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Agreement A-16-635 with Exceptional Parents Unlimited Inc..pdf
Agreement No. 16-635 1 AGREEMENT 2 3 THIS AGREEMENT is made and entered into this 1st day of November , 2016, by and 4 between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter 5 referred to as "COUNTY", and Exceptional Parents Unlimited, Inc., a California non-profit 6 corporation, whose address is 4440 N. First St., Fresno, CA, 93726, hereinafter referred to as 7 "CONTRACTOR". 8 WITNESSETH: 9 WHEREAS, COUNTY, through its Department of Public Health (DPH), is in need of an 10 independent contractor to continue establishment of the Help Me Grow (HMG) system in Fresno 11 County by enhancing the existing infrastructure to advance developmental surveillance, response 12 and follow up for young children and their families in need of early identification and intervention 13 resources to achieve their full potential; and 14 WHEREAS, COUNTY, through its DPH, participated in a joint Request for Applications with 15 the Children and Families Commission of Fresno (First 5) County to select an appropriate 16 contractor; and 17 WHEREAS, CONTRACTOR, has the facilities, equipment and personnel skilled in the 18 provision of such services; and 19 WHEREAS, CONTRACTOR, is qualified and is willing to provide such services, pursuant 20 to the terms and conditions of this Agreement. 21 NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions 22 herein contained, the parties hereto agree as follows: 23 1. RESPONSIBILITIES OF THE CONTRACTOR 24 A. CONTRACTOR shall implement all four core components of HMG 25 (Healthcare Provider Outreach; Community Outreach; Centralized Telephone Access Point; 26 and Data Collection and Analysis) with fidelity to the HMG model, meet HMG affiliate 27 requirements, and comply with HMG's structural and contractual requirements, as identified in 28 The Help Me Grow Manual, attached hereto and incorporated herein by this reference as -1- 1 Exhibit A. 2 B. CONTRACTOR shall outreach to healthcare providers to support early 3 developmental screening, surveillance and referral of identified children offering the assistance of 4 the Centralized Telephone Access Point (One Call for Kids) with linking children to services and 5 Help Me Grow staff with implementing screening protocols in their practices. 6 C. CONTRACTOR shall outreach to community providers/professionals and 7 families to support the expansion of developmental screening and referral of identified children 8 across the community in a variety of settings and events (health, schools, malls, farmers' markets 9 and neighborhoods) in a variety of rural and urban locations. 10 D. CONTRACTOR outreach shall include hosting networking opportunities, 11 such as Connection Cafes to providers of services to young children in order to promote and 12 support developmental screening and referral of young children across the community. 13 E. CONTRACTOR shall incorporate various outreach methods to include use of 14 social media in order to reach diverse and isolated populations not reached through typical 15 outreach activities. 16 F. CONTACTOR shall employ a diverse staff and provide services that are 17 culturally and linguistically sensitive and meet the needs of each child and family served. 18 G. CONTRACTOR shall provide centralized call center support to parents, 19 professionals, and healthcare providers seeking information, support, referral, and service linkage 20 assistance to parents of young children. 21 H. CONTRACTOR shall develop and maintain a listing of general community 22 and specialized resources for children. 23 I. CONTRACTOR shall make the resource listing as well as links to other 24 developmental websites, materials, and information available to the community on it's website. 25 J. CONTRACTOR shall provide face to face care coordination and service 26 linkage assistance to families who are unable to navigate service systems unassisted. 27 K. CONTRACTOR shall assist with linking and providing services to families of 28 children exhibiting delays who have been unable to access developmental services elsewhere. -2- 1 L. CONTRACTOR shall participate in the Screening, decision Making, 2 Assessment, Referral and Treatment (SMART) Model of Care Partner Oversight Committee 3 (MOCPOC) and other collaboratives focusing on services for young children and families to 4 support HMG's continuous improvement, expansion, and coordination of efforts. 5 M. CONTRACTOR shall use HMG California common indicators to collect and 6 report data on a common set of indicators to monitor progress, improve services and share 7 lessons learned with the MOCPOC leadership team and other communities across California 8 counties and states. 9 N. CONTRACTOR shall survey HMG service recipients (families, professionals 10 and physicians) to obtain information about their HMG experience and use the information 11 obtained to improve services. 12 O. CONTRACTOR shall participate in the statewide and national technical 13 assistance opportunities and learning communities. 14 P. CONTRACTOR shall prepare and provide time studies quarterly to COUNTY 15 in order to receive leveraged federal funds. California Department of Public Health's (CDPH) 16 Maternal, Child and Adolescent Health (MCAH) program requires all personnel that are funded by 17 Federal Title XIX funds to time study at least once per quarter. 18 Q. CONTRACTOR shall be responsible for the overall management and control 19 of the Assessment Center for Children (ACC) at Exceptional Parents Unlimited, ensuring the ACC 20 is staffed according to the Staffing Chart attached hereto and incorporated herein by this reference 21 as Exhibit B. 22 2. RESPONSIBILITIES OF THE COUNTY 23 A. COUNTY, through its DPH, shall provide additional information regarding 24 MCAH time studying to CONTRACTOR as needed. 25 B. COUNTY, through its Department of Behavioral Health (DBH), shall provide 26 compensation for operational costs as defined in Exhibit C, attached hereto and incorporated 27 herein by this reference. 28 C. COUNTY, through its DBH, shall also provide, or arrange for, the placement -3- 1 of a mental health clinician trained in infant and early childhood mental health to provide 2 assessments at CONTRACTOR's site in support of the HMG system in Fresno County. 3 3. TERM 4 The term of this Agreement shall be for a period of three (3) years, commencing on 5 the 1st day of July 2016 through and including the 30th day of June 2019. This Agreement may be 6 extended for two (2) additional consecutive twelve (12) month periods upon written approval of 7 both parties no later than thirty (30) days prior to the first day of the next twelve (12) month 8 extension period. The DPH and/or DBH Director or his or her designee is authorized to execute 9 such written approval on behalf of COUNTY based on CONTRACTOR's satisfactory performance. 10 4. TERMINATION 11 A. Non-Allocation of Funds - The terms of this Agreement, and the services to 12 be provided hereunder, are contingent on the approval of funds by the appropriating government 13 agency. Should sufficient funds not be allocated, the services provided may be modified, or this 14 Agreement terminated, at any time by giving the CONTRACTOR thirty (30) days advance written 15 notice. 16 B. Breach of Contract - The COUNTY may immediately suspend or terminate 17 this Agreement in whole or in part, where in the determination of the COUNTY there is: 18 1) An illegal or improper use of funds; 19 2) A failure to comply with any term of this Agreement; 20 3) A substantially incorrect or incomplete report submitted to the 21 COUNTY; 22 4) Improperly performed service. 23 In no event shall any payment by the COUNTY constitute a waiver by the COUNTY 24 of any breach of this Agreement or any default which may then exist on the part of the 25 CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to the 26 COUNTY with respect to the breach or default. The COUNTY shall have the right to demand of 27 the CONTRACTOR the repayment to the COUNTY of any funds disbursed to the CONTRACTOR 28 under this Agreement, which in the judgment of the COUNTY were not expended in accordance -4- 1 with the terms of this Agreement. The CONTRACTOR shall promptly refund any such funds upon 2 demand. 3 C. Without Cause - Under circumstances other than those set forth above, this 4 Agreement may be terminated by COUNTY upon the giving of thirty (30) days advance written 5 notice of an intention to terminate to CONTRACTOR. 6 5. COMPENSATION/INVOICING 7 COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive 8 compensation for actual expenditures incurred by CONTRACTOR as identified in Exhibit C. 9 CONTRACTOR shall submit monthly itemized invoices to the DPH and DBH for each 10 Department's respective obligations under this Agreement by the 15t" day of the month following 11 month of said expenditures to DPHBOAP@co.fresno.ca.us, or DBHlnvoices@co.fresno.ca.us, as 12 appropriate. 13 In no event shall services performed under this Agreement be in excess of One 14 Million, Twenty-Six Thousand, One Hundred Fifty-Three and No/100 Dollars ($1,026,153) for each 15 twelve (12) month period of this Agreement. In no event shall the total maximum compensation 16 for the full term of the Agreement exceed Five Million, One Hundred Thirty Thousand, Seven 17 Hundred Sixty-Five and No/100 Dollars ($5,130,765). It is understood that all expenses incidental 18 to CONTRACTOR's performance of services under this Agreement shall be borne by 19 CONTRACTOR. 20 Payment by COUNTY shall be in arrears, for services provided during the preceding 21 month, within forty-five (45) days from date of receipt of invoice by the COUNTY. CONTRACTOR 22 shall provide backup documentation for each expenditure claimed on two (2) invoices per twelve 23 (12) month period for COUNTY to review and approve prior to payment of said invoices. 24 COUNTY's commitment to pay CONTRACTOR the monies is contingent upon the 25 COUNTY's receipt of the money from First 5 under its agreement for funding of the Help Me Grow 26 Fresno County system and contingent on the COUNTY's ability to use the monies received from 27 First 5 to leverage additional federal funds. To the extent that either or both of these 28 contingencies are reduced, the COUNTY's duty to pay CONTRACTOR the monies is -5- 1 correspondingly reduced. 2 6. INDEPENDENT CONTRACTOR 3 In performance of the work, duties and obligations assumed by CONTRACTOR 4 under this Agreement, it is mutually understood and agreed that CONTRACTOR, including any 5 and all of the CONTRACTORSs officers, agents, and employees will at all times be acting and 6 performing as an independent contractor, and shall act in an independent capacity and not as an 7 officer, agent, servant, employee, joint venturer, partner, or associate of the COUNTY. 8 Furthermore, COUNTY shall have no right to control or supervise or direct the manner or method 9 by which CONTRACTOR shall perform its work and function. However, COUNTY shall retain the 10 right to administer this Agreement so as to verify that CONTRACTOR is performing its obligations 11 in accordance with the terms and conditions thereof. 12 CONTRACTOR and COUNTY shall comply with all applicable provisions of law and 13 the rules and regulations, if any, of governmental authorities having jurisdiction over matters the 14 subject thereof. 15 Because of its status as an independent contractor, CONTRACTOR shall have 16 absolutely no right to employment rights and benefits available to COUNTY employees. 17 CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its 18 employees all legally-required employee benefits. In addition, CONTRACTOR shall be solely 19 responsible and save COUNTY harmless from all matters relating to payment of 20 CONTRACTOR'S employees, including compliance with Social Security withholding and all other 21 regulations governing such matters. It is acknowledged that during the term of this Agreement, 22 CONTRACTOR may be providing services to others unrelated to the COUNTY or to this 23 Agreement. 24 7. MODIFICATION 25 Any matters of this Agreement may be modified from time to time by the written 26 consent of all the parties without, in any way, affecting the remainder. 27 Notwithstanding the above, changes to line items in the budget, attached hereto as 28 Exhibit C, that do not exceed ten percent (10%) of the maximum compensation payable to the -6- 1 CONTRACTOR, may be made with the written approval of COUNTY's DPH and/or DBH Director, 2 or designee. Said budget line item changes shall not result in any change to the maximum 3 compensation amount payable to CONTRACTOR, as stated herein. 4 8. NON-ASSIGNMENT 5 Neither party shall assign, transfer or sub-contract this Agreement nor their rights or 6 duties under this Agreement without the prior written consent of the other party. 7 9. HOLD HARMLESS 8 CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's 9 request, defend the COUNTY, its officers, agents, and employees from any and all costs and 10 expenses, damages, liabilities, claims, and losses occurring or resulting to COUNTY in connection 11 with the performance, or failure to perform, by CONTRACTOR, its officers, agents, or employees 12 under this Agreement, and from any and all costs and expenses, damages, liabilities, claims, and 13 losses occurring or resulting to any person, firm, or corporation who may be injured or damaged 14 by the performance, or failure to perform, of CONTRACTOR, its officers, agents, or employees 15 under this Agreement. 16 10. INSURANCE 17 Without limiting the COUNTY's right to obtain indemnification from CONTRACTOR 18 or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect, the 19 following insurance policies throughout the term of the Agreement: 20 A. Commercial General Liability 21 Commercial General Liability Insurance with limits of not less than One 22 Million Dollars ($1,000,000) per occurrence and an annual aggregate of Two Million Dollars 23 ($2,000,000). This policy shall be issued on a per occurrence basis. COUNTY may require 24 specific coverages including completed operations, products liability, contractual liability, 25 Explosion-Collapse-Underground, fire legal liability or any other liability insurance deemed 26 necessary because of the nature of this contract. 27 B. Automobile Liability 28 Comprehensive Automobile Liability Insurance with limits for bodily injury of -7- 1 not less than Two Hundred Fifty Thousand Dollars ($250,000.00) per person, Five Hundred 2 Thousand Dollars ($500,000.00) per accident and for property damages of not less than Fifty 3 Thousand Dollars ($50,000.00), or such coverage with a combined single limit of Five Hundred 4 Thousand Dollars ($500,000.00). Coverage should include owned and non-owned vehicles used 5 in connection with this Agreement. 6 C. Professional Liability 7 If CONTRACTOR employs licensed professional staff, (e.g., Ph.D., R.N., 8 L.C.S.W., M.F.C.C.) in providing services, Professional Liability Insurance with limits of not less 9 than One Million Dollars ($1,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00) 10 annual aggregate. 11 D. Worker's Compensation 12 A policy of Worker's Compensation insurance as may be required by the 13 California Labor Code. 14 E. Child Abuse/Molestation and Social Services Liability 15 Sexual Abuse/Molestation Liability Insurance (including but not limited to 16 corporal punishment liability, sexual abuse and molestation liability, and child abduction liability) 17 with limits of not less than One Million Dollars ($1,000,000.00) per occurrence, Two Million 18 Dollars ($2,000,000.00) annual aggregate. This policy shall be issued on a per occurrence 19 basis. 20 CONTRACTOR shall obtain endorsements to the Commercial General Liability 21 insurance naming the County of Fresno, its officers, agents, and employees, individually and 22 collectively, as additional insured, but only insofar as the operations under this Agreement are 23 concerned. Such coverage for additional insured shall apply as primary insurance and any other 24 insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be 25 excess only and not contributing with insurance provided under CONTRACTOR's policies herein. 26 This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance 27 written notice given to COUNTY. 28 Within Thirty (30) days from the date CONTRACTOR signs and executes this -8- 1 Agreement, CONTRACTOR shall provide certificates of insurance and endorsement as stated 2 above for all of the foregoing policies, as required herein, to the County of Fresno, Department of 3 Public Health, P.O. Box 11867, Fresno, California, 93775, Attention: Contracts Section-6t" Floor, 4 stating that such insurance coverage have been obtained and are in full force; that the County of 5 Fresno, its officers, agents and employees will not be responsible for any premiums on the 6 policies; that such Commercial General Liability insurance names the County of Fresno, its 7 officers, agents and employees, individually and collectively, as additional insured, but only insofar 8 as the operations under this Agreement are concerned; that such coverage for additional insured 9 shall apply as primary insurance and any other insurance, or self-insurance, maintained by the 10 COUNTY, its officers, agents and employees, shall be excess only and not contributing with 11 insurance provided under CONTRACTOR's policies herein; and that this insurance shall not be 12 cancelled or changed without a minimum of thirty (30) days advance, written notice given to 13 COUNTY. 14 In the event CONTRACTOR fails to keep in effect at all times insurance coverage 15 as herein provided, the COUNTY may, in addition to other remedies it may have, suspend or 16 terminate this Agreement upon the occurrence of such event. 17 All policies shall be issued by admitted insurers licensed to do business in the State 18 of California, and such insurance shall be purchased from companies possessing a current A.M. 19 Best, Inc. rating of A FSC VII or better. 20 11. AUDITS AND INSPECTIONS 21 The CONTRACTOR shall at any time during business hours, and as often as the 22 COUNTY may deem necessary, make available to the COUNTY for examination all of its records 23 and data with respect to the matters covered by this Agreement. The CONTRACTOR shall, upon 24 request by the COUNTY, permit the COUNTY to audit and inspect all of such records and data 25 necessary to ensure CONTRACTOR'S compliance with the terms of this Agreement. 26 If this Agreement exceeds ten thousand dollars ($10,000.00), CONTRACTOR shall be subject to 27 the examination and audit of the Auditor General for a period of three (3) years after final payment 28 under contract (Government Code Section 8546.7). -9- 1 12. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT 2 A. The parties to this Agreement shall be in strict conformance with all 3 applicable Federal and State of California laws and regulations, including but not limited to 4 Sections 5328, 10850, and 14100.2 et seq. of the Welfare and Institutions Code, Sections 2.1 and 5 431.300 et seq. of Title 42, Code of Federal Regulations (CFR), Section 56 et seq. of the 6 California Civil Code, and the Health Insurance Portability and Accountability Act (HIPAA), 7 including but not limited to Section 1320 D et seq. of Title 42, United States Code (USC) and its 8 implementing regulations, including, but not limited to Title 45, CFR, Sections 142, 160, 162, and 9 164, The Health Information Technology for Economic and Clinical Health Act (HITECH) regarding 10 the confidentiality and security of patient information, and the Genetic Information 11 Nondiscrimination Act (GINA) of 2008 regarding the confidentiality of genetic information. 12 Except as otherwise provided in this Agreement, CONTRACTOR, as a 13 Business Associate of COUNTY, may use or disclose Protected Health Information (PHI) to 14 perform functions, activities or services for or on behalf of COUNTY, as specified in this 15 Agreement, provided that such use or disclosure shall not violate the Health Insurance Portability 16 and Accountability Act (HIPAA), USC 1320d et seq. The uses and disclosures of PHI may not be 17 more expansive than those applicable to COUNTY, as the "Covered Entity" under the HIPAA 18 Privacy Rule (45 CFR 164.500 et seq.), except as authorized for management, administrative or 19 legal responsibilities of the Business Associate. 20 B. CONTRACTOR, including its subcontractors and employees, shall protect, 21 from unauthorized access, use, or disclosure of names and other identifying information, including 22 genetic information, concerning persons receiving services pursuant to this Agreement, except 23 where permitted in order to carry out data aggregation purposes for health care operations [45 24 CFR Sections 164.504 (e)(2)(i), 164.504 (3)(2)(ii)(A), and 164.504 (e)(4)(i)] This pertains to any 25 and all persons receiving services pursuant to a COUNTY funded program. This requirement 26 applies to electronic PHI. CONTRACTOR shall not use such identifying information or genetic 27 information for any purpose other than carrying out CONTRACTOR's obligations under this 28 Agreement. -10- 1 C. CONTRACTOR, including its subcontractors and employees, shall not 2 disclose any such identifying information or genetic information to any person or entity, except as 3 otherwise specifically permitted by this Agreement, authorized by Subpart E of 45 CFR Part 164 4 or other law, required by the Secretary, or authorized by the client/patient in writing. In using or 5 disclosing PHI that is permitted by this Agreement or authorized by law, CONTRACTOR shall 6 make reasonable efforts to limit PHI to the minimum necessary to accomplish intended purpose 7 of use, disclosure or request. 8 D. For purposes of the above sections, identifying information shall include, but 9 not be limited to name, identifying number, symbol, or other identifying particular assigned to the 10 individual, such as finger or voice print, or photograph. 11 E. For purposes of the above sections, genetic information shall include genetic 12 tests of family members of an individual or individual, manifestation of disease or disorder of family 13 members of an individual, or any request for or receipt of, genetic services by individual or family 14 members. Family member means a dependent or any person who is first, second, third, or fourth 15 degree relative. 16 F. CONTRACTOR shall provide access, at the request of COUNTY, and in 17 the time and manner designated by COUNTY, to PHI in a designated record set (as defined in 18 45 CFR Section 164.501), to an individual or to COUNTY in order to meet the requirements of 19 45 CFR Section 164.524 regarding access by individuals to their PHI. With respect to 20 individual requests, access shall be provided within thirty (30) days from request. Access may 21 be extended if CONTRACTOR cannot provide access and provides individual with the reasons 22 for the delay and the date when access may be granted. PHI shall be provided in the form and 23 format requested by the individual or COUNTY. 24 CONTRACTOR shall make any amendment(s) to PHI in a designated 25 record set at the request of COUNTY or individual, and in the time and manner designated by 26 COUNTY in accordance with 45 CFR Section 164.526. 27 CONTRACTOR shall provide to COUNTY or to an individual, in a time and 28 manner designated by COUNTY, information collected in accordance with 45 CFR Section -11- 1 164.528, to permit COUNTY to respond to a request by the individual for an accounting of 2 disclosures of PHI in accordance with 45 CFR Section 164.528. 3 G. CONTRACTOR shall report to COUNTY, in writing, any knowledge or 4 reasonable belief that there has been unauthorized access, viewing, use, disclosure, security 5 incident, or breach of unsecured PHI not permitted by this Agreement of which it becomes aware, 6 immediately and without reasonable delay and in no case later than two (2) business days of 7 discovery. Immediate notification shall be made to COUNTY's Information Security Officer and 8 Privacy Officer and COUNTY's DPH HIPAA Representative, within two (2) business days of 9 discovery. The notification shall include, to the extent possible, the identification of each individual 10 whose unsecured PHI has been, or is reasonably believed to have been, accessed, acquired, 11 used, disclosed, or breached. CONTRACTOR shall take prompt corrective action to cure any 12 deficiencies and any action pertaining to such unauthorized disclosure required by applicable 13 Federal and State Laws and regulations. CONTRACTOR shall investigate such breach and is 14 responsible for all notifications required by law and regulation or deemed necessary by COUNTY 15 and shall provide a written report of the investigation and reporting required to COUNTY's 16 Information Security Officer and Privacy Officer and COUNTY's DPH HIPAA Representative. This 17 written investigation and description of any reporting necessary shall be postmarked within the 18 thirty (30) working days of the discovery of the breach to the addresses below: 19 County of Fresno County of Fresno County of Fresno Dept. of Public Health Dept. of Public Health Information Technology Services 20 HIPAA Representative Privacy Officer Information Security Officer 21 (559) 600-6439 (559) 600-6439 (559) 600-5800 P.O. Box 11867 P.O. Box 11867 2048 N. Fine Street 22 Fresno, CA 93775 Fresno, CA 93775 Fresno, CA 93727 23 H. CONTRACTOR shall make its internal practices, books, and records relating 24 to the use and disclosure of PHI received from COUNTY, or created or received by the 25 CONTRACTOR on behalf of COUNTY, in compliance with HIPAA's Privacy Rule, including, but 26 not limited to the requirements set forth in Title 45, CFR, Sections 160 and 164. CONTRACTOR 27 shall make its internal practices, books, and records relating to the use and disclosure of PHI 28 received from COUNTY, or created or received by the CONTRACTOR on behalf of COUNTY, -12- 1 available to the United States Department of Health and Human Services (Secretary) upon 2 demand. 3 CONTRACTOR shall cooperate with the compliance and investigation 4 reviews conducted by the Secretary. PHI access to the Secretary must be provided during the 5 CONTRACTOR's normal business hours, however, upon exigent circumstances access at any 6 time must be granted. Upon the Secretary's compliance or investigation review, if PHI is 7 unavailable to CONTRACTOR and in possession of a Subcontractor, it must certify efforts to 8 obtain the information to the Secretary. 9 I. Safeguards 10 CONTRACTOR shall implement administrative, physical, and technical 11 safeguards as required by the HIPAA Security Rule, Subpart C of 45 CFR 164, that reasonably 12 and appropriately protect the confidentiality, integrity, and availability of PHI, including electronic 13 PHI, that it creates, receives, maintains or transmits on behalf of COUNTY and to prevent 14 unauthorized access, viewing, use, disclosure, or breach of PHI other than as provided for by this 15 Agreement. CONTRACTOR shall conduct an accurate and thorough assessment of the potential 16 risks and vulnerabilities to the confidential, integrity and availability of electronic PHI. 17 CONTRACTOR shall develop and maintain a written information privacy and security program 18 that includes administrative, technical and physical safeguards appropriate to the size and 19 complexity of CONTRACTOR's operations and the nature and scope of its activities. Upon 20 COUNTY's request, CONTRACTOR shall provide COUNTY with information concerning such 21 safeguards. 22 CONTRACTOR shall implement strong access controls and other security 23 safeguards and precautions in order to restrict logical and physical access to confidential, 24 personal (e.g., PHI) or sensitive data to authorized users only. Said safeguards and precautions 25 shall include the following administrative and technical password controls for all systems used to 26 process or store confidential, personal, or sensitive data: 27 1. Passwords must not be: 28 a. Shared or written down where they are accessible or -13- 1 recognizable by anyone else; such as taped to computer screens, stored under keyboards, or 2 visible in a work area; 3 b. A dictionary word; or 4 C. Stored in clear text 5 2. Passwords must be: 6 a. Eight (8) characters or more in length; 7 b. Changed every ninety (90) days; 8 C. Changed immediately if revealed or compromised; and 9 d. Composed of characters from at least three (3) of the 10 following four (4) groups from the standard keyboard: 11 1) Upper case letters (A-Z); 12 2) Lowercase letters (a-z); 13 3) Arabic numerals (0 through 9); and 14 4) Non-alphanumeric characters (punctuation symbols). 15 CONTRACTOR shall implement the following security controls on each 16 workstation or portable computing device (e.g., laptop computer) containing confidential, 17 personal, or sensitive data: 18 1. Network-based firewall and/or personal firewall; 19 2. Continuously updated anti-virus software; and 20 3. Patch management process including installation of all operating 21 system/software vendor security patches. 22 CONTRACTOR shall utilize a commercial encryption solution that has 23 received FIPS 140-2 validation to encrypt all confidential, personal, or sensitive data stored on 24 portable electronic media (including, but not limited to, compact disks and thumb drives) and on 25 portable computing devices (including, but not limited to, laptop and notebook computers). 26 CONTRACTOR shall not transmit confidential, personal, or sensitive data 27 via e-mail or other internet transport protocol unless the data is encrypted by a solution that has 28 been validated by the National Institute of Standards and Technology (NIST) as conforming to -14- 1 the Advanced Encryption Standard (AES) Algorithm. CONTRACTOR must apply appropriate 2 sanctions against its employees who fail to comply with these safeguards. CONTRACTOR 3 must adopt procedures for terminating access to PHI when employment of employee ends. 4 J. Mitigation of Harmful Effects 5 CONTRACTOR shall mitigate, to the extent practicable, any harmful effect 6 that is suspected or known to CONTRACTOR of an unauthorized access, viewing, use, 7 disclosure, or breach of PHI by CONTRACTOR or its subcontractors in violation of the 8 requirements of these provisions. CONTRACTOR must document suspected or known 9 harmful effects and the outcome. 10 K. CONTRACTOR's Subcontractors 11 CONTRACTOR shall ensure that any of its contractors, including 12 subcontractors, if applicable, to whom CONTRACTOR provides PHI received from or created 13 or received by CONTRACTOR on behalf of COUNTY, agree to the same restrictions, 14 safeguards, and conditions that apply to CONTRACTOR with respect to such PHI and to 15 incorporate, when applicable, the relevant provisions of these provisions into each subcontract 16 or sub-award to such agents or subcontractors. 17 L. Employee Training and Discipline 18 CONTRACTOR shall train and use reasonable measures to ensure 19 compliance with the requirements of these provisions by employees who assist in the 20 performance of functions or activities on behalf of COUNTY under this Agreement and use or 21 disclose PHI and discipline such employees who intentionally violate any provisions of these 22 provisions, including termination of employment. 23 M. Termination for Cause 24 Upon COUNTY's knowledge of a material breach of these provisions by CONTRACTOR, 25 COUNTY shall either: 26 1. Provide an opportunity for CONTRACTOR to cure the breach or end 27 the violation and terminate this Agreement if CONTRACTOR does not cure the breach or end 28 the violation within the time specified by COUNTY; or -15- 1 2. Immediately terminate this Agreement if CONTRACTOR has 2 breached a material term of these provisions and cure is not possible. 3 3. If neither cure nor termination is feasible, the COUNTY's Privacy 4 Officer shall report the violation to the Secretary of the U.S. Department of Health and Human 5 Services. 6 N. Judicial or Administrative Proceedings 7 COUNTY may terminate this Agreement in accordance with the terms and 8 conditions of this Agreement as written hereinabove, if: (1) CONTRACTOR is found guilty in a 9 criminal proceeding for a violation of the HIPAA Privacy or Security Laws or the HITECH Act; or 10 (2) a finding or stipulation that the CONTRACTOR has violated a privacy or security standard or 11 requirement of the HITECH Act, HIPAA or other security or privacy laws in an administrative or 12 civil proceeding in which the CONTRACTOR is a party. 13 O. Effect of Termination 14 Upon termination or expiration of this Agreement for any reason, 15 CONTRACTOR shall return or destroy all PHI received from COUNTY (or created or received 16 by CONTRACTOR on behalf of COUNTY) that CONTRACTOR still maintains in any form, and 17 shall retain no copies of such PHI. If return or destruction of PHI is not feasible, it shall 18 continue to extend the protections of these provisions to such information, and limit further use 19 of such PHI to those purposes that make the return or destruction of such PHI infeasible. This 20 provision shall apply to PHI that is in the possession of subcontractors or agents, if applicable, 21 of CONTRACTOR. If CONTRACTOR destroys the PHI data, a certification of date and time of 22 destruction shall be provided to the COUNTY by CONTRACTOR. 23 P. Disclaimer 24 COUNTY makes no warranty or representation that compliance by 25 CONTRACTOR with these provisions, the HITECH Act, HIPAA or the HIPAA regulations will be 26 adequate or satisfactory for CONTRACTOR's own purposes or that any information in 27 CONTRACTOR's possession or control, or transmitted or received by CONTRACTOR, is or will 28 be secure from unauthorized access, viewing, use, disclosure, or breach. CONTRACTOR is -16- 1 solely responsible for all decisions made by CONTRACTOR regarding the safeguarding of PHI. 2 Q. Amendment 3 The parties acknowledge that Federal and State laws relating to electronic 4 data security and privacy are rapidly evolving and that amendment of these provisions may be 5 required to provide for procedures to ensure compliance with such developments. The parties 6 specifically agree to take such action as is necessary to amend this agreement in order to 7 implement the standards and requirements of HIPAA, the HIPAA regulations, the HITECH Act 8 and other applicable laws relating to the security or privacy of PHI. COUNTY may terminate 9 this Agreement upon thirty (30) days written notice in the event that CONTRACTOR does not 10 enter into an amendment providing assurances regarding the safeguarding of PHI that 11 COUNTY in its sole discretion, deems sufficient to satisfy the standards and requirements of 12 HIPAA, the HIPAA regulations and the HITECH Act. 13 R. No Third-Party Beneficiaries 14 Nothing express or implied in the terms and conditions of these provisions is intended to confer, 15 nor shall anything herein confer, upon any person other than COUNTY or CONTRACTOR and 16 their respective successors or assignees, any rights, remedies, obligations or liabilities 17 whatsoever. 18 S. Interpretation 19 The terms and conditions in these provisions shall be interpreted as 20 broadly as necessary to implement and comply with HIPAA, the HIPAA regulations and 21 applicable State laws. The parties agree that any ambiguity in the terms and conditions of these 22 provisions shall be resolved in favor of a meaning that complies and is consistent with HIPAA 23 and the HIPAA regulations. 24 T. Regulatory References 25 A reference in the terms and conditions of these provisions to a section in 26 the HIPAA regulations means the section as in effect or as amended. 27 U. Survival 28 The respective rights and obligations of CONTRACTOR as stated in this -17- 1 Section shall survive the termination or expiration of this Agreement. 2 V. No Waiver of Obligations 3 No change, waiver or discharge of any liability or obligation hereunder on 4 any one or more occasions shall be deemed a waiver of performance of any continuing or other 5 obligation, or shall prohibit enforcement of any obligation on any other occasion. 6 13. NON-DISCRIMINATION 7 During the performance of this Agreement, CONTRACTOR shall not unlawfully 8 discriminate against any employee or applicant for employment, or recipient of services, 9 because of race, religious creed, color, national origin, ancestry, physical disability, mental 10 disability, medical condition, genetic information, marital status, sex, gender, gender identity, 11 gender expression, age, sexual orientation, military status or veteran status pursuant to all 12 applicable State of California and Federal statutes and regulation. 13 14. GOVERNING LAW 14 Venue for any action arising out of or related to this Agreement shall only be in 15 Fresno County, California. 16 The rights and obligations of the parties and all interpretation and performance of 17 this Agreement shall be governed in all respects by the laws of the State of California. 18 15. SEVERABILITY 19 The provisions of this Agreement are severable. The invalidity or unenforceability of 20 any one provision in the Agreement shall not affect the other provisions. 21 16. DISCLOSURE OF SELF-DEALING TRANSACTIONS 22 This provision is only applicable if the CONTRACTOR is operating as a 23 corporation (a for-profit or non-profit corporation) or if during the term of the agreement, the 24 CONTRACTOR changes its status to operate as a corporation. 25 Members of the CONTRACTOR's Board of Directors shall disclose any self- 26 dealing transactions that they are a party to while CONTRACTOR is providing goods or 27 performing services under this agreement. A self-dealing transaction shall mean a transaction 28 to which the CONTRACTOR is a party and in which one or more of its directors has a material -18- 1 financial interest. Members of the Board of Directors shall disclose any self-dealing 2 transactions that they are a party to by completing and signing a Self-Dealing Transaction 3 Disclosure Form, attached hereto as Exhibit D and incorporated herein by reference, and 4 submitting it to the COUNTY prior to commencing with the self-dealing transaction or 5 immediately thereafter. 6 17. NOTICES 7 The persons and their addresses having authority to give and receive notices under 8 this Agreement include the following: 9 COUNTY CONTRACTOR COUNTY OF FRESNO Exceptional Parents Unlimited, Inc. 10 Director, Deaartment of Public Health Ellen KnaDp, Executive Director P.O. Box 11867 4440 N. First St. 11 Fresno, CA 93775 Fresno, CA 93726 12 All notices between the COUNTY and CONTRACTOR provided for or permitted 13 under this Agreement must be in writing and delivered either by personal service, by first-class 14 United States mail, by an overnight commercial courier service, or by telephonic facsimile 15 transmission. A notice delivered by personal service is effective upon service to the recipient. A 16 notice delivered by first-class United States mail is effective three COUNTY business days after 17 deposit in the United States mail, postage prepaid, addressed to the recipient. A notice delivered 18 by an overnight commercial courier service is effective one COUNTY business day after deposit 19 with the overnight commercial courier service, delivery fees prepaid, with delivery instructions 20 given for next day delivery, addressed to the recipient. A notice delivered by telephonic facsimile 21 is effective when transmission to the recipient is completed (but, if such transmission is completed 22 outside of COUNTY business hours, then such delivery shall be deemed to be effective at the 23 next beginning of a COUNTY business day), provided that the sender maintains a machine record 24 of the completed transmission. For all claims arising out of or related to this Agreement, nothing in 25 this section establishes, waives, or modifies any claims presentation requirements or procedures 26 provided by law, including but not limited to the Government Claims Act (Division 3.6 of Title 1 of 27 the Government Code, beginning with section 810). 28 -19- 1 18. ENTIRE AGREEMENT 2 This Agreement, including all Exhibits, constitutes the entire agreement between the 3 CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes all 4 previous Agreement negotiations, proposals, commitments, writings, advertisements, publications, 5 and understanding of any nature whatsoever unless expressly included in this Agreement. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -20- 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of 2 the day and year first hereinabove written. 3 4 CONTRACTOR: COUNTY OF FRESNO: 5 Exceptional Parents Unlimited, Inc. 6 7 By / B }8 Chairman, Board of 5upervisors 9 Print Name: 10 11 Title: ter=G Date: Chairman of the B ard, or 12 President, or any Vice President 13 Date: /o���� BERNICE E. SEIDEL, Clerk 14 Board of Supervisors 15 B 16 17 Print Name: 2,A-,JNe E �1(5 By 1 18 U 19 Title: Date: tJZ-y� I .ao1 k, 20 Secretary (of Corporation), or any Assistant Secretary, or Chief 21 Financial Officer, or any Assistant Treasurer 22 23 Date: PLEASE SEE ADDITIONAL SIGNATURE PAGE ATTACHED 24 25 Mailing Address: 4440 N. First St. 26 Fresno, CA 93726 Telephone: (559) 229-2000 27 Contact: Ellen Knapp 28 -21- 1 APPROVED AS TO LEGAL FORM: 2 DANIEL C. CEDERBORG, COUNTY COUNSEL 3 4 By 5 6 APPROVED AS TO ACCOUNTING FORM: VICKI CROW, C.P.A., AUDITOR-CONTROLLER/ 7 TREASURER-TAX COLLECTOR 8 By 10 11 REVIEWED AND REC MM ENDED F R APPROVAL: 12 / 13 / 14 By ` David Pomaville 15 Director 16 Department of Public Health 17 18 By Dawan Utecht 19 Director 20 Department of Behavioral Health 21 22 Fund/Subclass: 0001/10000 23 Organization: 56201706 ($1,017,401.00) 56302230 ($8,752.00) 24 Account Number: 7295 25 26 27 ax 28 -22- THE I Ielp Me Grow MANUAL FIRST EDITION DULY 2014 Exhibit A ;;Help Me Grow National Center Exhibit A Help Me Grow National Center Table of Contents Getting Started with Help Me Grow/ 5 Building the Help Me Grow Infrastructure / 15 Organizing Entity & Leadership Team 15 Site Visit & Community Meeting 23 Building the Help Me Grow System: Core Components / 29 Centralized Access Point 29 Child Health Provider Outreach 49 Community & Family Outreach 61 Data Collection & Analysis 77 Sustaining the Help Me Grow System / 85 Marketing Help Me Grow 85 Funding & Expanding Help Me Grow 97 Exhibit A The Help Me Grow Manual I, We are pleased to introduce the newly revised Help Me Grow Manual. Whether you are a new or long-standing affiliate, I and the team at the Help Me Grow National Center appreciate your enthusiasm for creating a Help Me Grow system in your State. We are honored to work with you and your team to build a system emphasizing the early detection of vulnerable children at-risk for adverse developmental and behavioral outcomes and the connection of these children and their families to community-based services and supports. We hope you will find the Manual comprehensive, informative and easy to access. The content supports the core components and structural requirements that are essential to maintaining fidelity to the system. We acknowledge that this is an ongoing project that we will continue modify and expand, as needed. Help Me Grow National is pleased to provide states with information, resources, and support to assist in the replication of Help Me Grow.This manual is an example of the benefits of membership in the Help Me Grow National Network, which provides affiliate states member-only access to these resources and information. This Manual could not have been created without the support of and contributions from our affiliate network, the staff at Help Me Grow National and, especially, our marketing and social media professional, Becky Karush. Please contact us at Help Me Grow National with your questions. We are excited and gratified to help you help at-risk children and their families in your State. Best regards, Paul Dworkin,MD, Founder and Director Help Me Grow National Center www.HeIpMeGrowNational.org 860-837-6232 Exhibit A First Edition,July 2014.Copyright 2014 Help Me Grow National Center.All rights reserved. Help MeGrow Getting Started with Help Me Grow National Center First Edition,July 2014 Copyright © 2014 Help Me Grow National Center.All rights reserved. Unless otherwise indicated, all materials on these pages are copyrighted by the Help Me Grow National Center. All rights reserved. No part of these pages, either text or image, may be used for any purpose other than by approved members of the Help Me Grow National Network. Reproduction, modification,storage in a retrieval system or retransmission, in any form or by any means, electronic, mechanical or otherwise, for reasons other than Help Me Grow National Network use, is strictly prohibited without prior written permission. Inquiries should be directed to info@ helpmegrownational.com. Exhibit A 2 Getting Started with Help Me Grow b ,.O Help Me Grow National Center Getting Started What is Help Me Grow? / 5 Core Components & Strucutural Requirements / 6 The History of Help Me Grow Replication / 7 Diagram: Building the Help Me Grow Infrastructure & System / 8 Becoming a Help Me Grow National Network Affiliate / 9 Benefits & Requirements of Affiliation / 10 Help Me Grow National Technical Assistance for Replication / 11 Assess Your State's Readiness for Affiliate Membership / 12 Exhibit A Exhibit A Getting Started with Help Me Grow 6 ,.g Help Me Grow National Center What Is Help Me Grow? Help Me Grow is a unique, comprehensive, and integrated statewide system designed to address the need for early identification of children at risk for developmental and/ or behavioral problem, and then to link these children and their families to community- based developmental and behavioral services and supports. Why Help Me Grow Is Needed Undetected and untreated behavioral and developmental problems in children can have a profound impact on the lives of children and families and on our society. Mental health, education, and juvenile justice costs are demonstrably higher when such problems are not managed. Nationwide, it is estimated that 12 to 16 percent of American children experience developmental, behavioral and/or emotional delays or problems. Experts agree that early detection of at-risk children offers the best hope for optimal outcomes. Yet current early detection efforts are primarily focused on children with significant delays and disorders. Further, Use of the Help Me Grow eligibility for early intervention programs typically requires significant evidence of delays and precludes system has been shown to the provision of services based on risk for potential or improve access to services subsequent delay. for children at risk, encourage Even when the needs of at-risk children are recognized and collaboration across sectors, appropriate programs and services are identified,connecting and lower costs. children to such services often proves difficult.In most cases, successful linkage requires knowledge of programs and eligibility requirements and persis- tence in overcoming barriers. Many states have some of the necessary components for a comprehensive, coordinated system for the early detection and referral of at-risk children. However, few states have a statewide system that is integrated, comprehensive, and effective. • The Help Me Grow National Network „ Help Me Grow Washington Video This moving 5-minute video features a mother �. who found help for her one-year-old daughter through � Help Me Grow Washington. Learn more at www.parenthelpl23.org Exhibit A 5 Help Me Grow Getting Started with Help Me Grow National Center Core Components Structural The four core components of a comprehensive Help Me Grow system are: 1. Centralized telephone access point for connection of children and their families to services and care coordination 2. Community and family outreach to promote the use of HMG and to provide net- working opportunities among families and service providers 3. Child health provider outreach to support early detection and early intervention 4. Data collection and analysis to understand all aspects of the HMG system, including the identification of gaps and barriers The three structural requirements for building an Help Me Grow system are: 1. An organizing entity 2. A strategy for expanding statewide over time 3. The implementation of a continuous quality improvement plan The Help Me Grow National Network Help Me Grow Utah & the National Network t<We have networked with multiple affiliate states through phone calls and emails. We have found that this affiliation has helped us to articulate our methods and means of executing Help Me Grow and made it possible to discuss problems within our system and how to make changes. We have talked to Colorado, California, South Carolina, Delaware, New York and Florida.The national team has also facilitated discussions and webinars for all affiliates on timely topics. They have also been instrumental in highlighting affiliates' creativity so that we can learn from each other." Learn more at www.helpmegrowutah.org Members of the Help Me Grow National Network at the 2012 Help Me Grow National Forum. Exhibit A 6 Getting Started with Help Me Grow 6 ,.g Help Me Grow National Center The History of Help I' Grow Replication Over the past ten years, Help Me Grow Connecticut (CT), an initiative of the Children's Trust Fund within the State's Department of Social Services, has not only successfully identified at-risk children, but has also effectively and efficiently linked them and their families to services. This has been accomplished through a state level partnership among CT's Department of Public Health, Department of Developmental Disabilities Services, Department of Education, the CT ChildreiA Trust Fund within the Department of Social Services, and a specialized call center housed at the CT United Way/2-1-1.1his States affiliated with the Help state level partneship supports the involvement of pediatric primary care practices, early care and Me Grow National Center education professionals, families, and community use the Help Me Grow system providers at the grass roots level. to implement effective, In 2005, with support from the Children and Families Commission of Orange County,California, universal, early surveillance Help Me Grow Orange County(HMG OC) became and screening for all children, the first replication site of the Connecticut Help and then link them to Me Grow model. Experts knowledgeable in the HMG CT system provided technical assistance and existing quality programs. support to the HMG OC planning activities. Expansion of replication efforts continued in 2008 with a grant from The Commonwealth Fund to Connecticut Childrens Medical Center. The grant supported the provision of technical assistance to five states selected through a competitive application process. Sites selected were in Colorado, Kentucky, New York, Oregon, and South Carolina. Replication activities are ongoing in these states. Effective May 2010, the W.K. Kellogg Foundation began support for the provision of technical assistance for the replication of the HMG system to 16 states over 3 years. The addition of 10 more replication sites began in December 2010. These new HMG affiliates were Alabama, California, Delaware, Florida, Iowa, Louisiana, Massachusetts, New Jersey, Utah and Washington As of June 2013, Michigan, the District of Columbia (The District), and West Virginia have been added as affiliates. A total of 19 states including the District are currently part of the National Network,with more beginning the affiliation process. For more background on Help Me Grow, please visit www.HelpMeGrowNational.org. Exhibit A 7 Building Grow BUILDING THE INFRASTRUCTURE Select an Organizing Entity/Structural Requirement Designate a Program Manager Identify & Recruit Leadership Team Members (ongoing) Create a Leadership Team Coordinate a Help Me Grow National Site Visit & Host a Community Meeting Depending on your state's needs,this step may take place earlier in the process. BUILDING THE SYSTEM Design & Implement the Core Components 7 Centralized Child Health Community & Data Collection & Telephone Access Provider Outreach Family Outreach Analysis SUSTAINING THE SYSTEM Establish Sustainable Funding (ongoing) This work may begin earlier in the process. Design & Implement a Plan for Statewide Expansion /Structural Requirement It is advisable to develop a vision for statewide expansion early in the process. Develop Continuous Quality Improvement/Structural Requirement Your Help Me Grow system may follow a different path than the diagram above. Building a Help Me Grow system isn't a rigid process;it is designed to adapt to the needs and strengths of your community in order to support and maximize your resources for children at developmental and/or behavioral risk. A Getting Started with Help Me Grow Help Me Grow National Center Becomoingan Affiliate The Help Me Grow system is specifically designed to help states organize and leverage existing resources in order to best serve families with children at-risk. Affiliation with the Help Me Grow National Network provides states with the guidance and technical assistance needed to seamlessly implement a system reform that promotes both early detection of and service delivery for children at risk of developmental and behavioral problems. Affiliate states also find that implementation of an HMG system improves their ability to inform policy,programs,and legislation with critical concepts from early brain research that have a positive, far-reaching impact on young children's healthy development. This includes maternal and child health,public health, and health safety net programs. The Help Me Grow National Center brings interested states into affiliation as they demonstrate readiness to move toward fidelity to the system's core components and structural requirements, as well as a willingness to meet the requirements of affiliation. The Help Me Grow National Network Help Me Grow Connecticut in Action During a follow-up interview for a 2012 Help Me Grow Connecticut study of parents served by the system, a mother of a two-year-old stated, "I don't know what I would have done without Help Me Grow and that is the understatement of my life" She had called seeking support for her son, who was exhibiting aggressive behaviors both at home and child care. Given his frequent ear infections, she had already taken him to doctors to ensure that he was healthy. The Help Me Grow Care Coordinator referred the family to a community agency that provides mental health consultation services. The provider met with the parents and child care staff, observed the child at home and at the child care center, and provided specific strategies to help with his behaviors. "I now feel like I am not the only one out there," the ~M,, mother said. "Now, he is less aggressive at home. Some of his behaviors have stopped and he is not harming ` himself any longer." . . . Image David Castillo Dominici/FreeDigitalPhotos.net Learn more at www.ctunitedway.org Exhibit A 9 Help Me Grow Getting Started with Help Me Grow National Center Benefits of Affil Affiliation to the Help Me Grow National Center and payment of the annual membership fee provides Affiliate States the following: • Use of the Help Me Grow name,logo and tagline • Regional technical assistance conference calls held quarterly • Access to the comprehensive Building a Help Me Grow System manual • Access to the resources of the affiliates-only section of the National website • Use of common indicators reports • Access to e-newsletters, research, and webinars • Invitations to participate in the annual National Forums, regional peer-to peer activities, and summits • Support for federal and state advocacy, including policy briefs Additional technical assistance is available on a fee-for-service basis (see page 12). The Help Me Grow National Network �w Help Me Grow Alabama & the National Network <<Help Me Grow National Forums and Regional Peer-to-Peer meetings have been an invaluable source of ideas, insight, and information. The camaraderie developed at these events makes it much easier throughout the year to seek out individuals in other states who have experience or may be able to help with particular concerns. Face-to-face meetings with peers have been immensely Jane Witowski(HMG South Carolina),Joanna Bogin (HMG National),Patsy Hampton(HMG California) valuable as HMG Alabama grows" at the Fourth Annual Home Visiting Summit Learn more at.heipmegrowal.blogspot.com in Washington, D.C.,January 2014 Exhibit A 10 Getting Started with Help Me Grow •„ Help Me Grow National Center Requirements of Affil Affiliation will be contingent on a sustained fidelity to the Help Me Grow system and fulfillment of the following responsibilities of affiliation. • Annual membership fee • Agree to contract with Help Me Grow National for on-going technical assistance as part of the annual Affiliate Membership fee, as well as any recommended targeted technical assistance and support (see next page) • Designation of a project lead that serves as a local convener/facilitator of planning and related meetings for the Help Me Grow Leadership Team • Creation of a Leadership Team with identified partners who are committed to implementing Help Me Grow in their state • Participation in regularly scheduled Regional quarterly calls with Help Me Grow National staff • Participation in webinars and learning collaboratives • Funding of travel,lodging and meals for at least two participants to attend Help Me Grow annual forums • Sharing of relevant marketing materials, data and documents with Help Me Grow National, including contributions to the Help Me Grow National website and annual Forums • Sharing of agreed-upon common indicators data with Help Me Grow National • Demonstration of a commitment to fidelity to the model, always including the four core components (see page 6) • Establishing a plan for the three structural requirements The Help Me Grow National Network Affiliate State Profiles Exhibit A 11 Help Me Grow Getting Started with Help Me Grow National Center Help Me Grow National Additional Listed below are the types of initial Technical Assistance Help Me Grow National can provide to a state beyond the benefits of membership. This assistance is provided on a fee- for-service basis. Initial Site Visit Three-day preliminary site visit by National Center staff to meet those involved in Affiliate State's early childhood systems,programs,and services and to assess the unique strengths and needs of the community. Activities can include preparation and site visit follow-up report. These items can be added in or taken out depending on the budget. In preparation for an initial site visit, National Center staff will review documents, conduct interviews with critical stakeholders, and research relevant services, agencies, and community-based efforts. Site Visit Follow-Up Report Help Me Grow National will produce a site visit report/strategic plan for implementing a Help Me Grow system and obtain consensus from the Affiliate State's team on the report recommendations and plans for implementing them. The Help Me Grow system will be designed to assist Affiliate State's early childhood programs, providers and services in effectively and efficiently linking young children and young children and their families to needed developmental services and supports and related community resources. Ongoing Consultation Based on Site Visit Ongoing consultation will be based on key components of a Help Me Grow system,including the development of a centralized call center; the development of outreach campaigns that target communities and health care providers; and the collection and analysis of data. Activities include: ongoing communication with the project manager by phone calls and emails; at minimum, monthly TA conference calls with the Affiliate State's team with a summary write up from each call;sharing relevant information(research,affiliate activities, data,marketing efforts,etc.);a second site visit to Affiliate State;and a site visit to Connecti- cut by an Affiliate State delegation. Additional Site Visit Affiliates states can invite the National Center for a second site visit for several reasons, including the Help Me Grow system formal launch or to meet with targeted stakeholders. Exhibit A 12 Getting Started with Help Me Grow ;; FMpMeGmw National Center Assess Your State's Readiness for Affiliate Membership The following questions are designed to help states assess the resources,support,and personnel needed to implement a successful Help Me Grow System. They are designed to prompt conversation and questions within your state, community, and/or organization. • Do you have a neutral organization to facilitate the creation of an organizing entity (in- cluding partners from state agencies, public officials, health care providers, early care and education services, social services, funders, parents and advocates)? • Do you have the capacity to hire or designate a program manager to provide leadership and guidance in the implementation of the system? • Are you willing to bring together existing call centers, such as 2-1-1, Maternal Child Health Hotline, Child Find, and/or Child Care Resources and Referral Systems (CCR&R), that serve or have the potential to serve as a centralized telephone access point for programs/services for children from birth to eight and their families? • Do you have experience and are you familiar with the resources that exist in your state/region for Community Outreach activities that may help to promote the use of HMG and to provide networking opportunities among families & service providers? • Do you have a relationship with your state chapter AAP and a physician who will champion/advocate for the program within the medical community? • A successful plan for creating a HMG system includes identiFication and recruitment of partners in key areas. Do you have existing partnerships with any of the following? -State Early Childhood Special Education (i.e., Part B) -State Early Intervention (i.e., Part C) -State Health Department (i.e., Title V) • Do you have a funding mechanism to support the annual membership to the HMG National Network and targeted technical assistance from HMG National for one year? • Can you describe 1-2 scenarios for sustaining Help Me Grow over the long term? Exhibit A 13 Help Me Grow Getting Started with Help Me Grow National Center The Help Me Grow National Network Affiliate State Profiles* Help Me Grow Alabama Help Me Grow California Help Me Grow Colorado Help Me Grow Connecticut Help Me Grow Delaware Help Me Grow Florida Help Me Grow Iowa Help Me Grow Kentucky Help Me Grow Louisiana Help Me Grow Massachusetts Help Me Grow Michigan Help Me Grow New Jersey Help Me Grow Oregon Help Me Grow South Carolina Help Me Grow Utah Help Me Grow Washington Help Me Grow West Virginia Help Me Grow Western New York *as of July 2014 Exhibit A Building the Help Me Grow System Infrastructure/Organizing Entity&Leadership Team it Help Me roW National Center The Organizing Entity LeadershipTeam Design and implementation of a Help Me Grow system requires communication, coordination, and integration of resources and services. Genuine collaboration is needed to make changes in policies, governance, and operating procedures at the administrative and direct service levels. One of the first steps in developing a Help Me Grow system is to enlist partners who have mutual interests, serve the same populations,and/or have the capacity to move the agenda forward. The organizing entity provides administrative and fiscal oversight and initially helps identify and coordinate partners into a Leadership Team or steering committee that will guide the Help Me Grow system as it evolves. As the roles of each partner are defined, the responsibility for administrative and fiscal oversight may change,but having a stable administrative "home" is essential for system sustainability over the long term. Select an Organizing Entity The organizing entity facilitates the planning and implementation of the Help Me Grow stem. Selecting an organizing entity is the first step in building the Help Me Grow system infrastructure,which in turn supports system development. t IN THIS SECTION: 1 The Organizing Entity & Leadership Team Select an Organizing Entity The Initial Tasks of the Organizing Entity Plan and Convene Leadership Team Meetings Create and Staff Work Groups Next Step: Site Visit & Community Meeting Exhibit A First Edition,July 2014.Copyright 2014 Help Me Grow National Center.All rights reserved. 15 %tj F1*MeGrow Building the Help Me Grow System: Infrastructure/Organizing Entity& Leadership Team National Center State agencies, private non-profits, universities, and medical centers serve as organizing entities. It is important for the organizing entity to be viewed as a neutral organization by those serving young children and their families. Throughout the planning and implementation process, the organizing entity provides a stable administrative home for the Help Me Grow system. The organizing entity is responsible for designating a program manager. This person then identifies, recruits, and staffs a Leadership Team. The Leadership Team guides the Help Me Grow system as it evolves from planning to implementation. Building the Help Me Grow System Flow Chart The Initial Tasks of the Organizing Entity Designate a Program Manager The program manager drives the formation of the Leadership Team and serves as convener and facilitator of planning and meetings. The program manager facilitates the formation of the Leadership Team; outlines roles and responsibilities of Leadership Team members; and staffs and administers the Leadership Team. Additional duties are to: • Plan, convene, and facilitate meetings • Maintain ongoing communication with Leadership Team members and other groups as needed • Serve as the go-to person to answer questions from the Leadership Team • Coordinate technical assistance with the Help Me Grow National Center • Participate in Help Me Grow National &Network activities, such as regional calls • The Help Me Grow National Network Current Help Me Grow Organizing Entities • State Agency: West Virginia Office of Maternal. Child & Family Health • AAP & University: Iowa American Academy of Pediatrics and University of Iowa • Community Organization: United Way of Utah County • Children's Hospital: South Carolina Greenville Hospital System • State Taxing Entity: Florida Children's Service Council • State-funded Public Entity: California First 5 Alameda Exhibit A 16 Building the Help Me Grow System Infrastructure/Organizing Entity&Leadership Team ;; Help Me National Center Define the roles & responsibilities of Leadership Team members The Leadership Teams tasks include,but are not limited to,the following: • Attend Leadership Team meetings and Work Group meetings • Understand the Help Me Grow system and the state's strengths and challenges in planning and implementation • Convene a Help Me Grow meeting to introduce the system to the broader community • Create a strategic plan for the implementation of the Help Me Grow system, including statewide expansion • Facilitate the building of the Help Me Grow system • Secure sustainable funding for Help Me Grow(or a path to sustainable funding) • Monitor progress of Leadership Team's work Potential Team Member Template Identify& recruit Leadership Team members Identify Potential Leadership Team Members The Leadership Team is made up of representatives from agencies, community partners, and individuals who have expertise in early childhood services in their state.Team members share mutual interests,serve similar populations,and have the capacity to move the agenda forward. They are dedicated to improving their state's system of early childhood services. It is especially important to build a Leadership Team that can support the creation of and participate in a statewide system. To support statewide expansion,the team should include representatives from the: • State Early Intervention and Preschool Special Education Programs (i.e., Parts C and B) • State Health Department (e.g., Title V) • State Chapter of the American Academy of Pediatrics (e.g.,physician champions) Additionally,it is important that advocacy and family support community service providers are represented on the Leadership Team. Recruit Leadership Team Members Once you identify potential partners,ask yourself,"What's in it for them?"More specifically, would they benefit from having one or more of the following in their community? • A single centralized access point system • A program that connects"at-risk' children to services • Providers trained in developmental screening Be purposeful and strategic in recruiting Leadership Team members, as well as chairs of Exhibit A 17 d He1pMeGroW Building the Help Me Grow System: Infrastructure/Organizing Entity& Leadership Team National Center the Work Groups and Work Group members (see the Help Me Grow National Site Visit for more information on Work Groups).For instance,is there a strong advocate who is well-con- nected and respected who could become a champion? (Read a Help Me Grow champion profile.) If so, that person should be recruited first as that support will add leverage and credibility. Document and be able to discuss current gaps/barriers in the systems that serve at-risk children. Know what is needed from a systems and fiscal perspective and how your proposal will be cost-effective, coordinate systems, offer"one-stop shopping," and be family-focused. Keep in mind that agency heads that are invited to join the Leadership Team often assign staff members to attend meetings on their behalf. The Leadership Team will need to develop a mechanism for ongoing identification of potential members. Once members are recruited, the Leadership Team will need to conduct a periodic review of the number and types of organizations/services represented to determine if changes need to be made. The Leadership Team continues recruitment as needed. Help Me Grow Iowa Advisory Committee Contacts Help Me Grow Kentucky Leadership Team Plan and Convene Leadership Team Meetings The program manager organizes the Leadership Team meetings. The meeting schedule for the Leadership Team is flexible and depends on the team and state's needs.Typically,however, the Leadership Team meets monthly during the first quarter of its existence.As the Help Me Grow system develops further,meetings can occur every other month and eventually move to a quarterly schedule. The First Leadership Team meeting The first meeting often covers the following topics: Team member introductions ' Sf Building the Help Me Grow System Tools to Tell the Help Me Grow Story Communicating the Help Me Grow story powerfully is an important part of building a strong leadership team. We recommend using the following videos in your presentations to potential members: • What is Help Me Grow?A four-minute introduction • Help Me Grow Florida Media Cliffs • Paul Dworkin, M.D.. TEDx Talk Help Me Grow& Promoting Children's Healthy Development Exhibit A 18 Building the Help Me Grow System Infrastructure/Organizing Entity&Leadership Team ;; Help Me National Center • A Help Me Grow system overview(We recommend using the 14-minute video "Making The Connection-Help Me Grow: The Connecticut Experience" It provides an excellent,moving overview.) • Initial questions about the state's strengths and needs to plan&implement a system, including,Who else needs to be on this team?What programs and services for children at risk currently exist in the state? • The Work Groups and who might serve on them • Next steps and next meeting time • Sharing contact information Create Leadership Team infrastructure In subsequent meetings,the Leadership Team will create its infrastructure,including: • Develop core principles,including values,vision,and mission. Help Me Grow Utah: Values,Visions &Mission Statement • Discuss the type of administrative structure that will best serve this initiative, e.g. public, private or public/private. The pros/cons of each option should be researched from the perspective of long-term collaboration and sustainability. • Develop internal communication systems. Internal communication includes, but is not limited to,meeting announcements,agendas,and summaries.It maybe useful to establish listservs,group email lists,or other collaborative tools for the core Leadership Team,as well as one for each Work Group.These tools should be developed and maintained by the program manager or other person staffing the Help Me Grow administrative function within the organizing entity. • Develop external communication systems. External communication should be done with the guidance of the core Leadership Team and targeted and designed for different groups,such as potential funders,policy makers,doctors, and families. • Create a strategic plan.Help Me Grow California Business Plan • Investigate leveraging of state and federal programs to support Help Me Grow. Rigorously explore how existing funding streams can be leveraged to ensure the sustainability of the Help Me Grow system. This includes funding for in- frastructure building and maintenance, such as ongoing training and technical assistance. • Monitor and evaluate progress. • Plan for the evolution of the Leadership Team as the Help Me Grow system moves from planning to implementation. For example, the team may become a steering committee. Leadership Team Infrastructure Checklist Exhibit A 19 Help Me Grow Building the Help Me Grow System: Infrastructure/Organizing Entity& Leadership Team National Center Create & Staff Core Component Work Groups The most important function of the Leadership Team is to create and staff Work Groups that will build the Help Me Grow Systems Core Components. Common questions asked by Work Groups include: • Who should chair each Work Group? • Who are potential Work Group members from the broader early childhood provider community? • How will Work Groups report on their progress and give recommendations? • How will recommendations be enacted? The Work Groups obtain support and guidance from those with expertise in the subject area. Only the Work Group chair needs to be a member of the Leadership Team,and often a community member of the Work Group serves as a co-chair. See the Help Me Grow South Carolina Work Groups Chart for an example of Work Groups staffed with Leadership Team members and community members. Leadership Team Meeting Agendas & Reports Guidance for First Work Group Meetings Collaboration and Action to Improve Child Health Systems: A Toolkit for State Leaders Next Step: Site Visit & Community Meeting Within the first few months of its work, the Leadership Team begins to inform its state and/or geographic region about the Help Me Grow system. This includes organizing and facilitating a Help Me Grow National Site Visit and Community Meeting, during which the Work Groups are created or expanded. Help Me Grow National Site Visit& Community Meeting Building the Help Me Grow System � , Attributes of an Effective Help Me Grow Leadership Team Neutral leader& neutral facilitator Leadership Skills, including but not limited to: Mission &vision alignment • Knowledge of early childhood development Clear operating principles • Cultural awareness&sensitivity across disciplines Actionable commitment • Respect&credibility to system sustainability • Deep and wide connection to broader community • Driver of the strategic plan • Tenacity, persistence, passion &flexibility • Develop longterm plan • Understanding of systems • Collective passion as opposed to"siloed" passion Exhibit A 20 Building the Help Me Grow System Infrastructure/Organizing Entity&Leadership Team it Help Me National Center ACTION PLAN The Organizing Entity & Leadership Team ❑ Select an Organizing Entity ❑ Organizing Entity: Designate a Program Manager ❑ Organizing Entity: Define Roles and Responsibilities of Leadership Team ❑ Organizing Entity: Identify & Recruit Leadership Team Members ❑ Program Manager: Plan and Convene Leadership Team Meetings ❑ Program Manager/Leadership Team: Create Team Infrastructure ❑ Program Manager/Leadership Team: Create & Staff Core Component Work Groups ❑ Program Manager/Leadership Team: Plan & Run the Help Me Grow Site Visit and Community Meeting Note that these are the broad tasks for selecting an organizing entity and creating a Leadership Team. The particular duties of the Program Manager and the Leadership Team are more detailed, as noted in the manual. Exhibit A 21 Help Me Grow Building the Help Me Grow System: Infrastructure/Organizing Entity& Leadership Team National Center CHECKLIST Leadership Team Infrastructure Develop core principles, including values, vision, and mission.* E Establish administrative structure: public, private, or combination L Define leadership team roles & responsibilities Determine meeting frequency Develop systems for communication Create stategic plan for implementation of Help Me Grow system, including statewide expansion Investigate leveraging of District and federal programs to support Help Me Grow. Periodically evaluate Team to see if changes are needed in membership/structure Transition to steering committee as needed *Leadership Team missions often include the following language: • Facilitate building of the Help Me Grow system • Create a plan/timeline to expand the system statewide • Secure sustainable funding for the Help Me Grow system or a path to sustainable funding. Exhibit A Building the Help Me Grow System: Infrastructure/Site Visit& Community Meeting •„ Help Me Grow National Center •He/p MeGtow NationalSite CommunityMeeting One of the first steps in bringing Help Me Grow to your state is a three-day Site Visit by staff from the Help Me Grow National Center, followed by a large Help Me Grow Community Meeting. For many potential Help Me Grow stakeholders, including state agencies, community-based organizations, parents, and advocates, the Site Visit and Community Meeting serve as an introduction to the Help Me Grow system. Many states use this activity as a kick-off for planning and implementation of their Help Me Grow system. Other states use it as way of introducing the key concepts that create the system. The Site Visit serves yet another function: It is extremely important that the National team learn about each state's specific programs and services. While states use many of the same programs and services (i.e., Early Intervention), each state's resources are tailored to meet the specific needs of their children and families. A Help Me Grow system does not change or reinvent these programs and services—but instead supports and maximizes their use to best serve the state. • IN THIS SECTION: Help Me Grow National Site Visit & Help Me Grow Community Meeting Preparing for a Help Me Grow National Site Visit Preparing for a Help Me Grow Community Meeting Running a Community Meeting: The Agenda Next Step: Building the Help Me Grow Core Components NOW Exhibit A First Edition,July 2014.Copyright 2014 Help Me Grow National Center.All rights reserved. 23 0vi F1*MeGrow Building the Help Me Grow System: Infrastructure/Site Visit& Community Meeting 24 National Center Preparing for a Help Me Grow National Site Visit Preparatory conference calls with the National Center During these calls we discuss the meeting agenda and venue,as well as share information on Community Meetings convened by other affiliates.Participation in the calls depends on the needs of the state. Usually the Program Manager and select Leadership Team members are involved. Key Informant Interviews National Center staff conduct interviews with key stakeholders who are responsible for programs in the state or region that impact the lives of children birth to eight.Through these interviews,the National Center stafflearn about the programs directly from the managers and providers of these programs;answer questions;and provide information on the Help Me Grow system. The interviews are done before the large Community Meeting so stakeholders are positioned to support the introduction of Help Me Grow to the community. Key Informant Interview Questions Preparing for a Help Me Grow Community Meeting Location and budget In preparing for the meeting, reserve a location with adequate capacity; free and easily accessible parking; and easy access through the mass transportation system. Determine if there is a need to offer child care and/or to cover transportation costs for families. Community Meeting budgets usually include the following items: • Cost of National Center Site Visit&technical assistance continued on next page • , Building the Help Me Grow Infrastructure Engaging the Pediatric Community Many child health providers cannot attend a day meeting without many months notice. Other affiliate states have hosted a gathering specifically for the child health provider community the evening before the Community Meeting. This gathering provides an opportunity for child health providers to meet the National Center staff and learn about Help Me Grow. This is often a chance to identify a Physician Champion who will join the leadership team and advocate for Help Me Grow. See Child Health Provider Outreach for more on the Physician Champion. Exhibit A 24 Building the Help Me Grow System: Infrastructure/Site Visit& Community Meeting ;; Help MeGrow National Center • Meeting space rental • Food (some affiliate states have found sponsors for the event who share food costs) • AN requirements • Presentation materials Action Plan for Site Visit and Community Meeting Scheduling Ensure the Community Meeting date does not conflict with other important meetings in your region. Consider how long attendees will have to travel.Note that full-day meetings require food purchase. Often sites receive funds for food from community foundations. Be sure to create a system to collect RSVPs before you send out save-the-date notices or invitations. Help Me Grow National used a free online service to track RSVPs for the 2014 Forum. Affiliates will often send save-the date notices several months in advance of the Communi- ty Meeting, followed by an invitation with RSVP request four to six week before the event. Save-the-Date Notices and Meeting Invitations Invitation List The Leadership Team should cast the widest possible net in order to ensure that everyone who may have interest and/or involvement in the Help Me Grow system is invited to attend. This includes all those with an interest in children's healthy develop- ment. We recommend representation from the following entities: • 2-1-1 • Hospitals • Child Care Resource and Referral(CCR&R's) 0 Parents • Children and Youth with Special Health • Physician/Champion Care Needs Program (CYSHCNs)/(Title V) 0 Physician outreach programs • Children's Trust Fund . Program Evaluators • Child advocacy groups • State Medicaid Agency • Early Childhood Comprehensive System • Specialized Call Centers Grant(EGGS) • State Health Department • Home Visiting Programs, including Maternal Infant and Early Childhood State Child Welfare Agency Home Visiting (MIECHV) • State Chapter of the American • Early Childhood Special Education(Part B) Academy of Pediatrics • Early Intervention (Part C) • Success By 6 • Family support groups United Way-Local Chapters • Foundations Universities Exhibit A Help Me Grow Building the Help Me Grow System: Infrastructure/Site Visit& Community Meeting National Center It is important to invite representatives from organizations who can speak on behalf of families and children, including those from child advocacy and family support groups. Invitees can also include government officials,such as commissioners from Departments of Health,Education, and Welfare. Sample Invitation List Running a Help Me Grow Community Meeting The meeting agenda Suggested agenda items include: • Welcome &The Help Me Grow Story. Leadership Team members share their support for the system and why it will be a powerful and effective asset for the state.The Help Me Grow videos,available at www helpmegrownational.org,are a powerful and compelling way to introduce people to the Help Me Grow story. • Help Me Grow National Presentation. A representative from the National Center presents the story of Help Me Grow; the science of early brain development in the context of assuring that children at-risk are linked to appropriate services;and National's experience with replication throughout the country. • Leadership Team Presentation. Leadership Team members share information on existing resources in their state that support the identification of children with behavioral and developmental risks, and how to link those children to appropriate community-based services. • Small Group Discussions.There are two options for organizing discussions. Option 1:Core-Component Specific Discussion After the Leadership Team presentation, attendees break into groups based on the four Core Components. Leadership Team members facilitate the small-group discussions, often paired with a community member representative. In these small groups,participants discuss how their system could work using the Help Me Grow framework, as well as determine potential gaps and barriers to successful identification and linkage to services. Option 2: General Discussion Organize attendees into small groups. Ideally, groups will be made up of attendees who wouldn't otherwise have crossed paths. Leadership Team members serve as facilitators and notetakers for each group as they discuss the questions below,typically for 20 to 30 minutes. -How do you see Help Me Grow benefitting children and families? -How will a Help Me Grow system support your work? Exhibit A Building the Help Me Grow System: Infrastructure/Site Visit& Community Meeting td F MpMeGrow National Center -How does your work align with the four core components of a Help Me Grow system: centralized access point, child health care provider outreach, community/family outreach, data collection and analysis? -What are the opportunities and challenges in designing a system that offers integrated access? -Who else should be participating in this initiative? -What do you see as next steps? • Groups Report Out. The small groups report out to larger audience by sharing: -up to 3 "ah-ha" moments -up to 3 steps that can be taken quickly to build the Help Me Grow system -up to 3 challenges that they see to building the system The notes from each group are compiled and sent to all participants. • Work Groups Sign-Up.Next,participants sign up for Core Component-based work groups to begin building the Help Me Grow system.Meeting dates will now be set.Or, the Leadership Team facilitators will determine the dates and share the information. Do keep in mind that Work Group members tend to have many commitments. It is recommended that meeting dates are scheduled several months in advance. See the following core component sections for more information on the tasks of each Work Group. The Leadership Team should circulate a list to collect contact information for any- one who was not able to attend the Community Meeting and might be interested in joining a Work Group. • Meeting Wrap-up with National Center. Typically, the National Center summarizes the meeting and outlines the state's strengths and opportunities as they move forward in creating a successful Help Me Grow system. Help Me Grow South Carolina 2008 Site Visit Agenda Community Meeting Small Group Discussion Questions South Carolina 2008 Site Visit Report Excerpt Next Steps in Building the Help Me Grow System Core Components Following the Community Meeting,the Leadership Team guides the Work Groups in the cre- ation and development of the Core Components. As the Work Groups move forward with system building, keep in mind that all the components of a Help Me Grow system are interdependent. They do not operate in isolation. The system infrastructure should encourage and support each component to communicate and collaborate effectively with the others. As the system grows, the Leadership Team monitors and evaluates progress from planning to implementation. It also creates a strategic plan to guide future growth. Guidance for First Work Group Meetings Exhibit A 27 Help Me Grow Building the Help Me Grow System: Infrastructure/Site Visit& Community Meeting National Center ACTION PLAN Site Visit & Community Meeting Prepare for a Help Me Grow National Site Visit ❑ Hold preparatory conference calls with National Center ❑ National Center staff conducts Key Informant Interviews Prepare for Help Me Grow Community Meeting Determine location and budget. The location requires adequate capacity free & accessible parking easy access through mass transportation ❑ Schedule meeting ❑ Create invitation list ❑ Establish RSVP system ❑ Send save-the-date notices and formal invitations ❑ Organize food& beverage if needed ❑ Arrange childcare if needed ❑ Arrange transportation costs if needed for families ❑ Create the meeting agenda ❑ Prepare presentation materials (including A/V equipment) Run the Help Me Grow Community Meeting Use momentum and information from Community Meeting to begin building Core Components in Work Groups Exhibit A 28 Building the Help Me Grow System:Core Components/Centralized Access Point 1 Help Me Grow National Center The The Centralized Access Point is built around a call center that is available through a toll- free phone line, fax and email. The call center is staffed by care coordinators who connect children and their families to appropriate community-based services and programs. Call centers must have access to a computerized resource directory and must utilize an automated client-tracking system. The call center serves as the Help Me Grow"go-to" place for family members, child health care providers, and other professionals seeking information, support, and referrals for children at risk for behavioral and/or developmental problems. Telephone services provide an effective, single point-of-access to community resources. They are cost-effective, easy to promote, efficient in identifying needs, and successful in supporting callers and triaging to appropriate services. New technology such as texting, apps,and online access to referrals,resources,and services can enhance telephone services. The Centralized Access Point is the Help Me Grow system linchpin. As such, the process of selecting a call center requires due diligence. It also provides an opportunity to share information on the Help Me Grow system and to involve entities that serve as telephone access points in the planning and implementation of the system. This section of the manual begins with guidance on the process for selecting a Help Me Grow Centralized Access Point. The process has three phases: 1. Establish a Centralized Access Point (or Call Center) Work Group 2. Research existing call centers 3. Make a recommendation to the Leadership Team dL iI IN THIS SECTION: A1011k P Centralized Access Point Establish a Call Center Work Group Research Existing Call Centers Make a Recommendation to the Leadership Team Transition to Establish & Launch Establish & Launch the Help Me Grow Call Center Exhibit A First Edition,July 2014.Copyright 2014 Help Me Grow National Center.All rights reserved. 29 • FkApMe Grow National Center Building the Help Me Grow System: Core Components/Centralized Access Point Establish a Call Center Work Group The Call Center Work Group researches call center options and makes a recommendation to the Leadership Team, ideally within a three month timeframe. (See Organizing Entity&Leadership Team for more on creating and staffing Work Groups.) The following is a partial list of organizations/individuals that have served on similar Work Groups convened by Help Me Grow affiliates.This list is meant to prompt discussion around the type of expertise needed to successfully complete the Work Group's task. • United Way&other funders of call centers, e.g, community foundations, hospitals • Nonprofit agencies that serve young children and their families • Advocacy groups • State agencies, such as Departments of Health (Maternal and Child Health MCH-Title V),Early Learning, Child Welfare, and the state agency that administers the state's Early Intervention program • Early care and education providers • Schools and universities • Parent representative(s) • Data specialist • Evaluator Structurally, the Work Group benefits from having co-chairs, with one chair being a member of the Leadership Team and the other a community representative(not necessarily a Leadership Team member). The identification and recruitment of Work Group members should be thoughtful and reflective of the knowledge and expertise needed to make an informed recommendation to the Leadership Team. When recruiting Work Group members,be clear about why they are being asked to serve, the purpose of the Work Group,and the expectations of membership, such as the number of meetings they are required to attend. Research Existing Call Centers With the assistance of the Help Me Grow Program Manager, compile a comprehensive list of call centers within the targeted geographic area. Examples of call centers that serve Help Me Grow's target population of young children,their families, and their providers include: 2-1-1 • Child Care Resource &Referrals (CCRRs) services • Maternal and Child Health (MCH) hotlines • Intake lines for Early Intervention (EI) and/or Early Childhood Special Education (ECSE) services • Parenting help lines Exhibit A 30 Building the Help Me Grow System:Core Components/Centralized Access Point otdil Hieb)MeGrow, National Center If a call center(s) in your area already serves young children and their families, partnering with it is the most efficient way, structurally and financially,to create access to services. Assessing Potential Call Centers The answers to these questions help determine a call center's capacity and interest in serving as the access point for Help Me Grow. • How long has the call center been operating? • How is it funded? • What is its reputation with families, providers and stakeholders? • Would serving as the access point for Help Me Grow be consistent with the call center's mission and goal? • What is the call volume? • What is the target population? (Note: The goal of Help Me Grow is to serve as a universal resource for families with young children.) • What is the capacity to handle requests for assistance concerning young children's physical, developmental and/or social/emotional growth? • To what degree are direct service staff currently trained in this substantive area? • How would Help Me Grow be embedded into the call center structure? • Would all direct service staff be trained in child development and the service delivery systems available to support Help Me Grow callers? Or would the call center create a specialized Help Me Grow unit? • How is information on community resources collected and maintained? • What information is collected on those who contact the call center? • Can new fields be added to the computerized resource directory, as well as new data within an existing field? Checklist: Assessing Potential Call Ceners Exhibit A 31 %� Help Me Building the Help Me Grow System: Core Components/Centralized Access Point National Center Keep in mind that a a Help Me Grow call center must be able to perform, at minimum, the following functions. Can existing call centers accommodate these functions? Functions of a Help Me Grow Call Center • Answer requests for assistance by families,health care providers,child care providers, and others who touch young children and their families • Maintain, in real time, a community resource directory • Within the geographic area served,have visibility among: -Health care providers -Child care providers -Other community based agencies -Families' network and communities • Collect data,via an automated client-tracking system, on calls handled by Help Me Grow care coordinators, including: -Caller demographics -How caller heard of service -Reason for call -Actions taken -Outcomes as a result of contacting the call center. -Common Indicators established by the National Center Checklist: Functions of a Help Me Grow Call Center The most direct way to obtain the information sought and engage potential partners is to meet with them. Prior to a meeting with call center administrators, Work Group members should view the call center website, review annual reports and other materials produced and consider calling as a consumer seeking services. Building the Help Me Grow System When Meeting with Existing Call Centers... Be prepared to explain the Help Me Grow system, particularly the essential role of the call center. Be able to articulate what value Help Me Grow brings to their service. Ascertain the call center's level of interest prior to leaving the meeting. Be clear on next steps. What would the call center need in order to serve as the Help Me Grow access point?What could the Leadership Team do to support the call center? Exhibit A 32 Building the Help Me Grow System:Core Components/Centralized Access Point ;; Help MeGrow National Center Make a Recommendation to the Leadership Team Once the fact finding work is completed and there is consensus among Work Group members as well as agreement to pursue this opportunity by the selected call center a recommendation can be made to the Leadership Team. Establishing a new call center is usually the costliest and least efficient option. Recommending that Help Me Grow establish a new call center should be a last resort and well-supported with the rationale. While the Work Group is responsible for making a recommendation to the Leadership Team, it is the Leadership Team's responsibility to review the recommendations and make the final decision on where the Help Me Grow call center will be housed. Transition from Research to Establish & Launch Once a call center agrees to serve as the Help Me Grow access point (or the Leadership Team decides to start a call center) the collaborative process to establish, launch, and maintain a call center commences.Key to the collaborative process is the Leadership Team's commitment to support the call center as it takes on the planning and implementation of serving as the access point for the Help Me Grow system. The Leadership Team's commitment needs to be concrete, specific, and outlined in a Memorandum of Understanding (MOU) that may need to evolve over time. The Help Me Grow Leadership Team's responsibilities in this MOU can include,but are not limited to: • Meeting with staff and/or Board members on a regular basis (internal meetings) • Researching and sharing funding opportunities to support the Help Me Grow services offered through the call center • Writing letters of support • Writing grant applications/proposals • Meeting with potential funding sources, key stakeholders, legislators, state agency representatives, community-based provider staff and groups that represent parents (external meetings) • , Building the Help Me Grow System Maintain Positive Relationships with Fellow Call Centers If more than one call center was under consideration to serve as the call center, make sure that the one(s) not selected can continue to be involved in the Help Me Grow system. A reciprocal relationship between the call centers would help all to feel included and provide a supportive infrastructure for networking efforts and efficient referrals. Exhibit A 33 %� Help Me Building the Help Me Grow System: Core Components/Centralized Access Point National Center • Assisting the call center in addressing its structural needs for expansion, such as space configuration and equipment • Posting Help Me Grow call center job opportunities • Identifying trainers and training opportunities for care coordinators • Assisting in marketing the service • Promoting and sharing the data collected Establish & Launch a Help Me Grow Centralized Access Point This section provides guidance on how to establish the Help Me Grow access point within the selected call center and launch the service. Leadership Team responsibilities The Leadership Team's collaborative responsibilities in this process include: • Ensuring that the call center creates an access point that demonstrates fidelity to the model • Supporting the call center as it identifies its needs—structural,personnel, funding,etc.—in order to serve as the Help Me Grow access point • Agreeing with the call center on what needs to be added or enhanced and developing a plan to meet the identified needs ' The Help Me Grow National Network Delaware 244 Help Me Grow 2-1-1 Help Me Grow is a centralized call center that connects families to child development services and other resources within the state. This call center serves to seamlessly link for children and families to community based programs and services. By calling this one number, parents can be connected to dozens of programs to help their child. This eliminates the need for parents to search for phone numbers on their own, streamlining what was once a complicated system. When parents call 2-1-1 Help Me Grow, parents are connected with an .;, 2�,�14.J ' experienced child development specialist, who answers questions and connects them with the community-based programs and services in their area. All parents need to do is to provide the referral from their primary care provider or describe their everyday observations of their child to the child development specialist. From there parents will be connected with the best resources to address their child's specific needs. Learn more at dethrives.com/help-me-grow. Exhibit A 34 Building the Help Me Grow System 111WSteps to Implementation Develop a startup budget and a maintenance budget A Help Me Grow call center startup budget needs to reflect all the essential components of the Help Me Grow access point with minimal startup staffing. The maintenance budget should reflect the cost of a fully functioning Help Me Grow access point that can handle a call volume based on marketing and caller demand. Typically the Leadership Team and Call Center Work Group, in partnership with the call center, draft the startup and maintenance budgets.As the budgets are developed, the four steps below need to be incorporated into them. These steps are presented in a logical flow for establishing and launching the call center. In reality,the process is fluid. The tasks described under each step may blend, occur simultaneously,or happen in a different order. As you work through the steps, revise the budget accordingly. For example, the Help Me Grow call center's salary ranges and staffing requirements will need to be consistent with the call center in which it is embedded. For a budget template see Framework for a Help Me Grow Call Center Budget. For a sample of a completed implementation budget see Help Me Grow South Carolina Proposed Implementation Budget. Once the budgets are finalized and agreed upon by all parties,the organizing entity and the Leadership Team need to be specific about how they will support the call center in securing funds for Help Me Grow. (See the Funding&Expansion Help Me Grow for funding guidance.) Step 1: Assess Staffing Needs & Gather Information on Community Resources Staffing • How many staff members (administrators/supervisors and care coordinators) are needed to accommodate the geographic area and racial and ethnic populations targeted? 1. In projecting the number of care coordinators needed,factor in the difference between the staff who answer the phones at the call center and Help Me Grow care coordinators. Call center staff are responsible for a broader range of issues and a higher call volume than Help Me Grow care coordinators,who have a lower number of cases with an increase in intensity and scope. continued on next page Exhibit A • He1pMe Grow National Center Building the Help Me Grow System: Core Components/Centralized Access Point 2. Since the Help Me Grow supervisor/manager will be a new position within the call center, a job description needs to be developed. A job requirement should be knowledge of and a background in child development or a related field. • What is the scope of systems/resources the Help Me Grow call center will be responsible for knowing?This scope will expand over time. • What are the expectations of funders?What has the call center been contracted to do? For more information see the Help Me Grow Iowa Centralized Intake Best Practice Guide • What is the anticipated volume of calls? This figure will also grow over time. To help with call volume estimates, see Help Me Grow Utah Call Capacity Grid. Community Resources If the Help Me Grow call center is joining an operating call center,what relevant resources are already being collected and maintained?What is the scope of information collected? Call centers use a number of data resource systems. Review the system currently used by the call center to determine if Help Me Grow resource information is or could be collected in the system. Keep in mind what types of information you would like made available to call center staff and ultimately to families. The Alliance of Information and Referral Systems (AIRS) and 2-1-1 LA County offers support and guidance on developing a "human services taxonomy".The AIRS/2-1-1 LA Taxonomy of Human Services defines this as "a classification system that allows you to index and access community resources based on the services they provide and the target populations they serve, if any. It provides a structure for your information and it tells people what is in your information and how to find it. Help Me Grow requires resource information and knowledge on the following: Early intervention (Part C) Preschool Special Education (Part B) Early care and education Primary health care providers Mental health Parent education and support groups State agencies/programs, including -Children and Youth with Special Needs (CYSHCNs) -Medicaid/Children's Health Insurance Plan (CHIP) Local community-based agencies Advocacy groups/legal rights organizations continued on next page Exhibit A 36 Building the Help Me Grow System:Core Components/Centralized Access Point Help Me Grow National Center Step 2: Hire Staff and Expand Resource Directory Staffing • Using the experiences of affiliates as guidance, develop job descriptions for administrators and care coordinators. • Use effective vehicles to advertise job openings. Strategic advertising will create a pool of appropriate applicants. Promote the openings within the call center and at colleges and universities that offer degrees in relevant areas. Identify agencies in the Help Me Grow resource database that post job openings, and post the positions with them. • Prepare for interviews. • Check references. • Hire staff. Sample Job Descriptions Resources for Hiring Call Center Staff Community Resources • Decide what additional information is needed for Help Me Grow calls and how it will be incorporated into the community resource directory. Step 3: Train Staff, Update the Resources & Establish Client Tracking System Staffing • Develop an orientation package. • Develop internal protocols within the call center for transferring calls, coding cases, and following up with callers. Training Topics for Care Coordinators New Team Member Checklist: Care Coordinator Help Me Grow Connecticut: CDI Protocols for Handling Calls Help Me Grow Connecticut: CDI Protocols for Triaginp, Referrals Community Resources • Implement system(s) for collecting additional information needed for Help continued on next page Exhibit A Help Me Grow Building the Help Me Grow System: Core Components/Centralized Access Point National Center Me Grow calls. Be aware of possible legal issues related to referring to for- profit services or private practices. If those are important resources for families in your area,think about how that information can be shared. Sample Call Center Protocols and Forms Further Resource Directory Information Establish 5 Maintain an Automated Client Tracking System Notes on Data Collection Call centers are in a unique position to collect data that reflect system-level issues—information not only on who calls and why,but on what happens to families seeking help. Many call centers also have the ability to track barriers experienced by families referred for services. A client tracking system captures the issues families are experiencing,the actions taken on their behalf, and outcomes as a result of contacting the call center. All Help Me Grow call centers collect data for generating external and internal reports. External reports are shared with the Help Me Grow Work Groups, funders,legislators,providers, advocates, and the media. They help identify best practices,needs, gaps, and barriers. Internal management reports ensure the accuracy of information given, referrals made and coding consistency among the care coordinators. Help Me Grow data collection falls into five broad categories: • How the caller heard about Help Me Grow • Demographics on the child (or family) in need of assistance • Assistance sought • Action taken by the Help Me Grow care coordinator • Outcomes as a result of contacting the call center The Help Me Grow National Center has established Common Indicators to assist with data collection. All Help Me Grow affiliates are required to collect and report data on this set of indicators. Data collected will help you monitor your progress and share lessons learned with other states and the National Center. Additionally, collected data enables you to: • Contribute to the national dialogue on promoting early detection and intervention and the role of Help Me Grow systems in doing so • Learn how your system data compares to aggregate national data • Have the National Center advocate on behalf of the National Network more effectively • Serve, with the National Center, as leaders in the child development field See Data Collection &Analysis continued on next page Exhibit A 38 Building the Help Me Grow System:Core Components/Centralized Access Point Help Me Grow National Center Steps to establish and maintain an automated client tracking system • Determine if Help Me Grow's data requirements can be collected within the call center's current automated client tracking system. • If not, research the viability of using the automated client tracking systems developed by Help Me Grow Orange County or Help Me Grow Utah. • Write and maintain a manual for coding cases in the automated client tracking system. A manual ensures consistency of coding among the care coordinators and provides a frame of reference for coding questions. The manual needs to address coding from both a technical and substantive perspective. It is imperative that it is maintained. Having a coding committee with responsibilities that include maintaining the manual will help to ensure that it stays current. Help Me Grow California Orange County: STAR Database Help Me Grow Utah Family Database Step 4: Launch the Call Center Soft Launch A soft launch is an opportunity to test the Help Me Grow call center's operational readiness. By"going live" on a limited basis,this field test allows the call center to experience actual calls that often provide insight to needs that were not identified or addressed in the planning process. Official Launch Once issues identified through the soft launch have been addressed,the call center is ready for the official launch. A more comprehensive strategic plan supports a successful official launch, including the marketing and public awareness efforts of the Outreach Work Group. When other organizations market Help Me Grow, their efforts must be coordinated with the call center. Care coordinators need to know what kinds of potential calls they may receive as a result of the marketing efforts. Once these calls are received,the information collected through the automat- ed client tracking system,particularly how callers heard about Help Me Grow, can inform ongoing marketing efforts. This information is helpful not only to the call center,but also to the Provider Outreach and Community Outreach Work Groups and staff.:: Exhibit A 39 %� Help Me Building the Help Me Grow System: Core Components/Centralized Access Point National Center Developing care coordinator training curriculum & identify trainers There are two levels of care coordinator training: • Orientation for newly hired staff • Ongoing training There are a range of vehicles for training care coordinators, including,but not limited to: • Reading material • Staff meetings and in-service days • Pre/post tests • Conferences • Online courses • Webinars • Role-playing • Case studies • Job shadowing • Peer-to-peer mentoring • Call listening • Case discussion • Meetings with collaborators • Eco-maps There are a number of resources for identifying and recruiting trainers, including: • Help Me Grow call center supervisors • Seasoned care coordinators from both the Help Me Grow call center and the call center in which it is embedded (or with whom there is a formal relationship) continued on next page ' Building the Help Me Grow System National and Local Sources for Training While each Help Me Grow affiliate call center is unique, there are common components among all. The Help Me Grow National Center offers guidance on those common components and shares examples of call center trainings, curriculum, and other products and suggestions from affiliate sites. In addition to the resources available through the National Center, it is advisable to tap local resources to assist in training and supporting call center staff. Exhibit A 40 Building the Help Me Grow System:Core Components/Centralized Access Point Help Me Grow National Center TRAINING TOPICS FOR CARE COORDINATORS Topics Orientation Ongoing Job description, role & responsibilities, X and the support/resources available Skills needed for handling a Help Me Grow call: • active listening skills • interviewing techniques X X • being non-judgemental The questions to ask and how to ask them X X Overview of relevant state-level systems X X and formal relationships with these systems, in any Cultural competence and sensitivity X X Child development & Developmental Screening X X Medical information privacy regulations (HIPAA) X X Chronic health conditions X X and behavioral health issues of young children How to handle difficult callers X X Protocols for handling crisis calls X X Using the resource directory X X How to code cases X X in the automated client-tracking system w The Help Me Grow National Network Call Center Expertise within the National Network Help Me Grow affiliate states have learned many valuable lessons as they designed and implemented their call centers. It is strongly recommended to reach out to Network peers for models, advice, and lessons learned. Help Me Grow Directory of Expertise Call Center Specialists Exhibit A 41 %� Help National Center MeGrow Building the Help Me Grow System: Core Components/Centralized Access Point • Staff with expertise from direct service agencies, universities, parent and advocacy organizations • Physician champion • Representatives from relevant state systems, such as Early Intervention; Preschool Special Education; Early Childhood Comprehensive Systems (ECCS) grant;home visiting programs,including the federal Maternal,Infant and Early Childhood Home Visiting(MIECHV)program;Project LAUNCH;Race to the Top Recruiting and utilizing volunteers and student interns Given the amount of work needed to maintain a well-functioning call center, consider using volunteers and/or student interns to supplement the work of the call center staff. For volunteers, AmeriCorp VISTA is a reliable national resource. Check with local Unit- ed Ways on other resources for recruiting volunteers. Be thorough and thoughtful in determining how volunteers will be used and supported. For interns, research schools within the geographic area of the call center to identify those that offer degrees in relevant areas. Review their requirements for student placements, community projects and internships. Contact schools that are a potential match for Help Me Grow's intern needs and offerings. Prior to securing student interns,make sure that the call center can meet the requirements needed to be a student placement and has the administrative infrastructure and time to support interns. Help Me Grow Utah Volunteer Training Curriculum Help Me Grow Utah Intern Manual Help Me Grow National Webinar: Enlisting Volunteers & Interns ' The Help Me Grow National Network Help Me Grow Connecticut: Child Development Infoline < <Every day, the Child Development Infoline care coordinators amaze me. They work with families whose children have disabilities or other behavioral issues, with families struggling with financial issues or other stressors, and with families who just want more information so they can help their child develop as healthfully and happily as possible. Each call is important to the staff and they take care to do the best they can for every family. This is the heart of Help Me Grow." —Kareena Duplessis, Child Development Infoline Director Exhibit A 42 Building the Help Me Grow System:Core Components/Centralized Access Point ;; Help Me Grow National Center Framework for a Help Me Grow Call Center Budget LINE ITEMS START UP MAINTENANCE NOTES BUDGET BUDGET STAFFING & BENEFITS Help Me Grow Supervisor Could be a %of another call center staff member. These are the direct service staff who Care Coordinators answer the calls and work directly with families and providers This person is responsible for Resource Data Manager maintaining the resource inventory. Could be a %of another call center staff member. Data Collection This person is responsible for ensuring Technical Support that the data collected through the automated client tracking system generates valid and reliable data required for the Common Indicators and internal management reports as well as external reports that document needs of children and families who call the Help Me Grow access point. Could be a %of another call center staff member. Administrative Support Could be a %of another call center staff member. Benefits Calculated based on the call center's benefit rate. NON PERSONNEL Space Renovations (if needed) This is a one-time cost. Furniture Equipment(phones, Adding a separate line for Help Me computers, etc.) Grow will involve one-time start-up costs and an ongoing monthly expense. Supplies Staff training & development Travel Exhibit 43 Developmental Screening and the Help Me Grow System Developmental screening is an indispenable tool for detecting children at developmental risk. However, it is of value only to the extent that it is paired with developmental surveillance and with linkage to appropriate and effective programs and services. The Help Me Grow system is designed to be that necessary link between screening, surveillance, and connection to community resources. "Screening and surveillance are too often viewed as separate activities," writes Paul Dworkin, M.D., on The Help Me Grow Blog. "This perspective minimizes the effectiveness of both. Surveillance without screening is likely to contribute to children eluding early detection, while lofty expectations for the isolated use of screening tools may result in over- or under- identification" (See the July 2006 AAP Policy Statement for recommendations on how child health providers can use developmental surveillance.) When accurate detection does occur, linkage to appropriate services must follow. Ellen Perrin, M.D., Director of Research at the Center for Children with Special Needs and professor at Tufts University School of Medicine, questions the ethics of detection without the provision of services. She states, "Detection without referral/intervention is ineffective and may be judged unethical."' The following examples show how four Help Me Grow affiliates use their centralized access point to provide families and child health providers both screening and surveillance tools and linkage to community resources. Help Me Grow Connecticut Ages & Stages Monitoring Program Help Me Grow Connecticut offers the Ages & Stages Child Monitoring Program via Child Development Infoline (CDI). The program is voluntary, free, and designed for families with infants, toddlers, and/or preschoolers. To begin the process, a family completes the online program enrollment form or fills out a paper form to send to CDI. CDI then mails a developmental questionnaire and postage- paid envelope to the family as the child reaches the appropriate age. The family returns the completed questionnaire to CDI, where the staff score it. If the questionnaire shows that the child is developing on schedule, CDI sends a letter saying such to the family and encloses suggestions for fun parent-child activities. CDI mails the next age-level questionnaire to the family at the appropriate time. If a questionnaire leads to a concern, a CDI Care Coordinator contacts the family for further discussion. This process may result in a development evaluation completed by Connecticut Birth to Three System if the child is under age three, or by the local school district if the child is between the ages of three and five. With the parents' consent, the results of the questionnaires are sent to the child's primary health provider. Help Me Grow Michigan Regional ASQ Developmental Screening Project Michigan uses state funds along with a grant from United Way for Southeastern Michigan to support the Regional ASQ(Ages & Stages Questionnaire) Developmental Screening Project in the Metropolitan Detroit area. Other counties have begun to use this screening tool and as a result, Help Me Grow Michigan is leveraging the regional efforts into a statewide approach. Help Me Grow Michigan has also created annual regional and county data profiles based on the ASQ results; a one-page FAQ on the project; and a comprehensive list of ASQ project partners. Exhibi rHelpMe Grow Delaware PEDS Online PEDS Online is a web-based tool that allows parents to complete a free developmental screening assessment. The tool is electronically scored and the results are available for the child's health provider to review with the parent at the next well-child visit. The Help Me Grow Delaware Health Provider Outreach staff coordinate efforts to promote the use of PEDS Online, including Grand Rounds at all major hospitals in the state; Meet and Greets within the state's three counties; and speaker sessions by PEDS author Frances Page Glascoe, Ph.D. To date, approximately 11,000 developmental screens have been administered in Delaware with the participation of 28 pediatric and family practice centers. Recently the PEDS referral system was streamlined to ensure that physicians utilize the 2-1-1 Help Me Grow call center as a referral source for families. The outgrowth of this effort has been the development of a PEDS promotional kit that includes an algorithm on the PEDS referral process and an intake form for physicians. Help Me Grow Washington Child Development Screening Washington State's Within Reach Call Center provides the Ages & Stages tool both online and by telephone. The state's first Help Me Grow call from a parent resulted in the care coordinator using the ASO.to complete a screening over the phone with the mother, who worried that her young daughter might not be getting the services she needed. The screening results prompted referrals made for the child, who did receive effective and appropriate help. Help Me Grow Washington created a powerful video about the experience. (See also the Help Me Grow Washington PowerPoint.) The Help Me Grow system can also support screening in other sectors, such as child care settings. See Community & Family Outreach and Child Health Provider Outreach for more information. See the Administration for Children and Families's Thrive by Five Initiative for detailed information on screening tools and further resources for child health providers and families. • V Building the Help Me Grow System it The Health Insurance Portability and Accountability Act (HIPAA) Questions regarding HIPAA compliance often arise when a health provider contacts the Help Me Grow Call Center. The Federal HIPAA Standards for Privacy of Individually Identifiable Health Information, or Privacy Rule, address the disclosure and use of individual's protected health information. The Privacy Rule permits a Covered Entity to disclose protected health information for the purposes of treatment, payment, and health care operations, including care coordination. A Covered Entity refers to a health plan, health care provider or health care clearinghouse. A Help Me Grow centralized access point is not considered a Covered Entity, A summary of the HIPAA Privacy Rules can be found here. Exhibit A 1 Perrin E. Ethical questions about screening. J Dev Behav Pediatr 1998; 19:350—352 45 jtj F1*MeGrow Building the Help Me Grow System: Core Components/Centralized Access Point National Center ACTION PLAN Help I'le Grow Centralized Access Point PLANNING ❑ Select a Help Me Grow Centralized Access Point ❑ Establish a Call Center Work Group ❑ Research existing call centers ❑ Make a recommendation to the Leadership Team ❑ Transition to Design & Implementation ❑ Partner with a call center& establish an agreement ❑ Outline a Leadership Team Memorandum of Understanding IMPLEMENTATION ❑ Establish & Launch the Call Center ❑ Develop a Help Me Grow Call Center budget ❑ Clarify Leadership Teams responsibilities ❑ Assess staffing needs & gather information on community resources ❑ Hire staff and expand the resource directory ❑ Train staff, update the resources, and establish & maintain an automated client tracking system ❑ Launch the Help Me Grow Call Center Exhibit A 46 Building the Help Me Grow System:Core Components/Centralized Access Point Help Me Grow National Center Sample Job Descriptions Help Me Grow California-OC Care Coordinator Help Me Grow California-OC Supervisor Help Me Grow Connecticut: Care Coordinator Help Me Grow Delaware: Child Development Specialist Help Me Grow Louisiana: Care Coordinator Help Me Grow South Carolina: Program Manager Help Me Grow Washington: Program Lead Help Me Grow Utah: Care Coordinator Help Me Grow Utah: Call Center Manager Resources for Hiring Call Center Staff Help Me Grow Utah: Interview Form/Care Coordinator Interview Questions Help Me Grow Utah: Interview Form/Second Interview Email Help Me Grow Utah: Interview Form/Second Interview Prep Sheet Help Me Grow Utah: Interview Form/Second Interview Case Scenarios Help Me Grow Utah: Interview Form/Questions for References Help Me Grow Utah: Overview of Weekly Hours Sample Call Center Protocols and Forms Help Me Grow Connecticut: CDI Call Center Case Examples Help Me Grow Connecticut: CDI Intake Sheet Help Me Grow Connecticut: CDI Notes from Parents Help Me Grow Utah: Early Intervention Referral Form Further Resource Directory Information Help Me Grow Utah: Resource Database Help Me Grow Utah: Inclusion Policy for Resource Database Exhibit A 47 Help MeGrow Building the Help Me Grow System: Core Components/Centralized Access Point National Center Exhibit A 48 Building the Help Me Grow System:Core Components/Provider Outreach ;; Help MeGrow National Center ChildHealth One of the four core components of a Help Me Grow system is Child Health Provider Outreach. Child health providers,who have near universal access to young children,are in a unique position to identify children who are at risk for developmental delay or behavioral problems. Their work with families also requires that they provide ongoing monitoring of children's developmental status. Given providers' critical role in child development, Help Me Grow staff members conduct targeted outreach to child health providers through office-based education, trainings and/or workshops. The purpose is to educate and motivate physicians and other child health care providers to: Systematize developmental surveillance and screening and the use of Help Me Grow in their practices. In addition, staff members conduct follow-up office visits to leave materials, maintain visibility of Help Me Grow and learn about local issues,specific needs,and best practices in supporting developmental surveillance and screening. IN THIS SECTION: Child Health Provider Outreach Create & Staff a Child Health Provider Outreach Work Group Design & Implement Child Health Provider Outreach • Identify staffing needs I • Develop provider outreach budget • Develop provider outreach training curriculum • Create materials for office-based trainings & presentations L • Conduct trainings & presentations • Special Section: Help Me Grow Maintenance of Certification • Measure, evaluate & improve child health provider outreach efforts Exhibit A First Edition,July 2014.Copyright 2014 Help Me Grow National Center.All rights reserved. 49 %� Help Me National Center Building the Help Me Grow System:Core Components/Provider Outreach Create & Staff a Child Health Provider Outreach Work Group The purpose of the Work Group is to be a vehicle for obtaining support and guidance from those with expertise in child health and development,developmental screening and surveil- lance, provider outreach and engagement. Common Work Group questions include: • Who should chair the group? • Who are potential Work Group members from the broader community? • What are the tasks of the Work Group? • How will this group report on their progress and give recommendations? • How will recommendations be enacted? Determine Work Group chairs and membership Ideally, the core of this group is formed during the Help Me Grow Community Meeting. Leadership Team members make sure to include other stakeholders who may not have attended the community meeting. Two co-chairs are ideal. One should be a member of the Leadership Team, and the other a community child health provider, ideally the identified physician champion. Note that • ` Building a Help Me Grow System Finding a Physician Champion The physician champion serves a key role in the development of an Help Me Grow system. They give the system credibility and authority, particular for the physician community. Physician champions with strong connections to university medical schools and a background in developmental-behavioral medicine can be good matches for Help Me Grow. Other affiliates have found that retired physicians are interested in serving in this capacity. He or she is often a member of the leadership team. Typically the physician champion takes on the following duties: • attend outreach trainings at doctors' offices as available • market Help Me Grow to physician community to bridge sector gap • attend and present at state AAP meetings on Help Me Grow For example, Desmond Kelley, M.D., is the physician champion for Help Me Grow South Carolina. He is an outstanding advocate, regularly sharing his presentation Why Physicians Should Love Helo Me Grow. Learn More: Help Me Grow Oregon Physician Champions Exhibit A 50 Building the Help Me Grow System:Core Components/Provider Outreach ;; Help MeGrow National Center other Leadership Team members can serve on the Work Group as well,as long as there are individuals outside the Leadership Team involved. Examples of Work Group members include representation from: • AAP and/or AAFP • Medicaid state department • Children's hospitals • Community members Complete Work Group tasks This group analyzes how Help Me Grow child health provider outreach would fit into the community and establishes important relationships in that community. Tasks include: • Research and meet with organizations that already provide outreach and/or can serve as entities to manage Help Me Grow provider outreach efforts • Establish a relationship with the local chapter of the American Academy of Pediatrics and/or the Academy of Family Physicians • Identify potential physician as a Help Me Grow champion if not already secured • Make recommendations to the Leadership Team for provider outreach efforts Share recommendations with Leadership Team The Work Group is responsible for making recommendations to the Leadership Team for how Help Me Grow provider outreach should proceed. The Leadership Team is responsible for reviewing those recommendations and making final decisions if they have the authority, or bringing it to the final decision maker. The Work Group has now completed its task and may evolve into an advisory resource as Help Me Grow provider outreach is implemented. • , The Help Me Grow National Network it Provider Outreach in Affiliate States Affiliates have organized their provider outreach in several different ways. • Help Me Grow Orange County employs a provider outreach coordinator. • Help Me Grow South Carolina secured grant funding for the provider outreach position. • Help Me Grow Connecticut works in collaboration with a not-for-profit organization that performs provider outreach. Exhibit A 51 %� H>r1pMQ Grow, National Center Building the Help Me Grow System:Core Components/Provider Outreach Leadership Team enacts recommendations The Leadership Team reviews the recommendations and makes the final decision on how Help Me Grow child health provider outreach will proceed. Once this decision is made and agreed upon by all parties, the organization and staff members who will be directly responsible for outreach now take the baton. The Leadership Team, however, needs to cre- ate a system to serve as a reliable support and resource as this component grows. The Community Outreach Liaison may also conduct provider outreach. No matter where provider outreach originates, the staff must have a strong ongoing relationship with the Call Center care coordinators. Design & Implement Child Health Provider Outreach Identify staffing needs& hire as needed Building on the work of the provider outreach Work Group, the chosen entity assesses its current staff and determines what must be added to meet the needs of Help Me Grow provider outreach. This process holds whether the outreach originates at the call center or an outside agency. There are six questions to ask regarding the provider outreach staff: 1. Are they already employed at the entity responsible for provider outreach? 2. Are more staff needed? 3. How will they be recruited and retained? 4. Are there other staff roles that need to be filled to support provider outreach? Building a Help Me Grow System ' Attributes of Effective Child Health Provider Outreach • Identify a Physician Champion • Use the Academic Detailing Model (office-based training) • Loop information back to physician • Establish relationship with state AAP or AFP chapter • Identify lead for management and coordination • Use child health provider outreach staff • Develop and use training curriculum • Create and use an evaluation tool Exhibit A 52 Building the Help Me Grow System:Core Components/Provider Outreach ;; Help Me Grow National Center 5. What organizational infrastructure is needed to support provider outreach? Because all the components of a Help Me Grow system are interdepedent, the system infrastructure should allow each component of the system to communicate well and collaborate easily. 6. Can the same staff conduct community and provider outreach AND marketing? Help Me Grow Connecticut: EPIC CoordinatorJob Description Develop provider outreach budget These are the basic line items to consider when creating a provider outreach budget. If provider outreach is staffed within an existing call center,maximizing and sharing resources can greatly reduce the cost. • Food for office-based training • Salary for provider outreach staff • Computer • Travel reimbursement(Outreach staff typically cover a large geographic area for trainings.) • Presentation materials • Office space • Cell phone Help Me Grow South Carolina Proposed Implentation Budget Develop provider outreach staff training curriculum There are five main topics for provider outreach staff training.They can be adapted for your staff's needs. • What office-based training is &why it works • How to deliver effective office-based trainings • The ins and outs of developmental surveillance and screening • Presentation &networking skills when working with child health providers • Communicating and collaborating easily and well with the rest of the Help Me Grow system All topics should be included in orientation trainings. Ongoing trainings cover emerging research in the field of developmental surveillance and screening, as well as tools and techniques for communicating and collaborating well within the Help Me Grow system.The appendix contains a wealth of material to inform your provider outreach training. Provider Outreach Staff Training Resources Exhibit A 53 Reframing the Early Detection and Early Intervention Pathway by Paul Dworkin, M.D., Founder of Help Me Grow Since its inception in 1998, a fundamental Translating Evidence-Based Developmental premise of Help Me Grow is that developmental Screening (TEDS) study. While I commend the surveillance and screening, with early detection researchers for assessing the feasibility of of at-risk children and their referral to community implanting developmental screening into primary resources, enhances the capacity of the medical care, I am less enthusiastic about their comparison home to support families in raising healthy children. of the effectiveness of standardized screening with The National Center promotes Help Me Grow as that of"routine developmental surveillance" an evidenced-based approach to early detection Surveillance and screening represent a single and intervention. Recently published research now process, not separate components amenable to offers further evidence of the validity and comparison.This comparative analysis is a "straw importance of our collective efforts. man" argument that contradicts the AAP policy A Summer 2012 brief from the PolicyLab of statement and is even incompatible with the views The Children's Hospital of Philadelphia Research of certain screening advocates. My favorite Institute advocates for a more coordinated example is the renaming of the revised Denver approach to meeting children's developmental Developmental Screening Test-Revised as the needs and the adoption of the SERIES paradigm Denver II in 1992 by Bill Frankenburg and of developmental screening in which each step colleagues, who dropped "screening test"from the (Screening, Early Identification, Referral, Intake, title and reframed the tool as an aid to surveillance, Evaluation, and Services) is seen as an integral much in the manner of a growth chart. component of a single process. Their emphasis is Still,the researchers'findings are important and concordant with our formulation of developmental compatible with the Help Me Grow experience. surveillance and screening as a single process Despite implementation of the ASQ during 73 combining longitudinal monitoring with the percent of well-child visits in the study, only two- periodic administration of formal screening tools. thirds of children referred by their pediatrician Indeed,too often surveillance and screening are received a successful early intervention intake and viewed as separate activities,thereby minimizing multidisciplinary evaluation and only 11%of those the effectiveness and potential benefits of either who failed developmental screening ever received Furthermore, despite the clarity of the 2006 policy intervention services. The investigators conclude statement of the Council on Children with that cross-system information exchange and Disabilities of the American Academy of Pediatrics intake processes must be strengthened to meet (AAP),the surveillance/screening interface may be the developmental needs of children. inappropriately viewed as an "either/or" option. Findings from this study validate our Help Me Yet surveillance without screening is likely to Grow experience and the importance of ensuring contribute to children eluding early detection, that early detection leads to the linkage of at-risk while the isolated use of screening tools is children and their families to community-based challenged by lofty expectations despite programs and services.That multiple contacts are modest psychometric properties and may required to facilitate such linkage emphasizes the result in over-or under-identification. We have critical need for effective care coordination and the long been critical of the "relentless pursuit of the importance of facilitated access to programs and perfect screening tool,"since we do not believe services through a single portal of entry. Cross-sec- that such tools should be used in isolation, but for collaboration among child health, early care rather within the context of all that is known of the and education, and family support providers is child and family through longitudinal surveillance. integral to the Help Me Grow process.The authors The PolicyLab brief draws upon their recent of the brief acknowledge Help Me Grow among the experience implementing developmental screening successful strategies to enable the "spectrum of in four urban primary care practices as part of the referral" approach. Read Dr.Dworkin's original blog post. Exhibit A Building the Help Me Grow System:Core Components/Provider Outreach ;; Help MeGrow National Center Create materials for child health provider trainings and presentations Let this be your rule of thumb: Short and to the point. You may find print materials work best,as PowerPoint presentations are less effective due to time and space limitations. No matter your medium, make sure to cover three key points: 1. Doctors need to ask parents: Do you have concerns about your child's development, learning, or behavior? 2. Help Me Grow supports pediatricians so they can connect families to community resources that address developmental,learning, and/or behavioral concerns. 3. Developmental surveillance should be done at every well-child visit, and developmental screening should be done at 9, 18, and 24 and/or 30 months, per AAP recommendations. (See the AAP policy statement on screening and surveillance.) EPIC Presentation: Developmental Screening &Help Me Grow Developmental Screening & the Help Me Grow Call Center It is hard to overstate the importance of carefully planned education,training,and follow-up for child health providers on effective developmental surveillance and screening. The goal of a training session is to share with providers why Help Me Grow saves time and makes their practice both more effective and more efficient. During the training, outreach staff should also provide reimbursement info.After, outreach staff conduct follow-up visits and stay in ongoing contact to identify improvements in the practice's use of screening and surveillance. Provider Outreach Training & Presentation Resources See Marketing Help Me Grow • , Building a Help Me Grow System How Help Me Grow Helps Doctors Reduce Health Care Costs Help Me Grow National's 2012 Policy Brief, "Cost Benefits of"De-medicalizing" Childhood Developmental and Behavioral Concerns: National Replication of Help Me Grow Policy Brief;' can be a powerful tool in explaining how the system can help doctors reduce health care costs. National collaborated with Help Me Grow Orange County to identify the cost savings of connecting families to community-based services rather than high-end referrals such as neurology, psychiatry, and developmental pediatric evaluation. Scaling the Orange County data up to the U.S. population, we find that nationwide Help Me Grow replication has the potential to "de-medicalize" an estimated 218,651 children annually through earlier detection and more cost-effective treatment-- and save an estimated$50 million per year. Exhibit A 55 Help Me Grow Building the Help Me Grow System: Core Components/Provider Outreach National Center Conduct office-based trainings in developmental surveillance and screening Selected Tips for Engaging Providers • Providers have limited time and require brief,focused information that will be useful to them and their patients. The availability of a system for referring children and families to programs and services is an incentive for doctors to talk with the families about their developmental and behavioral concerns, especially for those children who may not be eligible for early intervention and preschool special education services. • Include the entire office staff. Implementing screening and utilization of Help Me Grow requires staff collaboration. • Remember that you are at the mercy of the practice's schedule: presentations must stick to the allotted time;providers will be late and leave early; and emergencies will keep some from attending. • Be prepared to answer a lot of questions during and after the presentation. • Bring resources that will help the practice implement screening and referral such as magnets with the Call Center's telephone number, sample copies of screening tools, and stickers for charts to remind providers that children have been referred to Help Me Grow. • Bring food to draw staff away from their desks. • Be flexible in terms of providing practices with the information they want. Some already screen and have a list of referral options.Work with these. • Distribute feedback forms to assess how your presentations are going. Regularly review feedback and make adjustments accordingly. Help Me Grow Utah Fax Cover Sheet to Physician • , Building a Help Me Grow System I Insurance Reimbursement for Formal Screening Formal screening is reimbursed by Medicaid and commercial insurance. In many states, child health providers can be reimbursed for developmental screening with a formal tool on the same day as a well child exam. The standard CPT code to use for obtaining reimbursement for screening with a formal tool is 96110. In some states, providers also use modifier 25 with the well child E and M code to show that an extra service was provided. Some commercial insurers require the modifier 59 with the well child visit E and M code. To determine whether or not reimbursement is available for developmental screening with a formal tool and how to bill properly, contact your state Medicaid program and the major commercial insurers in your state. If your state accepts utilization of 96110, it is a good idea to use this as it allows states and practices to track screening rates. Exhibit A 56 Building the Help Me Grow System:Core Components/Provider Outreach j, Help Me Grow National Center The Help Me Grow Maintenance of Certification for Pediatric Physicians The Help Me Grow Maintenance of Certification program is a tool that encourages and supports pediatricians' use of the Help Me Grow system and provides an incentive for pediatricians' early detection of developmental risks/concerns and connection of children to services. The program is available to pediatric practices in all Help Me Grow affiliate states. All pediatric physicians must complete a maintenance of certification (MOC) process every seven years.An MOC consists of four primary parts. Pediatricians need to complete all of them in each cycle: Part 1: Evidence of professional standing Part 2: Evidence of lifelong learning and self-assessment Part 3: Evidence of cognitive expertise Part 4: Evidence of satisfactory performance in practice The Help Me Grow Maintenance of Certification program, approved by the American Board of Pediatrics, provides Part 4 Credit. It uses a Quality Improvement methodology to guide pediatricians in implementing developmental surveillance, developmental screening, and connecting children to evaluation and intervention services using the Help Me Grow system. Help Me Grow MOC Resources Measure, evaluate, and improve outreach efforts It is important to keep track of all provider outreach activities. This continuous quality improvement helps staff improve their Help Me Grow outreach and makes the entire system more sustainable. The data you collect here may also help you to further market the strengths and measurable positive outcomes of Help Me Grow. The more energetic and thorough your evaluation and improvement efforts, the more children Help Me Grow can ultimately reach. Measurement, Evaluation & Improvement Resources See Data Collection &Analysis The Help Me Grow National Network Help Me Grow Connecticut: Physician-to-Physician Outreach One pediatric provider called the Help Me Grow Connecticut office after on-site training had been completed to invite Help Me Grow staff to a monthly pediatric community provider meeting at the local hospital.The provider believed that other practices in the community would benefit from knowing about developmental surveillance and the Help Me Grow system.After a brief presentation,ten practices requested on-site training. Another pediatrician learned about Help Me Grow during a community-based elective in the Pediatric Residency Program of the University of Connecticut School of Medicine.At her invitation, Help Me Grow provider outreach staff met with a large practice that she joined following her training. Her colleagues now make referrals to Help Me Grow. Exhibit A 57 %� Help Me National Center Building the Help Me Grow System:Core Components/Provider Outreach ACTION PLAN Child Health Provider Outreach PLANNING Create & Staff a Child Health Provider Outreach Work Group ❑ Complete Work Group tasks ❑ Research and meet with organizations that already provide outreach and/or can serve as entities to manage Help Me Grow provider outreach efforts ❑ Establish a relationship with the local chapter of the American Academy of Pediatrics and/or the Academy of Family Physicians ❑ Identify potential physician as a Help Me Grow champion if not already secured ❑ Make recommendations to the Leadership Team for provider outreach efforts ❑ Share recommendations with Leadership Team IMPLEMENTATION Design & Implement Child Health Provider Outreach ❑ Identify staffing needs ❑ Develop provider outreach budget ❑ Develop provider outreach training curriculum ❑ Create materials for office-based trainings & presentations ❑ Conduct trainings & presentations ❑ Measure, evaluate & improve child health provider outreach efforts Exhibit A 58 Building the Help Me Grow System:Core Components/Provider Outreach ;; Help Me Grow National Center Provider Outreach Staff Training Resources Help Me Grow CT: EPIC Physician Outreach Presentation Help Me Grow Utah: Healthcare Provider Outreach Tips for Engaging Providers Why We Train at the Provider's Office Features of Academic Detailing in Office-Based Training Three Publications on Academic Detailing What Is Developmental Surveillance? Why Does It Matter? Resources on Developmental Surveillance, Screening& Referrals An Evaluation of Strengthening the Developmental Surveillance & Referral Practices of Child Health Providers Identifying Infants & Young Children with Developmental Disorders in the Medical Home Screening Tools/ASQ and PEDS comparison chart Screening Tools/Birth to Five: Watch Me Thrive! Provider Outreach Training & Presentation Resources Help Me Grow CT: EPIC Physician Outreach Presentation Cost Benefits of"De-medicalizing" Childhood Developmental and Behavioral Concerns—National Replication of Help Me Grow(Policy Brief) Help Me Grow Alabama Trifold Physician Brochure Help Me Grow M 0 C Resources Project Description and FAQ Help Me Grow MOC PowerPoint Measurement, Evaluation & Improvement Resources Help Me Grow California: OC ASQ Participant Survey-2011 Help Me Grow California: OC Physician Survey-2010 Help Me Grow Iowa: Provider Training Evaluation Highlights Outreach Training Data Fields Exhibit A %Iff H2lpMeCiIOW National Center Building the Help Me Grow System: Core Components/Provider Outreach Exhibit A 60 Building the Help Me Grow System: Core Components/Community Outreach ;; Help Me National Center Community The Community & Family Outreach Core Component promotes the use of Help Me Grow to families and provides service providers networking and training opportunities. A community presence encourages support for and participation in the Help Me Grow system and helps with marketing the service. Regularly meeting with service providers also helps build the Help Me Grow resource directory and keeps it up-to-date. Community & Family Outreach is managed by a Help Me Grow Community Liaison. The Liaison is the "maven" of the Help Me Grow system, the information gatherer and trusted expert who shares knowledge with others. She or he is an expert on early childhood programs, services, and initiatives in their region or catchment area. With this expertise, the liaison connects the components of the system, as she or he can function as the "go-to" support for the telephone care coordinator to help research resources for families. Liaison (or outreach staff) duties include: • Support the telephone care coordinator • Facilitate networking meetings • Provide trainings for community and child health providers on developmental screening and the Help Me Grow system • Visit agencies to learn about current services • Research current programs and services • Update the resource directory The Community Liaison also markets Help Me Grow to families by participating in key community meetings, forums, and fairs. Finally, the Liaison is responsible for marketing the system to child health providers,parents, and service providers. f IN THIS SECTION: Community & Family Outreach Create & Staff a Community & Family Outreach Work Group Design & Implement Community & Family Outreach • Identify staffing needs • Develop community outreach budget • Develop a process for resource directory updates • Facilitate networking meetings • Special Section: Engaging Families • Market Help Me Grow • Meaure, evaluate, and improve outreach efforts Exhibit A First Edition,July 2014.Copyright 2014 Help Me Grow National Center.All rights reserved. 61 %Iff H81pMQGrow,National Center Building the Help Me Grow System:Core Component/Community Outreach Create & Staff a Community & Family Outreach Work Group The purpose of the Work Group is to have a vehicle for obtaining support and guidance from those with expertise in the subject area. Common Work Group questions include: • Who should chair the group? • Who are potential Work Group members from the broader community? • What are the tasks of the Work Group? • How will this group report on their progress and give recommendations? • How will recommendations be enacted? Determine Work Group chairs and membership Ideally, the core of this group is formed during the Help Me Grow Community Meeting. Leadership Team members make sure to include other stakeholders who may not have attended the community meeting. Two co-chairs are ideal. One should be a member of the Leadership Team, and the other a community child health provider, ideally the identified physician champion. Other Leadership Team members can serve on the Work Group as well, as long as there are individuals outside the Leadership Team involved. Examples of Work Group members include representation from: • Not-for-profits (i.e., child guidance centers) • Advocacy groups • School districts • Resource centers • Parents Building the Help Me Grow System Funding the Community Outreach Liaison Position The Community & Family Outreach Liaison plays an essential role in a Help Me Grow system, and the position can be funded through a variety of agencies such as Children's Trust Funds, United Ways/2-1-1, and children's hospitals. The number of people needed to fill the Community Liaison role depends on the needs of your system and your state. Large states like California need to consider travel time when staffing for Community Outreach; similarly, states with large populations may need several Liaisons to do sufficient outreach. Exhibit A 62 Building the Help Me Grow System: Core Components/Community Outreach ;; Help Me Grow National Center Complete Work Group tasks This group analyzes how Help Me Grow outreach would fit into the community and establishes important relationships. Tasks include: • Research and meet with organizations that already provide outreach and/or can serve as entities to manage Help Me Grow community outreach efforts • Research and document existing resource directories to see what could be modified and enhanced to meet the needs of the Help Me Grow call center • Make recommendations to the Leadership Team for community outreach Share recommendations with Leadership Team The Work Group is responsible for making recommendations to the Leadership Team based on which entity or entities can best: 1) manage and coordinate Help Me Grow community outreach; 2) support the care coordinators; 3) and maintain a robust and updated resource directory. If an agency outside the Call Center will house the Liaison position, be sure to secure the agency's agreement before submitting recommendations to the Leadership Team. The Leadership Team is responsible for reviewing those recommendations and making final decisions if they have the authority, or bringing it to the final decision maker. The Work Group has now completed its task and may evolve into an advisory resource as Help Me Grow community outreach is implemented. Forum 2013 Family and Community & Family Outreach Interest Group Leadership Team enacts recommendations The Leadership Team reviews the recommendations and makes the final decision on how Help Me Grow community and family outreach will proceed.Note that once this decision is made and agreed upon by all parties,the Leadership Team does not develop community outreach; rather, the organization and staff members who will be directly responsible for outreach now take the baton. The Leadership Team, however, needs to create a system to serve as a reliable support and resource as this component grows. Building the Help Me Grow System 01% Community Outreach Staff & Call Center Staff Community outreach workers need to have a coordinated relationship with the Call Center staff, no matter whether they operate from the Call Center or an outside agency. Outreach staff and Call Center staff support one another. Call Center staff can contact community outreach workers and ask for help when researching resources for a specific family. The reverse is also true: Community outreach workers may contact Call Center staff for advice on resources in their catchment area. Exhibit A 63 Help Me Grow Building the Help Me Grow System:Core Component/Community Outreach National Center Design & Implement Community & Family Outreach Identify staffing needs& hire as needed Building on the work of the Community&Family Outreach Work Group,the chosen entity assesses its current staff and determines what must be added to meet the needs of Help Me Grow community outreach. This process holds whether the outreach originates at the call center or an outside agency. The Liaison is the most important outreach staff position. Other positions to consider are administrator,supervisor,and support staff such as administrative assistants and marketing/ development staff. There are six general questions to ask regarding the outreach staff: 1. Are they already employed at the entity responsible for community outreach? 2. Are more staff needed? 3. How will they be recruited and retained? 4. Are there other staff roles that need to be filled to support community outreach? 5. What organizational infrastructure is needed to support community outreach? Because all the components of a Help Me Grow system are interdepedent, the system infrastructure should allow each component of the system to communicate well and collaborate easily. 6. Can or should the same staff member(s) conduct community AND provider outreach AND marketing efforts? Help Me Grow OC Child Development Community Liaison*ob description Child Development or Family Community Liaison job description Overview of Weekly Hours Develop community outreach budget These are the basic line items to consider when creating a community outreach budget. If community outreach is staffed within an existing call center, maximizing and sharing resources can greatly reduce the cost. • Food, room rental for networking meetings (see Funding Tip.) • Salary for Community&Family Outreach Liaison • Computer • Travel reimbursement (Liaisons typically cover a large geographic area for networking meetings.) • Marketing&presentation materials • Office space • Cell phone Help Me Grow South Carolina Proposed Implementation Budget Exhibit A 64 Building the Help Me Grow System: Core Components/Community Outreach ;; Help MeGrow National Center Develop a process for updating the resource directory A Help Me Grow system relies on an extensive directory of community-based resources and programs. The mechanism for a resource directory needs to be "live" — online, cloud- based, and easily accessible so it can be constantly updated to provide the most timely information possible. In the past, it was common to print resource directory catalogs; this approach is inefficient and expensive. In addition, having each agency and/or healthcare provider office create their own resource directory is equally inefficient. A centralized, online resource directory and a centralized intake system are core components of a healthy Help Me Grow system. As services and supports are ever changing, the Help Me Grow staff, and especially the Community Liaison, is responsible for keeping this resource directory up-to-date. The resource directory includes, at minimum, the following supports and services: • Primary and specialty medical care providers • Early childhood education and child care programs • Developmental disabilities assessment and intervention programs • Mental health services • Family and social support programs • Child advocacy and legal services Many Help Me Grow affiliates have partnered with 2-1-1 for their Centralized Access Point. These affiliates then use the 2-1-1 resource directory and enhance it to specifically ' , The Help Me Grow National Network 1% Creative Thinking & The Resource Directory A Connecticut child health provider had a practice in a rural area. He called Help Me Grow Connecticut to find translation and support services for a family whose child had developmental and behavioral concerns. The provider was having trouble explaining to the parent the recommendation that they bring the child to the regional children's hospital for tests and an evaluation. He requested an interpreter/support person to go with the family. They spoke an uncommon language and did not have support. The Community Liaison contacted agencies in the geographic area for these services but none of them could help. She then began a search including area churches. It took twelve calls to find a church that had a parishioner from this remote country. The parishioner spoke the language and was able to support the family. The family received the help they needed for their child and established a support system at the same time — and the Community Liaison had a new resource for the directory. Exhibit A 65 %Iff Help MQGrow,National Center Building the Help Me Grow System:Core Component/Community Outreach target services and supports for young children typically ages birth to 8. No matter how the directory is created,it is of the utmost importance that the Outreach staff(and,if it is a cloud- based directory,providers themselves) can update it easily,thoroughly, and frequently. The Community Liaison regularly researches community-based agencies to learn about new services and confirm the status of existing ones. On-site visits can be especially helpful in determining the efficacy and reality of an agency or organization. For example, a resource that might have been available one month ago may no longer exist because the agency lost a staff member or funding. Families might be experiencing such barriers to service as long waiting lists,lack of transportation,cultural barriers,and exclusion of specific insurance plans. A resource directory needs to include all of this information. Volunteers and interns can also be an asset to the resource directory. For example, Help Me Grow Utah employs interns and Americorp voluteers to research and update their resource directory(see the Help Me Grow Utah Intern Manual/.) Note that when a specific,requested resource is not available,the telephone care coordinator can call the Community Liaison for suggestions of other resource options. Even when there are obstacles to finding appropriate resources,it is the job of Help Me Grow to find a solution that will work. The Help Me Grow National Network Help Me Grow Connecticut: Networking Meetings In Action A Help Me Grow Connecticut Community Liaison was looking for a support group for a Spanish-speaking family who had a child with autism. She found a community provider that held a support group with several bilingual parents. The provider offered to help the family. Several days later, the provider contacted the Liaison to see if other agencies would be interested in forming a Spanish-speaking support group. The Liaison says, "I sent an email to my distribution list from the networking 'a meetings asking if anyone knew of existing support groups for Spanish- speaking families. Within two days I received 15 to 20 responses from other providers. I passed the list on to the provider who was very grateful" Help Me Grow Connecticut's networking meetings have also included y pediatric residents from the University of Connecticut School of Medicine. Dr. Dena Hoberman, one of the residents who now practice pediatrics in Connecticut, reported that, "Before I began working with Help Me Grow, I found it challenging to connect families and children to needed services. With Help Me Grow, I have had the opportunity to attend the networking meetings. Here I met representatives from community programs that have helped me find resources for a family who had a unique, at-risk situation." Exhibit A 66 Building the Help Me Grow System: Core Components/Community Outreach Help Me Grow National Ce:;ter The Help Me Grow staff is encouraged to think outside the box, using creativity and perseverance to assist families. This system collaboration helps parents avoid the frustration of maneuvering through the maze of community-based resources.Thinking creatively about alternative options has proven to be a very effective way to maximize existing resources. Help Me Grow Utah Intern Manual: The Resource Database Help Me Grow Utah Inclusion Policy for the Resource Directory The Networking Meetings The Community Liaison organizes and facilitates meetings of community-based agencies to share information and to develop solutions to challenging situations. These events help strengthen the collaboration between supports and service agencies within the community, increase the accuracy of the resource database, and present possible educational speakers for use at other community events. Networking meetings are typically held in the morning and include a light breakfast. This allows participants to attend without interrupting their workday. Several affiliate states have found it more effective to hold meetings during lunch. The timing of the meetings, however, should be flexible depending on your community's needs. The meetings are brief, usually about 1lh hours, and occur with a regular frequency. Some affiliate states hold monthly meetings,while others have found that bimonthly or quarterly meetings better suit their community. Networking meetings allow agencies to share information, widen their connections to a broader group of service providers, and support one another. Service providers often come to a meeting feeling frustrated about the challenges in helping a family— and leave with a list of options and connections to resources that they never knew existed. The agenda also includes brief presentations on topics generated by the group. Topics can include current issues facing families and information on new resources and iniatitives, i.e., changes in immigration laws, domestic violence supports, and special education laws. Tips for Organizing&Facilitating Successful Networking Meetings Organizing the Meeting • Set a consistent location,time, and frequency • Send out notices no later than 3 weeks ahead, followed by a reminder • Arrange for speaker to present on selected topics identified by participants • Share participant list to facilitate carpooling as appropriate and/or requested • Provide agendas, evaluation forms, and surveys when appropriate • Set up a resource table for flyers,brochures,business cards, etc. Exhibit A continued on next page 67 %Iff Help MQGrow,National Center Building the Help Me Grow System:Core Component/Community Outreach • Create a listsery of participants to address specific situation that needs immediate attention. For example, if a provider needs to find a car seat for a family, he or she can contact the listserv. A helpful response is often immediate. Invitation List • Home visitors • Early care educators • Family/child advocates • Medical and/or health providers • Social workers • School system representatives • Parent educators • Educators • Domestic violence prevention groups • Anyone working with families with young children Sample Topics to Cover • Introduction to Help Me Grow • Learning, development,behavior,physical and mental health • Dental health • Autism • Early literacy • Cultural competency(e.g., Panel on Latino Outreach) • Taking care of yourself • Opportunities for federal and state funding • Hows and whys of Medicaid funding Resources for Networking Meetings Building the Help Me Grow System Funding Networking Meetings Participating agencies are often willing to co-sponsor Help Me Grow networking meetings and will provide food and/or meeting space. Another funding strategy is to find support from a foundation. Currently Connecticut holds more than 70 networking meetings involving hundreds of providers throughout the state every year. Their collaborators include early care and education organizations such as Head Start and child care centers, Home Visiting agencies, and the Early Childhood Alliance. In California, networking meetings are called Connection Cafes, and the state's Part C Early Intervention helps fund them. Learn more about Help Me Grow Alameda County Connection Cafes Exhibit A 68 Moving toward Cultural Competence by Paul Dworkin, M.D., Founder of Help Me Grow During a 2013 Help Me Grow National site influences families' attitudes toward parenting visit to Minnesota, one of our newest interventions and practices. Families' perceived affiliate states, I gave a presentation to a large value of advice and guidance changes depending audience in St. Paul. Following my talk, I invited on the cultural awareness and sensitivity of questions and comments from the audience. program staff, including the extent to which staff includes members of the same race or Saciido Shaie, who identified herself as an ethnic group as the families served. Immigrant from Somalia, spoke about her difficulties in accessing community-based I further shared Help Me Grow's strategies programs and services that are often not to enhance its cultural competence. These culturally appropriate or acceptable. Saciido include: shared the poignant example of how she, • encouraging diverse staffing of as a Muslim woman, cannot use public gyms, Information and Referral(1&R) Lines pools, or programs; nor can she use private with language capacity consistent with recreation centers (e.g.,the YMCA), because of a region's demographics, the lack of gender-specific and culturally-sensi- including a wide array of programs and five facilities and programs. services within the resource inventory that serve diverse clientele;and She asked, "How do we ensure that the resources offered by Help Me Grow to families engaging multicultural community-based are culturally appropriate and sensitive?" organizations in such outreach activities as networking breakfasts. After some reflection, I replied to Saciido However, the most important strategy that Help Me Grow is not a program or service, to ensure that our efforts are culturally but rather a system that provides linkages to appropriate is to continually seek feedback community-based programs and services. from the diverse parents and families whom Thus, the community programs themselves, we serve, and then act on that feedback. not the Help Me Grow system, primarily determine their degree of cultural competency Prior to our Minnesota visit, I had not and sensitivity, in part through their staffing. appreciated the scope of health disparities within the State's population, nor that the Yet, I continued, it would be an egregious State has the highest Somali population in the oversight not to acknowledge the importance country. Saciido's speaking up reminds us of of cultural competence in Help Me Grow's the critical importance of open dialogue. Her functions. National's own research emphasizes experience highlights the essential need to how cultural beliefs strongly influence the embrace strategies that strengthen our own efficacy of a Help Me Grow system. cultural competence, so that we may serve all the families who need the help we can provide. For example, cultural beliefs and practices shape parents' expectations of their children's We look forward to exploring this issue in development and behavior, as well as their greater depth with the entire Help Me Grow willingness to share concerns about it. Culture National Network of affiliate states. Read Dr.Dworkin's original blog post. Exhibit A Help Me Grow Building the Help Me Grow System:Core Component/Community Outreach National Center Special Section: Engaging Families A healthy Help Me Grow system actively helps parents gain knowledge of and access to needed services;supports them in learning about their child's development;and facilitates the professional and community connections that will help them become more resilient parents. Below are several ways Help Me Grow affiliates have engaged families in their states: • Family events Books, Blocks, and Balls Halloween parties museum trips community baby showers • Presentations to parent groups • Brochures and posters Helo Me Grow Alabama Parent Brochure • Social media • Partnerships with family friendly organizations • Cultivation of parent champions • Basic needs support Help Me Grow Utah Diaper Kits Help Me Grow Connecticut basic needs support example Tips for Successful Family Outreach 1. To reach families effectively,be sure to: • Use multiple methods to conduct outreach and engage families • Be culturally sensitive • Get out in the community • Seize opportunities • Be tenacious • Building the Help Me Grow System Attending & Organizing Community Meetings, Forums & Fairs All events and organizations that involve young children, families and/or early childhood caregivers can offer opportunities to promote Help Me Grow. The Community Liaison regularly works to attend and/or organize these events and form partnerships with relevent organizations to raise awareness of Help Me Grow and developmental screening. For example, Help Me Grow Orange County coordinates ASQ screenings with Pretend City Children's Museum in Irvine, California. The museum offers parents a free online or print ASQ. When parents submit it, they receive free tickets to the museum. Exhibit A 70 The Power of a Parent Champion Janae Moss, Help Me Grow Utah Parent Champion Janae Moss has been a Parent Champion for Help Me Grow Utah for many years. She organizes fundraising events, helps promote and run family events, and mentors other affiliate states in the art of recruiting, empowering, and using parent champions. Janae also has expertise in social media, including strategies for using it to drive online traffic to Help Me Grow Utah's website. Below is Janae's 2012 interivew with the National Center. Janae Moss is a busy woman. She's a mother to though once we did find those resources we seven kids, young children to young adults. She really used and needed them. and her entrepreneur husband, Jon, co-own more than a dozen businesses, including the I believe in the Help Me Grow model because largest janitorial company in the state of Utah. I know from my experience that the resources One of her newest projects is the My Mommv for families are there, but too often people can't ' Style blog and My Mommv Style YouTube get to them. And whether it's your first child or channel for mothers around the world to share seventh, we as parents all need help! their parenting styles. What is a favorite moment from your work Janae and Jon have been staunch supporters of with Help Me Grow Utah? Help Me Grow from its earliest days in the state, At the very first community event Jon and I contributing both funds and their marketing and helped at [Books, Blocks, and Balls], we set up outreach expertise. Recently, Janae shared some different stations, showing parents how to play of the reasons that she and Jon have embraced Help Me Grow Utah. with kids with inexpensive toys and games. Parents could fill out the Ages &Stages Ques- Why are you a Parent Champion? tionnaire, too. It was so exciting to see parents learning about their kids, to see parents and kids I come to this work as a stepparent, foster playing together. I loved it. parent, biological parent, and adoptive parent who has herself needed the resources that Help What do you love about philanthropic work? Me Grow helps people find. I think it helps us teach our kids that service is When my husband,Jon, and I got married, he part of a happy, fulfilling life. I see it already in already had a daughter, and pretty quickly we them, how my kids changed. On Valentine's Day had two more daughters of our own. Not long this year, my daughter took her babysitting after,Jon's niece came to live with us. I was money from the last six months and bought a young, 22 years old, and suddenly I had four rose for every kid in the special needs class in her kids — and then Jon lost his business. school. Even the boys were like, 'I got a rose!' It was a scary time. I was so young and had so When Jon and I lost everything, it changed much responsibility. We didn't have money for us. Partly because of those hard years, I truly food; bill collectors were banging on the door. believe that happiness and success come I didn't know where to look for help, how to through service. With Help Me Grow Utah, apply for food stamps, how to get my niece the we have a structured and hands-on way to counseling she needed. It was hard to find help, give back the help that was given to us. Visit MvMommvStvle.com Exhibit A Help Me Grow Building the Help Me Grow System:Core Component/Community Outreach National Center 2. You may also find encouragement,inspiration, and ideas in the Strengthening_ Families Protective Factor Framework developed by the Center for the Study of Social Policy.Also see the National Center's policy brief,Help Me Grow Promotes Optimal Child Development by Enhancing Protective Factors. 3. Volunteers can be an important resource in family outreach. For example, Eagle Scout volunteers have made blocks for Help Me Grow Utah Books,Blocks and Balls events. Resources for Family Engagement Forum 2012 Help Me Grow Utah Family Engagement Poster Market Help Me Grow The Community Liaison is in a prime position to market Help Me Grow in the course of his/her travels,including networking meetings and family events. Because Help Me Grow is a complex system with multiple parts and works with a number of different populations, it is helpful to tailor marketing materials and campaigns to these distinct audiences. Help Me Grow Utah describes the needs and interests of each audience as follows: Families Families want to know about: • The ASQ and how it can help them be better prepared as a parent • Community resources and what is offered • How to contact Help Me Grow • The"commitment"level of signing up Building the Help Me Grow System Family Outreach: BOOKS, BLOCKS, & Balls Books, Balls, and Blocks (BBB) is a free event held for children and their families. The event is designed to to encourage play between parents and their children. While parents and children engage in games and activities at different stations, parents learn how these activities support their child's development. Parents also complete the Ages and Stages Questionnaire (ASQ-3), the recommended tool to screen children for developmental delays, while the children play. There are professionals on-site who score the completed ASQ-3s. Afterwards, parents receive a follow-up from a professional to learn if his or her child's development 1) appears on schedule, 2) needs to be monitored and provided learning activities, or 3) requires further professional assessment. Before leaving, parents are given resources on child development and ideas for fun, inexpensive activities to do at home. Help Me Grow Utah BBB instructions Help Me Grow Alabama inaugural BBB event blog post Exhibit A 72 Building the Help Me Grow System: Core Components/Community Outreach ;; Help MeGrow National Center Service Providers Service Providers want to know about: • How Help Me Grow works with any family referrals • The resource database and how they can list their programs • How to use the resource database • How to contact Help Me Grow Child Health Providers Healthcare providers want to know about: • Community resources and what is offered to them and their patients • The ASQ and how it can help their patients and office staff • How to contact Help Me Grow • See the Child Health Care Provider Outreach sections for more information See Marketing Help Me Grow Measure, evaluate, and improve outreach efforts It is important to keep track of all community outreach activities. This continuous quality improvement helps staff improve their Help Me Grow outreach and makes the entire system more sustainable. The data you collect here may also help you to further market the strengths and measurable positive outcomes of Help Me Grow. The more energetic and thorough your evaluation and improvement efforts, the more children Help Me Grow can ultimately reach. Measurement, Evaluation, and Improvement Resources See Data Collection &Analysis. Exhibit A 73 %Iff Help MQGrow,National Center Building the Help Me Grow System:Core Component/Community Outreach ACTION PLAN Community & Family Outreach PLANNING Create & Staff a Community & Family Outreach Work Group ❑ Complete Work Group tasks ❑ Research and meet with organizations that already provide outreach and/or can serve as entities to manage Help Me Grow community outreach efforts ❑ Research and document existing resource directories to see what could be modified and enhanced to meet the needs of the Help Me Grow call center ❑ Make recommendations to the Leadership Team for Community Outreach ❑ Share recommendations with Leadership Team IMPLEMENTATION ❑ Design & Implement Community & Family Outreach ❑ Identify staffing needs ❑ Develop community and family outreach budget ❑ Develop a process for updating the resource directory ❑ Facilitate networking meetings ❑ Engage families Market Help Me Grow ❑ Measure, evaluate & improve community&family outreach efforts Exhibit A 74 Building the Help Me Grow System: Core Components/Community Outreach ;; Help Me Grow National Center Resources for Networking Meetings Help Me Grow National Webinar: Networking Meetings: Lessons Learned! Help Me Grow California QC: Connection Cafe Report Help Me Grow California QC: Networking Meetings Topics Help Me Grow CT: 2008 Networking Luncheon Agenda Help Me Grow CT: 2011 Networking Breakfast Flyer Help Me Grow CT: 2012 Networking Meeting Calendar Help Me Grow South Carolina: Community Connections Help Me Grow Utah: Networking Breakfasts Help Me Grow Utah Networking Breakfasts Focus Group Resources for Family Engagement Help Me Grow National Webinar:Ensuring Family Engagement Help Me Grow National Webinar: Volunteers and Interns Help Me Grow California Alameda County: Will They Grow Out of It? campaign Help Me Grow Connecticut: Example of Request for Basic Needs Support Help Me Grow Utah Family Events Help Me Grow Utah: Volunteers Help Me Grow Promotes Optimal Child Development by Enhancing Protective Factors (Policy Brief) Measurement, Evaluation, and Improvement Resources Help Me Grow CT: Networking Breakfast Evaluation Outreach Training Data Fields Exhibit A %� H81pMQ Grow, National Center Building the Help Me Grow System:Core Component/Community Outreach Exhibit A 76 Building the Help Me Grow System: Core Components/Data Collection &Analyis ;; Help Me National Center Data Analysis "If you don't have measurement,you don't have a mission.The capital you need to have is the data measuring the outcomes." Jeffrey Dann, Help Me Grow Western New York Business Champion The fourth core component is Data Collection and Analysis. Information on Help Me Grow system operations is critical to ensuring that children's developmental needs are recognized and that families are connected to the right services in an appropriate and timely manner. Help Me Grow is in a unique position to collect data that reflect system- level issues—not only who calls and why,but also what happens to families seeking help. Data Collection and Analysis also serves as a crucial tool for Continuous Quality Improvement. Evaluation of the Help Me Grow system helps to assess how well it is working or what may need to be changed to improve the service, including gaps and barriers. This information also helps to inform funders and policy makers about families' experiences and guide their thinking about service delivery. Help Me Grow Data Collection and Analysis procedures require that Help Me Grow call centers track program participants through a service `pipeline' that begins with a participant's initial inquiry to Help Me Grow. The tracking concludes with follow-up on service linkage referrals. All Help Me Grow affiliates conduct ongoing data collection and analyses. Early in your efforts, it is advisable to identify an individual or organization, such as a university, to suggest data collection and analysis methods and provide expertise. This guidance will help focus the Leadership Team and Work Group as they determine how, what, and when to collect data and measure progress. qb 0 IN THIS SECTION: Data Collection & Analysis Create & Staff a Data Collection & Analysis Work Group Design & Implement Data Collection & Analysis • Develop and/or modify a database program & process for collecting&tracking call center data • Develop and/or modify process for collecting and tracking data on other components of the Help Me Grow system _ • Routinely analyze descriptive and outcome data and monitor trends overtime • Create and publish evaluation results for advocacy and planning • Use results from evaluation to improve/modify program Exhibit A First Edition,July 2014.Copyright 2014 Help Me Grow National Center.All rights reserved. 77 Help Me Grow Building the Help Me Grow System: Core Components/Data Collection&Analyis National Center As you review the steps to establish Data Collection,keep in mind Help Me Grow Orange County and Help Me Grow Utah have developed data collection systems that other affiliate states can purchase and adapt.Adopting and adapting an existing Help Me Grow-focused data collection system may be the most effective and efficient approach for your state. (Seepage 82.) Create & Staff a Data Collection & Analysis Work Group The Work Group functions as a vehicle for obtaining support and guidance from those with expertise in data collection and analysis. Common considerations in forming a Work Group include: • Who should chair the group? • Who are potential Work Group members from the broader community? • What are the tasks of the Work Group? • How will this group report on their progress and give recommendations? • How will recommendations be enacted? Determine Work Group chairs and membership Ideally, the core of this group is formed during the Help Me Grow Community Meeting. Leadership Team members make sure to also include other stakeholders who may not have attended the community meeting. Two co-chairs are ideal. One should be a member of the Leadership Team, and the other an expert in the field of data collection and analysis.Note that other Leadership Team members can serve on the Work Group as well, as long as there are individuals outside the Leadership Team involved. The Data Collection & Analysis Work Group members should includes representatives from: • Centralized Access Point leads • Medicaid state department • Evaluator • Childrens hospitals • Community members Complete Work Group tasks This group analyzes how to best design and implement Help Me Grow Data Collection. Tasks include: • Research data collection methods include how,what, and when to collect data Exhibit A 78 continued on next page Attributes of an Effective Help Me Grow System Data Collection & Analysis Help Me Grow National Forum 2012 Brainstorming Session ATTRIBUTES INCUDE STRATEGIES TO CONSIDER Quantitative and qualitative data Rules and regulation on using & sharing data Organized methodology • safeguards, guidance, policy, procedures Centralized intake process • data warehouse Uniformity and consistency in • share examples — website tools measurements Share data • common language formalize common language • coding, reliability of coding (data dictionary) across all • standardization of program stakeholders, inc. legislators descriptions • share with legislators/ advocacy groups Common indicators write on what legislators know Comprehensive reports — share & interact with providers linked to outcome and outputs, • a strategy for and regularity service activities with sharing promotes • modify for use comprehension by everyone with different audiences Qualitative data narrative, External evaluation of component nuanced stories • success stories keeping track • use storytelling techinques to translate date to wide audience Exhibit A Help Me Grow National Common Indicators Affiliate states are required to collect and report data on a common set of indicators developed by the National Center. Data collected will help affiliates to monitor their progress and share lessons learned with other states and the National Center. Additionally, collected data will: • Enable states to build their data systems; • Enable states to more efficiently pull data to share with their key stakeholders for fundraising and advocacy; • Enable states to contribute to the national dialogue on promoting early detection and intervention and the role of Help Me Grow systems in doing so; • Enable states to learn how their system data is similar to/different from aggregate national data; and • Position the National Center and the affiliated states as leaders in the child development field. The Help Me Grow Common Indicators are defined as follows:* Help Me Grow Demographics • Number of children entered into client tracking system (unduplicated count per calendar year) • Who initially contacted Help Me Grow on behalf of the child • Age of child at time of initial entry (includes prenatal as an age) • Ethnicity of the child • How the initial caller learned about Help Me Grow • The state the child lives in Nature of Presenting Issues • Number by type of presenting issues/concerns.* • Number of children entered in client tracking system for linkage to services as a result of developmental screening. Referrals by Help Me Grow to Services/Programs • Top five types of services to which referrals were made.* • Top five service/program gaps (i.e., a service/program doesn't exist to address the need). • Top five barriers that keep children from receiving a service/program that does exist. Help Me Grow Outcomes • Total number of children successfully connected to at least one service.* • Total number of children referred for services and are pending the start date.* *Definitions and categories provided by Help Me Grow Notional Center 3118114 Exhibit A Building the Help Me Grow System: Core Components/Data Collection &Analyis o d FWnMeGrow National Center and measure progress. This includes both call center activities &outcomes and outreach activities &outcomes. • Review the Common Indicators in order to understand the types of data that need to be collected. • Make recommendations to the Leadership Team for data collection and analysis. Share recommendations with Leadership Team The Work Group is responsible for making recommendations to the Leadership Team for how Help Me Grow data collection should proceed. The Leadership Team is responsible for reviewing those recommendations and making final decisions if they have the authority, or bringing it to the final decision maker. The Work Group has now completed its task and may evolve into an advisory resource as Help Me Grow data collection is implemented. Leadership Team enacts recommendations The Leadership Team reviews the recommendations and makes the final decisions on how Data Collection &Analysis will proceed. Once these decision is made and agreed upon by all parties, the organization and staff members who will be directly responsible for Data Collection &Analysis now take the baton. The Leadership Team,however, remains a reliable support and resource as this component grows. Help Me Grow Western Summit: Data and Evaluation Powerpoint Presentation Design & Implement Data Collection & Analysis Develop and/or modify a database program & process for collecting&tracking call center data The process for collecting and tracking data should include call center and provider and community outreach activities: 1. Help Me Grow callers: how many people call, who callers are, how they learned of the program, and their presenting issues and needs. 2. Referrals made on behalf of the Help Me Grow families and outcomes of referrals (i.e., number of times families are linked to services). 3. Community Outreach activities: networking, training, inventory of community programs and services. 4. Outreach activities and training for pediatricians and other health care providers; should begin with a complete inventory of practices in designated areas. 5. Developmental screening: who is conducting it, who is making referrals, and how many families are participating. 6. Gaps and barriers in services from child health care practices to community-based services. Exhibit A 81 %� Help Me National Center Building the Help Me Grow System: Core Components/Data Collection&Analyis Develop and/or modify a process for collecting and tracking data on other components of the Help Me Grow system Below are examples of information to collect for other system components. Physician Outreach Community Outreach Networking Meetings • Who conducted the outreach? . Who conducted the meeting? • Outreach type 0 Meeting agenda • Topics 0 Location • New or repeat outreach? 0 Date • Location 0 Event topic • Date 0 Individual contact person • Individual contact person 0 Participants • Participant • Number attended/reached • Evaluation/feedback • Evaluation/Feedback • Follow up 0 Notes (type in) • Notes (type in) Affiliate states have also collaborated with outside specialists to review and evaluate their outreach efforts. For example, in 2012, Help Me Grow Utah hired a consulting group to conduct focus groups on the networking breakfasts. Help Me Grow Utah Networking Breakfast Focus Group Routinely analyze descriptive and outcome data & monitor trends over time Help Me Grow National recommends using Results-Based Accountability to report on data collection. Evaluation of the first Help Me Grow system in Connecticut began in 2002. • Building a Help Me Grow System Data Collection Systems Available to Affiliates As you review mechanisms for data collection and analysis, keep in mind that Help Me Grow Orange County and Help Me Grow Utah have developed database programs that other affiliates can purchase and adapt to meet their data collection needs. Help Me Grow OC System for Tracking Access to Referrals (STAR) Help Me Grow Utah Family Database Exhibit A Building the Help Me Grow System: Core Components/Data Collection &Analyis ;; Help MeGrow National Center utilizing the Results-Based Accountability Framework. Summary evaluation of Help Me Grow has demonstrated promising results for families and communities. Evaluations address the three RBA performance measures: • How much is Help Me Grow doing? (i.e., utilization of the program and related data) • How well is Help Me Grow doing? (i.e., family referrals for services and community outreach efforts) • Is anyone better off as a result of utilizing Help Me Grow? (i.e., final disposition of cases and outcomes) Connecticut Appropriations Committee RBA Template Create and publish evaluation results for advocacy and planning and use results from evaluation to improve/modify program Several affiliate states have shared their periodic evaluation results. The Help Me Grow National Center has also published two evaluative Policy Briefs Help Me Grow California-Orange County Three Year Annual Report 2012 Help Me Grow Utah Annual Evaluation 2012 National Policy Brief: Help Me Grow Promotes Optimal Child Development by Enhancing Protective Factors National Policy Brief: Cost Benefits of"De-medicalizing" Childhood Developmental and Behavioral Concerns: National Replication of Help Me Grow Exhibit A 83 %� Help Me National Center Building the Help Me Grow System: Core Components/Data Collection&Analyis ACTION PLAN Data Collection & Analysis PLANNING ❑ Create & Staff a Data Collection &Analysis Work Group ❑ Complete Work Group tasks ❑ Research data collection methods, including how, what, and when to collect data and measure progress. This includes both Call Center activities and outcomes and Outreach acti vi ties/outcomes. ❑ Review the Common Indicators in order to understand the types of data that need to be collected. ❑ Make recommendations to the Leadership Team for data collection and analysis. IMPLEMENTATION ❑ Develop and/or modify a database program & process for collecting & tracking call center data ❑ Develop and/or modify process for collecting and tracking data on other components of the Help Me Grow system ❑ Routinely analyze descriptive and outcome data and monitor trends over time ❑ Create and publish evaluation results for advocacy and planning ❑ Use results from evaluation to improve/modify program Exhibit A 84 Sustaining the Help Me Grow System: Marketing Help Me Grow A Iv Help Me Grow National Center Markefiong Help Me Grow For all the strengths of the Help Me Grow system,the reality is that such system-level change may appear abstract and difficult to explain. Because Help Me Grow is not a new program or service,but a reorganization of an early childhood system, it can be a challenge for individuals to understand what exactly Help Me Grow is,what it does,and why it matters. Effective marketing is your most powerful tool in establishing awareness of and appreciation for a Help Me Grow system. You must be able to tell the story of Help Me Grow—the mission, the process, the positive outcomes—clearly and compellingly (and often) to many different sectors. This outreach helps cultivate Help Me Grow as an indispensable part of the early childhood community in your state. The marketing audience for a Help Me Grow system includes: • Child health providers • Child care providers • Community-based programs and service providers • Family-oriented organizations,i.e. museums,libraries,YMCAs • Parents • Legislators and public officials • Family advocates • Funders • Educators • State and federal early childhood organizations Who is in charge of marketing? System budgets, system maturity, size of the population served, and staff-size all inform marketing.Help Me Grow marketing efforts are often coordinated and executed by the Community Outreach Liaison, as well as those responsible for Child Health Provider Outreach. Some affiliates employ a dedicated marketing and development staff person to manage the work. Still others partner with like-minded organizations to plan and launch marketing campaigns. lb ff IN THIS SECTION: d Marketing Help Me Grow Marketing Overview Foundational Marketing Tools Examples of Help Me Grow Marketing Exhibit A First Edition,July 2014.Copyright 2014 Help Me Grow National Center.All rights reserved. 85 ;; F1*MeGrow Maintaining&Expanding a Help Me Grow System: Marketing Help Me Grow National Center Foundational Marketing Tools Logo The National Center will provide a logo template (see below). However, some affiliates have designed their own logos. The option that best communicates your Help Me Grow system and story is the right one for you. If you develop a new logo, keep in mind that logo and brand uniformity is extremely important in building a statewide system. Consistency helps your audiences recognize who you are and what you can offer. Help Me Grow National Center Logo Template and Guidelines Help Me Grow Utah Logo and Brand Guidelines Tagline If you choose not to use the Help Me Grow logo template, the National Center requires use of the following tagline: "An affiliate of the Help Me Grow National Network" Elevator speech It is helpful to create a unique "elevator speech" for every audience, including families, service providers, physicians, legislators, funders, and public officials. What is their main interest in a Help Me Grow system? What are their top needs and how can a Help Me Grow system meet them?What essential information do they need to know about Help Me Grow? For instance, when you communicate with key state agencies, you will be helping state leaders map and understand the early childhood system in their state and how it needs improvement. Help Me Grow Utah "Elevator Speech" Guidance Informational brochures and posters A Help Me Grow brochure should include the message that Help Me Grow will answer parents' questions about their child's behavior, development, and/or learning; that it is a free service; and that anyone can call and talk to a telephone care coordinator. Brochures should be available in several different languages and convey that the state is an affiliate of the Help Me Grow National Network. Examples of Informational Print Materials The Help Me Grow National Network 11IJ Marketing Expertise within the National Network Help Me Grow affiliate states have launched many successful marketing campaigns. It can be helpful to reach out to Network peers for models, advice, and lessons learned. Help Me Grow Directory of Expertise Marketing Specialists Exhibit A 86 ' , Sustaining the Help Me Grow System rj The "Elevator Speech"" Help Me Grow Utah has developed several elevator speeches to speak to the varying interests of their target Help Me Grow populations. Below are two examples. See the originals. FAMILIES Families want to know about: 1. The ASQ and how it can help them be better prepared as a parent 2. Community resources and what is offered 3. How to contact Help Me Grow 4. The "commitment" level of signing up Sample Elevator Speech Help Me Grow is a parent information line designed to connect families to information about child development and to community resources. You can simply dial 2-1-1 and ask any questions you might have about their child's development. To help you understand normal child development, we have a free developmental questionnaire that a you can complete based on the age of your child. The questionnaire focuses on the five areas of development(communication,fine and gross motor, problem solving skills and personal/ social skills) and is very useful for parents. We'd like to have you participate in the program so that you can better support your child. HEALTH CARE PROVIDERS Health Care providers want to know about: 1. Community resources and what is offered to them and their patients 2. The ASQ and how it can help their patients and office staff 3. How to contact Help Me Grow Sample Elevator Speech Help Me Grow is a parent information line designed to connect families to information about child development and community resources. Parents are welcome to dial 2-1-1 and ask any question they might have about child development, parenting, etc. As a healthcare provider you work with so many families that need to be connected to various resources, not just medical resources. Help Me Grow supports you by making referrals and then following up with the families to make sure that they received help appropri- ate to their concerns and circumstances. We also provide parents with a developmental screening tool that helps them understand normal child development. To strengthen the relationship between you and your patient, we always will fax a copy of the summary sheet of those questionnaires and the connected resources (contingent upon family's permission) to you so you can see how the child is doing. Exhibit A 87 v The Help Me Grow National Network Fj Sample Affiliate Websites & Logos Alabama • helpmegrowal.blogspot.com ;� Help MeGrow Alabama California Alameda County • first5alameda.org/help-me-grow �q Help Me Grow Orange County • helpmegrowoc.org Alameda Covnty Solano County • helpmegrowsolano.org Ventura County • helpmegrowvc.org i \ 0 ;Help Me Goa o Connecticut • ct.gov/oec IF Help Me Grow ORANGE COUNTY Alp Delaware • dethrives.com/help-me-grow mG G R% M 7rvt� eGrow - Connecticut Florida • switch boardmiami.org/help-me-grow Iowa • iowapeds.org/help-me-grow.asp � Help Me Grow r of-iula Michigan • helpmegrow-mi.org Minnesota • helpmegrowmn.org W Michigan South Carolina • helpmegrowsc.org heap me \�Utah • helpmegrowutah.org 9RDw �;�help me Washington • parenthelp123.org Utah Minnesota West Virginia • dhhr.wv.gov/helpmegrow lb a Western New York &�. �k *Hebme lrol Western New York • helpme rg owny.org Western New York Exhibit A 88 Maintaining& Expanding a Help Me Grow System: Marketing Help Me Grow ;; Help Me Grow National Center Website&Social Media Prescence A Help Me Grow website and social media account(s) are strongly recommended. In the case of social media, including blogs, you will need to establish protocols for how you will use these tools to support and grow your Help Me Grow system. For example, Help Me Grow Utah has honed its social media to broadcast its mission to support families to promote children's healthy development. Help Me Grow Utah Social Media Policy Examples of Help Me Grow Marketing Events & Presentations Family events Books, Blocks &Balls Fundraising events Help Me Grow Orange County Annual Art Auction Help Me Grow Utah Halloween Party Informational workshops on the Help Me Grow System Paul Dworkin,M.D.presentation to the American Academy of Pediatrics Community trainings on ASQ Help Me Grow Orange County professional development training Presentations at Professional Conferences Help Me Grow National Center at Zero to Three Conference Traditional Media Broadcast media Help Me Grow Utah Director Barbara Leavitt on KBYU Eleven Help Me Grow Michigan Public Television PSAs Dr. Paul Dworkin WKRF interview Print media Help Me Grow Alameda Will They Grow Out of It campaign Help Me Grow Orange County newspaper advertisements Help Me Grow Washington Press Release on Federal Grant Brochures,flyers, &packets Examples of print materials Exhibit A 89 Help Me Grow Maintaining&Expanding a Help Me Grow System: Marketing Help Me Grow National Center Online Media Listsery&email newsletter Help Me Grow Alameda listsery&email newsletter Website See page 88 Note:Many affiliates don't build a dedicated Help Me Grow website, but rather are housed within a larger site, such as their organizing entity or call center. Blog Help Me Grow Washington Help Me Grow Alabama Help Me Grow Utah Social media Help Me Grow Iowa Social Media Campaign Help Me Grow Utah Pinterest First 5 Alameda (home of Help Me Grow Alameda) Facebook Help Me Grow National Center Twitter Video Help Me Grow Washington Help Me Grow Florida Video 1 (Engish) Help Me Grow Florida Video 1 (Spanish) Help Me Grow Florida Video 2 (English) Making the Connection-Help Me Grow: The Connecticut Experience Outreach Efforts Child Health Provider Outreach Trainings Networking Breakfasts Need to find setvicesto helpyourchiId? • The Help Me Grow National Network 2.1.1 Help Me Grow Delaware Mall Kiosk Dialing 2-I.1 connect,r�wpm HELP ME GROW,a f...... ^►i^gna em+mt°eP,n,— an0 resources tort In 2012� Help Me Grow Delaware creatively used i' :vN Dialing 2-1-1 a mall kiosk as a different way to market Help Me can be life changing Grow to families. Exhibit A 90 The Help Me Grow National Network Sample Marketing Materials Help Me Grow Alameda Postcards � r • r r • As a parent,you may have worries or questions about how your child is behaving,learning and developing. • Completing the Ages&Stages Questionnaire(ASQ)for your child age Imo-Syrs is a great way to learn about their development. • ASQ results help you and your doctor determine if your child might need + ` extra support. • Answer the screening questions the - best you can.If you need help,you . r• .. loam. . . .r. can ask your doctor or staff. va Help Me Grow Hlameda Govnty En ocasiones usted podria tener inquietudes o preguntas sobre Como que se desarrolla su nino,se comporta y aprende. r Contestar los cuestionarios Hades y IL{ Etapas(ASQ)puede ser un excelente I medio a trav€s del que usted y el doctor ' de su nino pueden obtener information acerca del aprendizaje de su hijo. \ , r r .- Los resultados del ASQ le ayudan a usted ��- y a su doctor a determinar si su nino necesita apoyo adicional. Responda las preguntas to mejor que pueda pero no dude en hacerle preguntas a su doctor de su hijo o al personal. • - • - kF Help Me Grow Alameda Ccvnty • 11®A S Mc't-T3C3jf7 r,6.lf tll° 6cP9 (Ages& Stages T Questionnaire ASQ) JT�Z- • ASQ P97t v�]J 3C > 1� w. 1 \ +�r • A. 51 a)iooM a±r 111 N z"Ka Help Me Grow Alameda Covnty Exhibit A 91 Help Me Grow Delaware Poster �o help me grow i • f � 0 Call Delaware 2-1-1 for Dlaware Healthy Help Me Grow M°�1er DELAWARE HEALTH & AND SOCIAL SERVICES Infant Division of Public Health Consoruum If you're pregnant,you can schedule a prenatal screening to see p°„WOe* if your baby is at-risk for birth defects or rare disorders.Call to IM 2.1or find the prenatal care center nearest you or to talk to a health care professional.Learn more at HeIpMeGrow211DE.com xhibit A 92 Help Me Grow Washington Poster tL M& Help • Grow Washington connects ALL kids their best start 1 Ielp Me Grow i4amilies to the resources needed to give Washington A program of WithinReach The Help Me Grow Washington program offers families: • FREE developmental screening,without waitlists or income limits • Activities and games that support healthy growth and learning • Community resources,from parenting classes to food banks • Referrals for evaluation and early intervention services Call the friendly,knowledgeable staff at our Family Health Hotline to get started today! Call 1-800-322-2588 or visit www.ParentHelp123.org (Look for us under the "Child Development"tab) WithinReach We make the connections Washington families need to be healthy. WR13001012 Exhibit A 93 Help Me Grow Connecticut Growth Chart hE) , fie,e+ 47,, f� 47" G R v� 4ph 1-800-505-700f 45„ 44„ 5 Years•Very interested in friends 43" •Speaks clearly using full sentences •Counts 10 objects ! 4G" •Eats with a fork or a spoon 41" 40" d. oa u` 4 Years 39" Enjoys make-believe O 'Tells stones •Knows some colors and 38" O some numbers •Can catch a bounced ball most ofthe lime 37" 35" i 34" 33" we can nned 32" you N&need 31" 30" 29" 28„ n h— 27,, 26 25 2 Years fee •Becomes more and more independent •Uses 2-4 word sentences •Names pictures in a book like 23" "house,""ball,"or"dog" •Goes up and down stairs holding on 4y 22" 1 Year 20„ •Plays peek-a-boo and pat-a-cake •Says"mama,"'dada;'and"uh-oh" •Finds hidden things easily 19" •Pulls up to stand,may stand alone 7 an 18„ y we nape o ,ne,non, 17» r o 16" 15" Ea7h Ksa 14„ 3„ 1 Exhibit A 94 Sustaining the Help Me Grow System: Marketing Help Me Grow A Iv Help Me Grow National Center Examples of Informational Print Materials Help Me Grow Alabama Books, Balls, and Blocks One Pager Help Me Grow Alabama Fact Sheet Help Me Grow Alabama Trifold Parent Brochure Help Me Grow Alabama Trifold Physicians Brochure Help Me Grow Alameda County Chinese Postcard Help Me Grow Alameda County English Postcard Help Me Grow Alameda County Spanish Postcard Help Me Grow Alameda Will They Grow Out of It Campaign Help Me Grow Delaware Four-Page Brochure Help Me Grow Delaware Poster, Spanish Help Me Grow Fresno Call & Care Coordination Examples Help Me Grow Iowa Social Media Campaign Debrief Help Me Grow Iowa Social Media Campaign Spreadsheet Help Me Grow Kentucky Trifold Brochure Help Me Grow South Carolina Two-Page Flyer Exhibit A 9S d IkIpMeGroW Sustaining the Help Me Grow System: Marketing Help Me Grow National Center Exhibit A 96 Sustaining the Help Me Grow System: Funding& Expanding Help Me Grow ;; Help Me Grow National Center Funding & ExpHelp Me The goal for a Help Me Grow system is statewide implementation. Sustainable funding is crucial for ongoing success and growth. This section includes an overview of planning and implementation costs, strategies to secure sustainable funding, and examples of statewide expansion in the Help Me Grow National Network. Funding a Help Me Grow System Help Me Grow system expenses Expenses for planning, implementation, and expansion vary from state to state. Those in the planning phase of development can have budgets ranging from$60,000 to more than $150,000 annually. A major budget determinant is whether a the system starts at the state or county level. Staffing costs (i.e., number of care coordinators and community liaisons) depend on the size of the population and rate of system expansion. IN THIS SECTION: Funding & Expanding Help Me Grow Funding • Help Me Grow System Expenses • Common Funding Sources • Common Funding Strategies • Common Funding Challenges Statewide Expansion: A Structural Requirement • Overview of Statewide Expansion • Help Me Grow Delaware: A Statewide Launch • Help Me Grow California: County-by-County Growth • Help Me Grow Connecticut: City Pilot Program to Statewide Reach • Help Me Grow Florida: Rapid Statewide Expansion Exhibit A First Edition,July 2014.Copyright 2014 Help Me Grow National Center.All rights reserved. 97 • He1pMe Grow National Center Sustaining the Help Me Grow System: Funding&Expanding Help Me Grow Illustrative Expenses as a State System Develops (2011) Year I W Year 2 Year 3 Year 4 Year 5 Personnel $18,750 $37,500 $287,500 $396,000 $407,880 Office Supplies and Expenses $24,550 S25,290 S26,040 S26,830 $27,630 Data Collection(Database Developmentbfa=enance) S20,000 $8,000 $3,000 $3,000 Equipment $4,500 $4,000 $2,000 Ex-Auation(Data Ank su and xeportinJ S 10,000 $20,000 S20,000 Meetings and Conferences $7,100 $11,800 S13,000 $11,000 S11,000 -Marketing and Communications $9,000 $10,500 S17,000 $21,000 $21,000 Indirect(Ad.swport; -K $19,000 $32,000 $107,000 $138,000 $141,000 Total Expenses $82,900 $137,090 $472,540 $617,830 $631,510 South Carolina Proposed Comparative Budget(2011) Expanded Illustrative State Budget(2011) Common funding sources A combination of monetary funding and in-kind support sustain Help Me Grow systems. • United Ways/2-1-1 • State agencies (i.e., Departments of Health or Early Childhood) • Corporate partners • Health insurance companies • Medicaid • Private foundations • Federal agencies, (i.e., SAMHSA, MIECHV, ECCS) • Business community partnerships • Public health organizations Affiliate Funding Sources Chart(2012) Role of Public Health Funding in Help Me Grow(Forum 2013) Help Me Grow& Medicaid: Opportunities for Expansion and Sustainability The Help Me Grow National Network Funding Expertise within the National Network Help Me Grow affiliate states have completed a number of successful fundraising campaigns. It can be helpful to reach out to Network peers for models, advice, and lessons learned. Help Me Grow Directory of Expertise Funding Specialists Exhibit A 98 Sustaining the Help Me Grow System: Funding& Expanding Help Me Grow ;; Help MeGrow National Center Common funding strategies Blending and braiding funding has been an effective strategy for many Help Me Grow affiliates, as has embedding the Help Me Grow system within existing organizations that have stable funding streams. Below are a few funding strategies to consider. • Highlight the behavioral health component of Help Me Grow to create opportunities for funding. For example, Help Me Grow Connecticut has state funding because it framed Help Me Grow as a secondary prevention program for behavioral health. • Offer Help Me Grow as a resource for foster parents to help secure funding from child protective services agencies. • Embed Help Me Grow in existing programs (e.g. Home Visiting, ECCS, Reach Out and Read) • Embed or associate Help Me Grow with an organization (e.g., children's hospitals) • Join or develop social impact bonds/pay-for-success efforts • Use your champions to market the program to potential funders • Craft a compelling, exciting story about your Help Me Grow system Pay for Success Presentation (Forum 2014) Corporate & Foundation Sustainability Strategies Presentation (Forum 2014) Help Me Grow Orange County, Connecticut & South Carolina Funding Models Help Me Grow Delaware: Embedding in State and Federal Initiatives Help Me Grow Alabama: Moving from Grant Submission to Infrastructure Building Common funding challenges • Instability of state budgets • Funders asking for evidence of direct and immediate Return on Investment. (Visit TheHeckmanEduation.org_for a wealth of resources on the practical value of investing in early childhood systems,programs, and services.) • Turnover at governmental agencies and other community organizations • Knowing how to talk to funders about re-purposing their dollars • Being prepared for grant submissions (recruiting partners, starting discussions) ahead of RFP deadlines ' ff Sustaining the Help Me Grow System Vj Demonstrating the Cost Savings of Help Me Grow In J2012,the National Center released a policy brief, "Cost Benefits of"De-medicalizing" Childhood Developmental and Behavioral Concerns: National Replication of Help Me Grow." Using research collected by Help Me Grow Orange County, policy brief author Christopher Taylor, MBA, demonstrates that the system has the potential to save up- wards of$50 million nationally in health care costs. Exhibit A 99 Help Me Grow Sustaining the Help Me Grow System: Funding&Expanding Help Me Grow National Center Statewide Expansion: A Structural Requirement All Help Me Grow systems must have a plan for expansion_Having a statewide vision for Help Me Grow from the beginning is a structural requirement for the following reasons: 1. A Help Me Grow system depends on building broad-based ownership of the system across service sectors to leverage resources and improve linkages in communities. While this type of collaboration can happen initially at the county or regional level, local and regional gaps and barriers to service are often rooted in larger, statewide challenges. A Help Me Grow system that strives for statewide reach will have a greater ability to address these gaps and barriers,which in turn will help build an effective early childhood system that serves all children in the state. 2. A statewide system creates cost efficiencies through achieving economies of scale, thus lowering the expense of administering and delivering the system. 3. Research on early child development indicates that promoting optimal child development depends on: • universal screening and surveillance, so that children who may be at risk for developmental or behavioral health issues can receive services before their issues become more serious and difficult to remedy; and • the ability to connect with services that are comprehensive and aligned with children's developmental phases and needs. (See the AAP article "Identifying Infants and Young Children with Developmental Disorders in the Medical Home" for more information.) A statewide system helps to ensure universal access and identification of children for intervention as early as possible, and it facilitates a multidisciplinary approach to service delivery. Some states choose to implement the Help Me Grow system statewide from the start.Others begin in one or two counties and apply a spread strategy over a determined amount of time. The process depends on the needs and the capacities of each state. Below are four examples of affiliate statewide expansion. Resources for Statewide Expansion ' Sustaining the Help Me Grow System The Importance of a Statewide Champion It can be helpful for the Leadership Team to have a statewide champion who represents a key state agency or office. For example, Delaware secured the support of Lieutenant Governor Matt Denn early in their planning and implementation. His support was an important factor in the system's successful statewide expansion. In the Spotlight: Help Me Grow Delaware Champion Lt. Gov. Matt Denn Exhibit A 100 Sustaining the Help Me Grow System: Funding& Expanding Help Me Grow A Iv Help Me Grow National Center Help Me Grow Delaware: A Statewide Launch STATE STATS Population /925,749 Population aged 0-5/ app. 56,000 No. of counties/ 3 No. of cities &towns/ 57 Community type/ primarily suburban Early childhood services/generally administered at the state level EXPANSION PROCESS In Delaware,the second smallest state in the country, it was most feasible to implement Help Me Grow statewide from the start. The Delaware Deptartment of Health has contracted with Delaware United Way 2-1-1, which functions as the Help Me Grow Centralized Access Point for the state's three counties. Help Me Grow Delaware Affiliate State Profile Help Me Grow Florida: Rapid Statewide Expansion STATE STATS Population/ 19,552,860 Population aged 0-5/app. 1.1 mil No. of counties/ 67 No. of cities &towns/410 Community type/ mix of rural, suburban, and urban Early childhood services/ administered at the county level EXPANSION PROCESS In 2012, Help Me Grow Florida simultaneously implemented the Help Me Grow system in Miami-Dade and Hillsborough Counties. Switchboard of Miami,the Dade County organizing entity, has expanded services for Help Me Grow into neighboring Monroe County. In the 2014-2015 session, the Florida Legislature and Governor Rick Scott allocated $2 million through the Office of Early Learning to support statewide expansion of Help Me Grow. During the initial year,Help Me Grow Florida will issue an RFP for up to five additional 2-1-1 regions and their service partners to receive funding and technical assistance. If Help Me Grow Florida successfully implements its plan over the next 6-8 months, legislators may allocate recurring funding through the next legislative session to sustain and grow the program to all 16 of the 2-1-1 regions covering Florida's 67 counties. An inaugural statewide Help Me Grow office has been established in the Florida Developmental Disabilities Council in Tallahassee.The Help Me Grow Florida steering committee will recruit a statewide program coordinator. Help Me Grow Florida Affiliate State Profile Exhibit A Population data/U.S.Census Bureau 101 Help Me Grow Sustaining the Help Me Grow System: Funding&Expanding Help Me Grow National Center Help Me Grow Connecticut: City Program to Statewide Reach STATE STATS Population / 3,596,080 Population aged 0-5/app. 190,592 No. of counties/8 No. of cities&towns/ 169 Community type/ primarily suburban Early childhood services/administered at the city or town level EXPANSION PROCESS Help Me Grow Connecticut began as a pilot program in the city of Hart- ford in 1998 and expanded statewide in 2002. That year, Help Me Grow was included in the Governor's budget and money was allocated to the Conneticut Children's Trust Fund, an agency of the Deptartment of Social Services. The Trust Fund contracts with the CT 2-1-1/United Way Child Development Infoline to provide the Centralized Access Point. Help Me Grow Connecticut Affiliate State Profile Help Me Grow California: County-by-County Growth STATE STATS Population/38,332,521 Population aged 0-5/app. 2.5 mil No. of counties/58 No. of cities &towns/482 Community type/ mix of rural, suburban, and urban Early childhood services/generally administered at the county level EXPANSION PROCESS In 2005, Help Me Grow Orange County, California, became the first site to replicate Help Me Grow in the country. With support from the Kellogg Foundation, California became a Help Me Grow replication state in 2011 and developed a consortium comprised of Orange, Alameda and Fresno counties, in collaboration with California Project LAUNCH, to implement Help Me Grow across the state. In 2012, Help Me Grow California created a Learning Community to engage and cultivate counties and regions interested in becoming Help Me Grow affiliates. To date, 21 counties participate and are represented by stakeholder groups from early childhood, mental health, special education, early intervention and health sectors. In 2013, Help Me Grow California developed an affiliation application process for Learning Community counties interested in adopting the Help Me Grow system Recognizing the need for a state-level infrastructure to support this expansion, California has developed a business plan and will focus on four key tasks: provide support to county affiliates; promote sustainability and growth of the system; support the collection and analysis of data statewide; and conduct advocacy and policy activities. Help Me Grow California Affiliate State Profile Exhibit A 102 Sustaining the Help Me Grow System: Funding& Expanding Help Me Grow A Iv Help Me Grow National Center Resources for Statewide Expansion Building State Systems for Optimal Child Development: Affiliates Re oorrt Report on State Leadership in Building an Early Childhood Development System 2011 Helping Communities &States Spread and Scale Up Integrated, Place-Based Initiatives for Children Exhibit A 103 EPU ASSESSMENT CENTER FOR CHILDREN STAFFING CHART • FY 2016-2017 Executive Director k?EPU Ellen Knapp Children's Center Hope Starts Here Mental Health Clinician Program�linical Director " (0.30 F5)&(0.10 MHSA*) -- Contract ---- Daryl Hitchcock, PhD ______ Barbara Swan (0.80 F5/MCAH) &(0.20 MHSA*) 7(-0.96 F5/MCAH) &(.12 MHSA*) 1p Me Grow Coordinator Data Management Assistant Early Childhood Specialist (0.54 F5/MCAH) & (0.40 MHSA*) (1.0) 1.10 F5/M CAHChildren's Services Coordinators Mental Health Clinicia ) (5.80 F5/MCAH)&(4.0 MHSA*) (1.05 F5/MCAH)&(1.97 MHSA*) (0.90 MCAH)& (0.05 MHSA*) (1.30 F5/MCAH)&(0.70 MHSA*) Family Resource SpecialistPathologist (2.0 MCAH)&(1.0 EPU other) _._- .._y (0.50 F5)&(0.50 MHSA*) (0.75 F5/MCAH) (0.15 F5/MCAH)&(0.45 MHSA*) Infant Mental Health Clinician Coordinator (0.93 F5/MCAH) Communication Specialist (1.0) (1.0) Funding Legend ' 'WTI - EPU/First 5 (3.60 F5/MCAH)&(1.40 MHSA*) Exceptional Parents Unlimited Dept of Public Health MCAH/First 5 Maternal Child&Adolescent Health SMART Model of Care- Leadership Team DBH CASA Court Appointed Spec.Advocate Jason Williams EPU Exceptional Parents Unlimited Ellen Knapp Department of Behavioral Health CSN Children Services Network Gayle Duffy First 5 Fresno County Lilith Assadourian CVRC Central Valley Regional Center Rachel Hagans FUSD Fresno Unified School Dist. Deanna Mathies EPU/MHSA*Exceptional Parents Unlimited FCEOC Economic Opportunities Com. Tamela Olsby MMC Marjoree Mason Center Open Mental Health Services Act Fresno County VCH Valley Children's Hospital Kristine Aubry DBH Dept.of Behavioral Health Susan Holt Community Rep Marion Karian EPU Administration DPH Dept.of Public Health Rose Mary Rrahn Exceptional Parents Unlimited DSS Dept. of Social Services Tricia Gonzalez FCOE Fresno County Office of Education L.Jaime/T. Pinhero/T. Frates Exceptional Parents Unlimited/Other *MHSA—not included in Master Agreement August 1,2016 Exhibit B Assessment Center for Children Help Me Grow Budget Summary FY 16-17 Annual MCAH/ EPU/ EXPENSES: Budget DBH FIRST 5 FIRST 5 Personnel Expenses $1,427,723 $124,001 $774,602 $529,120 Facilities Cost $143,000 $5,914 $83,565 $53,522 Operational Supplies $39,360 $1,149 $16,245 $21,965 Training/Travel/Transportation $20,900 $0 $8,470 $12,430 Insurance&Audit $16,500 $682 $9,643 $6,176 Program Supplies $8,500 $0 $0 $8,500 Professional Services $170,560 $0 $7,830 $162,731 Capital & Equipment $0 $0 EPU Indirect Cost $221,333 $1,007 $117,046 $103,281 County Indirect Cost $72,246 $9,221 $63,025 TOTAL EXPENSE i $2,120,122 $141,973 i $1,080,426 $897,723 REVENUE: First-Five Commission (30%of MCAH) $324,128 $324,128 First-Five Commission (50%of remaining 70%) $378,149 $378,149 First-Five Commission $897,723 $897,723 State MCAH (50%of remaining 70%) $378,149 $378,149 Short Doyle Medical $74,400 $74,400 Projected EPSDT $49,600 $49,600 M H Realignment $10,533 $10,533 Other Revenue $7,440 $7,440 TOTAL REVENUE 1 $2,120,122 $141,973 $1,080,426 $897,723 Note: Shaded amounts represent costs paid through EPU Exhibit C SELF-DEALING TRANSACTION DISCLOSURE FORM In order to conduct business with the County of Fresno (hereinafter referred to as "County"), members of a contractor's board of directors (hereinafter referred to as "County Contractor"), must disclose any self-dealing transactions that they are a party to while providing goods, performing services, or both for the County. A self-dealing transaction is defined below: "A self-dealing transaction means a transaction to which the corporation is a party and in which one or more of its directors has a material financial interest" The definition above will be utilized for purposes of completing this disclosure form. INSTRUCTIONS (1) Enter board member's name,job title (if applicable), and date this disclosure is being made. (2) Enter the board member's company/agency name and address. (3) Describe in detail the nature of the self-dealing transaction that is being disclosed to the County. At a minimum, include a description of the following: a. The name of the agency/company with which the corporation has the transaction; and b. The nature of the material financial interest in the Corporation's transaction that the board member has. (4) Describe in detail why the self-dealing transaction is appropriate based on applicable provisions of the Corporations Code. (5) Form must be signed by the board member that is involved in the self-dealing transaction described in Sections (3) and (4). Exhibit D (1)Company Board Member Information: Name: Date: Job Title: (2)Company/Agency Name and Address: (3) Disclosure(Please describe the nature of the self-dealing transaction you are a party to): (4) Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233(a): (5)Authorized Signature Signature: Date: Exhibit D