FAQ Maternal, Infant & Early Childhood Home Visiting Programs

Home Visiting Program - Overview F.A.Q Questions from Members of MCAH Action Which counties have been identified? The Statewide Needs Assessment identified all 58 counties to be at risk. However, specific counties or sub-counties have not been fully determined. The 54 counties that completed the Capacity Assessment Home Visiting Survey indicated that they had unmet needs that could be addressed through new home visiting services. MCAH will complete a more in depth analysis of counties to refine the designation of at risk communities. Further assessment of gaps in services will be required through local identification of specific high risk populations and the capacity of local public health systems to effectively meet their service delivery needs. Are sub-county areas being considered? Yes. If so, how will they be determined? Sub-county analyses will be completed based on the benchmarks, once this information is released, and key indicators available in California at the sub-county level. Sub-county analyses may include geospatial hot spot analysis to refine the boundaries of the highest need communities. By incorporating hot-spot analyses and corresponding hot-spot maps into this process, sub-county areas could be determined by identifying geographic clusters with statistically significant higher risk values (i.e., hot spots). Additionally, the criteria for allocating the funds is currently in development. Are current NFP sites eligible to receive funding? Yes. If their funding is from private grantors currently could they be eligible? Yes, they may qualify.

Home Visiting Program - Overview F.A.Q Questions from Members of MCAH Action Have models been chosen and if so which one(s)? Models have not been selected yet. The six benchmarks required by legislation will be among the criteria used for model selection. Furthermore, HRSA and ACF contracted with Mathematica Research, Inc. to conduct a comprehensive analysis of national and local home visiting programs, to determine which of these programs meet “evidence-based” criteria. It is anticipated that Mathematica will release their findings prior to the release of the final updated state plan guidance. Additionally, the Home Visiting legislation includes the below Maintenance of Effort language: “Maintenance of Effort” Funds provided to an eligible entity receiving a grant shall supplement, and not supplant, funds from other sources for early childhood home visitation programs or initiatives. The grantee must agree to maintain non-Federal funding (State General Funds) for grant activities at a level which is not less than expenditures for such activities as of the date of enactment of this legislation, March 23, For purposes of this FOA (HRSA ), home visiting is defined as an evidence-based program, implemented in response to findings from a needs assessment, that includes home visiting as a primary service delivery strategy (excluding programs with infrequent or supplemental home visiting), and is offered on a voluntary basis to pregnant women or children birth to age 5 targeting the participant outcomes in the legislation which include improved maternal and child health, prevention of child injuries, child abuse, or maltreatment, and reduction of emergency department visits, improvement in school readiness and achievement, reduction in crime or domestic violence, improvements in family economic self-sufficiency, and improvements in the coordination and referrals for other community resources and supports.”

Home Visiting Program - Overview F.A.Q Questions from Members of MCAH Action Is the State considering the biggest Return On Investment for selecting models? Considering cost benefit ratio may be one of many criteria subjected to analysis in the HVP model selection process. By selecting HVP models that clearly and specifically make the biggest positive impact on indicators and in the highest need counties or sub-counties, a return on investment may be gained for the CA HVP. How will the funding be distributed to counties (allocation, RFP)? An internal Feasibility Workgroup has been formed to evaluate this issue. Based on the release of the federal guidance and the completion of the HVP model analysis, California will develop an application process inviting all counties to apply for Home Visiting Program funds to be administered by CDPH/MCAH. A targeted RFA detailing selected criteria which applicants are required to meet is probable. An RFA that will run through the MCAH allocation process is under consideration. Which tribal entities (county location) have applied? The California Home Visiting Program at MCAH is not involved in this application process. It is a separate HRSA FOA. What are the next steps for MCAH Directors? MCAH directors are encouraged to collaborate with their local education, welfare directors and alcohol and drug use community partners to begin thinking about home visiting for their at-risk communities. It is advisable to begin reviewing local data that would support the need for a Home Visiting program in their community. However, CHPH has been advised by our legal office that to the extent MCAH directors or others are planning to be applicants, they should not be involved in the RFA planning process. Participation in the RFA process would disqualify one as an applicant.