECHV programs will self-report on emergency department visits. 

Information Provided or Training of Participants on Prevention of Child Injuries 

Three measures were selected to measure the Information on Prevention of Child Injuries 

Construct: (1) percent of participating families with children 3 to 6 years of age who have 

completed the Protective Factors Survey (PFS), (2) percent of participating families with 

children 3 to 6 years of age who had a positive change in individual family protective factors 

from pretest to posttest using the PFS, and (3) percent of participating families with children 3 to 

6 years of age who had a home visitor complete a home safety checklist. The Protective Factors 

Survey (PFS) is a 20-item pre- and post-self-administered survey that measures caregiver 

protective factors against child abuse and neglect. The PFS measures protective factors in five 

areas: family functioning and resiliency, social support, concrete support, nurturing and 

attachment, and knowledge of parenting and child development. A positive change is defined by 

improvement from pretest to posttest in any one of the five areas. The pretest will be given prior 

to parental education on prevention of child injuries, and the posttest will be administered after. 

The PFS is an appropriate tool to measure this construct since its primary purpose is to provide 

feedback to agencies for continuous improvement of where home visitors can focus on 

increasing individual family protective factors. The survey takes approximately 10 to 15 minutes 

to complete and is divided into two sections. The first section is completed by a home visitor, 


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and the second section is completed by the program participant. Therefore, the burden of data 

collection is minimal. Further, the survey has undergone four national field tests for establishing 

reliability and validity. One study administered the PFS to 11 agencies from four states to 

evaluate the internal structure of a self-report measure of multiple family-level protective factors 

against abuse and neglect and explore the relationship of this instrument to other measures of 

child maltreatment. This study concluded the PFS is a valid and reliable instrument to measure 

individual differences in multiple protective factors in families. In addition to the PFS, home 

visitors will conduct a home safety checklist. The items on this check list will be developed after 

meeting with the national model developers and after review of existing materials used in the 

programs participating in Virginia’s Home Visiting Consortium. 

Incidence of Child Injuries Requiring Medical Treatment 

Four measures will be used to measure the Incidence of Child Injuries requiring Medical 

Treatment Construct: (1) rate of falls, (2) rate of poisonings, (3) rate of burns, and 4) rate of 

motor vehicle accidents. Using the LSP, families participating in MIECHV programs will selfreport 

on child injuries requiring medical treatment. Self-reporting child injuries is not ideal and 

will most likely be underreported. However, at this time, Virginia does not have the 

infrastructure in place to link to ambulatory and emergency department data. In an effort to 

collect meaningful data, the LSP Relationships with Children Safety Domain will be used to 

measure child injuries requiring medical treatment including ambulatory care, emergency 

department visits, and hospitalizations. 

Reported Suspected Maltreatment for Children in the Program 

One measure was selected to measure the Reported Suspected Maltreatment of Children 

Construct: percent of children with a suspected child maltreatment report filed. Virginia 

Department of Social Services (DSS) has an On-line Automated Services Information System 

(OASIS) to automate processes and information for child welfare programs and other social 

services in the state. Identifiable client-level data will be sent to DSS biannually to be linked to 

OASIS. Since DSS is not authorized to release the identity of any family to use, DSS staff will 

prepare a de-identified, aggregate report for VDH. OASIS collects unfounded (or suspected) and 

founded (or substantiated) child maltreatment data. For this construct, DSS will report on any 

program participant during the specified timeframe that had an unfounded case(s) as a 

perpetrator or victim. By abstracting administrative data from OASIS, the data will be more 

reliable and reduce the burden of data collection for home visitors. 

Reported Substantiated Maltreatment for Children in the Program 

One measure was selected to measure the Reported Substantiated Maltreatment for Children 

Construct: percent of children with a suspected child maltreatment report filed. Using OASIS, 

DSS will report on any program participant during the specified timeframe that had a founded 

case(s) as a perpetrator or victim. By abstracting administrative data from OASIS, the data will 

be more reliable and reduce the burden of data collection for home visitors. 

First-Time Victims of Maltreatment for Children in the Program 

One measure was selected to measure the First-Time Victims Construct: percent of participating 

families reported to CPS who were not previously served by CPS. Using OASIS, DSS will 

report on any program participant during the specified timeframe that had either a founded or 


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unfounded case as a perpetrator or victim with no prior reports to CPS. By abstracting 

administrative data from OASIS, the data will be more reliable and reduce the burden of data 

collection for home visitors. 

Improvements in School Readiness and Achievement 

Parent Support for Children's Learning and Development 

Two measures were selected to measure the Parent Support Construct: (1) percent of 

participating families with children who have completed the Life Skills Progression (LSP) and 

(2) percent of participating families with increased parent involvement in the children’s care and 

education. The first measure is a process measure. The second measure is an outcome measure 

where increased parental involvement will be indicated by any positive movement from intake to 

closure of the LSP Support of Development Domain. For more information on the LSP, please 

refer to the Breastfeeding Construct. 

Parent Knowledge of Child Development and of Their Child's Developmental Progress 

Five measures were selected to measure the Parent Knowledge Construct: (1) percent of parent 

participants who have completed all of the recommended Ages and Stages Questionnaires (ASQ) 

for the age of their child, (2) percent of parent participants who have reviewed the results of the 

ASQ with their home visitor, (3) percent of children who have screened positive for 

developmental delay who have received a referral for services, (4) ASQ mean total score, and (5) 

percent of parents with increased knowledge of early childhood development and improved 

parenting practice. The first four measures rely on the ASQ. The ASQ is a commonly used 

instrument for the assessment of developmental progress in young children and educate parents 

on developmental milestones. Parents complete the questionnaire in 10 to 15 minutes. Parents 

can assess their children at 19 age intervals in skills readily observable in the home environment. 

It is available in English, Spanish, and many other languages. ASQ has repeatedly been shown 

to correctly flag children who have developmental delays and exclude those who do not. The 

ASQ has been normed on ethnically and economically diverse populations. The test-retest 

reliability between ASQ and other standardized assessments was 84 percent, ranging from 74 

percent for 4 month ASQ to 91 percent for 36 month ASQ. Improvement will be defined by 

increases in these measures. 

The fifth measure in this construct uses the Protective Factors Survey (PFS), specifically the 

Child Development/Knowledge of Parenting Items (5 items). The PFS is an appropriate tool to 

use to measure parents’ understanding and utilization of effective child management techniques 

and having age-appropriate expectations for children’s abilities. An increase in knowledge will 

be defined as any collective, positive movement from pretest to posttest on these five items. The 

survey takes approximately 10 to 15 minutes to complete and is divided into two sections. For 

more information on the PFS, refer to the Information Provided or Training of Participants on 

Prevention of Child Injuries Construct. In sum, the PFS minimizes the burden of data collection 

and is a valid and reliable tool. 

Parenting Behaviors and Parent-Child Relationship 

Two measures were selected to measure the Parenting Behaviors Construct: (1) percent of 

participating families who have completed the Life Skills Progression (LSP) and (2) percent of 


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participating families with improved positive parent-child relationships. The first measure is a 

process measure. The second measure is an outcome measure where improvement in positive 

parent-child relationships will be indicated by any positive movement from intake to closure of 

the LSP Relationship with Children Nurturing and Discipline Domains. The Nurturing Domain 

measures the emotional ties and pattern of positive interaction between the parent and child. The 

Discipline Domain measures the use of age appropriate discipline. For more information on the 

LSP, please refer to the Breastfeeding Construct. 

Parent Emotional Well-Being or Parenting Stress 

Two measures were selected for the Parent Emotional Well-Being Construct: (1) percent of 

participating women who received a behavioral health screening and (2) percent of women who 

screened positive on the behavioral health tool who have received a referral for services. Trained 

home visitors will screen for maternal depressive symptoms using Virginia’s Behavioral Health 

Risks Screening Tool for Pregnant Women and Women of Childbearing Age. This tool is meant 

to be a brief screening for substance use, depression, and intimate partner violence and to help 

detect risks, not to assess the severity of the risks. For information on this tool, refer to the 

Screening for Maternal Depressive Symptoms Construct. 

Child's Communication, Language, and Emergent Literacy 

Three measures were selected for the Child's Communication Construct: (1) percent of parent 

participants who have completed the ASQ-3 Communication Scale and who have reviewed the 

results with their home visitor, (2) percent of child participants who screen positive for a 

communication delay and who have received a referral for services specific to communications, 

and (3) Mean ASQ-3 Communication Scale scores. These measures will use the Communication 

scale from the ASQ, which provides early detection of communication delays and allows for 

early intervention. Improvement will be defined by increase over time in Communication Scale 

scores. Internal reliability for the ASQ’s Communication Scale ranged from 0.63 at the 4-month 

questionnaire to 0.75 at the 24-month questionnaire. For more information on the ASQ, refer to 

the Parent Knowledge of Child Development and of Their Child's Developmental Progress 

Construct. 

Child's General Cognitive Skills 

Six measures were selected for the Child’s Cognitive Skills Construct: (1) percent of 

participating families with children aged 4 months to 3 years who have completed the LSP 

Infant/Toddler Development Domain, (2) percent of parent participants who have completed the 

ASQ-3 Gross and Fine Motor Scales for the age of their child, (3) percent of children who have 

screened positive for motor developmental delay and who have received a referral for services, 

(4) percent of parent participants who have reviewed the results of the ASQ-3 Gross and Fine 

Motor Scales with their home visitor, (5) mean total score for Fine Motor Scale, and (6) mean 

total score for Gross Motor Scale. This construct will use three scales for the LSP Infant/Toddler 

Development Domain: gross motor, fine motor, and problem solving. Collectively, these three 

scales will be used to assess the general cognitive skills of children participating in the program. 

Rating for these LSP scales will be based on developmental screening from the ASQ scales on 

Gross and Fine Motor. Improvement will be defined by an increase over time in the Gross and 

Fine Motor Scales scores. For more information on the ASQ, refer to the Parent Knowledge of 


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Child Development and of Their Child's Developmental Progress Construct. For more 

information on the LSP, please refer to the Breastfeeding Construct. 

Child's Positive Approaches to Learning Including Attention 

Four measures selected to measure the Child's Positive Approaches to Learning Construct: (1) 

percent of parent participants who have completed the ASQ-3 Problem Solving Scales for the 

age of their child, (2) percent of children who have screened positive for problem solving (e.g., 

positive approaches to learning) developmental delay who have received a referral for services, 

(3) percent of parent participants who have reviewed the results of the ASQ-3 Problem Solving 

Scale with their home visitor, and (4) mean total score for Problem Solving Scale. These 

measures will use the Problem Solving scale from the ASQ, since many of the questions in this 

scale address the child ability to pay attention. Internal reliability for Problem Solving ranged 

from 0.52 percent at the 20-month questionnaire to 0.75 percent at the 8-month questionnaire. 

For more information on the ASQ, refer to the Parent Knowledge of Child Development and of 

Their Child's Developmental Progress Construct. 

Child's Social Behavior, Emotion Regulation, and Emotional Well-Being 

Three measures were selected for the Child's Social and Emotional Well-Being Construct: (1) 

percent of parent participants who have completed the Ages and Stages Social-Emotional 

Questionnaires (ASQ-SE) and who have reviewed the results with their home visitor, (2) percent 

of child participants who screen positive for a social-emotional delay and who have received a 

referral for intervention services, and (3) mean ASQ-SE scores. The Ages and Stages Social- 

Emotional Questionnaire screens social and emotional behavior to identify young children 

requiring further evaluation. In response to the maturation of young children, the ASQ-SE is 

designed for use at eight different age intervals that coincide with the ASQ. Like the ASQ, the 

ASQ-SE has been normed to a diverse group of children over time and it reliable and valid. Its 

internal consistency reliability overall was 0.82 (Cronbach’s alpha) and ranged from 0.67 at the 

12-month interval to 0.91 at the 60-month interval. Its validity is between 75 and 89 percent. 

The ASQ-SE is written at a sixth grade reading level and available in both English and Spanish. 

Child's Physical Health and Development 

One measure was selected for the Child's Physical Health and Development Construct: percent 

of child participants whose parents rate child's health as excellent (or excellent and very good). 

Families participating in MIECHV programs will be asked about the overall health of their 

children using the validated, standardized question from the National Survey of Children’s 

Health (NSCH). The NSCH examines the physical and emotional health of children from birth 

to 17 years of age. The question reads, “In general, how would you describe your child’s 

health?” This question will be asked at various points in time. Improvement will be defined at 

positive movement toward very good or excellent health over time. The Maternal and Child 

Health Bureau leads the development of the NSCH survey and indicators, in collaboration with 

the National Center for Health Statistics (NCHS) and a national technical expert panel. In 

development of this question, respondents’ cognitive understanding of the survey question was 

assessed during the pretest phase and revisions made as required. 


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Domestic Violence 

Screening for Domestic Violence 

One measure was selected for Screening for Domestic Violence Construct: percent of 

participating families screened for domestic violence. Families participating in MIECHV 

programs will be screened for domestic violence using Virginia’s Behavioral Health Risks 

Screening Tool for Pregnant Women and Women of Childbearing Age. Improvement for this 

measure will be defined by increased screening among participating families. The tool asks, 

“Are you currently or have you ever been in a relationship where you were physically hurt, 

choked, threatened, controlled, or made to feel afraid?” If a woman responds yes, then she will 

be given the full Abuse Assessment Screening (AAS) or the Women’s Experience with Battering 

(WEB) screening. Both of these screenings are evidence-based tools for screening for intimate 

partner violence. For information on this tool, refer to the Screening for Maternal Depressive 

Symptoms Construct. 

Number of Referrals Made to Relevant Domestic Violence Services 

One measure was selected for Number of Referrals for Domestic Violence Construct: percent of 

families who were identified for the presence of domestic violence and who received a referral to 

relevant domestic violence services. Indicated in the previous Construct, as part of Virginia’s 

Behavioral Health Tool, referral and development of a follow up plan are required. 

Improvement will be defined by increased referrals among women who identified for the 

presence of domestic violence. 

Number of Families for Which a Safety Plan was Completed 

One measure was selected for Number of Families with a Safety Plan Construct: percent of 

families who were identified for the presence of domestic violence who have completed a safety 

plan. Home Visitors will report on completed safety plans for families participating in the 

program. Improvement will be defined by an increase in the safety plans developed compared to 

the program population served over time. 

Family Economic Self-Sufficiency 

Household Income and Benefits 

Two measures were selected for the Household Income and Benefits Construct: (1) percent of 

households with an increase in income and (2) percent of households with an increase in 

government benefits (e.g., TANF, WIC, Food Stamps, and Medicaid). The LSP Basic 

Essentials-Income Domain tracks parents’ income from private and public sources. 

Improvement will be defined by increased income as the family progresses through the program. 

For more information on the LSP, please refer to the Breastfeeding Construct. 

Employment or Education of Adult Members of the Household 

Two measures were selected for the Employment or Education Construct: (1) number of paid 

hours worked plus unpaid hours devoted to care of an infant by all adults in participating 

households and (2) percent of adults in participating households completing any postsecondary 

education. The LSP Education and Employment Domain tracks parents’ education attained and 

employment. Improvement will be defined by increased educational attainment and employment 


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opportunities as the family progresses through the program. For more information on the LSP, 

please refer to the Breastfeeding Construct. 

Health Insurance Status 

Two measures were selected for the Health Insurance Status Construct: (1) percent of adults in 

participating households with health insurance in the last month and (2) percent of families that 

received assistance to get health insurance. The LSP Basic Essentials-Medical/Health Insurance 

Domain tracks parents’ medical and health insurance. Improvement will be defined by increases 

in families with health insurance. For more information on the LSP, please refer to the 

Breastfeeding Construct. 

Coordination and Referrals for Other Community Resources and Supports 

Using the aforementioned screening tools and processes, home visitors will screen to identify 

families in need of services, refer them to available community resources, and assess completion 

of referrals. In addition, the LSP Relationships with Supportive Resources Domain tracks 

parents’ relationship with the home visitor, use of information, and use of resources. 

Improvement will be defined as positive progression from intake to closure. For more 

information on the LSP, please refer to the Breastfeeding Construct. The next three Constructs 

show the proposed measures for specific services. 

Number of Families Identified for Necessary Services 

Four measures were selected for the Families Identified for Necessary Services Construct: 

Percent of participating families who are screened for needs, including the following: (1) 

substance abuse service, (2) mental health services, (3) medical services, and (4) Part C / Early 

Intervention. 

Number of Families That Required Services and Received a Referral to Available Community 

Resources 

Four measures were selected for the Families that Received Referrals Construct: Percent of 

families identified with a need who receive an appropriate referral for the following services: (1) 

substance abuse services, (2) mental health services, (3) medical services, and (4) Part C/Early 

Intervention. 

Number of Completed Referrals 

Four measures were selected for the Completed Referral Construct: Percent of families with 

referrals for the following services for which receipt of services can be confirmed: (1) substance 

abuse services, (2) mental health services, (3) medical services, and (4) Part C/Early 

Intervention. 

Memorandum of Understanding (MOU) 

One measure was selected for the MOU Construct: percent of recommended formal agreements 

(MOUs) that have been established by the home visiting program. VDH and community 

agencies will collect MOUs from agencies to which they refer program participants. 

Improvement will be defined as the increase in the number of formal agreements with other 

social service agencies that engage in regular communication with the home visiting provider. 


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Information Sharing 

One measure was selected for the Information Sharing Construct: percent of recommended 

agencies with which the home visiting provider is in regular contact. Improvement will be 

defined by an increase in the number of agencies with which the home visiting provider has a 

clear point of contact in the collaborating community agency that included regular sharing of 

information between agencies. 


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Table 8. Legislatively Mandated Benchmark Areas and Virginia Proposed Measures of Progress 

Improved Maternal and Newborn Health 

Construct Measures Success Source Population Schedule 

Prenatal Care 1) Percent of prenatally 

enrolled women with 

first trimester entry 

into prenatal care. 

2) Percent of prenatally 

enrolled women with 

adequate or better 

prenatal care 

utilization on the 

Kotelchuck Adequacy 

Parental use of 

alcohol, 

tobacco, or 

illicit drugs 

of Utilization Index. 


1 XO2MC19411 


enrolled women 

drinking alcohol at 

enrollment that are 

still drinking alcohol at 

delivery. 


enrolled women using 

tobacco products at 


still using tobacco 

products at delivery. 


enrolled women using 

illicit drugs at 


still using illicit drugs at 

delivery. 

Increase over time in 

the percent of 

prenatally enrolled 

participants with first 

trimester entry into 

prenatal care and with 

adequate or better on 

Kotelchuck Adequacy 

of Utilization Index 

Decrease over time in 


prenatally enrolled 

participants drinking 

alcohol, using tobacco 

products, or illicit 

drugs at enrollment 

that are still using at 

delivery 

Abstraction of 

Administrative Data - 

Prenatally enrolled 

program participants 

will be linked to birth 

certificate data from 

the Virginia 

Department of Health 

Self-reported by 

program participant - 


women will be asked 

about alcohol use, 

tobacco use, and illicit 

drug use at enrollment 

and after delivery 

using Virginia’s 

Behavioral Health Risks 

Screening Tool for 

Pregnant Women and 

Women of 

Childbearing Age 


women (women who 

were enrolled in the 

MIECHV programs 

during pregnancy) 


women 

Bi-annually MIECHV 

programs will report 

client-level data to the 

State Office for linkage 

and analyses. 

Each quarter MIECHV 


on these measures. 

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Improved Maternal and Newborn Health – continued 


Preconception 

care 

Inter-birth 

intervals 


1 XO2MC19411 

1) Percent of women 

participating in the 

program for at least 

one year who had a 

routine check-up in the 

past year. 



program with an 

specific source of 

primary care. 


having a live birth who 

had less than 18 

months between their 

previous live birth and 

the start of the most 

recent pregnancy. 


the percent of women 


program for at least 

one year who had a 

routine check-up in the 

past year and an 


primary care 



having a live birth who 

had less than 18 

months between their 

previous live birth and 

the start of the most 

recent pregnancy 



Women participating 

in MIECHV programs 

for at least one year 

will be asked (bout 

routine check-ups and 


primary care using 

validated, standardized 

questions from the 

National Health 

Interview Survey 

(NHIS) 




women participants 

will be linked to birth 

certificate data from 

the Virginia 



in the program for at 

least one year 


women who have 

participated in the 

program for at least 24 

consecutive months 



on this measure. 

Bi-annually MIECHV 




and analyses. 

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Screening for 

maternal 

depressive 

symptoms 


who have been 

screened for maternal 

depressive symptoms. 


who screened positive 

for depressive 

symptoms who were 

re-screened for follow 

up. 

Breastfeeding 1) Percent of women 

enrolled prenatally and 

deliver a live-born 

infant who initiate 

breastfeeding. 


enrolled prenatally 

who initiated 

breastfeeding and are 

still breastfeeding at 

six weeks postpartum. 


1 XO2MC19411 



screened for maternal 

depressive symptoms 



enrolled prenatally and 

deliver a live-born 

infant who initiated 

and continued to 

breastfeed 





will be screened (in an 

interview or on a 

survey) for maternal 


at various time points 





Women of 





women who delivered 

a live-born infant will 

be asked about 

breastfeeding 

initiation and duration 

using the LSP - 

Infant/Toddler 

Development Domain 


in the MIECHV 

programs at various 

time points (e.g., 

during pregnancy, 

postpartum, etc) 


women who delivered 

a live-born infant 







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Well-child 1) Percent of children Increase over time in 1) Self-reported by Children enrolled Bi-annually MIECHV 

visits 

enrolled prenatally up the percent of children program participant - prenatally or up to 3 programs will report 

to 3 months of age enrolled prenatally or Parents of children months of age 


who are up-to-date for enrolled up to 3 enrolled prenatally will 


well-child visits at 1 months of age who are be asked about well 

and analyses. 

year of age. 

up-to-date for well- child visits using the 

2) Percent of children child visits at 1 year of LSP Health & Medical 

enrolled prenatally up age and who are up- Care Domain 

to 3 months of age to-date for 

2) Abstraction of 

who are up-to-date for immunizations at 1 Administrative Data - 

immunizations at 1 year of age 

Children enrolled 

year of age. 

Increase in the percent prenatally will be 

3) Percent of children of children with a linked to 

under age six enrolled medical home from immunizations records 

at least 6 months who enrollment to at least from VIIS (Virginia 

have a regular source 6 months of 

Immunization 

of health care with a participation in the Information System) 

primary care provider. program 

Maternal and 1) Percent of prenatally Increase over time in 1) Self-reported by Prenatally enrolled Each quarter MIECHV 

child health enrolled women with the percent of 

program participant - women 


insurance health care coverage prenatally enrolled Prenatally enrolled 


status 

during pregnancy. women with health women will be asked 

2) Percent of prenatally care coverage during about health insurance 

enrolled women with pregnancy and at status during 

health care coverage at delivery 

pregnancy and at 

delivery. 

delivery using 



Pregnancy Risk 

Assessment 

Monitoring System 

(PRAMS) survey 


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Child Injuries, Child Abuse, Neglect, or Maltreatment and Reduction of Emergency Department Visits 


Visits for 

children to the 

emergency 

department 

from all causes 

Visits of 

mothers to the 

emergency 

department 

from all causes 


1 XO2MC19411 

1) Rate of emergency 

department visits 

among participating 

children from all 

causes. 

1) Rate of emergency 



mothers from all 

causes. 


the rate of emergency 



children from all 

causes 


the rate of emergency 



mothers from all 

causes 



Families participating 


will be asked about all 

causes of emergency 



children 





will be asked (in an 


survey) about all 

causes of emergency 

department visits for 

themselves 

Children participating 



in the MIECHV 

programs 







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Child Injuries, Child Abuse, Neglect, or Maltreatment and Reduction of Emergency Department Visits – continued 


Information 1) Percent of 

Increase over time in Self-Reported - Families participating Each quarter MIECHV 

provided or participating families the percent of parent Families participating in the MIECHV 


training of with children 3 to 6 participants who in MIECHV programs programs with children on this measure. 

participants on years who have received education on will be asked about 3 to 6 years 

prevention of completed the prevention of child their family using the 

child injuries Protective Factors injuries 

Protective Factors 

(including Survey (PFS). 

Survey (PFS) 

topics such as 2) Percent of 

safe sleeping, participating families 

shaken baby with children 3 to 6 

syndrome or years who had a 

traumatic positive change in 

brain injury, individual family 

child 

protective factors from 

passenger pre to post using the 

safety, PFS. 

poisonings, 3) Percent of 

fire safety participating families 

(including with children 3 to 6 

scalds), water years who had a home 

safety (i.e. visitor complete a 

drowning), 

and 

playground 

safety) 

home safety checklist. 


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Incidence of Rate of child injuries Decrease over time in Self-reported by Families participating Each quarter MIECHV 

child injuries requiring medical the rate of child program participant - in the MIECHV 


requiring treatment (including injuries requiring Families participating programs 


medical ambulatory care, medical treatment in MIECHV programs 

treatment emergency 

(including ambulatory will be asked about 

department visits, and care, emergency child injuries requiring 

hospitalizations due to department visits, and medical treatment 

injury or ingestions) hospitalizations due to using the LSP - 

among participating injury or ingestions) Relationships with 

children: 

among participating Children Safety 

1) Rate of Falls 

2) Rate of Poisonings 

3) Rate of Burns 

4) Rate of Motor 

Vehicle Accidents 

children 

Domain 

Reported 

suspected 

maltreatment 

for children in 

the program 


1 XO2MC19411 

1) Percent of children 

with a suspected child 

maltreatment report 

filed. 



participating children 

with a suspected child 

maltreatment report 

filed 




in the programs will be 

linked to Department 

of Social Services data 

(OASIS) 


in the MIECHV 

programs 




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Reported 

substantiated 

maltreatment 


the program 

First-time 

victims of 

maltreatment 


the program 


1 XO2MC19411 


with a substantiated 

child maltreatment 

report filed. 

1) Percent of 

participating families 

reported to CPS who 

were not previously 

served by CPS. 



participating children 

with a substantiated 

child maltreatment 

report filed 




reported to CPS who 

were not previously 

served by CPS 







(OASIS) 







(OASIS) 


in the MIECHV 

programs 


in the MIECHV 

programs 







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Improvements in School Readiness and Achievement 


Parent support 

for children's 

learning and 

development 


1 XO2MC19411 

1) Percent of 


with children who 

have completed the 

Life Skills Progression 

(LSP). 

2) Percent of 


with increased parent 

involvement in the 

children’s care and 

education. 


the percent of families 

with children who 


LSP; increase over time 

the percent of families 

with increased parent 

involvement in the 

children’s care and 

education 

Home Visitor 

Collection through 

direct observation and 

parent interview using 

the LSP – Relationships 

with Children Support 

of Development 

Domain 


in the MIECHV 

programs with children 




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Improvements in School Readiness and Achievement – continued 


Parent 1) Percent of parent Increase over time the Self-reported by Families participating Each quarter MIECHV 

knowledge of participants who have percent of 

program participant - in the MIECHV 


child 

completed all of the participating families Families participating programs 


development recommended ASQs who have completed in MIECHV programs 

and of their for the age of their all of the 

will complete the Ages 

child's 

child. 

recommended ASQs and Stages 

developmenta 2) Percent of parent for the age of their Questionnaire - 3rd 

l progress participants who have child, reviewed the Edition (ASQ-3) for the 

reviewed the results of results, and with age of their child and 

the ASQ with their increased 

complete the 

home visitor. 

understanding and use Protective Factors 

3) Percent of children of effective child Survey (PFS) – Child 

who have screened management 

Development/Knowled 

positive for 

techniques 

ge of Parenting Items 

developmental delay 

who have received a 

referral for services 

4) ASQ Mean total 

score. 

5) Percent of parents 

with increased 

knowledge of early 

childhood 

development and 

improved parenting 

practice. 

(5 items) 


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Parenting 

behaviors and 

parent-child 

relationship 

Parent 

emotional 

well-being or 

parenting 

stress 

1) Percent of 


who have completed 

the Life Skills 

Progression (LSP). 

2) Percent of 


with improved positive 

parent-child 

relationships. 


1 XO2MC19411 

1) Percent of 

participating women 

who were received a 

behavioral health 

screening. 


who screened positive 

on the behavioral 

health tool who have 

received a referral for 

services. 

Increase over time the 

percent of 


who have completed 

the LSP and increase 

over time the percent 

of participating 

families with verbal 

interactions between 

caregiver and the child 


percent of women 

who received a 

behavioral health 

screening and the 

percent of women in 

need of referrals who 

received them 




Interview parent 

interview using the LSP 

– Relationship with 

children Nurturing, 

Discipline Domains 





will be screened (in an 


survey) for maternal 


at various time points 





Women of 



in the MIECHV 

programs with children 


in the MIECHV 

programs 







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Child's 1) Percent of parent Increase over time the Self-reported by Families participating Each quarter MIECHV 

communicatio participants who have percent of parent program participant - in the MIECHV 


n, language, completed the ASQ-3 participants who have Families participating programs 


and emergent Communication Scale completed the ASQ-3 in MIECHV programs 

literacy who have reviewed Communication Scale will complete the Ages 

the results with their who have reviewed and Stages 

home visitor. 

the results with their Questionnaire - 3rd 

2) Percent of child home visitor; increase Edition (ASQ-3) for the 

participants who the percent of child age of their child 

screen positive for a participants who 

communication delay screen positive for a 

who have received a communication delay 

referral for services who have received a 

specific to 

referral for services 

communications. specific to 

3) Mean ASQ-3 communications; 

Communication Scale increase the mean 

scores. 

ASQ-3 Communication 

Scale scores 


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Child's general 1) Percent of 

Increases over time in Home Visitor 

Families participating Each quarter MIECHV 

cognitive skills participating families the developmental Collection through in the MIECHV 


with children ages 4 progress of 

direct observation and programs 


months to 3 years who participating children Interview parent 


interview using LSP - 

LSP - Infant/Toddler 

Infant/Toddler 

Development. 

Development 

2) Percent of parent 

Communication, Gross 

participants who have 

Motor, Fine Motor, 

completed the ASQ-3 

Problem Solving, 

Gross and Fine Motor 

Personal-Social, Social- 

Scales for the age of 

emotional, and 

their child. 


who have screened 

positive for motor 

developmental delay 

who have received a 

referral for services. 

4) Percent of parent 


reviewed the results of 

the ASQ-3 Gross and 

Fine Motor Scales with 

their home visitor. 

5) Mean total score for 

Fine Motor Scale. 


Gross Motor Scale. 

Regulation Domains 


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Child's positive 1) Percent of parent Increase over time Self-reported by Families participating Each quarter MIECHV 

approaches to participants who have percent of parent program participant - in the MIECHV 


learning completed the ASQ-3 participants who have Families participating programs 


including Problem Solving Scales completed the ASQ-3 in MIECHV programs 

attention for the age of their Problem Solving Scales will complete the Ages 

child. 

for the age of their and Stages 

2) Percent of children child; Increase the Questionnaire Social 

who have screened percent of children Emotional (ASQ-SE) 

positive for problem who have screened for the age of their 

solving (e.g. positive positive for problem child 

approaches to 

solving developmental 

learning) 

delay who have 

developmental delay received a referral for 

who have received a services; increase the 

referral for services. mean total score for 

3) Percent of parent the Problem Solving 


reviewed the results of 

the ASQ-3 Problem 

Solving Scale with their 

home visitor. 


Problem Solving Scale. 

Scale 


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Child's social 1) Percent of parent Increase over time the Self-reported by Families participating Each quarter MIECHV 

behavior, participants who have percent of parent program participant - in the MIECHV 


emotion completed the ASQ-SE participants who Families participating programs 


regulation, who have reviewed completed the ASQ-SE in MIECHV programs 

and emotional the results with their and reviewed the will complete the Ages 

well-being home visitor. 

results with their home and Stages 

2) Percent of child visitor; and increase Questionnaire Social 

participants who the percent of child Emotional (ASQ-SE) 

screen positive for a participants who for the age of their 

social-emotional delay screen positive for child 

who have received a social-emotional 

referral for 

delays that had 

intervention services. referrals for 

3) Mean ASQ-SE intervention services; 

scores. 

increase the mean 

ASQ-SE scores 

Child's 1) Percent of child Increase over time the Self-reported by Families participating Each quarter MIECHV 

physical health participants whose percent of child program participant - in the MIECHV 


and 

parents rate child's participants whose Families participating programs 


development health as excellent (or parents rate child's in MIECHV programs 

excellent and very health as excellent will be asked about 

good). 

the overall health of 

their children using the 



National Survey of 

Children’s Health 

(NSCH) 


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Domestic 

Violence: 

Screening for 

domestic 

violence 

Domestic 

Violence: Of 

families 

identified for 

the presence 

of domestic 

violence, 

number of 

referrals made 

to relevant 

domestic 

violence 

services 


1 XO2MC19411 

1) Percent of 


screened for domestic 

violence. 

1) Percent of families 

who were identified 

for the presence of 

domestic violence who 

received a referral to 

relevant domestic 

violence services. 


percent of families 

screened for domestic 

violence 



who received a referral 

to relevant domestic 

violence services 





will be screened using 

Virginia’s Behavioral 

Health Risks Screening 

Tool for Pregnant 

Women and Women 

of Childbearing Age 


Collection - Home 

Visitors will report all 

referrals to domestic 

violence services 


in the MIECHV 

programs 


in the MIECHV 

programs 







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Domestic Violence – continued 


Domestic 

Violence: Of 

families 


the presence 

of domestic 

violence, 

number of 

families for 

which a safety 

plan was 

completed 


1 XO2MC19411 


who were identified 

for the presence of 

domestic violence who 

have completed a 

safety plan. 



who have completed a 

safety plan 



Visitors will report on 

completed safety plans 


in the MIECHV 

programs 




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Family Economic Self-Sufficiency 


Household 

income and 

benefits 

Employment 

or Education 

of adult 

members of 

the household 


1 XO2MC19411 

1) Percent of 

households with 

increase in income. 

2) Percent of 


increase in 

government benefits 

(TANF, WIC, Food 

Stamps, Medicaid). 

1) Number of paid 

hours worked plus 

unpaid hours devoted 

to care of an infant by 

all adults in 

participating 

households. 

2) Percent of adults in 

participating 

households completing 

any postsecondary 

education. 

Increase in total 

household income and 

benefits over time 


number of paid and 

unpaid hours worked; 

Increase in the 

educational 

attainment of adults in 

participating 

households over time 






Basic Essentials - 

Income Domain 






Education & 

Employment - Less 

than 12 th Grade 

education, 

Employment Domains 


in the MIECHV 

programs 


in the MIECHV 

programs 







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Family Economic Self-Sufficiency – continued 


Health 

insurance 

status 


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1) Percent of adults in 

participating 


health insurance in the 

last month. 


received assistance to 

get health insurance. 



participating 

household members 

with health insurance 

and increase the 


receiving assistance to 

get insurance 






Basic Essentials 

Medical/Health 

Insurance Domain 


in the MIECHV 

programs 




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Coordination and Referrals for Other Community Resources and Supports 


Number of 

families 


necessary 

services 

Number of 

families that 

required 

services and 

received a 

referral to 

available 

community 

resources 


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Percent of 


who are screened for 

needs, including the 

following: 

1) Substance abuse 

services 

2) Mental health 

services 

3) Medical services 

4) Part C / Early 

Intervention 

Percent of families 

identified with a need 

who receive an 

appropriate referral 

for the following 

services: 


services 


services 



Intervention 

Decrease over time the 


needing services 


percent of referrals for 

families in need 



Visitors will screen and 

report families in need 

of services 




referrals 


in the MIECHV 

programs 


in the MIECHV 

programs 







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Coordination and Referrals for Other Community Resources and Supports – continued 


MOUs: 

Number of 

Memoranda of 

Understanding 

or other 

formal 

agreements 

with other 

social services 

agencies in the 

community 

Information 

sharing: 

Number of 

agencies with 

which the 

home visiting 

provider has a 

clear point of 

contact in the 

collaborating 

community 

agency that 

included 

regular sharing 

of information 

between 

agencies 


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1) Percent of 

recommended formal 

agreements (MOUs) 

that have been 

established by the 

home visiting program. 

1) Percent of 

recommended 

agencies with which 

the home visiting 

provider is in regular 

contact. 

Increase in the number 

of formal agreements 

with other social 

service agencies that 

engage in regular 

communication with 


provider 

Increase in the number 

of agencies with which 


provider has a clear 

point of contact in the 

collaborating 

community agency 

that included regular 

sharing of information 

between agencies 

Program Records 

Management - State 

Program Office (VDH) 

and community 

agencies will collect 

MOUs from agencies 

to whom they refer 


Program Records 

Management - State 

Program Office (VDH) 

and community 

agencies will collect 

MOUs from agencies 

to whom they refer 


State Program Office 

(VDH) and community 

agencies 

State Program Office 

(VDH) and community 

agencies 

Annual 

Annual 

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Coordination and Referrals for Other Community Resources and Supports – continued 


Number of 

completed 

referrals 


1 XO2MC19411 

Percent of families 

with referrals for the 

following services for 

which receipt of 

services can be 

confirmed: 


services 


services 



Intervention 



with receiving referred 

services 




referrals 


in the MIECHV 

programs 




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Plan for Ensuring the Quality of Data Collection 

Home visitors will be required to collect data from MIECHV program participants during home 

visits. The primary data collected during these visits will be the backbone for most of the data 

used for reporting benchmarks and for the CQI process. Therefore, the following steps will be 

taken to ensure the quality of this primary collection of data: 

(1) Data dictionaries, data documentation sheets, and format specifications for all measures and 

data collection tools will be prepared. Preparation of these tools will involve consultation 

from the national model developer to ensure fidelity to the model. The data dictionary will 

specify how the data collected will be entered into the data collection system. The data 

documentation sheets specify how the measures will be defined. The documentation sheet 

will include a clear definition of the numerators and denominators used to compute each 

measure, along with the data source of the measure and why the measure is significant. It is 

important to explain why the measures are significant for home visitors so the home visitors 

clearly understand how valuable they are to the process and take ownership of the data. 

Format specifications will be automated as much as possible in order to reduce errors in data 

entry. Validation processes will be performed before home visitors leave the home so that if 

errors are found they can be immediately corrected. Validation processes also will be 

performed by local MIECHV program coordinators before submission to the State. These 

validation processes involve the use of checklists and signoffs for key steps in the data 

collection process. 

(2) All staff collecting data for benchmark reporting and the CQI process will be trained before 

any home visits are made. The trainings will entail orientation to the expectations of the 

MIECHV grant, review of reporting requirements, orientation to the data collection tools, 

system, and quality processes and how to report problems, issues, and ideas for improvement 

of the data collection system. National model developers will be involved in the training 

process to ensure fidelity to the model. The trainings also will include the 12 core trainings 

for home visitors, supervision training and enrichment topics. Please refer to Virginia’s 

Home Visiting Consortium’s webpage on training for more information: 

http://homevisitingva.com/?page_id=273. 

(3) Both local and state Coordinators will perform routine site visits as part of the day-to-day 

operations for the MIECHV program. Local coordinators will observe home visitors, 

monitor data collection, and develop corrective action plans with home visitors when 

necessary. The State coordinator may observe home visitors, will monitor data collection at 

the state level, will develop corrective action plans with local coordinators when necessary, 

and will routinely consult national model developers for all data collection processes. Both 

coordinators will spend no more than 25% of their time ensuring the quality of data. 

(4) The Data Managers at the local level will spend 50% of his/her time on MIECHV programs 

performing data management and analytic activities. A successful Data Manager has 

knowledge of MCH issues and MIECHV programs/models, good communications skills, 

strong computer skills, and the ability and willingness to be trained in new and technical 

areas. The duties and responsibilities of the Data Manager will be to: 


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− Validate and submit reports on the benchmark plan and CQI processes to the local 

Coordinator in a timely manner. (Local Coordinators will be responsible for submitting 

final reports to the State Coordinator.) 

− Enter or ensure accurate data entry into the data system determined by the State. 

− Communicate with home visitors to ensure understanding of data collection tools and 

processes. 

− Score instruments administered by well-trained home visitors (such as instruments used 

to assess child development). 

Ensuring the quality of client-level data linked to secondary data sets (such as birth certificates) 

will occur at the state level and will be an automated process using statistical programs and 

software to improve accuracy and reliability. The Data Manager at the state level will spend 

25% of his/her time on MIECHV programs overseeing day-to-day data collection and 

management activities as well as gathering data for the CQI plan. A successful Data Manager 

has experience and skills in basic statistical and epidemiologic analytic principles, knowledge of 

MCH issues and MIECHV programs, good communications skills, strong computer skills, and 

the ability and willingness to be trained in new and technical areas. The duties and 

responsibilities of the Data Manager will be to: 

• Execute the data collection activities for the MIECHV programs at the state level in 

collaboration with the Project Coordinator and HRSA. 

• Inform the Project Coordinator of MIECHV activities on a frequent basis. 

• Oversee data collection submitted by local programs (such as reviewing reports submitted by 

local programs, participating in trainings and site visits) 

• Conduct data management (such as ensuring the quality of data, generating reports for the 

CQI process, and maintaining security and confidentiality of families served in MIECHV 

programs. 

• Resolve discrepancies between local programs and the national developers, in collaboration 

with the State Coordinator. 

The Epidemiologist at the state level will spend 25% of his/her time analyzing data for the 

benchmark plan. A successful Epidemiologist has experience and advanced skills in statistical 

and epidemiologic analytic principles, knowledge of MCH issues and MIECHV 

programs/models, good communications skills, and is proficient in SAS Statistical Software. 

The duties and responsibilities of the Epidemiologist will be to: 

• Link client level data to secondary, administrative data sources 

• Analysis linked data and primary data in preparation for reporting benchmarks to HRSA 

Plan for Data Analysis 

Since start up of the project will be labor intensive, VDH will establish a contractual agreement 

with Virginia Tech’s Project Child HANDS to refine and implement the data analysis plan, 

design the initial data collection system, and transition from the initial to final data collection 


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system. Ultimately, the final data collection system will be designed by Go Beyond LLC’s Well 

Family System. In the first 90 days of the grant, the Virginia Tech contractors will meet with the 

national model developers from Parents as Teachers, Healthy Families America, and Nurse- 

Family Partnership to negotiate and reach consensus on data collection and reporting, especially 

since each of these models has different data collection systems. After which, an initial data 

collection system will be developed to ensure federal requirements will be met. With guidance 

from the Epidemiologist and Program Evaluator, the Virginia Tech contractors will make data 

available for analysis. 

The first phase of analysis will include computation of all measures specified in the benchmark. 

Next, input from the program coordinator will inform analyses to examine fidelity to the model 

and ongoing quality improvement processes. Timely and accurate data will be vital for the CQI 

plan, which is why VDH decide to contract out for start-up activities. Refer to the CQI plan for 

more detail. 

Plan for Gathering and Analyzing Demographic and Service Utilization Data 

All grantees will be required to collect individual-level demographic and service utilization data 

for eligible families that have been enrolled in evidence-based programs who receive services 

funded with MIECHV program funds. The data collection system will collect the following 

data: 

• Family’s participation rate in the home visiting program 

− Number of families served 

− Number of sessions 

− Duration of sessions 

• Demographic data 

− Child’s gender, 

− Age of all (including age in month of child) at each data collection point 

− Racial and ethnic background of all participants in the family 

− Participant’s exposure to languages other than English 

− Family socioeconomic indicators (family income, employment status, parental 

educational level) 

Plan for Data Safety and Monitoring 

Data collection to measure improvement in benchmark areas involves the collection of 

personally identifiable information and other sensitive information (such as domestic violence 

and child maltreatment reporting). For this reason, the following security precautions will be 

taken: 

• All grantees will be required to sign an Information Systems Security Access Agreement as a 

condition for funding, agreeing to abide by VDH Security Policy, which governs access to 

and use of the information and computer services of VDH. 

• Files stored on a network should be in directories accessible only by MIECHV staff. 

• All computers must have password-protected screen savers so that unauthorized people 

cannot use a computer that has access to MIECHV files. 


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• MIECHV program staff logged into their computers must log out before leaving their desk, 

even if just for a short break. 

• MIEHVC program staff with access to personally identifiable data must memorize their login 

information and never share it with anyone. 

• Completed assessments, other printed documents, and any hard copy files that contain 

personally identified information must be kept in a locked file cabinet or a locked room; 

access to these files must be limited to authorized personnel. 

• Completed assessments, other printed documents, and any hard copy files that contain 

personally identified information must be destroyed (shredded or burned) and not simply 

thrown away or recycled when they are no longer needed. 

• When a computer used for MIECHV programs is taken out of service, any hard drives that 

may have once contained MIECHV program data must be reformatted before being used for 

another purpose. 

• Floppy disks and other removable storage media that are no longer needed for MIECHV 

programs should be destroyed and not used for another purpose. 

• No information, including the fact that the woman recently gave birth, will be released to a 

woman’s friends or family (e.g., when speaking to a woman’s household members or when 

leaving answering machine messages). Individually identifiable information may be released 

only if authorization is explicitly granted by the affected individual or legal guardian. 

• No individually identifiable information will be presented in any reports arising from 

analysis of data collected as part of MIECHV programs. 

• Only a few individuals from VDH State Offices may have access to identified data. In all 

other cases, data sent to the State VDH Office will be de-identified. 

• All information collected shall be held in confidence to the extent allowed by law. All state 

staff and contractors involved in MIECHV programs will be trained concerning procedures 

and practices to ensure privacy of data and shall sign a confidentiality pledge. 

• All new hires will be trained concerning these procedures and practices when they begin 

work. 

• All MIECHV program staff will participate in supplemental training regarding protection of 

personally identifiable information. 

• All grantees will comply with applicable regulations related to Human Subjects Protection, 

HIPPA, and FERPA. 


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Section 6: Plan for Administration of the State MIECHV Project 

Statewide Administrative Structure 

The Virginia MIECHV Project will operate under the administrative structure of VDH, OFHS, 

Division of Child and Family Health (DCFH). The Project will be required to follow the state 

procurement and fiscal procedures and the policies and procedures established by VDH and 

OFHS for job descriptions (see Attachment D). The Project Manager will report to the Women’s 

and Infants’ Health Program Manager and supervise program staff. The Project Coordinator will 

report to the Project Manager and will work closely with the local sites, assisting them in 

implementing the expanded or new home visiting services. Administrative support will be 

provided by a wage position and a fiscal technician. The Epidemiologist will be a member of the 

OFHS, Data and Evaluation Unit assigned to the Virginia MIECHV Project. The Evaluator will 

be a part-time position hired by OFHS. Until the Evaluator is hired, the Virginia MIECHV 

Project plans to initiate a short-term (up to 180 days) contract with the university developing the 

state early childhood interagency data system, making use of their knowledge of the overall state 

system in gathering the MIECHV home visiting baseline measures and to make interagency 

connection so that diverse programs can provide data for the Virginia MIECHV Project’s 

quarterly quality measures and semi-annual baseline reporting. 

Local site coordinators will meet collectively with the state team to develop plans and 

procedures. The applicant agency will assure that the local program meets the state requirements 

for contractual and fiscal records. The local site coordinator will supervise the home visitors and 

the accuracy of the local data entry process. Additionally, the local site coordinator will monitor 

the local data collection and reporting, local staff professional development, and maintenance of 

case records. The local fiscal agent and the coordinator will assure accurate fiscal reports. 

Plan for Managing and Administering at the State and Local Levels 

VDH, the lead agency for the Virginia MIECHV Project, will develop contracts with the selected 

community applicants, which will have requirements for monthly fiscal and quarterly project 

reporting. The Project Manager will supervise the project staff and report to the Women’s and 

Infants’ Health Program Manager. Quarterly written project reports will be provided through 

OFHS to the ECAC and HRSA. The Project Manager will communicate with the appropriate 

national model developers in order to obtain their final approval of the Virginia Updated State 

Plan. The Project Manager will hire staff and report on the program development to the HVC 

each month and the ECAC at least annually. The Epidemiologist will work with the interagency 

early childhood data system team to assure that home visiting data are aligned. The Evaluator 

will review the progress of each local team on data collection, provide recommendations for 

improving the quality of the data, and work with the group developing the electronic Go Beyond 

Well Family case management system to be sure that it is aligned with the HRSA-ACF data 

reporting requirements. In conjunction with the Project Manager and the Project Coordinator, 

the Evaluator will assist local and state consortia in the development of the plan for quality 

improvement. 

Local site coordinators will hire and orient their staff and schedule their advisory group 

meetings. Through Virginia MIECHV Project meetings, local site visits, written reports, phone 

conference calls, web meetings, and emails, the Project team (consisting of the Project Manager, 


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Project Coordinator, Evaluator, and Epidemiologist) will provide support and consultation on 

local site management and monitor local program activities. Quarterly meetings of all the local 

sites will be scheduled at which time each site will present their progress, receive additional 

training, and develop solutions for common challenges. Resources from the Virginia early 

childhood system partners and from HRSA-ACF will be made available to local sites. (See 

Attachments E and F.) 

Collaborative Partners in the Private and Public Sector 

The Virginia MIECHV Project will develop a partnership with the Smart Beginnings Goal 

Group 2 Work Group. The public private agencies on the HVC at the state level and the Smart 

Beginnings coalitions on the local level will serve as advisory committees to the Virginia 

MIECHV Project. Annual project planning meetings will include public and private 

stakeholders. The Virginia MIECHV Project will connect with the state-level interagency 

project teams working on the early childhood data system with Virginia Tech and the 

interagency, cross-disciplinary early childhood professional development group. The 

collaboration with the other Virginia home visiting programs will continue to occur through the 

Home Visiting Consortium. 

State and Local Management Plan for Ensuring the Successful Implementation 

With the local site coordinators, the Project team will design a plan with each evidence-based 

model for implementation, training, data collection, and supervision that fits the Virginia system 

and exhibits fidelity to the program models. The Project Coordinator will support the local 

contractor in program implementation. During the first 90 days, in consultation with the Project 

Manager, the Epidemiologist and Evaluator will develop a plan for the schedule and mechanisms 

of data reporting and conduct training for local staffs on the data collection. (See 

Implementation Plan, Attachment C.) 

The HVC has supported the concept of shared administrative functions and common data 

collection among local home visiting programs. The Virginia MEICHV Project will support 

communities implementing coordination of referrals, assessment, and intake processes across the 

different models (e.g., a detailed plan for centralized intake, as appropriate). 

The Virginia Updated State Plan will meet the legislative requirements, including: 

• Well-trained, competent staff through ongoing HVC core training coordinated by JMU and 

assurance that the model-specific required training is completed; 

• High quality supervision through continuation of the reflective supervision training 

coordinated for the HVC by JMU and assurance that model-specific supervisory training is 

completed; 

• Capacity to implement activities within the leadership of the VDH and the ECAC Smart 

Beginnings Plan; 

• Referral and service networks through the enhanced 2-1-1 VIRGINIA network and the 

fostering of centralized intake models at the local level; and 


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• Monitoring for fidelity of program implementation to ensure services are delivered pursuant 

to a specified model. 

The Virginia Updated State Plan will be coordinated with the Virginia Plan for Smart 

Beginnings, which will report quarterly to the ECAC and, to the extent possible, with other state 

early childhood plans including the State Early Childhood Comprehensive Systems Plan. 

VDH will monitor local community or communities for evidence that they are complying with 

any model-specific prerequisites for implementation, including those discussed with national 

model developers and as identified in the implementation profiles available on the HomVEE 

website (http://www.acf.hhs.gov/programs/opre/homvee). 

Connecting to Other Research and Evaluation Projects 

The Virginia MIECHV Project will endeavor to coordinate with local evaluation projects on 

home visiting programs and to work with other evaluation projects on the state level such as the 

Virginia Tech early childhood data system with VDSS and VDOE, the Healthy Families research 

project funded by the Pew Home Visiting Initiative, the VDH-VDSS project to enhance the 2-1- 

1 VIRGINIA service, the CHIP of Virginia research project about retaining home visitors, the 

Florida State University research on the curriculum Partners for a Healthy Baby, and other 

projects conducted by university research partners. 

Section 7: Plan for Continuous Quality Improvement 

CQI will be used by the Virginia MIECHV Project as a systematic approach to specifying the 

processes and outcomes of the programs or set of practices through regular data collection and 

the application of changes that may lead to improvements in performance. CQI methods will 

provide a means for the state and local MIECHV programs to improve processes and outcomes. 

The CQI and program accountability methods will provide home visiting agencies with regular 

reports summarizing their performances on a variety of quality indicators reflecting processes 

and outcomes. Performance will be gauged against pre-established targets or benchmarks, 

individual agency performance, and when appropriate, averages across agencies, taking program 

models into consideration. The Virginia MIECHV Project CQI process plan will be 

implemented at both the state and community levels. 

• The state and community programs will endorse quality and performance values and promote 

a culture that values service quality and continual efforts by the full agency, its partners, and 

its contractors to achieve strong performance, program goals, and positive results for service 

recipients. 

• The state and community programs will develop the foundation for use of performance and 

quality improvement, sufficient to identify organization-wide issues, and implement 

solutions that improve overall productivity, and promote accessible, effective services in all 

regions and sites. The process criteria will support for ongoing fidelity to the model. 

• The state and community programs will include support for performance and outcome 

measurement. An inclusive approach to establishing measured performance goals and client 


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outcomes, indicators, and sources of data will ensure broad-based support for useful 

performance and measurement of outcomes. 

• The state and community programs will establish a time line for analyzing and reporting 

information. The plan will describe how valid, reliable data will be obtained and used on a 

regular basis to advance monitoring of actual versus desired; i.e., functioning of operations 

that influence the organization's capacity to deliver services, quality of service delivery, 

program results, client satisfaction, and client outcomes. 

• The state and community programs will use quality information to make improvements. 

Reports that include findings based on improvement efforts will be issued periodically to 

personnel throughout the project and provide information useful for improving programs and 

practice at all sites. 

• The state and community programs will include staff training and support. Staff and 

stakeholders will receive initial training and on-going support that increases their capacity to 

develop the local and state plans and conduct and sustain performance and quality 

improvement activities. 

The structure of CQI will involve two levels of teams: a state team and a community team for 

each of the selected program sites. The state team will be a subcommittee of the HVC and be 

composed of a chair, the Project Manager, the HVC, local home visiting model grantees, Smart 

Beginnings representative from the Virginia Early Childhood Foundation, and the Director of the 

Office of Early Child Development. The community team will be composed of a chair who is 

the grantee model program coordinator; a representative from the local early childhood coalition 

or Smart Beginnings Coalition; families; and representatives from the local departments of social 

services, education, mental health, and health as well as state or community partners and 

stakeholders. Each CQI team will include a chair or facilitator who will facilitate the 

CQI meetings, champion the CQI process, and coordinate input and feedback to staff; a recorder 

who will take detailed meeting minutes and provide administrative support; and members who 

will participate in the review of issues that are referred to the team and provide feedback to 

peers, stakeholders, and consumers. 

In addition to any quality improvement initiatives identified by the community team, each local 

evidence-based model will be expected to follow the QA practices associated with the national 

model’s standards. 

There will be many opportunities for stakeholders and partners to become involved in the state 

and local CQI efforts. For example: 

• Participate in community- or state-level CQI team meetings; 

• Review reports and provide feedback; 

• Help identify positive practices; 

• Recommend improvements when necessary; 

• Assist in development of short and long term planning; and 

• Complete surveys and/or focus groups. 


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Families will be asked to participate in periodic customer satisfaction surveys, advisory council 

meetings, and focus groups on special topics. 

The Virginia MIECHV Project plan has established goals and objectives to meet specific needs 

of children and families in the Commonwealth. Efforts have also focused on identifying 

benchmarks to ensure quality services are delivered to the children and families being served. 

The benchmark measures will, in part, be reviewed and monitored by the HVC. The HVC will 

serve to provide broad oversight of the state plan, to provide feedback, and as a resource in 

which to vet information. Their responsibility in the CQI process will be to help monitor the 

fidelity and quality of program implementation and to review and approve system change, 

thereby discouraging adoption of agency-specific procedural changes that may increase 

interagency variability and decrease quality. 

Data and Measurement 

The Virginia MIECHV Project CQI teams will establish targets based on program standards, 

funder requirements, and program goals. Because the CQI process is driven by performance 

data, a prerequisite for success is the degree to which agencies seek information about their 

performance. The combination of regular reports, direct accessibility by agencies, and a system 

for reviewing performance and implementing strategies to ensure continued quality is the 

foundation of CQI and performance accountability. To ensure success, the CQI state and local 

teams will establish a regular meeting schedule to review quality indicator targets and 

benchmarks and assess agency and system-wide performance. 

Specific areas of weakness or underperformance will be addressed in CQI reports, which are to 

be prepared and reviewed bi-annually by the CQI teams. Targeted areas of improvement will be 

identified in the reports, and procedures to bring about improvement will be delineated based 

upon individual agency needs and learned practices from more effective agencies. Extensive 

underperformance may require major system changes; whereas, more circumscribed areas of 

weakness may be rectified with relatively minor procedural changes or additional training and 

support. 

Table 9 outlines reporting activities, time frames, and a description of methods that will be used 

to aggregate and analyze data. Reports will be made available to agencies regarding 

performance and outcomes achieved by home visitors and agencies on a regular basis. 

Regarding the CQI process, it is not possible to definitively establish a causal connection 

between implementing a change in plans and subsequent improvements in indicators. Meeting 

such a standard is not feasible in the context of a community-based prevention program. Rather, 

the repeated demonstration of improvements following CQI procedures and using an iterative 

process provides support for the use of CQI as a means to enhance home visitation. 


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Table 9: CQI Reporting Outline 

MIECHV Data Reporting Activity and Description of the Methods Used to 

Time Frames 

Aggregate and Analyze the Data 

HV Annual Progress and Services Report Report contains information on the progress 

• State reporting requirements (annual) made on goals and objectives established in 

• Community reporting requirements 

(quarterly) 

the MIECHV Plan; any changes made to the 

plan; data collected for the benchmarks and 

demographics; and compliance with initiation, 

implementation, and data collection. 

CQI Report – Reported bi-annually Report provides information on the progress 

made to improve compliance with the federal 

mandated reporting, obstacles, and 

adjustments. 

Budget Performance Indicators - Reported Report contains performance measures 

semi-annually 

reported to the Virginia MIECHV Project. 

Virginia MIECHV Project Strategic Plan - The Strategic Plan sets forth the top priorities, 

Reviewed annually 

including goals, objectives, and benchmarks 

related to home visiting services. 

Virginia’s MIECHV Project CQI Plan will include a variety of approaches including those 

described below. 

• Peer Review 

− The Peer Review process does not replace supervisory case review but is a 

complimentary process. It allows for objective peers to focus on the quality of services 

provided to clients through review of documentation of those services found in the case 

record, worker interviews, and stakeholder focus groups. The information obtained from 

the review process will be used by the state and local CQI teams to identify and initiate 

process, program, and outcome improvement plans. 

• Program Improvement Plans 

− The plan will include the identified problem, strategies and steps for problem resolution, 

time lines for making the corrections, and methods for measuring progress. It will clearly 

identify staff responsible for implementing the changes as well as for monitoring 

progress. Additionally, feedback from the program improvement plan will be used to 

measure success and identify further areas needing improvement. 

• Consumer Satisfaction and Feedback Mechanisms 

− The agency may use a variety of measures to gather input from professional and family 

consumers of the home visiting program services. A survey might address items such as 

office or work hours, timeliness of appointments, professionalism of staff, and knowledge 

of how to receive services or referrals. The data gathered from these surveys will serve 

to assist in improving the service delivery process. 


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Each site will develop a CQI process during the first six months. Initially, the focus for the CQI 

plan at both the state and local levels will be implementation of the new and expanded evidencebased 

model services with fidelity and with high quality within the existing state and local early 

childhood systems. The Project Coordinator and Evaluator will work with each local program to 

create a local CQI plan. Working with the Evaluator to develop the state level CQI plan, the 

Project Manager will review the local plans and the reports. The Evaluator will be responsible 

for assuring that all localities have a CQI plan that is implemented. The plan should be reviewed 

and, possibly, revised at least semi-annually. 

Section 8: Technical Assistance Needs 

The Commonwealth of Virginia has identified the following technical assistance needs to 

implement the Virginia MIECHV Project. 

• Motivational Interviewing Training for all supervisors and home visitors 

• Data and information systems 

− Integrating home visiting data with the state early childhood system data collection 

− Collecting data from multiple evidence-based models in one state system 

• Coordination of multiple home visiting models with the national developers 

• Continuous Quality Improvement Plan Development 

• Professional Development 

− Coordinating training for home visitors across multiple models 

− Coordinating skill development of supervisors 

• Funding and Sustainability 

− Exploring Medicaid State Plans or policies to improve home visiting programs’ ability to 

bill for services 

− Leveraging education funding to support the Parents as Teachers model 

− Leveraging early intervention funding to support HV programs 

− Identifying funding for research on home visiting questions 

Virginia MIECHV Project staff—with the assistance of the HVC, SBCs, VECF, the evidencebased 

model staffs, and the federal project officer—will arrange technical assistance through 

state and federal partners on these and other topics as needed. Virginia MIECHV Project staff 

will be providing technical assistance and quality assurance to all sites and to the state system. 


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Section 9: Reporting Requirements 

VDH will comply with the legislative requirement for submission of an annual report to the 

Secretary of Health and Human Resources regarding the program and activities carried out under 

the program. VDH understands that the reporting forms will be sent to the states but that the 

report will address the following as described in the SIR2: 

• Virginia MIECHV Project Goals and Objectives 

• Implementation of Home Visiting Programs in Targeted At-Risk Communities 

• Progress Toward Meeting Legislatively Mandated Benchmarks 

• Home Visiting Program’s CQI Efforts 

• Administration of Virginia MIECHV Project 

• Technical Assistance Needs 

Local sites will be required to provide reports to the Virginia MIECHV Project on a regular 

schedule, possibly monthly during the first year’s implementation period and then quarterly. The 

state and local advisory committees will receive quarterly reports. Local sites will report at least 

semi-annually on data related to benchmarks and CQI targets. 

The Virginia MIECHV Project will report to the ECAC and other state agencies’ administrators 

that have signed the Memorandum of Concurrence (see Attachment G). 


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Attachment A. Local Community Plans 

1. Danville 

2. Fredericksburg 

3. Montgomery-Radford 

4. Norfolk 

5. Suffolk-Southampton 


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Danville 

66 of 147


1 XO2MC19411 

DANVILLE-PITTSYLVANIA COMMUNITY SERVICES 

1'RFVENTION SERVICES AND QUALITY ASSURANCE DIVISION-HEALTHY FAMILIES 

JAMES F . BEBEAU, LPC 1/1/2010 

5001 Executive Director 

Job Classification Executive Director 

DEBORAH VAUGHAN 

2001 Acting Director of Prevention and Quality Assurance Services 

Job Classification Prevention Services and Quality Assurance Division Director 

MEICHV 

t,ealthy Families Case Manager/Support Worker 

CRYSTAL AVERETT COBBS 11116/2009 

2006 Healthy Families Case Manager/Support Worker 

Job Ciass+fication Case Manager-Behavioral Health 

MEICHV 

healthy Families Family Resource Specialist 

DEBORAH VAUGHAN 9/1/2004 

2080 Prevention Program Manager 

Job Classification Prevention Program Manager 

LISA H. BRIGGS 10/1/2005 

2095 

Healthy Families Coordinator 

Job Classification Healthy Families Coordinator 

ANISSA HOWERTON 1/112011 


Job Classification Case Manager-Behavioral Health 

JESSICA SCEARCE OAKES 111/2008 


Job Classification Case Manager-Behavioral Health 

67 of 147

Organizations/individuals Contributing to Danville City (location) MIECHV proposal 

Name Organization email 

Ann Stratton Smart Beginnings ann,,,&SmartBe_tinnings .DPC.org 

Attachment G 

Sara Craddock Early Intervention/DPCS scraddock(ad ics .or~ 1 

John Moody Danville Social Services JohnMood yCdss .virginia . ov 

Laura Gatele Danville Health Department Laura . Gatele yCvdh . ov 

Jim Bebeau DPCS 'bebeau 2,d s .or 


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1

Virginia Local MIECHV grant application Attachment H 

Factors supporting Selection of the Specific Home Visiting Model(s) 2011 

LOCALITY : Danville City 

Local Local Target Evidence-Based 

Home Visiting Home Visiting Population(s) Home Visiting 

RESOURCES NEEDS/GAPS Model (s) Proposed 

Danville-Pittsylvania Program 

Community Services existing implementation, 

Healthy Families staff supervision 

MIECHV Staff Increase 

Positions screenings, 

assessments, 

services 

DPCS vehicles Transportation for 

home visits 

Funding sources Serve additional 

families 

in-kind contributions Support program 

needs 

Referral network Expand referrals 

Healthy Families Community 

Advisory Board leadership, 

advisement 

Smart Beginnings Initiative Early childhood 

organizational 

collaboration- - 


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At-risk families; 

teen parents ; 

families with 

multiple children 

At-risk families ; 

teen parents ; 

families with 

multiple children 


69 of 147

MIECHV Spring 2011 Attachment I 

Memorandum of Concurrence 

Locality : Danville City 

The following individuals and representing of local community organizations indicate by signing below 

their approval of the Maternal, Infant and Early Childhood Home Visiting plan proposed in this 

document . As partners in the early childhood community system, the partners agree to work to support 

the development and enhancement of quality home visiting services as one strategy for reaching the 

community's vulnerable families . 

;Name 

IF J 


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P osition 

. . log 'IN 

- 

- - 

j O rganization 

100V J 

70 of 147 

qtr On

Virginia Local MIECHV ATTACHMENT L 

ASSURANCES 

i. Benchmark Data Collection Assurances 

Under the Virginia application process, each community must state agreement to the 

following parameters around the benchmark data collection : 

1 .The community must collect data on all benchmark areas and for all constructs and 

elements under each benchmark area (See SIR #2, Appendix D) . 

2 . The data must be collected for eligible families that have been enrolled in the program 

who receive services funded with the MIECHV Program funds . 

3 . The community must collect the data based on the timing, method and definitions in 

the state plan . 

4 . The community will utilize the benchmark data and other appropriate data for CQI to 

enhance program operation and decision-making and to individualize services . Technical 

assistance will be provided to assist grantees in utilizing data for CQI . 

5 . The community must collect data on each participating family. 

6 . The community will complete a local template will be provided for grantees to report 

to HHS on benchmark progress at the 3- and 5-year points . 

7 . The community must collect individual-level demographic and service-utilization data 

on the participants in their program as necessary to analyze and understand the progress 

children and families are making . Individual-level demographic and service-utilization 

data may include but are not limited to the following : Family's participation rate in the 

home visiting program (e .g ., number of sessions/number of possible sessions, duration of 

sessions) ; Demographic data for the participant childlchildren, pregnant woman, 

expectant father, parent(s), or primary caregiver(s) receiving home visiting services 

including : child's gender, age of all (including age in month for child) at each data 

collection point and racial and ethnic hackground of all participants in the family ; 

Participant child's exposure to lanpiages other than Fngli .sh : .:lnd 1=atnil-,- SOCIOccwlf , nlic 

ii . General Assurances 

The applicant assurance that 

1 . The community }tome visiting program is designed to result in participant outcomes 

noted in the federal legislation ; 

2 . Individualized assessments will he conducted of participant families and that services 


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4 . The community will provide information to the state project director in a timely 

manner about changes in staffing or funding ; and 

5 . . Priority will be given to serve eligible participants who have low incomes ; are 

pregnant women who have not attained age 21 ; have a history of child abuse or neglect 

or have had interactions with child welfare services ; have a history of substance abuse or 

need substance abuse treatment ; are users of tobacco products in the home ; have, or 

have children with, low student achievement ; have children with developmental delays 

or disabilities ; are in families that include individuals who are serving or have formerly 

served in the armed forces, including such families that have members of the armed 

forces who have had multiple deployments outside of the United States ; 

Signed : /ly~~ fife 

Organization : Danville-Pittsylvania Community Services 

Position in Organization : Executive Director 

Date : April 28, 2011 


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Fredericksburg 


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Healthy Families Rappahannock Area 

Services Flow Chart 

SCREENING PROCESS 

Primary Referring Partners: 

" Mary Washington Hospital 

" Project LINK/ 

Fredericksburg Health Department 

" Other community partners 

ASSESSMENT PROCESS 

Family Resource Specialists : 

" Bilingual' 

" Bilingual' 

Negative Screen 

Receives letter, resource guide and 

PEID brochure 

Screen received from referral source 

Negative Assessment 

Placed on mailing list for developmental 

newsletters through baby's 2nd birthday 

Proposed Service: 

Developmental Screenings 

Families will receive developmental 

screening questionnaires via mail and 

follow-up information and referrals to 

PEID (early intervention) as needed 

Positive Screen 

Contacted for assessment 

HOME VISITING 

Case Management 

Family receives case management 

Family Support Workers : 

" Bilingual' 

" 

services, including referrals to : 

Departments of Social Services 

(Medicaid, TANF, Food Stamps, 

" Bilingual' emergency assistance) 

Positive Assessment 

Offered home visiting and/or case 

management services 

(if case space is available ; otherwise 

treated as negative assessment) 


Family receives home visiting services 

Level 0 

Initial engagement in program . Family has 

" Health Departments (WIC, 3 months to begin home visiting 

prenatal care, immunizations) 

" 

PEID (early intervention services) 

Rappahannock Area Community Level P2 (for prenatal families only) 

Services Board (mental health Two visits per month until one month after 

services) baby is born 

" 

LUCHA Ministries (emergency 

assistance) 

Catholic Charities Migration and 

Refugee Services (refugee 

assistance and resettlement) 

Level 1 

Four visits per month until at least six 

months after enrollment/birth of baby 

s Program for Teen Parents (Teen 

" 

Lamaze, infant massage, and 

childcare assistance) 

Medical providers 

Employment services 

Level 2 

Two visits per month until supervisor, 

FSW, and family agree to level change 

" 

" 

Educational services 

Emergency and financial 

assistance 

Level 3 

One visit per month until supervisor, 

FSW, and family agree to level change 

Ready For School : 

" Smart Beginnings Star Duality 

classrooms 

Head Start 

Level 4 

One visit per quarter until child enters 

preschool or turns 5 

Staff to be hired with MIECHV funding " Preschool Graduationl 


74 of 147 

Kindergarten 

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Organizations/Individuals Contributing to Fredericksburg ( location) MIECHV proposal 

Beth Girone 

Name Organization Email 

Marguerite Bartlett 

Fredericksburg Department of Social 

Services 

! Fredericksburg Health Department 

Healthy Families Rappahannock Area IWECHV Proposal 


1 XO2MC19411 

beth .girone@dss .virg nia.gov 

Trudy Smith Fredericksburg Regional Head Start tsmith(q-)cityschools .com 

Michele Powell Healthy Families Rappahannock Area michelepowell@racsb .state .va .us 

Laura Shoaf Healthy Families Rappahannock Area lshoaf@racsb . state . va .u s 

Tonja Couch Mary Washington Hospital tonja.couch@mwhc.com 

Jill Donaldson 

Alison Standring 

Parent Education - Infant Development 

Program jdonaldson*acsb .state .va .us 

Part C System Manager 

Infant & Toddler Connection astandring(& ,racsb .state .va.us 

Joan Gillis Program for Teen Parents jgillis@racsb .state . va .u s 

Glenda Knight Project Link gknight@racsb .state .va .u s 

Bob Nuzum 

Frank Deforest 

Ronald Branscome I 

Anderson 

r Kathy 

. . . . . . . . __ ._ .__.__. .. .__ . .._..__ 

Angela Sullivan 

Rappahannock Area Community 

Services Board bnuzum(@ racsb .state . va.us 


Services Board Deforest@ racsb .state .va .u s 


Services Board rbranscome( racsb .state . va .u s 

Rappahannock Council On Domestic 

Violence 

_ . . . .. . . . . . .. ._ ._.~. ._. . 

Smart Beginnings Rappahannock Area 

kathy( rcdv.com 

. . . . . 

Attachment G 

asullivan@RappahannockUnitedWay .org 

Beth Rabatin Smart Beginnings Rappahannock Area ( brabatin@RappahannocktJnitedWay .org 

75 of 147 

I

Virginia Local MIECHV grant application 


Local Local 

Home Visiting RESOURCES Home Visiting 

NEEDS/GAPS 


Rappahannock Area (HFRA) - 

evidence-based model providing 

intensive home visitation to atrisk 

first-time parents . HFRA has 

experience working with Spanishspeaking 

and teen parents 

Infant & Toddler Connection of 

the Rappahannock Area - 

the Interagency Coordinating 

Council for Planning District 16 

(including Fredericksburg) and 

provides coordination and 

oversi t 

Parent Education-Infant 

Development Program (PIED) - 

the Part C early intervention 

provider in Fredericksburg City . 

Provides home visiting services 

for infants and toddlers with 

developmental delays or 

disabilities and their families 

Program for Teen Parents - 

school-based program in 

Spotsylvania County . Program for 

Teen Parents has supplemental 

services available to 

Fredericksburg teens, upon 

referral from HFRA . 

Project LINK - interagency 

project focused on helping 

pregnant or parenting women with 

risk factors for substance abuse or 

dependency . Project LANK is able 

to provide screening and referrals 

during maternity clinics at the 

Heal th Department 

Smart Beginnings 

Rappahannock Area - 

community partnership created to 

address the needs of young 

children, birth to five . 

LOCALITY : Fredericksburg 

Insufficient capacity 

to meet demand fbr 

home visiting 

services 

High rate of child 

abuse and neglect 

Refugee Resettlement 

Placement site but 

insufficient support 

services available for 

refugee families 

High teen pregnancy 

rate but lack of 

services focused on 

teen parents 

Growing Hispanic 

population but 

limited services for 

non-Engl ish speakers 

Inability to access 

prenatal care among 

underserved 

populations 

High infant mortality 

rate 

Healthy Families Rappahannock Area MIECHV Proposal 


1 XO2MC19411 

Target 

Population(s) 

" Teen parents 

Attachment H 

" First-time at-risk Healthy Families 

parents I Rappahannock Area 

" Non-English 

speaking families 

" Diverse cultures 

(including refugees 

and immigrants) 

Evidence-Based Home 

Visiting Model (s) 

Proposed 

76 of 147



Locality : Fredericksburg City 



document. As partners in the early childhood community system, the partners agree to work to support 



Name Position Organization 

Frank DeForest, PH .D Clinical Services Director RACSB 

Marguerite Bartlett, RN, BSN Family Health Worker RAHD 

Beth Girone Assistant Director of Social 

Fredericksburg Dept . of Social 

Services 

Services 

Beth Rabatin Executive Director Smart Beginnings 

Tonja Couch, MSW Case Manager Mary Washington Hospital 

Kathy Anderson Executive Director Rappahannock Council on 


Trudy Smith, MSW Director, Head Start Original Walker- 

Grant Early Childhood Center 

Pamela Steinkoenig Director Fredericksburg City Public 

Schools 

Alison Standring Part C Manager Rappahannock Area Community 

Services 

Gillian Donaldson, MA, CC-SLP Program Coordinator Parent Education-Infant 

Development Program 

Joan Gillis Parent Educator ; Program for Teen Parents 

Michael Powell Program Manager Healthily Families 

Ronald Branscome Executive Director RACSB 


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ASSURANCES 

i . Benchmark Data Collection Assurances 



1 .The community must collect data on all benchmark areas and for all constructs and 


2 . The data must be collected for eligible families that have been enrolled in the program 

who receive services funded with the MIECHV Program finds . 



4 . The community will utilize the benchmark data and other appropriate data for CQI to 



5 . The community must collect data on each participating family . 








sessions) ; Demographic data for the participant childJchildren, pregnant woman, 



collection point and racial and ethnic background of all participants in the family ; 

Participant child's exposure to languages other than English, and Family socioeconomic 

indicators (e .g ., family income, employment status) . 



l . The community home visiting program is designed to result in participant outcomes 


2 . Individualized assessments will be conducted of participant families and that services 

will be provided in accordance with those individual assessments ; 

) .Services will be provided on a voluntary basis ; 


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4 . The community will provide information to the state project director in a timely 


5 . . Priority will be given to serve eligible participants who have low incomes ; are 






serve n t armed forces chiding such families that have members of the armed 

deployments fore s who ve half m tip , 

outside of the United States ; 

Signed : 

Organization : Rappahannock Area Community Services Board/Healthy Families Rappahannock Area 


Date : Apri129, 2011 


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Mont9omery- 


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Radford 

80 of 147

Montaomerv Radford-Parents as Teachers (PAT) MIECHV Proposal 

L C 

CHIP/ 

PAT 

MIECHV 

Project 

New River New River 

ommunityAction Health District 

Head Start 

Home Base 

MIECHV Coordinator (25%) 

I System MgmtSpecialist (75%) 

Family Case Manager (100%) 

i Family Case Manager (100%) 

Registered ' Nurse (50%) 

- Program Support Tech (25 `x) _ 

l 

Outreach ; ° 

Specialist (50%) 

New River Valley 

Community Services 

Special 

Deliveries 

Representation 

a 

Early 

Intervention 

SBNRV Home 

Visiting Coalition 

Smart Beginnings 

NRV 

Figure C.4 - The MIECHV program will be integrated into the existing local early childhood system . 


1 XO2MC19411 

15 

81 of 147

Attachment G 

Organizations/] ndividuals Contributing to Montgomery County and Radford City MICCHV proposal 

' 


' New River Community f ADehart'c%nrcaa .o 

Amy Deh~u- t Action CHIP 

New River Community ¬ v cr?nrcaa .or 

Glenda Vest Action 

New River Community tsmuszCii}nrcaa .or ; 

Terry Smusz Action 

New River Community tammyp«i)nrcaa .or 

Tammy Pennin ton Action 

New River Community sheilat6i)nrcaa.org 

Sheila Tucker { Action Head Start 

VT Inst . for Policy & Gov ., dmoore(a?vt.edu 

David Moore Smart Beginnings NRV 

New River Valley bev,&NRVCARES .or 

Beverly Walters CARES 

New River Health Carol yn.dundordr'}vdh .vir Tig ma.gov ! 

Carol n Dunford District 

New River Heath I Molly . Odel1,(~Vdh.virgin ia . o_v 

Margaret O'Dell, MD District 

Montgomery County Dept . L.arrv .Lindscy(u')dss.virginia .r ov 

Larry Lindse of Social Services 

Radford City Dept . of Victoria .C.Collins!i~dss .vir ,,inia .~,ov 

Victoria Collins Social Services 

Giles County Dept . of Sherri .Nipper,~dss .virginia .~,o : 

Sherri Nipper Social Services 

New River Valley _hbarker(i%NRVC S .or~; 

Harvey Barker, PhD . Community Services 

New River Valley i behN{ NRVCS.org 

Joan Behl Community Services 

New River Valley Ishar;a7,NRVCS.orgy 

Leslie Sharp Community Services 

Rainbow Riders Child Care RalnbowKWS(& aol.com 

Kristi Sn der ! & Smart Beginnings NRV 

Infant & Toddler khpiersonL>Radford .edu 

Kathy Pierson Connection, Radford Univ . 

Radford University School 1-cruise'~RadIord .edu 

Erin Cruise, RN of Nursing 

Christiansburg ~~ _wUuliammedr~ci-2_o r


LOCALITY : Montizomerv Countv and Radford Cit 

Local 


RESOURCES 

Existing regional Home 

Visiting Coalition (CHIP, 

Baby Care, Resource 

Mothers, Special 

Deliveries, Early 

Intervention) 

Existing Parents as 

Teachers (PAT) program 

through CHIP NRV 

Existing Smart 

Beginnings NRV Service 

Coordination, Outreach, 

Referral, Eligibility 

Initiative 

Smart Beginnings NRV 

Needs Assessment, Head 

Start Low Income Needs 

Assessment, and Virginia 

Home Visiting Needs 

Assessment 

Virginia Tech and 

Radford University 

programs in social work, 

nursing, human 

development and family 

therapy . -_-_- 



1 XO2MC19411 

Local 


NEEDS/GAPS 

Need to serve more families 

because there is more need 

in the community than 

existing home visiting 

programs can serve 

Need to reach families 

earlier, in a prevention role, 

to improve outcomes while 

maintaining the flexibility to 

serve all target populations 

Need to increase referrals to 

the early childhood system 

with a clear and coordinated 

outreach strategy to ensure 

family needs are met 

efficiently with effective 

services 

Need to serve poor and atrisk 

families 

Need to increase school 

readiness 

Need to increase positive 

parenting practice 

Need to reduce child abuse 

and neglect 

Need to improve black white 

birth outcome disparities 

bleed to increase diffusion of 

evidence-based practice 

from area academic 

programs and implement 

rigorous evaluations across 


Target 

Population(s) 

First time 

mothers not 

enrolled in 

Resource 

Mothers or Baby 

Care 

Black prenatal 

mothers 

Recent (within 

past 2 years) 

high school drop 

outs 

Clients who are 

ageing out of 

Resource 

Mothers or Baby 

Care 

Pregnant 

Mothers over the 

age of 20 (not 

first time 

mothers) 

" Pregnant teens 

for whom it is a 

second birth 

Attachment H 

i Evidence-Based 


Model (s) Proposed 

Parents as Teachers 

(PAT) through CHIP 

83 of 147


Localities : Montgomery County and Radford City 

The following individuals representing of local community organizations indicate by signing below their 

approval of the Maternal, Infant and Early Childhood Home Visiting plan proposed in this document . As 

partners in the early childhood community system, the partners agree to work to support the 

development and enhancement of quality home visiting services as one strategy for reaching the 



SIGNATURES ATTACHED 

Name _ 

Position Organization 

Margaret L . O'Dell, M.D . Director New River Health District 

Larry Lindsey Director i Montgomery County 

Department of Social Services 

Vicky Collins Director Radford City Department of 

Social Services 

Harvey Barker, Ph .D . Executive Director New River Valley Community 

Services 

Terry D. Smusz Executive Director New River Community Action 

David Moore Coordinator Smart Beginnings New River 

Valley & 

VT Institute for Policy and 

Governance 

Kristi W. Snyder Chairperson Smart Beginnings New River 

Valley & 

Rainbow Riders Child Care 

Centers 

' Bev Walters Chairperson Smart Beginnings NRV Home 

Visiting Coalition & 

NRV CARES 

Amy Dehart Program Coordinator Children's Health Improvement 

Partnership of NRV 

Carolyn Dunford, RN Nurse Manager New River Health District 

Resource Mothers and Baby Care 

Programs 

Joan J . Behl, M .A Program Director New River Valley Community 

Services Early Intervention 

Leslie Sharp Supervisor New River Valley Community 

i 

Services Special Deliveries 

Kathy Pierson Coordinator Infant & Toddler Connection of 

the NRV- Radford University 

Erin G . Cruise, RN, MSN Instructor- Community Health Radford University School of 

_ . ._ __.. . .~ . Nursing_ __ I -Nursing . . . . 


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Sheila Tucker Director Head Start Home Base Program 

Sherri Nipper Director 

Giles County Department of 

Social Services 

Rochelle Supervisor Montgomery County Public 

Schools Preschool Program 

Wayne Muhammed & 

Gladys Sokolow 


1 XO2MC19411 

PR and Development Specialist & 

Interim Executive Director 

Christiansburg Institute 

_ 

85 of 147


ASSURANCES 

i . Benchmark Data Collection Assurances 



I .The community must collect data on all benchmark areas and for all constructs and 


2. The data must be collected for eligible families that have been enrolled in the program 

who receive services funded with the MIECHV Program funds . 



4. The community will utilize the benchmark data and other appropriate data for CQI to 



5. The community must collect data on each participating family . 








sessions) ; Demographic data for the participant child/children, pregnant woman, 



collection point and racial and ethnic background of all participants in the family ; 

Participant child's exposure to languages other than English ; and Family socioeconomic 




1 . The community home visiting program is designed to result in participant outcomes 


2 . Individualized assessments will be conducted of participant families and that services 

will be provided in accordance with those individual assessments ; 

3 .Services will be provided on a voluntary basis ; 


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Virginia Local MTECHV ATTACHMENT L 

4. The community will provide information to the state project director in a timely 


5. . Priority will be given to serve eligible participants who have low incomes ; are 






served in the armed forces, including such families that have members of the armed 

forces who have had multiple deployments outside of the United States ; 


1 XO2MC19411 

Signed : 

Organization : 


Date : April 29.2011 

87 of 147


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Norfolk 

88 of 147

Smart Beginning South Hampton Roads 

Technical Advisory Committee 


1 XO2MC19411 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 

I Norfolk Parents as Teachers Collaborative 

! 

! 

! 

I 

NorfolkHealth Dept ./ 

CHIP PAT Nurse-Based 

Nome-Visiting Services 

I-_-_-_ _ r.------- a_____ V 

------------ 

, 

Othtr Norfolk H- V,S,t, rt 

Prolrems& Referrin;AQenc "ts 

~SOCVa! Serv~ces, C58, PubC¢ Schools, 

Health DWJ 

The Up Center 

Parents as Teachers Program 

Vice President of Counseling 

Parent 

Educator 

PAT Program Manager 

South Hampton Roads 

Home Visiting Aillance 

The Up Center 


Home-Visiting Services 

Parent 

Educator 

(Norfolk MIECHV Parents As Teachers Program) 

89 of 147

Attachment G 

Organizations/Individuals Contributing to Portsinoutb[Norfolk ( location) MIECHV proposal 


Laura O'Neal Early Intervention Part C Laura.oIneal a norfolk .gov 

Mary Wilt Eastern VA Perinatal 

Council 

Wi1tMK@evms .edu 

Lisa Howard 

Smart Beginnings lhoward@smartbegimiingsslu.org 

I 

Pamela Parham Norfolk Health Department pamela.parham@vdh.virginia .gov 

Dr . Demetria Lindsay Norfolk Health Department demetna.lindsay@vdh.virginia.gov 

Trish O'Brien CHIP-Norfolk and 

Chesatteake 

tobrien@chiphf org 

Delores Paulding Healthy StartfLoving Steps Delores.Paulding@vdh .virginia.gov 

Lily Smith F 

Eastern 

VA Medical School smithlm@evms .edu 

Katina Barnes The Up Center Katina.bames@theupcenter .org 

Andrea Long The Up Center Andrea.long@theupcenter .org 

Dia Duvernet The Up Center Dia.duvemet@theupcenter.org 

Dr . Jose' Rodriguez Portsmouth Health 

Department 

Lisa Geliring Portsmouth Office of Early 

Childhood Special 

Education 


1 XO2MC19411 

Rodriguez@vdh .virginia .gov 

Lisa . gehring@pps .kl2 .va .us 

90 of 147



LOCALITY : Norfolk and Portsmouth 

Attachment H 

Local Local Target Evidence-Based 

Home Visiting Home Visiting Population(s) Home Visiting 

RESOURCES NEEDS/GAPS Model (s) Proposed 

Home Visiting Alliance of Coordinated Intake Universal access Parents as Teachers : 

South Hampton Roads Procedures with priority in Expansion of home 

Smart Beginnings South Parental knowledge recruitment given to : visiting programs 

Hampton Roads of Child Low-income provided by The Up 

Development families with Center in Norfolk and 

Smart Beginnings/Norfolk Parental knowledge children ages 0 - 6, Portsmouth and CHIP 

Coalition and Coordinator of Effective and: of 

Parenting Practices - pregnant women Chesapeake/Portsmouth 

Norfolk and Portsmouth School Readiness under the age of 21 in Portsmouth . 

Health Departments, Social for young children - a history of child 

Services, public schools, 

abuse or neglect or 

CSB/DBHS 

interactions with 

child welfare 

Numerous home visiting Capacity of services 

programs in both cities, existing home - who have a history 

including evidence-based and visiting programs of substance abuse 

those that are not evidence- to serve all families or who need 

based in need substance abuse 

treatment 

James Madison University/ 

- who have user(s) 

Virginia Home Visiting 

Consortium 

of tobacco products 

in the home 

- who have or have 

Square One 

children with low 

student achievement 

Parents as Teachers (National) 

- who have children 

with developmental 

CHIP of Virginia 

delays or disabilities 

-families that 

Prevent Child Abuse Virginia 

include individuals 

who are serving or 

Early Intervention 

who have formerly 

served in the Armed 

Well established local Parents 

as Teachers provider 

organizations 

Forces 


1 XO2MC19411 

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Locality : PORTSMOUTH/NORFOLK 







Edward J . Welp President & CEO The Up Center 

Lisa Howard President & CEO Smart Beginnings of South 

Hampton Roads 

Maureen Womack Executive Director Norfolk Community Services 

Board 

Anne F . Odell Interim Director Norfolk Dept . of Human Services 

Mary Wilt Eastern Virginia Perinatal Council 

Coordinator 

Lisa Gehring Program Specialist, Special 

Education ECSE 

Eastern Virginia Medical School 

(EVMS) 

Portsmouth Office of Early 

Childhood Special Education 

Demetria Lindsay District Health Director Norfolk Health Department 

Tami M . White Teacher Specialist, Early 

Norfolk Office of Early Child 

Childhood Special Education Special Education Programs 

William Park Director Portsmouth Behavioral 

Healthcare Services 

Reynold Jordan Director Portsmouth Social Services 

Dr . Jose Rodriguez Director Portsmouth Health Department 

Dr . David Stuckwisch Superintendent Portsmouth Public Schools 

Dr . Richard Bentley Superintendent Norfolk Public Schools 

_ Trish O'Brien Executive Director CHIP Chesapeake - Portsmouth 

Delores Paulding Healthy Start/Loving Steps 

Coordinator 


1 XO2MC19411 

Healthy Start/Loving Steps 

92 of 147

Supplemental Nutrition Assistance Program agency ; and the State's Injury Prevention and 

Control (I'riblic Health Injury Surveillance and Prevention) program (if applicable) . 

ATTAClli\II?N'l , I, : Assurallccs 

ASSCIRAN(J;S 

Benchmark Data Collection Assurances 

Under the Virginia application process . each conlnlunity must state agreement to the following 

parameters around the benchmark data collection : 

I Tile CO111111t111Ity 111t1st COIICCt data on all benchmark areas and for all constructs and Clclnents 

under each benchmark area (Sec SIR i/2, Appendix D) . 

2 . The data nnlst be collected for eligible Families that have been enrolled in the 1nograln who 

receive services funded with the Iv1IIJCi-IV Program funds . 

3 . The commtrrlity must collect the data based on the tinning, method and definitions in file state 

plan . 

4 . The community will utilize the benchmark data and other appropriate data for CQI to enhance 

program operation and decision-making and to individualize services . "hecllnical asAstanee N-will be 

provided to assist grantees in t.ltilizill`~ data for CQI . 

J_ The community must collect data on etch participating family . 

6 . The community will complete a local template will be provided Ion grantees to report to I I1 I :; 

on benchmark progress at the 3- and 5-year points . 

7 . `fire community must collect individual-level demographic and service-utilization data on the 

palAcipants ¬ n their program as necassary to analyze and understand the progress children and 

families are making . Individual-level demographic and service-utilization data may include; but 

arc aot limited to the Moving : family's participation rate in the home visiting pro~~r~tn1 (e .' ., 

number of sessions number of , possible sessions, duration of sessions) : Demographic data 1irr the 

participant child/children, pregnant woman, expectant father, parcnt(s), or primary caregiver(s) 

receiving home visiting services including : child's gender, age of ell (including age irr montEi Achid) 

at each data collection point and racial rind ethnic background of all participants in the 

WAY, Participant child's exposure to Wliguages other than English ; and Family socioecolwl:li -indiccttom 

(mg., family income, e111ploynlent status) . 



1 . The community home visiting tnrotgranl is designed to resrllt in participant outCOIncs noted ill 

file federal legislation ; 

2 . Individualized assesslumus will be condnlc.ted of particifNrnt Andies and Out s,! lvkcs "ill he 

pnwided in accorc.Iance with those individual assesonents : 

3 .Services will be provided on it voluntary basis ; 


1 XO2MC19411 

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40

4; . I -he comnlullity will provide inloi-oration to the state project director in ,i timcl ., . ai~mncr 

about changes in staffing or funding ; and 

5 . Priority will be given to serve eligible. participants who have low incomes ; are pre

Suffolk- 

Southampton 


1 XO2MC19411 

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v . Proposed MIECHV Project Organizational Structure : 

The MIECHV Project will be supported by a Community Advisory Board (CAB) 

Goals : Project oversight ; high fidelity implementation ; rigorous CQI ; community collaboration . 

Members : Smart Beginnings (Southampton/Suffolk) ; DSS (Southampton/Suffolk) ; Obici Foundation Senior 

Program Office ; The Children's Center (Part C + Early Head Start) ; Bio-statistician (to support CQI efforts) 

Western Tidewater Health Department, Nancy Welch, MD, MHA, MBA Director 

WTHD Nurse Manager, Cynthia Hunting, RN, BSN 

MIECHV Project Supervisor, Marli Laudun, BSN,MPH 

Healthy Resource Southampton Suffolk City MIECHV 

Families Mothers 

County 

1 MIECHV NFP Home Visitor WTHD-funded 

2 Home Visitors 2 Home Visitors 1 MiIECHV NFP 

1 Private funded Home Visitor 

Clerical Assistant 


r 


1 XO2MC19411 

South Hampton NFP Client Support Team 

Goal : Support high fidelity implementation 

Members : WIC, family planning, DSS case workers, 

school districts, primary care providers, and other local 

resources to support home visitor and family . 

r 

Suffolk City NFP Client Support Team 

Goal : Support high fidelity implementation 

Members : WIC, family planning, DSS case workers, 

school districts, primary care providers, and other local 

resources to support home visitor and family . 

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ATTACHMENT G : Western Tidewater Health Department MIECHV Proposal 

List of Organizations and Individuals Contributing to this Proposal 


A . Bruehl The Children's Center 

Early Childhood 

abruehl ,thechildrenscenter .cc 

Brenda_ O'Donnell Development Commission 

Suffolk Department of 

bodonnell cn suffolkva .u s 

Leonard Horton Human Services lhorton suffolkva .us 

Sarah Bishop United Way { sbisho unitedwayshr .org 

Jamie Mason Western Tidewater CSB j .masonaa wtcsb .org 

Janice White Suffolk Public Schools 'anicewhite s skl2 .net 

Selena Cuffee-Glenn Suffolk City Manager citymanager a suffolkva .u s 

Gina Pitrone OHF Foundation g itrone@obicihc£org 

Tami Rittenhouse The Children's Center Rittenhouse thechildrenscenter .cc 

Anne Bryant United Way uw @uwfranklinsoutham ton .org 

Ellen Couch Smart Beginnings WT 

Southampton County Social 

ecouch@franklinva .com 

Michelle Stivers 

Services rnichelle .stivers@dss .virginia.gov 

Rosalyn Cutchins The Children's Center rcutchins thechildrenscenter .cc 

J . Saunders Voices for Kids jsaunders a isleofwi htus .net 

Paul Conco - Paul D . Cam College pconco a. dc .edu 

Kim Marks Southampton Memorial 

I-Ios ital 

k.marks@chs .net 

E. ; . Dar den American Red Cross DardenC(a seva-redcross .org 

Marli Laudun Western Tidewater HD marli .laudun @vdh.virginia.gov 


1 XO2MC19411 

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ATTACHMENT H Western Tidewater Health Department MIECHV Proposal 


Local 


RESOURCES 


Resource Mothers 


1 XO2MC19411 

LOCALITY : Western Tidewater 

Local 


NEEDS/GAPS 

renatal Care 

or all age 

More case 

capacity for up 

to 5 vears of age 

Target 

Population(s) 

Low income, 

first time 

mothers 

Evidence-Based 


Model (s) Proposed 

Nurse Family 

Partnership 

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MIECHV Spring 2011 

Locality: 


WESTERN TIDEWATER HEALTH DISTRICT 

Attachment I 


their approval of the Maternal, Infant and Eariy Childhood Home Visiting plan proposed In this 





0. h- 

_ I- 

c0, 

h~I~Nr'1~1lfi~tl u' ~!Y ~?R--If iiCjJlft/~~~ 1'.. ~ I"C~if _ 

- 

~'dnla~2 A ogre 1 ~lRpa'~o ~t_ - s~~E~ ~'' . ar~.c Sc,>RVra 

wi .aaw 


1 XO2MC19411 

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April 27, 2011 

Catherine J . Bodkin, LCSW, MSHA 

Program Director 


109 Governor Street, 8u' Floor 

Richmond, Virginia 23219 

Dear Ms . Bodkin : 

.i~.! OBICI 

~ 7 Healthcare Foundation 

On behalf of the Obici Healthcare Foundation, I am pleased to write a letter of support for the 

Western Tidewater Health District's application for the Nurse-Family Partnership Program . 

We are excited about the potential the Partnership has to reduce second pregnancies, improve 

birth outcomes and infant mortality rates and produce dramatic returns on investment . The 

Foundation has partnered with the Health District'since 2008 by awarding $554,000 to fund an 

expansion in family planning and maternal and child health programs . Their outcomes have 

been phenomenal in high-risk neighborhoods . From 2007 to 2008 infant death rates in Suffolk 

and Isle of Wight County decreased significantly from 10 .0 to 8.3 and 8.5 to 7.8 per 1,000 births, 

respectively . Low-birth weight percentages show similar improvements in both localities, 

dropping 15% in Suffolk and 16% in Isle of Wight . 

The advent of the Nurse-Family Partnership gives the Health District, which has a proven track 

record of implementing an effective infant mortality reduction program, with more potent 

resources to address this problem in at-risk communities . With your support of this robust, 

evidence-based partnership, we are confident that further progress can be made that will result 

in better birth outcomes . 

A Nurse-Family Partnership grant application for $104,000 is currently being considered by the 

Foundation Board ; the disposition of this proposal will be rendered on May 5, 2011 . If 

approved, we would look forward to you joining us as a funding partner . 

Please contact me if you would like to discuss my views of the Nurse-Family Partnership 

Program being housed at the Western Tidewater Health District . You can reach me at 

757-539-8810 . 

Gina Pitrohe 

Executive Dire 

Virginia 106 W Department Finney of Avenue Health " Suffolk, VA 23434 " 757-539-8810 " wwwAicilidorg 100 of 147 

1 XO2MC19411

ATTACHMENT L : Assurances 

ASSURANCES 

i. Benchmark Data Collection Assurances 

Under the Virginia application process, each community must state agreement to the following 

parameters around the benchmark data collection : 

1 .The community must collect data on all benchmark areas and for all constructs and elements 

under each benchmark area (See SIR #2, Appendix D) . 

2 . The data must be collected for eligible families that have been enrolledin the program who 

receive services funded with the MIECHV Program funds . 

3 . The community must collect the data based on the timing, method and definitions in the state 

plan . 

4 . The community will utilize the benchmark data and other appropriate data for CQI to enhance 

program operation and decision-making and to individualize services . Technical assistance will be 

provided to assist grantees in utilizing data for CQI . 

5 . The community must collect data on each participating family. 

6 . The community will complete a local template will be provided for grantees to report to HHS 

on benchmark progress at the 3- and 5-year points . 

7 . The community must collect individual-level demographic and service-utilization data on the 

participants in their program as necessary to analyze and understand the progress children and 

families are making . Individual-level demographic and service-utilization data may include but 

are not limited to the following : Family's participation rate in the home visiting program (e .g ., 

number of sessions/number of possible sessions, duration of sessions) ; Demographic data for the 

participant child/children, pregnant woman, expectant father, parent(s), or primary caregiver(s) 

receiving home visiting services including : child's gender, age of all (including age in month for 

child) at each data collection point and racial and ethnic background of all participants in the 

family; Participant child's exposure to languages other than English ; and Family socioeconomic 




1 . The community home visiting program is designed to result in participant outcomes noted in 

the federal legislation ; 

2 . Individualized assessments will be conducted of participant families and that services will be 

provided in accordance with those individual assessments ; 

3 .Services will be provided on a voluntary basis ; 

4 . The community will provide information to the state project director in a timely manner 

ahout changes in staffing or i:tinding ; and 


1 XO2MC19411 

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5 . Priority will be given to serve eligible participants who have low incomes ; are pregnant 

women who have not attained age 21 ; have a history of child abuse or neglect or have had 

interactions with child welfare services ; have a history of substance abuse or need substance 

abuse treatment ; are . users of tobacco products in the home ; have, or have children with, low 

student achievement ; have children with developmental delays or disabilities ; are in families 

that include indiv)duals who are serving or have formerly served in the armed forces, including 

such families t t have membeys of the armed forces who have had multiple deployments 

outside of the 

Signed : 

Organizati 

Position i 

Date : 


1 XO2MC19411 

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Attachment B. Logic Models 

1. Virginia’s Plan for Smart Beginnings Logic Model 

2. Virginia Home Visiting Consortium Logic Model 

3. MIECHV Logic Model 


1 XO2MC19411 

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G 

O ALS 

O BJECTIVES 

O UTC 

O 

M ES 

GOVERNANCE 

AND FINANCING: 

All sectors will be engaged in creating & 

sustaining collaborative structures to ensure 

an effective early childhood system. 

A) Establish & sustain a structure within 

the executive branch to effectively 

coordinate the planning, financing, 

delivery and evaluation of early 

childhood programs. 

B) Create and sustain a statewide publicprivate 

entity to consistently guide 

early childhood initiatives and provide 

resources, technical assistance, and 

accountability to local coalitions. 

C) Increase the capacity of local 

partnerships working to coordinate, 

improve, & expand delivery of early 

childhood programs & services. 

D) Increase public-private investments 

and braid funding streams for maximum 

impact. 

E) Ensure accountability with program 

standards & measurement mechanisms 

to track identified outcome indicators. 

F) Promote a high quality workforce 

providing services for young children 

and families. 

System Outcomes— 

1. Increased and more diverse public 

private resources are available for 


2. A strong workforce of professionals 

serving children and families sustained 

by an effective professional development 

system 

3. State budget and policies reflect and 

support key system goals 

4. Increased data linkages & information 

sharing among partners and agencies 

5. Local plans are aligned to state-level 

priorities & coordinated among programs 

6. A strong, effective governance structure 

at both the state & local levels 

7. An effective system of evaluation for 

program improvement & accountability 

REV: 10_10 


1 XO2MC19411 

virginia’s plan for smart beginnings 

PARENT SUPPORT 

AND EDUCATION 

All families of children prenatal to five 

will have the information & support they 

need to promote their child’s optimal 

development & school readiness. 

A) Increase access for all families to 

quality information and supportive 

services. 

B) Increase the quality of parenting 

support programs. 


1. Increased capacity of home visiting 

and parent education programs 

2. Increased use of strategies to promote 

and sustain parental involvement 

3. Increased child care and health 

professional awareness of family 

support best practices 

4. Increased inter-agency coordination 

and improved distribution mechanisms 

for parent information about state and 

local services 

5. Increased uniformity of agency and 

provider messages to parents 

Child/Family Outcomes— 

1. Increased family awareness of 

available services and supports 

2. Increased number of eligible families 

enrolled in evidence based or evidence 

informed home visitation programs 

3. Increased number of parents 

enrolled in evidenced based parent 

education and support programs 

4. Increased family participation in early 

childhood programs through parent 

leadership opportunities 

5. Increased number of families 

providing a safe home environment. 

EARLY CARE 

AND EDUCATION 

All families will have access to high 

quality early care and education. 

A) Improve the quality of early care and 

education programs. 

B) Expand availability and access to 

high quality early care and education 

programs. 


1. Increased quality of early care and 

education programs 

2. Increased coordination of funding and 

service delivery among ECE programs 

and between ECE programs and 

public schools 

3. Early care and education programs 

have increased and more sustainable 

funding sources, including increases 

in subsidy reimbursement rates to 

support quality 

4. Increased use of appropriate, consistent, 

and comprehensive assessments by 

public and private ECE programs 


1. Increased number of children enrolled 

in the Virginia Preschool Initiative, 

Head Start and Early Head Start, and 

high quality early care and education 

programs 

2. Increased number of children scoring 

in the appropriate development range 

or meeting the appropriate benchmark 

on the PALS preK and PALS K 

3. Increased number of children with 

special needs receiving consistent 

ECE services and supports 

4. Increased number of 3rd grade 

students passing standards of learning 

assessments 

5. Decreased retention rates for children 

in grades K-3 

HEALTH 

All families of children prenatal to 

age five will have access to a full range 

of prevention & treatment services to 

ensure their children are healthy. 

A) Foster public and private sector initiatives 

to improve the affordability of health 

services. 

B) Increase access to health services 

through expansion, increased 

coordination, and effective practices 

and policies. 


1. Increased resources available for Early 

Intervention services (mental health, 

mental retardation, and developmental 

delay) 

2. Increased access to quality healthcare 

(physical, behavioral, dental) for at-risk 

populations 

3. Increased use of a medical & dental home 


1. Increased number of children enrolled in 

public (Medicaid and FAMIS) and private 

insurance 

2. Increased number of pregnant women 

receiving prenatal care within first 13 weeks 

3. Increased number of EPSDT screenings 

and services provided 

4. Increased number of 0-1 and 0-3 year 

olds in Early Intervention programs 

5. Increased number of children receiving 

mental health services paid for by 

public & private insurance 

PUBLIC 

ENGAGEMENT 

All Virginians will recognize the importance 

of early childhood and act to support 

policies and investments promoting a 

Smart Beginning for all children. 

A) Persuade the public and key leaders 

and decision makers of the importance 

of early childhood and the benefits of 

early childhood initiatives (i.e., Make 

the Case). 

B) Increase participation and engagement 

of leaders to support state and local 

early childhood initiatives. 

C) Promote collective action to alter key 

early childhood systems and policies at 

local and state levels, in both public and 

private entities. 

D) Regularly inform the public and all 

stakeholders of progress on Virginia’s 

Plan for Smart Beginnings. 


1. Strong, organized community networks 

for advocacy and building public will 

2. Consistent and effective advocacy 

messages for various audiences 

3. A strong, growing, and mobilized pool 

of early childhood champions in all 

sectors 

4. Increased awareness of the importance 

of early childhood development and its 

role in improving Virginia’s economy 

and quality of life 

5. Stakeholder commitment to a unified 

policy agenda 

104 of 147 

VIRGINIA EARLY CHILDHOOD FOUNDATION

GOVERNANCE & FINANCING: 

All sectors will be engaged in creating & sustaining collaborative structures to ensure an effective early childhood system. 

OBJECTIVES STRATEGIES 

SYSTEM OUTCOMES 

A) Establish and sustain a structure within the executive 

branch to effectively coordinate the planning, financing, 

delivery and evaluation of early childhood programs. 

B) Create and sustain a statewide public-private entity to 

consistently guide early childhood initiatives and provide 

resources, technical assistance, and accountability to 

local coalitions. 

C) Increase the capacity of local partnerships working to 

coordinate, improve, and expand delivery of early childhood 

programs and services. 

D) Increase public-private investments and braid funding 

streams for maximum impact. 

E) Ensure accountability with program standards and 

measurement mechanisms to track identified outcome 

indicators. 

F) Promote a high quality workforce providing services for 

young children and families. 


1 XO2MC19411 

i. Establish working group of senior leaders of relevant agencies and organizations 

ii. Promote collaborative strategies for the most effective governance and leadership 

among agencies and organizations 

iii. Align and integrate service deliveries across agencies and organizations 

i. Establish an effective organizational structure for the Virginia Early Childhood 

Foundation 

ii. Serve as a centralized source for exchange of information and resources 

i. Create local leadership coalitions at the community level 

ii. Develop local strategic plans to meet identified needs aligned with statewide 

priorities 

iii. Create learning communities to share best practices and resources 

i. Maximize available resources and secure sustainable, diversified investment 

ii. Coordinate state and local level resource development 

i. Define standards 

ii. Utilize appropriate assessment instruments and outcome indicators 

iii. Develop a method for tracking system and child outcomes 

i. Increase the supply of qualified professionals: 

Conduct or utilize workforce studies to identify gaps & critical shortages; promote 

recruitment & retention strategies in fields & geographic areas with high needs; 

ensure adequate compensation & benefits 

ii. Increase access, availability, and affordability of professional development : 

Create a continuum of training, education, & ongoing professional development; 

expand the capacity of training & education institutions & organizations; expand 

scholarships, loan forgiveness, & other financial incentives 

1. Increased and more diverse public-private 

resources are available for the early childhood 

system and coordinated among programs 

2. A strong workforce of professionals serving 

children and families sustained by an effective 

professional development system 

3. State budget & policies reflect & support 

key system goals 

4. Increased data linkages and information 

sharing among all partners and agencies 

5. Local plans are aligned to state-level priorities 

6. A strong and effective governance structure 

at both the state and local levels 

7. An effective system of evaluation for program 

improvement and accountability 

105 of 147

PARENT SUPPORT & EDUCATION 

All families of children prenatal to five will have the information & supports they need to promote their child’s optimal 

development and school readiness. 


OUTCOMES 

A) Increase access for all families 

to quality information and 

supportive services 

B) Increase the quality of 

parenting support programs 


1 XO2MC19411 

i. Develop effective and efficient methods for providing information to all parents 

• Increase awareness and coordination of state resources such as the New 

Parent Kit, the 211 Line 1-800-CHILDREN, and VACCRRN 

• Increase awareness of community services that promote prevention and 

inclusion 

• Educate parents about high quality early care and education as a support 

for school readiness 

ii. Equip child- and family-serving providers with information to best serve families. 

• Increase provider awareness of how to refer to and work with local home 

visiting services and parent education programs 

• Adopt uniform messages across agencies, disciplines, and organizations 

iii. Identify gaps and develop strategies for 

expanding services. 

i. Implement best practice models, promising 

practices, and evidence-based family support programs 

• Provide professional development opportunities for child care and health 

professionals on best practices for supporting parents of all children 

• Promote and support use of best practices and researched based models in 

local coalitions 

• Involve families in the design and evaluation 

of services 

• Increase diverse parent representation on local and state-level coalitions 

and planning 

• Implement strategies to sustain parental 

involvement 

ii. Increase collaboration and coordination of services at the state and local levels 


1. Increased capacity of home visiting &parent education programs 

2. Increased use of strategies to promote and sustain parental 

and family involvement 

3. Increased child care & health professional awareness of 

family support best practices 

4. Increased interagency coordination and improved distribution 

mechanisms for parent and family information about state 

and local services 

5. Increased uniformity of agency and provider messages to 

parents and families 

CHILD OUTCOMES 

1. Increased family awareness of available services and supports 

2. Increased number of eligible families enrolled in evidence- based 

and evidence informed home visitation programs 

3. Increased # of parents in evidence -based parent education and 

support programs 

4. Increased family participation in early childhood programs 

through parent leadership opportunities 

5. Increased # of families providing a safe home environment 

106 of 147

EARLY CARE AND EDUCATION 

All families will have access to high quality early care and education. 


OUTCOMES 

A) Improve the quality of early 

care and education programs. 

B) Expand availability and access 

to high quality early care and 

education programs. 


1 XO2MC19411 

i. Establish a voluntary statewide quality ratings and improvement system 

(QRIS) 

• Create QRIS standards for all early learning settings 

• Implement QRIS 

ii. Promote alignment of child care programs and public schools 

• Promote Foundation Blocks for Early Learning and Milestones of 

Child Development 

• Promote transition practices 

• Provide joint professional development 

• Explore PK-3 strategies 

i. Establish and maintain a strong and effective preschool network 

• Coordinate enrollment among Head Start, VPI, and private child 

care providers 

• Blend classrooms and coordinate services 

• Promote effective and efficient funding strategies and policies 

ii. Promote greater efficiency, accessibility and quality in the subsidy system 

• Integrate subsidized child care into preschool delivery 

• Identify needs and gaps in subsidized services 

• Increase the percent of eligible families receiving subsidies and 

promote quality 

• Provide equitable subsidy reimbursement rates 

iii. Identify and address local barriers to expansion of high quality child 

care programs 


1. Increased quality of early care and education programs 

2. Increased coordination of funding and service delivery among 

ECE programs and between ECE programs and public schools 

3. Early care and education programs have increased and more 

sustainable funding sources, including increases in subsidy 

reimbursement rates to support quality 

4. Increased use of appropriate, consistent, and comprehensive 

assessments by public and private ECE programs 


1. Increased # of children enrolled in high quality early care and 

education programs 

2. Increased percentage of children scoring in the appropriate 

developmental range 

3. Increased # of children with special needs identified and 

receiving appropriate ECE services and supports 

4. Increased average 3rd grade SOL scores and pass rates 

5. Decreased retention rates for children in grades K-3 

107 of 147

HEALTH 

All families of children prenatal to age five will have access to a full range of prevention & treatment services to ensure 

their children are healthy. 


OUTCOMES 

A) Foster public and private 

sector initiatives to 

improve the affordability 

of health services. 

B) Increase access to 

health services through 

expansion, increased 

coordination, & effective 

practices and policies. 


1 XO2MC19411 

i. Increase health insurance coverage, ensuring 

services during the prenatal, infant, toddler, 

and childhood years 

• Promote enrollment and retention of all 

eligible children in Medicaid or FAMIS and 

all eligible pregnant women in FAMIS Moms 

• Explore policy changes to expand Medicaid 

eligibility for children and pregnant women 

i. Increase awareness and access to health care 

• Coordinate & expand use of medical & dental 

homes 

• Educate pregnant women and families about 

the value and use of medical and dental homes 

• Distribute the NPK to all new parents (universal 

parent education) 

• Educate medical providers about best practices 

(as defined by Bright Futures & AAPD) 

• Educate non-medical child & family service 

providers about physical, dental, & behavioral 

development & services 

• Promote Joint Commission on Health Care 

recommendations re: premature & low birth 

weight infants 

• Reduce disparities by ensuring availability & 

coordination of services for diverse populations 

ii. Increase availability and access to behavioral 

health services 

• Increase early intervention, perinatal depression, 

and substance abuse treatment services 

• Pursue universal screening of all children 0-5 

from birth 

• Train child- and family-serving providers in 

the identification of children in need of further 

assessment 

• Facilitate information-sharing & referrals across 

disciplines & systems 

• Educate health care providers about Medicaid 

reimbursement for oral health assessments and 

dental varnish services 

• Promote mandate of Medicaid reimbursement for 

oral health assessments and dental varnish services 

• Increase Medicaid reimbursement rates 

• Enhance employer-sponsored health insurance 

iii. Increase availability and access to early dental care 

• Promote initial pediatric dental appointment in the first year 

• Educate potential parents re: need of early dental services 

• Train medical & dental students in standards of care 

• Train non-medical & child care providers on dental risk 

assessment & prevention tools 

• Examine the scope of practice for professionals to 

maximize access to preventive services 

• Promote early referral of CSHCN for dental care 

iv. Promote healthy behaviors among all pregnant women 

and young children. 

• Promote nutrition education for parents & families 

• Expand SNAP (State Nutrition Action Plan) to include other 

community partners including child care providers 

• Implement CHAMPION plan 

• Educate child & family service providers, including those 

serving high risk populations 

• Ensure that professional education curricula include high 

risk behaviors 

• Maximize participation in WIC, Food Stamps, local food 

pantries, & other programs for high-risk populations 

• Improve documentation/ information sharing with referrals 

so that agencies can contact families to initiate services 


1. Increased resources available for Early 

Intervention services 

2. Increased access to quality healthcare 

(physical, behavioral, dental) for at-risk 

populations 

3. Increased use of a medical and dental home 

messages to parents and families 


1. Increased # of children & families enrolled 

in public (Medicaid and FAMIS) and private 

insurance 

2. Increased # of pregnant women receiving 

recommended prenatal care 

3. Increased # of children receiving health and 

developmental screenings & services 

4. Increased # of eligible children served in 

Early Intervention programs 

5. Increased number of eligible children & 

parents receiving mental health services 

paid for by public and private insurance 

108 of 147

PUBLIC ENGAGEMENT: 

All Virginians will recognize the importance of early childhood and act to support policies and investments promoting 

a Smart Beginning for all children. 

OBJECTIVES 

A) Persuade the public and key leaders and decision 

makers of the importance of early childhood and 

the benefits of early childhood initiatives 

(i.e., Make the Case). 

B) Increase participation and engagement of leaders to 

support state and local early childhood initiatives. 

C) Promote collective action to alter key early childhood 

systems and policies at local and state levels, in both 

public and private entities. 

D) Regularly inform the public and all stakeholders of 

progress on Virginia’s Plan for Smart Beginnings. 


1 XO2MC19411 

STRATEGIES 

i. Develop uniform messages and frames 

ii. Select target audiences; plan and execute tailored communication methods 

iii. Plan and execute print, broadcast and online media approaches to persuade 

general public 

iv. Facilitate local, community-driven public awareness campaigns 

(i.e help local school readiness coalitions conduct campaigns) 

v. Conduct state and local media relations efforts to increase positive 

media placements 

i. Increase the number and strength of local Smart Beginnings coalitions 

ii. Recruit and cultivate local leaders from business, faith communities, law 

enforcement, and other sectors statewide 

iii. Establish and cultivate relationships between these local leaders and key 

elected and government officials 

iv. Create a statewide Business Leader Advisory Council to support early 

childhood initiatives 

i. Prepare community leaders to conduct personal advocacy with elected officials 

ii. Encourage and support local coalition-sponsored advocacy activities 

iii. Strengthen partnerships and communication among early childhood stakeholders 

iv. Jointly define key policy change priorities and collective action steps 

v. Create and strengthen communications to promote legislative advocacy by early 

childhood supporters 

i. Create a Virginia Plan for Smart Beginnings section online within 

www.smartbeginnings.org 

ii. Post updates to this plan and provide status reports 

iii. Publish an annual online report of progress 

iv. Conduct an annual meeting of stakeholders 

v. Establish online communications vehicle (list-serv) for sharing information 

vi. Create and execute a plan to brand and market this initiative 


1. Strong, organized community networks for 

advocacy and building public will 

2. Consistent and effective advocacy messages 

for various audiences 

3. A strong, growing, and mobilized pool of early 

childhood champions in all sectors 

4. Increased awareness of the importance of early 

childhood development and its role in improving 

Virginia’s economy and quality of life 

5. Local plans are aligned to state-level priorities 

6. A strong and effective governance structure 

at both the state and local levels 

7. Stakeholder commitment to a unified policy 

agenda 

109 of 147

Goal One: 

Governance & 

Financing 

Zelda Boyd 

zelda.boyd@dss.virginia.gov 

804.726.7616 

REV: 10_10 

Goal Two: 

Parent Support 

& Education 

Maria Brown 

maria@vecf.org 

804.358.8323 

Cathy Bodkin 

Catherine.bodkin@ 

vdh.virginia.gov 

804.864.7768 

Goal Three: 

Early Care & 

Education 

Anne-Marie Twohie 

anne-marie.twohie@ 

fairfaxcounty.gov 

703.324.8014 

Karen Lange 

klange@childsavers.org 

804.644.9590 x 3014 

Wenda Singer 

wenda.singer@ 

dss.virginia.gov 

804.726.7655 

Goal Four: 

Health 

Lisa Specter Dunaway 

lspecter@chipofvirginia.org 

804.783.2667 

Mary Ann Discenza 

maryann.discenza@dbhds. 

virginia.gov 

804.371.6592 

For more information about a particular goal, please contact the appropriate goal group leader(s). 


1 XO2MC19411 

Office of Early Childhood Development 

Zelda Boyd 

zelda.boyd@dss.virginia.gov 

804.726.7616 

virginia’s plan for smart beginnings 

Virginia Early Childhood Foundation 

Scott Hippert 

scott@vecf.org 

804.358.8323 

Goal Five: 

Public Engagement 

John Morgan 

john@vakids.org 

804.649.0184 

Scott Hippert 

scott@vecf.org 

804.358.8323 

110 of 147 

VIRGINIA EARLY CHILDHOOD FOUNDATION

What We Have 

(Resources) 

Baby Care/ 

MICC 

Resource 

Mothers 

Project LINK 


Healthy Start/ 

Loving Steps 


Early Head Start 

Head Start 

Infant & Toddler 

Connection 


1 XO2MC19411 

Home Visiting System 

Strategies for Success 

Increase training modules 

shared among prenatal, 

infant and early childhood 

providers 

Increase number of home 

visiting staff completing 

core training 

Increase the capacity to 

analyze data to measure 

outcomes and to improve 

the quality of home visiting 

services 

Enhance existing and 

increase the number of 

local networking 

opportunities across the 

home visiting continuum 

Increase the efficiency and 

effectiveness of the services 

across the home visiting 

continuum. 

Streamline intrasystem 

referrals 

Virginia Home Visiting Logic Model 

What the Home Visiting Consortium Seeks to Achieve 

Pregnant Women 

Increase the # and % of women who receive early and 

adequate prenatal care 

Decrease the # and % of low weight births 

Increase the initiation and duration of breast feeding 

Reduce high risk behavior for pregnant women through 

comprehensive screening, referral and the provision of 

support services related to 

o prenatal depression, 

o domestic violence, 

o mental health, 

o substance use including alcohol, tobacco and 

inappropriate use of prescription drugs 

Of those women who have a subsequent pregnancy, 

decrease the # and % of repeat pregnancies that occur 

within a 24-month interval 

Families 

Increase the # and % of families providing a safe 

home (environmental toxins, safe sleep environment, 

car seats, fire alarms, latches); and those promoting 

positive child development through comprehensive 

screening and referral to appropriate supports and 

services 

Reduce high risk behavior for families through 

comprehensive screening and the referral and 

provision of support services related to 

o depression, 

o domestic violence, 

o mental health, 

o substance use including alcohol, tobacco and 

inappropriate use of prescription drugs 

Children 

Increase # and % of children 0-5 who complete the 

scheduled well-child visits 

Increase # and % of children 0-5 who are on-track with 

their immunizations 

Increase # and % of children 0-5 enrolled in 

medical/health care insurance 

Increase # and % of children 0-5 receiving 

comprehensive developmental screening and referral 

for early intervention/early childhood special education 

services, mental health and/or for other services as 

identified 

Communities/System to Create a 

Sustainable Home Visiting System 

Increase referral sources to home visiting programs; 

and Increase linkages and referrals to community 

services 

Enhance existing and increase number of local 

networks 

Promote healthy behaviors among all pregnant 

women and young children 0-5 

Establish a continuum of services based upon 

individual family and child need for children 0-5 

between the home visiting network, ensuring 

appropriate and timely referrals and ensure against 

unnecessary duplication across home visiting 

programs 

Increase the # and % of early and appropriate 

referrals from home visiting programs to the 

Infant/Toddler Connection (early intervention/Part C) 

Decrease founded child abuse/neglect reports 

So That We… 

Promote healthy behaviors 

among all pregnant women 

and their families; 

Improve access for all families 

to quality information and 

supportive services; 

Improve quality of home 

visiting programs; 

Improve awareness and 

utilization of early health care; 

Improve school readiness; 

Improve access to behavioral 

and mental health services; 

Promote child wellbeing 

1 

for children and families served 

through the home visiting 

continuum. 111 of 147

INPUTS 

Resources 

Staff 

HVC 

Time 

Funding/Money 

State Partners 

HV Model 

Programs 

Resources, (e.g. 

- Bright Futures; 

web sites) 

PD training 

Research & best 

practice 

Milestones & 

competencies 

Families 


1 XO2MC19411 

MIECHV Home Visiting Logic Model 

OUTPUTS 

Goals & Objectives 

Goal 1: Improve coordination of early childhood 

services at the state level. 

Objective 1: Increase the degree to which the state 

agencies collaborate to develop & improve home 


Objective 2: Enhance communication among state 

agencies, the Home Visiting Consortium, & local 

home visiting programs. 

Objective 3: Increase capacity to provide technical 

assistance, training, resources & data collection for 

early childhood home visiting programs. 

Goal 2: Improve coordination of early childhood 

services at the local level with priority in the 

identified at risk communities. 

Objective 1: Increase the degree to which the local 

home visiting programs collaborate together & with 

formal & informal community leaders & groups in 

program planning, service delivery & evaluation 

activities. 

Objective 2: Increase diversity of referral sources to 


Objective 3: Increase linkages & referrals to 

community services. 

Goal 3: Increase the quality, availability, and 

effectiveness of early childhood home visiting 

programs designed to strengthen families in 

Virginia. 

Objective 1: Increase quality of home visiting 

programs. 

Objective 2: Improve access to the early childhood 

continuum of services ensuring appropriate & 

timely elimination of duplication across home 


Objective 3: Increase effectiveness of home visiting 

programs to improve maternal & child health, 

improve parenting behaviors & the parent-child 

relationship, & support children’s learning & 

development. 

OUTCOMES- Impact 

Short Term (1-2 yrs) Long Term (> 2 years) 

*Establish & maintain an ongoing interagency 

collaborative process for the assessment of needs & 

assets and the provision of services. 

*Provide leadership for priority setting, planning, & 

policy development. 

*Increase participation & engagement of state leaders 

to support home visiting initiatives. 

*Publish regular online updates & reports of progress. 

*Conduct an annual meeting of all stakeholders. 

*Establish an online communication vehicle for sharing 

information. 

*Foster partnerships between parents, stakeholders, 

& service providers to enhance the effectiveness and 

impact of programs. 

*Assist in the development of a mechanism for 

screening, coordination, referrals, & service 

integration among programs including early 

intervention & special education, social services & 

family support services. 

* Provide technical assistance to develop a centralized 

intake, screening & referral process. 

*Identify & address barriers to HV programs. 

*CQI teams work together to inform state & local 

quality improvement efforts. 

Ensure accountability with model program standards & 

measurement mechanisms to track identified 

benchmarks. 

*Increase data system linkages & information sharing 

among partners and agencies. 

* Establish policies & standards based on home visiting 

models. 

*Develop & implement a professional development 

model for home visitors. 

*Ensure that policies, procedures, & practices reflect 

cultural competence. 

*Identify ways to promote input from families to 

identify needs & impact of successful programs. 

*Improvements in 

maternal and 

newborn health 

*Prevention of child 

injuries, child abuse, 

neglect, or 

maltreatment, and 

reduction of 

emergency 



school readiness 

and achievement 

*Reduction in crime 

or domestic 

violence 


family economic 

self-sufficiency 


the coordination 

and referrals for 

other community 

resources and 

supports 

Ensure that all 

children grow 

up healthy and 

ready to learn 

by reaching all 

families where 

they live. 

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Goal 1: Improve coordination of early childhood services at the state level. 

Objective 1: Increase the degree 

to which the state agencies 

collaborate to develop and 

improve home visiting programs. 

Objective 2: Enhance 

communication among state 

agencies, the HVC, and local 


Objective 3: Increase capacity to 

provide technical assistance, 

training, resources, and data 

collection for early childhood 



1 XO2MC19411 

Activities Lead Time/ Periodicity 

Establish & maintain an ongoing Project Manager (State) Monthly meetings 

interagency collaborative process for the 

assessment of needs & assets and the 

provision of services. 

Home Visiting Consortium 

Conduct an annual meeting of all 

stakeholders. 

Increase participation & engagement of 

state leaders to support home visiting 

initiatives. 

Publish regular online updates & reports 

of progress. 

Establish an online communication 

vehicle for sharing information. 

Arrange for state and local training with 

EB models 

Local Project Coordinators 

Local coalitions 

Project Manager 

Local Project Coordinators 

Monthly local 

meetings 

Start up Planning 

Annual 

Follow-up reports 

Report to ECAC Quarterly 

Project Manager Monthly 

Local site Director Monthly 

Project Coordinator Weekly updates of 

articles and 

announcements 


Project Coordinator 

Written plans 

Arrange sessions 

113 of 147

Goal 2: Improve coordination of early childhood services at the local level with priority in the identified at 

risk communities. 

Objective 1: Increase the degree to 

which the local home visiting programs 

collaborate together and with formal 

and informal community leaders/groups 

in program planning, service delivery, 

and evaluation activities. 

. 

Objective 2: Increase diversity of referral 

sources to home visiting programs. 

Objective 3: Increase linkages and referrals 

to community services. 


1 XO2MC19411 

Activities Lead Time 

/Periodicity 

Foster partnerships between parents, Home Visiting Consortium Quarterly 

stakeholders, & service providers to Local Advisory Council reports 

enhance the effectiveness and impact of Local Coordinator 

programs. 

Home Visitors 

Assist in the development of a mechanism 

for screening, coordination, referrals, & 

service integration among programs 

including early intervention & special 

education, social services, & family 

support services. 

Identify & address barriers to HV 

programs 

Provide technical assistance to develop a 

centralized intake, screening, & referral 

process. 

Project Evaluator 


Local Coordinator 


National Model Developer 


State Project Coordinator 

Local Advisory Group 


Home visitors 

Project Manger 



Quarterly 

reports 

Quarterly 

reports 

Site contract 

211 contract 

Quarterly 

114 of 147

Goal 3: Increase the quality, availability, and effectiveness of early childhood home visiting programs 

designed to strengthen families in Virginia. 

Objective 1: Increase quality of home 

visiting programs 

Objective 2: Improve access to the 

early childhood continuum of services 

ensuring appropriate and timely 

referrals and reduction/elimination of 

duplication across home visiting 

programs. 


1 XO2MC19411 

Activities Lead Time/ 

Periodicity 

Ensure accountability with model program Project Manager 

Startup 

standards & measurement mechanisms to Home Visiting Consortium Planning 

track identified benchmarks. 

National Model Developers 


Ongoing 


Epidemiologist 

monitoring 

Maintain and enhance professional Project Manager 

Startup 

development model for home visitors. National Model Developers 


Planning 

James Madison University Ongoing 

Identify ways to promote input from 

families to identify needs & impact of 

successful programs. 

Establish policies & standards based on 

home visiting models 

Increase data system linkages & 

information sharing among partners and 

agencies 


Local Coordinators 


Local Advisory Council 




Local Coordinators 


Project Epidemiologist 



Startup 

Planning 

Quarterly 

First 90- 

days Plan 

On going 

115 of 147

Objective 3: Increase effectiveness of 

home visiting programs to improve 

maternal and child health, improve 

parenting behaviors and the parentchild 

relationship, and support 

children’s learning and development 


1 XO2MC19411 

CQI teams work together to inform state & 

local quality improvement efforts. 

Ensure that policies, procedures, & 

practices reflect cultural competence. 




Local advisory group 




Local Advisory Group 

James Madison University 


Initial 90 

days 

Quarterly 

Start up 

Ongoing 

116 of 147

Virginia Home Visiting Program Manager (Virginia MIECHV Project Manager) 

Duties: Leads Virginia’s home visiting initiative and VDH’s Home Visiting Program in the 

Office of Family Health Services. Staffs and coordinates the activities of Virginia’s Home 

Visiting Consortium. Manages VDH home visiting grant. Supports the delivery of program 

services agency wide by formal supervision of project and other home visiting program staffs. 

Characteristic duties: setting priorities and performance standards for staff, training 

subordinates, monitoring overall program performance for quality based on goals and objectives, 

managing grants, and analyzing legislative or other regulatory impact on service delivery. May 

serve as liaison for the program to outside interests and may perform some direct technical 

service functions as necessary to meet customer demand. A comprehensive knowledge of the 

program, considerable understanding of supervisory principles and project management, and 

clear communication skills are necessary. Qualifications: Masters Degree in Public Health, 

Social Work, or Nursing preferred. Knowledge, Skills, and Abilities: Knowledge of early 

childhood home visiting, program assessment, public health, community development, and early 

childhood family dynamics. Skilled in oral and written communication and use of information 

technology including basic data skills. Able to effectively lead groups to achieve goals. Able to 

work effectively with diverse populations. Excellent leadership skills. Able to effectively 

manage grants to achieve positive outcomes. Prior Experience: Experience in public health and 

early childhood program delivery. Experience in strategic planning. Supervisor: Women’s and 

Infants’ Health Program Manager. Hours per Week: 32 (0.8 FTE). 

Virginia Home Visiting Program Coordinator (Virginia MIECHV Project Coordinator) 

Duties: Performs day-to-day program oversight in a district or as part of a statewide program. 

Characteristic duties include: conducting studies and research, technical training and 

programmatic assistance, program evaluation, policy development and analysis, and coordination 

of resources. Monitors grant applications and disbursements to assure sufficient funds are 

available to support program commitments. Responsibilities are carried out independently based 

on an outline or work plan developed by or approved by the supervisor. Thorough knowledge of 

program policies, procedures, service delivery methods and clear communication skills are 

necessary. Qualifications: Bachelors Degree in Public Health, Social Work, or Nursing 

preferred. Knowledge, Skills, and Abilities: Knowledge of early childhood development, 

multicultural issues, family dynamics, public health, and case management. Skilled in oral and 

written communication, up-to-date presentation skills, and use of information technology 

including basic data skills. Able to work effectively with diverse populations. Prior 

Experience: Experience in public health and early childhood program delivery. Experience in 

computer applications such as word processing and spreadsheets. Supervisor: Virginia Home 

Visiting Program Manager. Hours per Week: 20 (0.5 FTE). 

Administrative Assistant 

Duties: Maintains fiscal records, monitoring program inventory, assisting in grant application 

and contract development. Independently performs a variety of secretarial support tasks such as 

typing, filing, reception, scheduling appointments, making reservations, sorting mail, and 

transcribing, in direct support of a manager or higher level administrative, technical or 

professional staff. Work tasks regularly require discretion and interpretation of policies, 

procedures, or processes. May provide guidance to other staff as an information resource. May 

conduct research and assemble information on behalf of another administrative, technical, or 


1 XO2MC19411 

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professional staff member. Qualtifications: Bachelors Degree in Business or Public 

Administration preferred. Skill in effectively communicating with staff and consumers via 

telephone, fax, and electronic mail. Prior Experience: Experience successfully supporting 

program activities is necessary. Supervisor: Virginia Home Visiting Program Manager. Hours 

per Week: 30. 


Duties: Responsible for directly analyzing and leading or supervising others in the analysis of 

data in order to determine what trends exist in terms such as: the cause of death, cause and type 

of injuries, reported outbreaks of communicable and non-communicable diseases, variations in 

treatment administered and resulting outcomes. Utilizes a variety of data sources and statistical 

formulas to identify rates of change, develop reports for general distribution and to satisfy 

funding sources. Plans research and measurement techniques, and identifies the potential impact 

of regulatory or treatment changes on outcomes, service delivery, and resources required. 

Qualifications: Masters Degree in Public Health preferred. Knowledge, Skills, and Abilities: 

Knowledge of and experience in Epidemiology. Skill in data collection, specialized research, 

agency organizational studies, and statistical analyses. Knowledge of research methodology and 

statistical and analytical techniques, theory, and process. Prior Experience: Experience 

successfully conducting large epidemiologic studies. Supervisor: OFHS MCH Epidemiologist. 

Hours per Week: 8 (0.2 FTE) 

Evaluator 

Duties: Collects and analyzes data using a variety of established research methods, procedures, 

statistical formulas and techniques. Verifies data for accuracy, identifies trends, develops 

projections, and prepares reports as directed or follows established procedures. May lead other 

support staff on projects. Analysis is performed to address a limited variety of applications. 

Frequent contact with other staff as well as information sources and end users of data are 

required in order to accurately collect data and to meet user needs. Qualifications: Masters 

Degree in Public Health preferred. Knowledge, Skills, and Abilities: Skill in data collection, 

specialized research, agency organizational studies, and statistical analyses. Knowledge of 

research methodology, statistical and analytical techniques, theory, and process. Prior 

Experience: Experience working in data analysis and conducting program evaluations. 

Supervisor: OFHS MCH Epidemiologist. Hours per Week: 20 (0.5 FTE) 

Fiscal Technician: 

Duties: Performs fiscal, bookkeeping, and accounting-related duties associated with 

maintenance of fiscal information, following established procedures in support of office’s 

administrative operations. Prepares fiscal summaries and reports. Qualifications: Associates or 

Bachelors Degree in Accounting, Business, or Public Administration preferred. Knowledge, 

Skills, and Abilities: Knowledge of Generally Accepted Accounting Principles and federal 

grants management. Excellent organizational and communication skills. Prior Experience: 

Experience working in a governmental accounting office with a heavy focus of federal grants 

management preferred. Supervisor: Office of Family Health Services business manager. 

Hours per Week: 4 (0.1 FTE) 


1 XO2MC19411 

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NAME 

Catherine J. Bodkin, LCSW 

BIOGRAPHICAL SKETCH 

POSITION TITLE 

Project Manager (Acting) 

EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, and include 

postdoctoral training.) 

INSTITUTION AND LOCATION 

Duke University 

Case Western Reserve University 

Virginia Commonwealth University 

DEGREE 

(if applicable) 

BA 

MSSA 

MSHA 

YEAR(s) FIELD OF STUDY 

1964 

1972 

2001 

Psychology 

Social Work 

Health Administration 

Professional Experience: 

State Program Coordinator of Resource Mothers and BabyCare 10/96-present 

Office of Family Health Services 



Executive Director 1/1/93- 8/2/96 

Children, Youth and Family Services, Inc. 

Charlottesville, Virginia 22902 

Executive Director 2/1/79-12/31/92 

Family Service, Inc. 

Charlottesville, Virginia 22902 

Recent Publications: 

“The Virginia Home Visiting Consortium”, Zero To Three, vol. 20, no. 6 (July 2010), pp.28-35. 

“Health Promotion” and “Communication” chapters, Pediatrics in Practice, contributing editor. Springer 

Publications 2009 

Related Professional Presentations 

“Getting from Good to Great in Home Visiting: Systems Coordination,” web seminar sponsored by Pew 

Center for the States, December 1, 2010. 

“Building Successful Early Childhood Home Visitation State Systems,” web seminar sponsored by Zero To 

Three, June 22, 2010. 

“Evidence-Based Systems of Home Visitation: Opportunities for Replication and State Innovation”, web 

seminar sponsored by Chapin Hall, September 29, 2009. 

“Home Visiting in Virginia,” web seminar sponsored by the National Center for Children in 

Poverty/THRIVE, December 2, 2008 

“Pediatrics in Practice: An Innovative Web-Based Learning Program to Advance Competencies for MCH 

Professionals”, trainer, Association of Maternal and Child Health Programs (AMCHP) Meeting, 

Washington, D.C. 2008. 

“Developing Early Childhood Home Visiting Collaboration: the Virginia Approach”, State Early 

Childhood Planning Summit, Albuquerque, New Mexico, 2008. 

“Developing a Home Visiting Consortium,” Greensboro, NC, National Smart Start Conference, 

Greensboro, North Carolina, 2008. 

Grants/Funded Projects/Other Pertinent Activities: 

Member, Research Advisory Panel, Home Visiting Initiative, Pew Center for the States, 2009-present 

Member, National Bright Futures Work Group, 2001 to present 

Member, Advisory Committee, MCH Library, Georgetown University, 2006-present. 

Chair, Grant Review Committee, Virginia Chapter of the March of Dimes, 1998-2009 


1 XO2MC19411 

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William Hazel, MD 

Secretary of Health & Human Resources 

Karen Remley, MD, MBA, FAAP 

State Health Commissioner 

Maureen Dempsey, MD, FAAP 

Deputy Commissioner for 

Public Health Programs 

Diane Helentjaris, M.D, MPH 

Office of Family Health Services Director 

Nancy Ford, RN, MPH 

Division of Child and Family Health 

Division Director 

Home Visiting Program Manager 

(0.80) 


Program 

Coordinator (0.50) 


1 XO2MC19411 

Administrative 

Assistant (0.72) 

Gerard Robinson 

Secretary of Education 

Zelda Boyd 

Office of Early 

Childhood Director 

Early Childhood 

Advisory Council 

MIECHV 


Project Contracts 


James Madison University Contract 

Database Contract 

Fiscal Technician 

(0.10) 

Evaluator 

(0.50) 

Business 

Council 

Scott Hippert 

Virginia Early Childhood 

Foundation 

Smart 

Beginnings 

Local 

Coalitions 


(0.20) 

Goal Group 

Leaders 

120 of 147

Commonwealth of Virginia Memorandum of Concurrence 

The following individuals representing the required state organizations have indicated their approval of the Virginia 

Maternal, Infant and Early Childhood Updated State Home Visiting Plan proposed in this document. As partners in the 

early childhood community system, they agree to work to support the development and enhancement of quality home 

visiting services as one strategy for reaching the community’s vulnerable families. 

Name Position Program 

Gerard Robinson, Secretary of Education, Virginia 

Office of the Governor 

Karen Remley, MD, 

MBA, FAAP 

Commissioner, Virginia 


Martin D. Brown Commissioner, Virginia 

Department of Social Services 

James Stuart Commissioner, Virginia 

Department of Behavioral Health 

and Developmental Disabilities 

Wenda Singer Director, Virginia Head Start 

Collaboration Office 

Gregg A. Pane, MD, Director , Virginia Department of 

MPA, 

Medical Assistance Services 

Patricia L. Wright, 

Lisa Specter- 

Dunaway 

Superintendent, Virginia 

Department of Education 

State Advisory Council on Early Childhood 

Education and Care authorized by 

642B(b)(1)(A)(i) of the Head Start Act 

Title V agency 

Supplemental Nutrition Assistance Program 

agency 

Injury Prevention and Control (Public Health 

Injury Surveillance and Prevention) program 

Title II of the Child Abuse Prevention and 

Treatment Act (CAPTA) 

Child welfare agency (Title IV-E and IV-B) 

Child Care and Development Fund (CCDF) 

Administrator 

State’s Single State Agency for Substance Abuse 

Services 

Individuals with Disabilities Education Act 

(IDEA) Part C 

State’s Head Start State Collaboration Office 

State Medicaid/Children’s Health Insurance 

program (or the person responsible for Medicaid 

Early Periodic Screening, Diagnosis, and 

Treatment (EPSDT Program). 

Part B Section 619 lead agency 

State Elementary and Secondary Education Act 

Title I or State pre-kindergarten program 

CEO, CHIP of Virginia Virginia Coordinator of Parents as Teachers 

Johanna Schuchert Director, Prevent Child Abuse 

Virginia 


1 XO2MC19411 

Virginia Coordinator of Healthy Families 

121 of 147


`;e( retarv _+f Educau+m 

Audrey M . Yowell, PhD, MSSS 

Health Resources and Services Administration 

Maternal and Child Health Bureau 

5600 Fishers Lane 

18A-39 

Rockville MD 20857 

Dear Dr . Yowell : 

GR/lal 

Office o f the Governor 

May 27, 2011 

In my role as Chairperson for the Virginia Early Childhood Advisory Council, I wish to 

express approval of the Virginia Updated State Home Visiting Plan . 

As an active partner in the Virginia comprehensive early childhood system, I will seek to 

support the development and enhancement of quality home visiting services as one strategy for 

reaching the community's vulnerable families . Please contact my office by telephone or email at 

education) @ govemor.virginia.gov if you have any questions or comments . 

Sincerely, 


Prtrri,k )lei}r\ Building " I I11 I :a , r Br, + ;td '-~ " rcct e Richrrr)nl, Virgirnia 23?P 0 (x04) 7SG-I151 " FAX (+ti04) 371-054 " TTY 0 N) j2'? .Fl-_0 


1 XO2MC19411 

122 of 147

Karen Remley, MD, MBA, FAAP 






18A-39 

Rockville, MD 20857 


Comm NWEALTH of VIRGINIA 


P O BOX 2448 TTY 7-1-1 OR 

RICHMOND, VA 23218 1-800-828-1120 

June 8, 2011 

The Virginia Department of Health (VDH) is the state's Title V agency . Under the VDH 

Office of Family Health Services, the agency coordinates the Supplemental Nutrition Assistance 

Program and sponsors the Injury Prevention and Control Program . In my role as State Health 

Commissioner, I am writing to confirm my approval of the Virginia Updated State Home 

Visiting Plan . 



reaching the community's vulnerable families . 


1 XO2MC19411 

Sincerely, 

Karen~Remley, MD; MBA, FAAP 


DH(F HEALT~HNT 

Prweeling You and Your fnvironmtya 

www.vdh .virginia.gov 

123 of 147

Martin D . Brown 

C()MMISSIONFR 


MMONWEALTH o VIRGINIA 

DEPARTMENT OF SOCIAL SERVICES 

office cf the Commissioner 





18A-39 


May 26, 2011 

Governor Bob McDonnell has designated the Virginia Department of Health as the lead 

agency to apply for and administer the Maternal, Infant and Early Childhood Home Visiting 

Grant . The Virginia Department of Social Services (VDSS) is the state agency responsible for 

implementing Child Welfare Services including funding received through Title II of the Child 

Abuse Prevention and Treatment Act (CAPTA) . VDSS also administers the Healthy Families 

home visiting program and is a member of the Virginia Home Visiting Consortium . As 

Commissioner of the Virginia Department of Social Services . I concur with the Virginia Updated 

State Home Visiting Plan . 

The Affordable Care Act (ACA) Maternal, Infant, and Early Childhood Home Visiting 

Program provides an exciting opportunity to advance state and local efforts to improve health, 

social and educational outcomes for vulnerable children by implementing evidence-based home 

visiting programs and researching promising practices . As an active partner in the Virginia 

comprehensive early childhood system . VDSS will seek to support the development and 

enhancement of quality home visiting services as one strategy for reaching and strengthening 

vulnerable families . 

MDB :ac 


1 XO2MC19411 

Martin D . Brown 

51 ;1 I :am %Imn Street " Rwhnu,iui . `. :1'I'I --`901 

Itttp : w~aNsAscNirginia14"\ 

(80t) "_b-7 (III Fan : IF0dt 15 11)1) : 1X11013'8-1P it 

124 of 147

~;(4 

1; /X& It 

JAMCS W. STEWART . III 

COMM13SIONER 


JWSIII/IBS 

COMMONWEALTH of VIRGINIA 

DEPARTMENT OF 

3EHAWORAL REALTHAND DEVELOPMENTAL SERVICES 

Post Office Box 1797 

Richmoncl, Virginia 23218-1797 

May 20, 2011 

Audrey M. Yowell, Ph.D ., MSSS 


Matemal and Child Health Bureau 


Room 18A-39 

Rockville,llD 20857 

In my role as Commissioner of the Virginia Department of Behavioral Health and 

Developmental Services, I wish to express approval of the Virginia Updated State Home 

Visiting Plan . 

As an active partner in the Virginia comprehensive early childhood system, I will 

seek to support the development and enhancement of quality home visiting services as one 

strategy for reaching the community's vulnerable families . 


1 XO2MC19411 

Sincerely, 

James W: Stewazt, III 

Commissioner 

Tclcphonc(804)786-3921 

Fox(8n4)371.6638 

,v .vw.dl;hd+ .virginia .pov 

125 of 147





18A-39 


Dear Dr . Yowell, 

N WEA LTH of VIRGINIA 

Df"PAIZTIVIENT OF SOCIAL SERVICES 

May 19, 2011 

As Director of the Virginia Head Start State Collaboration Office, I concur with the Virginia 

Updated Maternal, Infant, and Early Childhood Home Visiting Home Visiting Plan . 

As a member of the Virginia Early Childhood Advisory Council (State Advisory Council) and 

Virginia Home Visiting Consortium (VHVC), I will support the goals and objectives of' 

Virginia's home visiting plan as an important component of an early childhood system of 

services . 

nda Singer . Director 

Virginia Head Start State Collaboration Office 

Virginia Department of Social Services 

801 East Main Stroet " Richmond, VA 23219-2901 

http ://WWW,dss:y~rgini ._gpv " 804-726-7000 " TDD 800-828-1120 


1 XO2MC19411 

126 of 147

GREGG A . PANE . MD . MPA 

DIRECTOR 





18A-39 


Dear Dr . YoAvell : 

GAP:ahb 

COMMONWEALTH of VIRGINIA 

Department of Medical Assistance Services 

May, 20 . 2011 

In my role as Director for the Virginia Department of Medical Assistance Services, the 

agency who administers the Medicaid and Children's Health Insurance Programs, I wish to 

express approval of the Virginia Updated State Home Visiting Plait . 

As an active partner in the Virginia comprehensive early childhood system, my agency 

will seek to support the development and enhancement of quality home visiting services as one 



1 XO2MC19411 

Sincerely . 

Pane . MD, MPA 

irector, Virginia Department of Medical 

Assistance Services 

SUITE 1300 

600 EAST BROAD STREET 

RICHMOND, VA 23219 

8041786-7933 

8001343-0634 (TDD) 

www, dmas .virgir)ia . gov 

127 of 147

Patricia I . Wright, Ed.D . DEPARTMENT OF EDUCATION Office : (804) 225-2023 

Superintendent of Puhlic Instruction P.O . BOX 2121) Fax : (804) 371-2099 

Richmond . Virginia 23218-2120 

Audrey M . Yowell, Ph.D ., MSSS 


Matemal and Child Health Bureau 


18A-39 

Rockville, Maryland 20857 


PIW/pm 

Comm NWEAL 

Sincerely, 

May 25, 2011 

In my role as Superintendent of Public Instruction, I wish to express approval of the 

Virginia Updated State Home Visiting Plan . 





1 XO2MC19411 

Patricia 1 . Wright 

® VIRGINIA 

128 of 147

May 20, 2011 





18A-39 




701 East Franklin Street Suite SC2 " Richmond, VA 23219 " Phone 804-783-2667 " Fcx 804-783-2723 

In my role as CEO of CHIP of Virginia, I wish to express approval of the Virginia Updated State 

Home Visiting Plan . 

Currently, local CHIP (Comprehensive Health Investment Project) programs are implementing 

the Parents as Teachers curriculum through our Virginia based model of maternal, infant and 

early childhood home visiting . One of our sites has been selected for expansion through the 

MIECHV grant . In addition, CHIP of Virginia is currently the lead agency in Virginia for 

Parents as Teachers, working in partnership with the PAT National Center . 




Sincerely, 

Lisa Specter-Dunaway 

CEO 


1 XO2MC19411 

129 of 147


May 20, 2011 





18A-39 



4901 Fitzhugh Avenue Suite 200 

Richmond . Virginia 23230 

804 " 359 " 6166tcl 

804 " 359 " 5065 fax 

1 " h(H) " CHILDREN 

mail(alpcav .org 

www. preventchildahuseva .org 

In my role as Executive Director of Prevent Child Abuse Virginia, which coordinates the 

Healthy Families Virginia state network, I wish to express approval of the Virginia 

Updated State Home Visiting Plan . 


support the development and enhancement of quality home visiting services as one 


Sincerely, 

Johanna Schuchert 

Executive Director 


17rs;inia Chapter, 

Prevent Child Abuse America 


Healthy Farnilicv Virginia 

1 XO2MC19411 

Hug. and Kisses Prevention Hav 

130 of 147 

Nurturing Programs for F'areyus and Children "

Attachment H. Letters of Approval From National Model Developer Partners 

1. Healthy Families America 

2. Nurse-Family Partnership 

3. Parents as Teachers 


1 XO2MC19411 

131 of 147

healthy 

families 

america,~, 

a program of Prevent Child Abuse America 

May 25, 2011 

Ms. Catherine Bodkin 


PO Box 2448 

Richmond, VA 23218 

Re : Documentation of Approval to Utilize the HFA Model 


228 S . Wabash, 10~' Floor 

Chicago, IL 60604 

312 .663.3520 

healthvfamiliesamerica .org 

This letter is in response to the Supplemental Information Request (SIR) from the Affordable Care Act Matemal, 

Infant and Early Childhood Home Visiting Program (MIECHV Program) requirement to receive documentation of 

approval by the model developer to implement the model as proposed . We have had an opportunity to review 

the information provided regarding implementation of HFA in Virginia . This letter outlines the approval of use of 

the HFA model (no adaptations were requested or approved) . 

Currently, HFA is present in 35 states and DC . Healthy Families Virginia is unique in our network . It is one of 

largest and most experienced multi-site accredited systems in our network which currently operates 35 

accredited HFA programs through the oversight and support of an accredited Central Administration at Prevent 

Child Abuse Virginia (PCAV). 

When a state system of sites is accredited through our multi-site process it means there is a Central 

Administration providing critical functions such as training, quality assurance, technical assistance and ongoing 

evaluation and quality improvement to ensure model fidelity and quality . The Central Administration in Virginia 

provides an infrastructure that allows the HFA National Office to grant certain privileges . These privileges 

include the following : 

1 . Any sites currently existing in this multi-site infrastructure are automatically approved from the HFA 

National Office to receive any funding that would be allocated from the MIEC Home Visiting Program . 

This includes both the Fredericksburg and Danville programs . 

2 . Healthy Families Virginia's Central Administration can affiliate and disaffiliate sites within its state 

network . Any new Healthy Families lead entities interested in implementing the Healthy Families model 

in counties that were eliminated this year due to budget cuts, would have to be approved by the Healthy 

Families Virginia Central Administration . These new lead agencies would become a part of the current 

statewide system and be accountable to the Healthy Families Virginia Central Administration . The 

Central Administration will work with the HFA national office to get final approval of any proposed new 

lead agencies that were not in existence prior to the budget cut made this year . 

3 . Because Healthy Families Virginia is an accredited multi-site system, the annual affiliation fee for each 

project is $1150 versus $1350 . 

4 . Healthy Families Virginia Central Administration has its own certified trainers allowing for a cost effective 

process in training new hires and providing the in-service and ongoing wraparound training required by 


1 XO2MC19411 


132 of 147

the HFA national standards . In the event that these trainers are not available, Healthy Families Virginia 

can contract with Healthy Families America to provide in-state training . 

To maintain the fidelity of the model which is required by the federal legislation, it is critical that any new sites in 

Virginia be a part of the current multi-state system administered by the Central Administration which would 

collaborate with the HFA national office and the Home Visiting Consortium in the planning, development, 

approval and implementation of any HFA program in the state From our perspective the multi-site infrastructure 

creates the highest level of model fidelity and greater outcomes in the most cost effective manner. 

If you would like to discuss this further, I can be reached at Kosanovich(a)preventchildabuse .org or at 703-888- 

3135 . I appreciate your commitment to Virginia's children and families and look forward to our continued work 

together. 

Sincerely, 

Lynn H . Kosanovich 

Northeast Regional Director 

Healthy Families America 

Cc : Johanna Schuchert 

Healthy Families Virginia 

Cydney M . Wessel, MSW 

National Director of HFA 



1 XO2MC19411 

o2w 0 


2 

133 of 147

N~Uu-:se-F 

~ership 

H41rtc Fins-1 imr p awful 5aawd 

May 25, 2011 

Ms . Catherine J . Bodkin, LCS\X', MSHA 

Project Director 


Room 8250 

109 Governor Street 

Richmond, VA 23219 


Based on the information provided in your state plan, I am pleased to grant approval from the 

Nurse-Family Partnership National Service Office (NIP NSO), so you may include the 

Nurse-Family Partnership® Program (NIT) in your revised state plan submission to the 

Health Resources and Services Administration as part of the Affordable Care Act-Maternal, 

Infant, and Early Childhood Home Visiting Program (X-11ECHVP) . Specifically : 

" NFP NSO verifies that we have reviewed Virginia's plan as submitted and that it 

includes the specific elements required in the SIR; and 

" NIT NSO is supportive of Virginia's participation in the national evaluation and any 

other related HI-IS effort to coordinate evaluation and programmatic technical 

assistance . 

Because the Updated State Plan, as required by the SIR, must include additional information 

on how you will implement the model(s) chosen, it will be important to provide a copy of this 

to the NFP NSO . We would like to review the following additional details in order to better 

support the implementation of NIT in your state : 

" Identification of the evidence-based home visiting model(s) to be implemented in the 

State and describe how each model meets the needs of the community(ies) proposed; 

" A description of the State's current and prior experience with implementing the 

models) selected, if any, as well as their current capacity to support the model; 

" A plan for ensuring implementation, with fidelity to the model, and include a 

description of the following: the State's overall approach to home visiting quality 

assurance ; the State's approach to program assessment and support of model fidelity; 

anticipated challenges and risks to maintaining quality and fidelity, and the proposed 

response to the issues identified ; 

" zkny anticipated challenges and risks of selected program model(s), and the proposed 

response to the issues identified, and any anticipated technical assistance needs . 

As part of our ongoing partnership to support implementation with fidelity to the model, and 

as part of our required processes, as referenced in the SIR, NIT NSO expects that Virginia 

will enter into a service agreement with NFP NSO and implement NIT in accordance with 

that agreement . This agreement will outline expectations for the State as well as what supports 

will be provided by the NFP NSO to include : 

" Working directly with the NFP NSO and designated program development staff to 

implement NIT as designed, including : 


1 XO2MC19411 

1900 Grant Street, Suite 400 1 Denver, (:() 811203-4304 

303.3274240 Fax 303.32' .4260 Toll Free 866.864 .5226 

www.nursefamily-1)artnership .org 

134 of 147

o Understanding the 18 requited model elements ; 

o Using NFP-specific implementation planning tools ; 

o Accessing NFP support as appropriate with RFP processes and a list of program 

requirements for inclusion in such processes ; and 

o Adhering to NFP agency selection requirements contained in the 

Implementation Plan and Guidance documents . 

" Ensure that every team of nurses employed to deliver NFP will : 

o Receive NFP-specific education as well as expert NFP nursing practice 

consultation to develop basic competencies in delivering the program model 

successfully; 

o Receive adequate support and reflective supervision within their agencies; 

o Receive ongoing professional development on topics determined by nursing 

supervisors to be critical for continued growth . Professional development may 

be offered within a host agency or through more centralized or shared venues ; 

o Engage in individual and collective activities designed to reflect on the team's 

own practice, review program performance data, and enhance the program's 

quality and outcomes over time ; and 

o Utilize ongoing nurse consultation for ongoing implementation success . 

" Participate in all NFP quality initiatives including, but not limited to, research, 

evaluation, and continuous quality improvement; 

" Assure that all organizations implementing NFP use data and reports from our webbased 

Efforts to Outcomes TM data system to foster adherence to the model elements 

in order to achieve outcomes comparable to those achieved in the randomized, 

controlled trials . This may include creating necessary interfaces between local or statebased 

data and information systems with our national web-based data system . 

This letter also affirms our commitment to work with you as your state implements NFP 

using designated funds from the MIECI-IVP . In order to further assist you, we have a set of 

online resources that can serve as your guide for our continued work together. We are 

particularly eager to partner with you to consider the kind of support that would enable you to 

successfully establish NFP in the communities identified in the statewide needs assessment. 

Successful replication of Nurse-Family Partnership as an evidence-based home visitation 

program is dependent on both unwavering commitment to program quality as well as creative 

and sensitive adaptability to local and state contexts and available resources . We are excited to 

partner with you to plan how best to support the successful development of Nurse-Family 

Partnership . 

Sincerely, 

Kammie Monarch . 

Chief Operating Officer 

Nurse-Family Partnership National Service Office 


1 XO2MC19411 

1900 Grant Street, Suite 400 f Denver, CO 80203-4304 

303.327 .4240 Fax 303.327 .4260 Toll Free 866.864.5226 

www.nursefamilypaanership .org 

135 of 147


May 31, 2011 

Catherine J . Bodkin, LCSW, MSHA, 

Program Coordinator 


109 Governor Street, 81h floor 



Thank you for submitting your State's updated plan for implementation of the Parents as 

Teachers model under the Maternal, Infant, and Early Childhood Home Visiting Program . 

We are pleased to know that Parents as Teachers will be implemented in two of the five sites 

selected : Montgomery-Radford and Norfolk . We also appreciate receiving budgetary 

information and the attention to technical assistance . This federal project is dependent upon 

good, quality technical assistance between the national office and the state offices as well as 

between the state office and the local sites . Your open invitation to become involved in the 

Home Visiting project in the coming year is encouraging to us and we look forward to this 

opportunity and will be back in touch to discuss further . 

Again, thank you . As mentioned in our earlier letter, we look forward to a long relationship 

with Virginia as we work together to improve the maternal, infant and early childhood 

outcomes in your state . 

Sincerely, 

Susan Stepleton, Ph .D . Cheryle Dyle-Palmer, M.A . 

President/CEO Chief Operating Officer 

2228 Bah : Dnvc St l ..oois VO c,3146 p 314.432 .4330 1'3 i4 .432 .R903 v ww P:vcntsAs IIeachcrs.oig 


1 XO2MC19411 

Board of Directors 

20M-2011 

Officers 

Kaiabelle Pilzipti . Pit D. 

(Chair), MI) 

Jane Nel$on.J .D . 

( Vice (.hair) . N10 

fhornas C Ntelzar 

(Seciet:oy), M0 

Dotiald D . Robeits 

(Treasurer), N10 

Members 

Sirn)rl Blackhurt . Pit D. 

Australia 

T Bciry faze;ron . M D. 

(Lili Memtwr). NIA 

Slic :!a ( . a3ey . D(: 

( K, (Chip) C asteel . J .D , %10 

Robert 13. (Brid) Cowan. NI0 

C aro ;yn ('0111({ . R I 

( .dare f1dredge . 11_ 

LuisA Femaiuirz .l-1_ 

Sleplonre NI . Jones. Ph .D . VI A 

N(elisso L Kefey. ('0 

Patricia Kempr:iornc, ID 

i ise Klein . PhD . KS 

Canilyn w [ODDS 

it . .iie Nlentiter) . N10 

Ardrut I . Mallow . Ed D 

(Life Mcmtet) . N"10 

David I Motley . M0 

('lvir!ca B. MAIms. NI .D . f:X 

Jz:iu K ?a!nc 

(Liic Memhei) . M0 

(i lulu Palrner Blackwcrl!, 

f At) . 11 . 

lick Iuredie .PIt1) 1D,(( ) 

i :dward I Iiy; ;e" . 

fh D I l ill: LleutberJ . ( I - 

President & CEO 

S ;isarl S SIVpicton . I'll 1), N10 

LX-officio Members 

Cio,criu,r 1ac Niron . N10 

(2» non ;-)[W1 14 I- (trrcat1un_ 

C In is L Nicastio, Ph D . N10 

Founding Director 

Mildred M . W:nter_ NICJ 

136 of 147

1. 

2. 

3. 

4. 

Grant Program 

Function 

or Activity 

(a) 

5. Totals 

6. Object Class Categories 

a. Personnel 

b. Fringe Benefits 

c. Travel 

d. Equipment 

e. Supplies 

f. Contractual 

g. Construction 

h. Other 

BUDGET INFORMATION - Non-Construction Programs 

SECTION A - BUDGET SUMMARY 

Catalog of Federal 

Domestic Assistance 

Estimated Unobligated Funds New or Revised Budget 

Number 

Federal 

Non-Federal 

Federal 

Non-Federal 

(b) 

(c) 

(d) 

(e) 

(f) 

$ $ $ $ $ 

i. Total Direct Charges (sum of 6a-6h) 

j. Indirect Charges 

k. TOTALS (sum of 6i and 6j) 

$ $ $ $ $ 

SECTION B - BUDGET CATEGORIES 

OMB Approval No. 0348-0044 

GRANT PROGRAM, FUNCTION OR ACTIVITY Total 

(1) (2) (3) 

(5) 

$ $ $ $ $ 

$ $ $ $ $ 

7. Program Income $ $ $ $ $ 

Authorized for Local Reproduction Standard Form 424A (Rev. 7-97) 

Previous Edition Usable Prescribed by OMB Circular A-102 


1 XO2MC19411 

Total 

(g) 

137 of 147

SECTION C - NON-FEDERAL RESOURCES 

(a) Grant Program (b) Applicant (c) State (d) Other Sources (e) TOTALS 

8. $ $ $ $ 

9. 

10. 

11. 

12. TOTAL (sum of lines 8-11) $ $ $ $ 

13. Federal 

14. Non-Federal 

SECTION D - FORECASTED CASH NEEDS 

Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter 

$ $ $ $ $ 

15. TOTAL (sum of lines 13 and 14) $ $ $ $ $ 

SECTION E - BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT 

(a) Grant Program FUTURE FUNDING PERIODS (Years) 

(b) First (c) Second (d) Third (e) Fourth 

16. $ $ $ $ 

17. 

18. 

19. 

20. TOTAL (sum of lines 16-19) $ $ $ $ 

SECTION F - OTHER BUDGET INFORMATION 

21. Direct Charges: 22. Indirect Charges: 

23. Remarks: 


1 XO2MC19411 

Authorized for Local Reproduction Standard Form 424A 138 (Rev. of 147 

7-97) Page 2

Virginia Maternal, Infant and Early Childhood Home Visiting Grant 

Budget Narrative 

Year 1: Project Period, July 15, 2010 – September 30, 2012 

1. Personnel Costs and Fringe Benefits: $235,617 

Based on a 15-month grant period (July 1, 2011 through September 30, 2012), Year-1 

funding requested for all personnel costs ($180,228) and all fringe benefit costs ($55,389) is 

$235,617. The breakdown for personnel and fringe benefits costs is presented below. 

Personnel ($180,228) 

Project Manager ($76,005): The to-be-hired Project Manager for this project will 

coordinate the Virginia Department of Health (VDH) home visiting grant, staff the activities of 

Virginia’s Home Visiting Consortium, support the delivery of program services agency wide, 

and provide formal supervision of the Project Coordinator and administrative Assistant. In 

addition, the Project Manager will provide supervision to other positions that are not funded by 

this grant, including the Home Visiting Specialist. The Project Manager will set priorities and 

performance standards for staff, train subordinates, and monitor the overall program performance 

for quality based on goals and objectives. The Project Manager will lead the development of the 

long range plan, monitor the local and state Continuous Quality Improvement Plans, 

communicate with partners in the Virginia Plan for Smart Beginnings, and provide training on 

the federal program or arrange for technical assistance and in-services necessary to ensure all 

stakeholders are knowledgeable about the project. The Project Manager will assure all elements 

of the grant are implemented and reports completed and will initiate any and all contracts. Year-1 

funding requested for 80 percent of this full-time position for the 15-month project funding 

request is for $76,005. Calculation: 80/100 x $76,005/year = $60,804/12 months = $5,067 

month x 15 months = $76,005. 

Project Coordinator ($31,874): The to-be-hired Project Coordinator for this project will 

manage the local site contracts of the grant project, oversee the Request for Proposals process, 

and collaborate with the VDH procurement office to award contracts. In addition, the Project 

Coordinator will monitor the ongoing activities of each site to assure appropriate and efficient 

use of grant funds, conduct site visits, convene contractors meetings, and communicate 

frequently to provide consultation and technical assistance to assure all project goals and 

objectives are accomplished. The Project Coordinator will be responsible for all project reporting 

requirements working closely with the Evaluator. Expected hire date is no later than July 1, 

2011. Year-1 funding requested for 50 percent of this full-time position is $31,874. Calculation: 

50% x $50,998/year = $25,499/12 months = $2,124/month x 15 months = $31,874. 

Administrative Assistant ($28,125): The to-be-hired Administrative Assistant for this 

project will maintain site reports and other grant records, provide office support to all grant team 

members, facilitate communication between project and sites and other partners, and make travel 


1 XO2MC19411 

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and meeting arrangements. Year-1 funding requested for 100 percent of this 1500-hours-per-year 

wage position is $28,125. Calculation: $15/hour x 1500 hours/year= $22,500/12= $1,875/month 

x 15 months = $28,125. 

Fiscal Technician ($3,900): The Fiscal Technician to be assigned to this project will be 

responsible for the accounting, fiscal record keeping, procurement, and contract management 

aspects of the grant. The Fiscal Technician will review requisitions and specifications to 

determine the appropriate method of procurement and assure that grant funds are used 

appropriately under state guidelines. Year-1 funding requested for 10 percent of this full-time 

position is $3,900. Calculation: 10% x $31,198/year = $3,120/12 months = $260/ month x 15 

months = $3,900. 

Epidemiologist ($14,850): The Epidemiologist to be assigned to this project will be 

responsible for working with the Evaluator on the Benchmark definitions and data collection 

processes to maintain the quality and accuracy of the data. The Epidemiologist will analyze the 

site-specific data and the state data for reports on Virginia’s progress in achieving the standards 

set in 4 out of the 6 Benchmark Areas. The Evaluator and Epidemiologist will review interim 

data for annual opportunities for quality improvements. Year-1 funding requested for 20 percent 

of this full-time position is $14,850. Calculation: 20% x $59,400/year = $11,880/12 months = 

$990 month x 15 months =$14,850. 

Evaluator ($25,474): The to-be-hired Evaluator assigned to this project will work 

closely with the Project Manager and the local contractors to develop a data collection system to 

collect and analyze the specific performance criteria as identified in the Evaluation Plan. The 

Evaluator will work with the Project Coordinator to monitor the local site performance on data 

collection and quality improvement actions. The Evaluator will develop the data reporting forms 

and orient the staff in the contracted schools on data reporting requirements. The Evaluator will 

review the participating quarterly reports for completeness and accuracy. The Evaluator will 

collaborate with the Project Coordinator in preparing all reports as required. Year-1 funding 

requested for 50 percent of this full-time position is $25,474/grant period. Calculation: 50% x 

$40,758/year = $20,379/12 months = $1,698 month x 15 months = $25,474. 

Fringe Benefits ($55,389) 

Year-1 funding requested for all fringe benefits costs is $55,389. The breakdown is 

presented below. 

Administrative Assistant ($2,152): The fringe benefits applicable to direct wages are 

treated as direct costs. The fringe benefit rate for this wage position is 0.0765 percent of salary. 

Year-1 for the 15-month project period, funding is requested for fringe benefits (FICA) for the 

Project Manager is $2,152. Calculation: 7.65% x $28,125 = $2,152. 


1 XO2MC19411 

140 of 147

Project Manager, Business Manager, and Evaluator ($53,237): The fringe benefit rate 

for a full-time position is 35 percent of salary. Year-1 funding requested for fringe benefits for 

the Project Manager, Project Coordinator, Epidemiologist, Fiscal Technician, and Evaluator is 

$53,237. Calculation: (35% x $76,005= $26,602) for Project Manager + (35% x 

$31,874=$11,156) for Project Coordinator + (35% x $3,900= $1,365) for Fiscal Technician + 

(35% x $14,850=$5,198) for Epidemiologist + (35% x $25,474=$8,916 for Evaluator = $53,237. 

2. Travel: $4,427 

Year-1 funding requested for all travel costs is $4,427. The breakdown for site visits and 

annual conference and regional training costs is presented below. 

Site Visits ($2,102): All travel estimates are based on the VDH, Office of Financial 

Management, and Cost-Benefit Analysis calculator. This calculator is used by VDH to estimate 

all travel within the agency. Year-1 travel costs for each site visit is $70.05 per day. This 

estimate is based on the following travel costs per day: rental car rate of $32.56, car insurance 

rate of $6.00, one hour of salary costs, and travel reimbursement to pick up and return rental car. 

Calculation: ($32.65/day for state car rental) + ($6.00/day for car insurance) + ($23.75/day for 1hour 

salary) + ($0.51/mile x 15 miles/day) = $70.05/day for state car rental, car insurance1-hour 

salary, and mileage. Year-1 funding requested for travel costs to conduct 30 site visits (6 visits 

for each of 5 contractors) is $2,102. Calculation: 30 site visits/year x $70.05/day = $2,102. Site 

visits to meet with coalitions and for longer planning and skill training sessions will occur more 

during the first 180 days of start-up than later in the project. Staff will travel together as possible 

Annual Conference and Regional Trainings ($2,325): Funding for travel is requested 

for the Project Manager, Project Coordinator, Epidemiologist and Evaluator to attend the grantee 

annual conference. The year-1 cost estimate for travel to an annual conference in Washington, 

D.C. is $774.25 per meeting (hotel + per diem + travel). Year-1 travel funding requested for 

conference travel is estimated at $2,325. Calculation: $775 /meeting x one annual meeting/year 

x 3 staff = $2,325/year. 

3. Equipment: $0.00 

There are no anticipated equipment needs. 

4. Supplies: $4,286 

Year-1 funding requested for supplies for 2.85 full-time equivalent positions is $3,206. 

Calculation: ($75/month x 15 months) x 2.85 FTEs = $3,206 for 15-month budget year year. 


1 XO2MC19411 

141 of 147

Printing: $1,080 

Year-1 funding requested for printing of annual report, materials for site planning 

meetings, and materials for presentations to communities and to other early childhood system 

partners, and materials for reports to the Early Childhood Advisory Council (ECAC) is $1,080. 

5. Contractual Services: $1,202,343 

Year-1 funding requested for all contractual services is $1,202,343. The breakdown for 

contractual services costs is presented below. 

Community Grant for Expansion with Evidence Based Program Models 

($1,112,493): VDH through a competitive application process is recommending 5 awards out of 

the 16 received applications representing 22 of the 39 communities. The funding requests were 

based on the formula costs and practice standards set by each of the national models and the 

number of families and children who will be served. Total Year-1 15-month budget period 

funding requested is $1,112,493. Each award is for 15 months, July 1, 2011, through September 

30, 2012. Calculation: $194,115 (Danville-Healthy Families) + $308,256 (Fredericksburg- 

Healthy Families) + $279,073 (Montgomery-Radford-Parents As Teachers) + $137,730 

(Norfolk-Parents As Teachers) + $193,319 (Suffolk-Southampton-Nurse Family Partnership) = 

$1,112,493. 

James Madison University ($31,350): VDH has contracted with James Madison 

University to develop a web-based module on the importance of the father in young children’s 

lives and how home visitors can encourage positive father involvement ($5,000), to develop a 

module for supervisors on applications of reflective supervision with home visitors ($5,000), and 

for technical assistance on quality improvement and for “at risk” communities on selection of 

evidence-based models and improvement of local home visiting system coordination ($21,350). 

Total Year-1 funding requested for the JMU contract is $31,350. Calculation: $5,000 

(fatherhood module) + $5,000 (advanced reflective supervision module) + $21,350 (technical 

assistance) = $31,350 

Screening Tools Training ($8,500): Training will be provided through contracts with 

trainers identified by the Home Visiting Consortium or the national model developers. The 

Benchmark data collection requires the home visitors use certain screening tools and techniques 

to improve the quality of the services. All home visiting programs in the 5 communities will be 

eligible to participate in training on use of these screening tools: the Ages and Stages 

Questionnaire (2 hours per session), the Ages and Stages Questionnaire-Social Emotional (3 

hours per session), High Risk Behavior Screen (2 hours per session), and the Life Skills 

Progression Assessment (4 hours per session) trainings. In addition, an introductory training on 

Motivational Interviewing (6 hours per session) will be provided in each of the 5 communities as 

this has been shown to increase retention of families and to enhance outcomes. Calculation: 5 

sites x 17 hours of sessions for all 5 trainings= 85 hours x $100/ hour = $8,500 


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Data Development ($50,000): Contract for 6 months with early childhood data systems 

expert to develop baseline data for all 5 sites prior to home visiting expansion, work with sites 

and national models to identify procedures for data reports to meet Benchmark data 

requirements, train staff on data collection with appropriate definitions for Benchmark measures, 

develop necessary agreements about data sharing, identify inconsistencies in data definitions, 

make recommendations for system improvements, and provide report to Project Manager. 

Calculation: 500 hours x $100 = $50,000 

7. Other: $19,528 

Year-1 funding requested for all other costs is $19,596. The breakdown for other costs is 

presented below. 

Virginia Information Technologies Agency ($6,345): VITA provides information 

technology and management services for all Commonwealth of Virginia agencies; these VITA 

support services include ongoing computer, Intranet, and servers support. VITA services for the 

project are charged at the rate of $150 per month per FTE or $1,800 per year per FTE or $2,250 

per 15-month budget period per FTE. Year-1 funding requested for VITA support services is 

$6,345, which includes $1,800 for the Project Manager (0.8 FTE x $2,250 per 15-month budget 

period= $1,800), $1,125 for the Project Coordinator (0.50 FTE x $2,250 for the 15-month budget 

period = $1,125), $1,620 for the Administrative Assistant (0.72 FTE x $2,250 for the 15-month 

budget period =$1,620), $225 for the Fiscal Technician (0.10 FTE x $2,250 for the 15-month 

budget period = $225), $450 for the Epidemiologist (0.2 FTE x $2,250 for the 15-month budget 

period = $450), and $1,125 for the Evaluator (0.5 FTE x $2,250 for the 15-month budget period 

= $1,125). 

Telecom Costs ($2,138): Telecom services for the project are charged by the agency at a 

rate of $50 per month per FTE or $600 per year per FTE. Year-1 for the 15-month budget period 

the rate would be $750 per FTE. Funding requested for telecom services is $2,138, which 

includes $600 for the Project Manager (0.80 FTE x $750= $600 for the 15-month budget 

period), $375 for the Project Coordinator (0.50 FTE x $750= $375 for the 15-month budget 

period), $563 for the Administrative Assistant (0.75 FTE x $750 = $563 for the 15-month budget 

period), $75 for the Fiscal Technician (0.10 FTE x $750 = $ 75 for the 15-month budget period), 

$150 for the Epidemiologist (0.2 FTE x $750 = $150 for the 15-month budget period) and $375 

for the Evaluator (0.5 FTE x $750 = $375 for the 15-month budget period). 

Rent ($11,045): Rent for the project is charged by the agency at a rate of $3,100 per year 

per FTE. For this grant the fee would be $3,875 for the 15-month budget period per FTE. Year-1 

funding requested for rent is $11,045, which includes $3,100 for the Project Manager (0.8 FTE x 

$3,875 = $3,100 for 15-month budget period), $1,938 for the Project Coordinator (0.50 FTE x 

$3,875 = $1,938 for 15-month budget period), $2,906 for Administrative Assistant (0.75 x 

$3,875 = $2,906 for 15-month budget period), $388 for the Fiscal Technician (0.10 FTE x 

$3,875 = $388 for 15-month budget period), $775 for the Epidemiologist (0.2 x $3,875= $775 

for 15-month budget period ) and $1,938 for the Evaluator (0.5 FTE x $3,875 = $1,938 for 15month 

budget period). 


1 XO2MC19411 

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7. Total Direct Cost: $1,466,201 

8. Indirect Costs: $17,122 

Year-1 funding requested for indirect costs is $17,122, which is 9.5% of personnel cost. 

Calculation: 9.5% x $180, 228 = $17,122. 

Total Requested for Year 1: $1,483,323 

Maintenance of Effort Requirement 

Virginia Department of Health staff had in-depth discussions with the HRSA project officer in 

February and March of 2011, during the General Assembly deliberations on the budget. The 

conclusion of the data review is that Virginia meets the requirements for Maintenance of Effort 

for the MIECHV funding. In fact, the General Funds total dedicated to home visiting programs 

increased from 3/23/2010. 


1 XO2MC19411 

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PO Rox 2448 June 29, 2007 

J.\r+~' LtGVi Ls 23216- 

pILINrl REV . " Tl7te p-e^eda,nG 

Yt &,"'r ." CLC~.4. ~ .t~:C1 

The rates approved in this agreement are for use on grants, contracts and other 

agreements with the Federal Coverrment, subject to the conditiOn$ in sectiaa Ill . 

SECTION I : INDIRECT COST RI4TES* 

RATE TYPES : FIXED FINAL PROV .(PROVISIONAL) PRED .(PREBETERMINED) 

EFFECTM PERIOD 

TYPE FROM To 

FRED . 07/01/09 06/30/11 

PRED_ 07/01/09 06/30/11 

FRED . 07/03./09 06/30/13 . 

PRED . 07/01/09 06/30/11 

PRED . 07/01/09 06/30/1 . 

PRED . 07/01/09 06/30/11 

PRED . 07/01/09 06/30/1 . 

PFm . 07/01/09 06/30/11 

PRED . 07/01/09 06/30/11 

PRc3V . 0,'7/01/11 uNTiL AMMmED 


1 XO2MC19411 

t'k ¬ ' Ct'I[E ILL. - 

RATE f LOCATTONS APPLICA13LE TO 

9 .5 All Programs Community alth Svcs . 

9 .5 - All Programs Family Health eves . 

9 .S All Program Communicable Disease 

9 .5 All Programs Emergency Preparedne 

9 .5 All Programs Health Policy 

9 .s All Programs Emrgncy Medical. Svcs 

9 .S All Programs Medical Examiner 

9 .5 AJ1 Programs Envrn=tl Hlth Svcs . 

9 .5 All Programs Drinking Water Imprv 

Use same rates and conditions as those cited 

for fiscal year ending June 30, 2011 . 

'G? 0 2 9 

145 of 147

sp i'VZN-'I:' CY- : 

~r . 

.'a1sCi. t LATE -, I-lay , 2005 

.7RL"'i TOK !I : SP7CZar " R&E 

TREATMENT OF .'~$ RKaEM$ ". 

. hfnsfits 

identified to each eVloyee and are charged individually 

as d-r-Ct Coate . The dir*CtlY Claimed E=ge beaffita are listed below. 

TREATMENT OP PAID ASSWCES 

vacation, holiday, s3CTF Leave pay and other paid absences are included in salaries and 

wages and a-re claimed on gramtm, contracts and other agreements as part of the normal cost 

far salaries and wages . Separate claims are not made for the casts of these paid 

absences . 

Fringe benefits includo : FICA, `group insurance, retirement, hospitalization/m-dical 

insurance and =employntent compensation . 


1 XO2MC19411 

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A . =91=:'103 , 

rates in this Agreement are cubjeet: to Any otatutory +i :bxf,ertrert>!~ 3.

Virginia Home Visiting Updated State Plan

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