Narrative Template 26-444-84-2889-01

Home Visiting Program Narrative (required, maximum 15 pages)

1. Executive Summary - maximum 1 page (5 points)

For successful applicants, the executive summary will serve as a stand-alone document that will be shared with various state-level stakeholders and others requesting a brief overview of funded projects. Applicants should be concise and direct in addressing the topics below.

1. Applicant Information: Provide your agency name and agency mailing address, along with the name, phone number, and email address of the contact person for this application.
2. Number of families to be served:
   1. Provide the number of families to be served by home visiting in SFY26.
   2. Provide the number of children to be served by home visiting in SFY26, if this is different than the number of families served.
   3. If your program is proposing doula services, also provide the number of families to be served by doulas in SFY26.
3. Budget: Provide the total amount of your SFY26 budget request for this project.
4. Community and population served: Briefly describe the geographic area to be served, including county(ies) and zip codes. Briefly describe the demographics of the local community to be served.
5. Program services: State the home visiting model used by your program and whether your program is currently in good standing with the model. In 1-2 sentences, describe how this model fits the population to be served. List any model enhancements or protocols that you propose to use in SFY26 (such as doulas). In 1-2 sentences, summarize how your program assures that staff provide family-centered services. In 1-2 sentences, summarize how your program plans to utilize Infant/Early Childhood Mental Health Consultation during SFY26.

2. Community Need - suggested limit 4 pages (total 20 points)

1. Geographic service area and community need. (5 points)
   1. Applicants must serve one or more of the geographic areas listed under Service Areas in Section II, Eligibility Information. For your proposed service area, list the county(ies) and/or subcounty area(s) to be served, complete with all related zip codes. If there are specific boundaries within a given geographic area(s), these must be explicitly spelled out in the application.
   2. Provide data on community needs. For county-level data, please see the Erikson Institute Risk and Reach Report and the IECAM Regional Reports. For assistance with sub-county level data, please contact IECAM (Illinois Early Childhood Asset Map).
   3. Provide the estimated number of home visiting slots in the service area, along with the estimated number of eligible families. The IECAM Regional Reports include county-level data on the estimated number of home visiting slots (see the Home Visiting tab). For assistance with sub-county level data, please contact IECAM (Illinois Early Childhood Asset Map).
   4. Explain how the proposed services do not duplicate other home visiting efforts in the service area.
2. Families to be served. (5 points) Describe the demographic characteristics of families to be served in the selected geographic area. (For county-level data, please see the IECAM Regional Reports. For assistance with sub-county level data, please contact IECAM.) Describe the strengths of families in the community, as well as the barriers that they experience. Briefly describe how your program will prioritize the priority populations listed in Section III, Program Description. For example, populations may be prioritized by using a weighted eligibility form or by establishing partnerships with organizations that serve these populations.
3. Coordination. (5 points) The www.igrowillinois.org website contains a list of home visiting programs in Illinois currently known to IDHS. Use the igrow Illinois "Find A Program" feature to locate the other home visiting programs within your proposed service area and list them in your program narrative. If there are other home visiting programs located within your service area, briefly describe how your program plans to coordinate with them to improve access for families and avoid competition, dual enrollment, and duplication of efforts. Explain how the proposed services do not duplicate other home visiting efforts in the service area.
4. Recruitment. (5 points) Briefly describe how you will recruit families, including at least one of the priority populations. Describe how your recruitment plan will partner with community assets in your service area (such as community-based organizations, faith-based institutions, healthcare providers, health departments, schools, libraries, Family and Community Resource Centers (formerly known as IDHS local offices), community collaborations, and local businesses). Describe how your recruitment efforts will be coordinated with other home visiting programs in your service area (if any).

3. Capacity - suggested limit 4 pages (total 25 points)

The purpose of this section is for the applicant to present an accurate picture of the agency's capacity, qualifications and ability to successfully implement the proposed program described in this Funding Notice. Include the following:

1. Mission. (5 points) Describe the fit between the proposed program and the agency mission, as well as the agency's knowledge of and standing in the community to be served.
2. Experience. (5 points) Briefly describe the organization's experience in providing community-centered home visiting services that are responsive to the needs of families in the service area. If your organization does not have experience providing home visiting services, describe your experience in providing community-centered prenatal to five programs that are responsive to needs of families in the service area. Refer to guidance from your program's home visiting model, if applicable.
3. Staffing. (5 points) List your agency's current Executive Director, Fiscal Officer, and Home Visiting Program Director, along with their highest appropriate credential. Outline the program's management and staffing structure, including any proposed consultants, such as Infant/Early Childhood Mental Health Consultants. Describe their areas of responsibility and lines of communication, and ensure the description aligns with the organizational chart submitted as Attachment B.
4. Enrollment and caseload capacity. (5 points) Please provide the number of families served during State Fiscal Year 2024 (July 1, 2023 - June 30, 2024), the number of families currently enrolled in your home visiting program and your home visiting program's current caseload capacity. Most programs calculate caseload capacity as the percentage of program slots that are currently full. If this percentage is below 85%, please explain.
5. Governance (5 points). Briefly describe your agency's governance structure. Include a list of the agency's Board of Directors or other governing body, identifying the chairperson and/or other key positions, submitted as Attachment C. If applicable, include the role the governing body will play in the decision-making process and how they receive key program information to inform these responsibilities.
6. Complete Table 1: Provide the name of each staff member to be funded by this application, the total Full Time Equivalent (FTE), and the% of time spent in each of the listed roles. Indicate open positions as "Vacant." In this table, a full-time staff member would be listed as 1.0 FTE. For your agency, please indicate here the number of hours per week that is considered 1.0 FTE ______.
   

   Home Visiting Staff Name	Total FTE	FTE Home Visitor	FTE Supervisor	FTE Other Role
   Example: Mary Jones	1.0 FTE	1.0 FTE
   Example: Jane Lee	1.0 FTE	0.5 FTE		0.5 FTE Outreach Worker
   Example: Ana Garcia	0.5 FTE		0.5 FTE

4. Quality- suggested limit 6 pages (35 points)

1. Home visiting model. (5 points) In a few sentences, please summarize your home visiting model's approach, including the desired family outcomes, eligibility criteria, initial assessment tool used, intensity of services, and curriculum/content. Describe how you assure that the model is carried out with fidelity. State whether or not your program is currently in good standing with the model. Provide the date of the program's most recent accreditation or credentialing review by the model. Describe how this model meets the specific needs of the population. If any model enhancements or protocols will be used (such as doula, Mothers and Babies, and/or the HFA child welfare protocol), describe them here.
2. Community-centered staffing (5 points) Describe to what extent your program's home visiting workforce reflects the community served. Describe the training, professional development, or technical assistance that your program uses to ensure that staff provide services in a family-centered manner. Describe hiring plans (whenever vacancies occur) to ensure staff reflect the community served. Refer to guidance from your program's home visiting model, if applicable.
3. Staffing supports. (5 points) Briefly describe the home visiting model's requirements for reflective supervision, including the supervisor-staff ratio and the required supervision hours (in 2-3 sentences). Describe how home visitors and supervisors are encouraged to obtain professional development. Describe how your program currently utilizes Infant/Early Childhood Mental Health Consultation (IECMHC) and how you plan to utilize IECMHC during the grant period. Describe how your agency will meet the minimum salary floor for home visitors and supervisors in SFY26. If it is not possible to implement the minimum salary requirements in SFY26, applicants must describe the barriers to meeting the requirement, and their plan and timeline for meeting the minimum salary level.
4. Family voice. (5 points). Describe how the program includes the voices of diverse families in designing or improving the program.
5. Data and Continuous Quality Improvement (CQI). (5 points) Describe how the program will utilize data collected to support continuous quality improvement. Include a specific example of how data have been used to drive program improvements.
6. Intake and referral. (5 points) Describe how local cross-sector or cross-systems partners collaborate on intake and referrals to support families' timely access to services. Describe the process for closing the loop on referrals, to ensure that families receive the referred services and referral sources are informed of the status in a timely manner.
7. Maternal and child health partnerships. (5 points) Describe how the program collaborates with maternal and child health partners for referrals, information sharing or care coordination. Briefly describe one example of such a partnership.

5. Assurances (10 points)

Complete the Assurances form as Attachment D to indicate the applicant's intent to meet ten (10) main expectations of the IDHS home visiting program.

6. Priority Points (25 points)

Complete the Priority Points form as Attachment E.

Attachment A: Application Checklist

Checklist	Applicant Response (please select one answer per line)
1. Is your organization registered in SAM.gov?	Yes No
2. Is your program narrative (without attachments) 15 pages or less?	Yes No
3. Is Attachment B included? (Organizational Chart)	Yes No
4. Is Attachment C included? (Board of Directors list)	Yes No
5. Is Attachment D completed? (Assurances)	Yes No
6. Is Attachment E completed? (Priority Points)	Yes No
7. If you are applying for the doula enhancement, is Attachment F included?	Yes No Not Applicable
8. If you included Attachment F, is it 10 pages or less?	Yes No Not Applicable
9. Have you combined the program narrative and attachments A-F into one PDF?	Yes No
10. Has the budget been submitted in the CSA and does it address the budget requirements in Section D of the Notice of Funding Opportunity?	Yes No
11. Has the CSA budget been signed by your Chief Executive Officer and/or Chief Financial Officer? (the budget status in CSA should say "GATA Budget signed and submitted to program review")	Yes No
12. Did you complete, sign, and submit the Uniform Application for State Grant Assistance?	Yes No
13. Did you complete, sign, and submit the Grantee Conflict of Interest Disclosure?	Yes No
14. Will you keep a copy of your submitted application, including the time and date of submission?	Yes No

Attachment B: Organizational Chart

Attachment C: Board of Directors List

Please include your organization's Board list, in any format.

Attachment D: Assurances Form

If funded, [name of applicant organization] agrees to meet the following program expectations:

Program Expectations	Response (Yes or No)	Points (1pt per "yes")
1. Support staffing that reflects the community served.
2. Provide home visitors with the following minimum salaries per FTE (full-time equivalent): at least $47,268 in the 6-County Metropolitan Chicago area (Cook, DuPage, Kane, Lake, McHenry, Will) and at least $41,204 in the rest of the state.
3. Provide home visiting supervisors with the following minimum salaries per FTE if the supervisor is at least 50% FTE on this grant: at least $59,598 in the 6-County Metropolitan Chicago area and at least $52,864 in the rest of the state.
4. Prioritize the following priority populations for services: a. Low income household (below 100% FPL) b. Household contains an enrollee who is pregnant and under age 21 c. Household has a history of child abuse or neglect or had had interactions with child welfare d. Household has a history of substance abuse or needs substance abuse treatment e. Someone in the household uses tobacco products in the home f. Someone in the household has attained low student achievement or has a child with low student achievement g. Household has a child with developmental delays or disabilities h. Household includes individuals who are serving or formerly served in the United States armed forces
5. Accept all referrals of families with child welfare involvement, and all referrals of families experiencing homelessness if they are otherwise eligible for the model and if there are openings in the program.
6. Avoid dual enrollment in multiple HV programs and avoid wait listing families when other home visiting slots are available.
7. Respond to referrals and follow-up inquiries from referral sources within two (2) business days.
8. Participate in the local All Our Kids (AOK) Early Childhood Network, Integrated Referral and Intake System (IRIS), or other coordinated intake and referral initiative, if such a collaborative initiative exists in the service area.
9. Use the IDHS-designated electronic data system and enter participant data by the fifth (5th) day of each month.
10. Utilize Infant/Early Childhood Mental Health Consultation (IECMHC) as described in the Illinois Model for IECMHC.
TOTAL POINTS

Attachment E: Priority Points

1. Communities served (maximum 10 points)

Priority	Description	Counties	Does the applicant propose to serve at least one of these communities?
1	"At-risk communities" currently receiving IDHS HV funding.	Champaign, Coles, Cook, Douglas, DuPage, Fayette, Franklin, Jackson, Kane, Lake, Livingston, Moultrie, Peoria, Rock Island, St. Clair, Stephenson, Vermilion, Winnebago.	Yes  No
2	"High consideration" communities currently receiving IDHS HV funding.	Adams, DeKalb, Macoupin, Ogle, Whiteside, Williamson.	Yes  No

• Applicants will receive 10 priority points if they propose to serve at least one of the Priority 1 communities.
• Applicants who do not serve any Priority 1 communities will receive 5 priority points if they serve at least one of the Priority 2 communities

2. Family Empowerment (maximum 5 points)

• If the applicant plans to hire, mentor, or otherwise support the engagement of former participants/parents as home visitors, please include this information here for up to 5 bonus points, as described in Section VI, Application Review Information, NOFO Scoring Table.

3. Current IDHS grantee (maximum 10 points)

Does the applicant currently receive IDHS home visiting funding as a home visiting grantee or subcontractor? This includes IDHS State Home Visiting funds, IDHS federal Maternal Infant and Early Childhood Home Visiting (MIECHV) funds, or IDHS Maternal Child Home Visiting funds through a subcontract with Start Early.	Yes No
Yes = 10 points; No = 0 points

Attachment F: Doula Enhancement Narrative (optional, maximum 10 pages)

FY26 eligibility for the doula enhancement is limited to home visiting programs with existing integrated doula services, that are currently funded by IDHS (this includes IDHS Maternal Child Home Visiting (MCHV) funding received through a subcontract with Start Early).

• If your home visiting program does not currently have integrated doula services, then you are not eligible to apply for the doula enhancement in FY26.
• If your home visiting program has existing integrated doula services that are funded by a source other than IDHS or MCHV/Start Early, then you are not eligible to apply for the doula enhancement in FY26.

Note: The Doula Enhancement Narrative will be scored separately (the doula narrative points will NOT be added cumulatively to the points for the home visiting program narrative).

1. Community Need (total 20 points)

   1. Geographic service area and community need. (15 points) Provide a clear definition of the population to be served and convincing evidence, including demographic information, that there is a need for doula services in the service area. Describe how the program reflects the needs of families.
   2. Coordination. (5 points) If there are other doula services in your service area, list those providers and briefly describe how your program plans to coordinate with them to improve access for families and avoid competition, dual enrollment, and duplication of efforts.

2. Capacity (total 50 points)

   1. Experience. (15 points) Briefly describe the organization's experience in providing family-centered doula services to families in the service area.
   2. Staffing. (10 points) Outline the doula program's management and staffing structure. Describe their areas of responsibility and their lines of communication, including how they relate to the home visiting program. Indicate which staff are already in place and which positions are vacant/to be hired. Describe your program's home visitor-to-doula ratio to ensure space for doula participants to transition into long term home visiting services.
   3. Doula coverage. (5 points) Because of the unique nature and demands of labor and delivery, doulas often work non-traditional hours and may sometimes work over 40 hours/week. Please describe your program's plan for doula coverage, including a back-up plan for labor and deliveries when a doula is unavailable or attending another birth.
   4. Caseload size. (5 points) Because time must be allowed for attending births, the maximum size for a doula caseload is nine (9) participants at any one time, and we expect that a 1.0 FTE doula would serve 23 families per year. Provide the number of families served by doulas in your program during State Fiscal Year 2024 (July 1, 2023 through June 30, 2024). Provide the number of families currently receiving doula services and your current doula caseload capacity. Describe your program's proposed doula caseload and the total number of families to be served in SFY26.
   5. Core services. (10 points) Describe your program's plan for: 1) creation of birth plans between doulas and participants; 2) offering prenatal groups, including sample topics and frequency schedule; and 3) supporting and encouraging breastfeeding during the perinatal period. Identify at least one prenatal curriculum that the doulas will use. Indicate how many of the proposed services are already in place and state what arrangements need to be made in order to fully implement the program.
   6. Embedding doulas into long-term home visiting program. (5 points) Doula participants are expected to integrate into the long­ term home visiting program. Explain your program's plan for full integration of families accessing doula services into long-term home visiting, including the frequency of prenatal visits and by whom, the transition plan from doula to home visitor, and the time frame in which the transition will occur.

3. Quality (total 25 points)

   1. Community-centered staffing. (5 points) Describe to what extent your program's doula workforce reflects the community served. Describe the training, professional development, or technical assistance that your program uses to ensure that staff provide doula services in a family-centered manner. Describe hiring plans (whenever vacancies occur) to ensure doula staff reflect the community served. Describe how your agency will meet the minimum salary floor for doulas and supervisors in SFY26. If it is not possible to implement the minimum salary requirements in SFY26, applicants must describe the barriers to meeting the requirement, and their plan and timeline for meeting the minimum salary level.
   2. Supervision. (5 points) The preferred supervisory ratio for doulas is 1:5, and 1:6 is the maximum. (This means that the supervisor of the Doulas must not supervise more than six (6) staff members in total.) Doula supervisors must attend training to ensure that they are knowledgeable of the doula's job responsibilities and can support their work. Describe your program's supervision ratio and the professional development plan for doula supervisors. Describe your agency's protocol for providing reflective supervision to supervisors.
   3. Clinical consultation. (5 points) Though doula services are not a medical intervention, some participants will have medical complications during pregnancy or in delivery. For this reason, it is important that doulas have access to clinical consultation from someone with a medical background (such as a nurse, a midwife, or a similarly trained expert). Explain your program's plan for engaging a clinical consultant, the consultant's qualifications, and the number of hours per month your program plans to contract with the clinical consultant.
   4. Referral partnerships. (5 points) Explain how your program plans to cultivate agreements with entities that work with pregnant persons in your area, to ensure families can be enrolled in services by the beginning of the third trimester. Indicate how many pregnant persons will be served and describe how all participants will be recruited and assessed for program intake. Describe how your program will coordinate the early identification of pregnant persons, including plans to develop collaborative agreements with local clinics/hospitals for screening of potential participants during pregnancy.
   5. Maternal health partnerships. (5 points) Cite names of hospitals or birthing centers where participants will deliver, and state how your program will formally partner with these entities to ensure that doulas are welcomed into delivery rooms for their participants' deliveries.