December 18th's Grant Informational Conference for the Home Visiting Programs RFP's

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ILLINOIS DEPARTMENT OF HUMAN SERVICES
DIVISION OF COMMUNITY AND PREVENTION
BUREAU OF CHILD AND ADOLESCENT HEALTH
BIDDERS' CONFERENCE

REQUEST FOR PROPOSALS
HOME VISITING PROGRAMS
TO SUPPORT
NEW AND EXPECTANT MOTHERS

MCFARLAND MENTAL HEALTH CENTER
901 SOUTHWIND DRIVE
SPRINGFIELD, IL
DECEMBER 18, 2008
1:00 P.M.


Employees Present

  • RALPH SCHUBERT
  • ANDREA PALMER
  • CLARE ELDREDGE
  • JEANNE MARIE ANDERSON

MR. SCHUBERT:

So we'll do introductions real quick and then get into the meat of this. My name is Ralph Schubert. I'm the associate director for program planning and development in the Division of Community Health and Prevention at DHS. And next to me is Andrea Palmer, who is our Healthy Families Illinois program coordinator. And next to her is Claire Eldredge, who works at the Ounce of Prevention Fund and is our resident parents-as-teachers expert. And next to her is Dr. Jeanne Anderson from the Nurse Family Partnership, who is there for obviously our Nurse Family Partnership expert. And everything is being transcribed by our court reporter, whose name I didn't catch. Thank you, Tina.

So a transcript of this bidder's conference will be on our website in a couple of days. A transcript of yesterday's bidder's conference will be there as well.

I'm going to talk about the mechanics of the RFP, the application process, all of those sorts of things, and then turn it over to my fellow panelists -- hi, please sign, and there's copies of the RFP over there if you need one. So I'm going to talk about mechanics, and in turn my three colleagues will talk about each of these models of home visiting that we are supporting through these grants, and then we will take questions.

Yesterday the presentations took about half an hour, and we took questions for about half an hour, and then we were done. And it may not take that long today, and given the weather, I understand everybody's interested in getting someplace safer than this by the time the day is over. But we'll stay as long as people need us to in order to answer questions, because you came here, and this is cheaper than a phone call, so.

Let me go -- let's talk, then, about the mechanics of the RFP. We are looking for organizations to do a couple of things. We're offering funds to expand existing home visiting programs that use one of these models, and we are offering funds to initiate new programs using one of these models.

The -- to be a little bit more mechanical about the application process, we're asking everybody to send us a letter of intent by the 30th of December. It's not binding. If you don't send one, you can still apply. If you send one, it doesn't mean you have to apply. We want you to indicate in your letter which model you want to implement. We're going to use all of those letters to help us sort out how many of what kind of review team we need. So we're bringing in, in addition to using our own staff, we are bringing people in from outside of the Department who are familiar with each of these models. So we'll have the -- the applicants that propose to implement Nurse Family Partnership will be reviewed by teams who are very familiar with the Nurse Family Partnership model, and so on.

Proposals are due, as you know, on Tuesday the 20th of January, 2009. I know there is something else going on that day, but get this in the mail the day before, and then you can relax and enjoy the inauguration.

We are accepting proposals from public and private organizations, public -- private not-for-profit organizations. We know a number of questions have come up from school districts about their eligibility, and I don't know if that's any of you, but yes, school districts are public organizations and are eligible to apply.

There is one small group of people that we  are excepting, or organizations, I should say, that we are excepting from the RFP, and that's the relatively small number of organizations that have a program grant from the Ounce Of Prevention Fund for the Parents Too Soon program. And we're not accepting proposals from those organizations to expand their Parents Too Soon programs. The Ounce Of Prevention Fund has additional money through this larger appropriation for that purpose. So those programs should be working with the Ounce Of Prevention Fund for additional resources. We're opening this up to everybody else.

We will be posting questions and answers, in addition to the transcripts of these two bidder's conferences, as they are received, so keep checking back to the website. Because people ask all kinds of good questions, and we don't think of everything in advance. So as questions come in, we develop an answer, post them on the website. That is your official source of information for clarification of the RFP. So even though you may call one of us and ask a question and we answer it, you have to rely on what we post on the website as the official information for clarifying the terms of the RFP.

We are expecting to make between six and eight awards, half a dozen awards, in that neighborhood, ranging in size from $50,000 to half a million dollars. Altogether we have a million and a half dollars to award. We are expecting to get in touch with the winners about the first of November. We will get in touch with everybody. We -- did I say November? All of a sudden -- the first of March. So we are expecting to get in touch with the winners about the first of March. You will get a letter from Secretary Adams that says congratulations.

Now, after that, we will send you a community services agreement, a grant agreement, a contract. And at the time that you sign it, send it back to us, we sign it and we file it with the Comptroller, then the contract is in effect and then you can start spending money. But you can't start spending money until the contract is executed and filed. Now, you sign it, send it back to us, we file it, sign it and file it very quickly. But that initial letter from the secretary is not a contract.

We want you to send in two budgets with your proposal. The first one should cover April, May and June of 2009. The second one should cover July 2009 through June 2010. So it covers 15 months worth of funding, but we want one for the rest of this fiscal year and one for all of next fiscal year.

Make sure that I have covered everything. Yep. Let's see. The one point left to make, which has to do with -- which has to do with reporting, submitting data to us. If you're successful, we are expecting everyone to use our Cornerstone management information system, and there is equipment and lots of other things that go along with that. In addition, if you propose to implement the Parents As Teachers model, there is a web-based reporting system called PATsim that goes along with that, so you will be entering data on both systems. If you propose Nurse Family Partnership, there is a web based data system that goes with Nurse Family Partnership, and you will end up entering data in both systems. So it is unfortunate that that is the case, but we want to tell everybody that that is the case up front.

All right. We're going to go through the three presentations on the models and then take questions. So make notes, and we will come back to questions in a few minutes. So first let me turn the floor over to Andrea Palmer, who is going to talk about Healthy Families Illinois. And I'm going to sit like over here someplace off screen.

MS. PALMER:

Healthy Families Illinois -- and I need glasses. Healthy Families Illinois is an intensive home visiting program that is designed to help new and expectant parents at risk for child abuse and neglect to reduce that risk and help get their children off to a healthy start.

We do that by helping with parent and child -- helping to strengthen the parent-child relationship, helping parents develop realistic expectations for their children, and improving the family support system. We also support healthy child growth and development. The Healthy Family Illinois program is modeled after the Prevent Child Abuse America, Healthy Family America program model.

The program adheres to 12 evidence based practices, which form the framework for implementation and operation of a Healthy Families Program. These three practice -- best practices, also known as critical elements, can be described in three categories: Service initiation, which means that we initiate services prenatally or at birth. We use a standardized assessment tool to systematically identify families who are most in need of services. We offer services voluntarily and use positive outreach efforts to build family trust.

The second category would be service content. We offer services over the long term, three to five years, using well-defined criteria for increasing or decreasing the frequency of home visiting services. We provide comprehensive services which are culturally relevant and designed to improve family functioning and reduce their risk for child abuse and neglect. All families are linked to a medical provider and other needed services. Staff members also have limited case loads.

The third category would be staff characteristics. Staff should be selected based upon their ability to establish trusting relationships, have extensive role specific training and access to ongoing reflective supervision.

Community involvement is critical to successful implementation and operation of a Healthy Families Illinois program. Providers are expected to work closely with the community to design program services that meet the unique needs of the community, as well as maintain advisory committees of community stakeholders and program participants to assure that programs continue to meet the needs of the community.

Home visitors should be selected based on their personal characteristics, educational or experiential backgrounds. Staff must have receptive, sensitive, nonjudgmental personalities used to establish the rapport required to provide effective services. Home visitors must be able to work with diverse family types and meet their varying needs. Assessment workers and home visitors must have a high school diploma or its equivalent, and supervisors must have at least a Bachelor's Degree.

In addition to having the interpersonal skills that prepare them for their roles, home visitors must also receive formal training to develop the knowledge and skills necessary to achieve the program's goals.

There are a variety of reasons to initiate services prenatally or at birth. It helps link parents and infants to early preventive medical care. It reaches parents when they are receptive to information and eager to learn how to care for their child. It assists families in developing appropriate expectations for their child's development. It identifies overburdened families early and provides guidance and support to curb drastic outcomes related to child abuse, and it facilitates the formation of a trusting relationship between a home visitor and the family.

It is essential that the home visitor's services maintain three focuses, or foci: The parents, the child, and the parent-child relationship. Services that support parents' needs reduce stress, improve home environment, and create healthy conditions for children. In addition, these services strengthen the relationship between the parents and the home visitors and increase parents' receptivity to other forms of services?

The following services are routinely provided during home visits: Developmental delay screenings, referrals, and follow-up, monitoring of well child visits and immunizations, linking families to medical and health care providers, and information referrals and linkages to other needed services.

The number of families that each home visitor serves comprises a caseload. Limited caseloads allow home visitors to spend more time with each family, facilitate intensive and responsive services, individualize to meet the needs of the family, afford staff time to receive the training, supervision and ongoing development needed to support their families, and reduce the likelihood of staff burnout and turnover. Caseloads for full-time home visitors may not exceed 15 families at the most intensive home visiting level. Caseloads for full-time home visitors may not exceed 25 families at any combination of home visiting levels.

Healthy Families Illinois programs are required to affiliate with Healthy Families of America. There's an annual fee of $325. The Department supports HFI programs to go on to become accredited through Healthy Families America or the Council on Accreditation.

For more information on the Healthy Families America program model, visit the HFA website at www.healthyfamiliesamerica.org.

And now Claire will present Parents As Teachers.

MS. ELDREDGE:

Good afternoon. My name is Claire Eldredge, and I'm a training manager for the Ounce Of Prevention Fund, and I specialize in Parents As Teachers the Ounce Of Prevention Fund serves as the state office for PAT in Illinois, and as such provides training and technical assistance for the over 220 programs in the state.

The Parents As Teachers, or PAT, vision is that all children will learn, grow, and develop to reach their full potential, and its mission is to provide information, supporting, and encouragement parents need to help their children develop optimally during those crucial early years of life. The PAT Born To Learn model is the vehicle used to reach those families.

So what is Parents As Teachers? It's a strengths-based family education and parent support model. Born in Missouri in 1984, this home visiting program is voluntary and focuses on prevention -- on prevention as it addresses the root causes of child abuse: Unrealistic expectations of children, feelings of isolation and parental stress.

The Born To Learn curriculum is research based and promotes optimal development and positive parent-child relationships and is the core of the Born To Learn model.

Originally designed as a universal access program for families with children prenatal to kindergarten entry, PAT's Born To Learn model has been adapted and targeted for high needs families. It has a strong evidence base, with numerous studies demonstrating positive outcomes and is nationally recognized. The Born To Learn model is supported through training, technical assistance and research by the Parents As Teachers national center in St. Louis, Missouri.

The PAT model is based on the following belief: All parents deserve support as their child's first and most influential teacher; that the home is the child's first and most important learning environment; and that the family is a unit of learning.

PAT begins prenatally, because research has shown us that the child's early years are critical for optimal development. The PAT Born To Learn model emphasizes that respect for a family's traditions and cultures is essential in order to engage and build strong relationships with families, relationships that are based on parent empowerment, appreciation of diversity, and partnership.

PAT also believes that one size doesn't fit all. The model is structured so that services to families are adapted and individualized to the needs of each family and the community they live in, and PAT is committed to promoting the development of each child through the use of a child development neuroscience curriculum based -- curriculum that's established on emerging research.

PAT's goals are for both the parent and the child. The goals are to increase parental knowledge of child development and improve parenting practice, to provide a means for early detection of potential learning problems, to prevent and reduce child abuse and neglect, and to increase the children's school readiness and school success.

For the purposes of this RFP, the PAT Born To Learn model will be targeted for at risk families. An eligible family must be low income and with a pregnant mother and/or a child under age one. Programs will need to develop an outreach plan that determines the specifics of the target population that will be served, and details how the program will identify, recruit and enroll eligible families.

The PAT Born To Learn model has four main components: Personal visits, group meetings, screening, and resource networks.

Personal visits are the heart of the program and support parents in their parenting role in order to promote optimal child development and positive parent-child interaction. Personal visits are delivered in the home; however, when extenuating circumstances exist, visits can be held in a mutually agreed upon site outside of the home. For high needs families, personal visits are completed weekly or twice a month, depending on need. Visits generally last 50 to 60 minutes, though more time may be required, depending on the number of children in the family or family needs. The average time allotted for personal visits is -- excuse me. The average time allotted for personal visits for planning, service delivery, record keeping and travel is two and a half hours.

Caseload size for a full-time parent educator delivering weekly visits is 12 to 14 families. If visits are twice a month, then caseload size is 24 to 25 families. And that's an approximation, but pretty close to that.

Parent educators use the Born To Learn curriculum on personal visits, and visit topics are individualized with respect to the family's needs and concerns.

The group meeting component provides opportunities for parents to acquire information about child development, parenting and positive parent-child interaction while gaining support from each other. During group meetings, parents are encouraged to build a support network by talking with each other about their common experiences as well as concerns. Group meetings are also offered -- are offered at least once a month and held at times and locations that are convenient to the families. Multiple strategies such as transportation and child care should be employed to encourage parents to attend.

Across the program year, the program provides a variety of meeting formats, including but not limited to parent-child interactions, presentation plus -- and that is when you have a speaker who is knowledgeable on a certain topic come to talk -- small ongoing groups, and community events. Group meeting topics and formats should be responsive to the special populations or groups served by the program, such as pregnant women, teen parents, non English speaking parents, et cetera.

The screening component provides regular information about each child's health and developmental progress, increases parents' understanding of their child's development, and identifies strengths and abilities, as well as areas of concern. All children enrolled in the program receive developmental, health, hearing and vision screenings at least once each program year. Developmental screening includes the areas of language, intellectual, social, emotional, and motor development through the use of instruments approved by PAT national center.

In Illinois, most of the programs use ASQ or Denver. Screenings should be administered with sensitivity to cultural background and accommodation for the family's primary language. When screening results indicate the need for further assessment, parent educators should provide parents with the appropriate early intervention resource information.

Screening can be conducted either by program staff or by an outside agency. If provided by an outside agency, the program must have a written agreement with the agency that states results will be reviewed with the parents, and that the record -- and then the record of the screening forwarded to the program.

The fourth and last component is the resource network. Through the resource network, PAT programs connect families to needed resources and take an active role in the community, establishing ongoing relationships with other institutions and organizations that serve families. PAT programs should have well-defined procedures for providing families with information about, and helping them access community resources. Program staff should be knowledgeable about those resources, including informal networks, local customs and events.

Because this RFP is for a targeted population, each family will have an individual family support plan with an appropriate family, adult and parent-child goals. With family permission, program staff will also consult with other organizations serving the family in order to coordinate services.

Staff qualifications. The staff for PAT programs should have the knowledge, skills and sensitivity to respond effectively to families' community, cultural and language backgrounds. It's preferred that both supervisors and parent educators have a Bachelor's Degree in early childhood, child development, or a related field, and supervised experience working with families with young children; however, an individual program may include additional or alternative education or work history requirements that they find appropriate and acceptable to meet the needs of their community. So in other words, while a four-year degree is preferred, it's not absolutely necessary in order to be trained as a parent educator.

All PAT supervisors and parent educators must successfully complete the PAT Born To Learn prenatal to three years training institute. Supervisors have the option of attending two days of that institute or five days of that institute, and we really strongly encourage that they attend all five days. The institute is a comprehensive five-day training, and covers neuroscience research on early development and learning, effective personal visits and visit plans, facilitation of parent-child interaction, ideas for the parent group meetings, ways to provide connections to community resources, services to diverse families, red flags in areas of development, recruitment and program organization.

Three to six months after attending the institute, parent educators must attend the follow-up day in either a face-to-face training or on-line. The follow-up is designed to answer questions and concerns about the curriculum or the model a few months after implementation has begun.

During the institute training, participants spend time getting acquainted with the Born To Learn curriculum that is based on child development and neuroscience research. Three very large modules include prenatal to 36 months home visit plans for monthly, biweekly or weekly visits. It also includes resource information on child development and human diversity written specifically for parent educators. Parent handouts with child development -- I'm sorry -- and parenting information are included and come in two different reading levels. The curriculum and all handouts are available in both Spanish and English.

Training fees for the Born To Learn institute include a $520 registration fee for the five-day training and $295 for the curriculum. Each parent educator must have their own curriculum. The cost of the follow-up day is included in the registration fee. In Illinois, training is offered through the Ounce Of Prevention Fund's Illinois Birth To Three Institute in both Chicago and Springfield.

To get started with the implementation of a PAT program, please contact me or Maureen Brennan at our Ounce Of Springfield office. We will help you individualize your program needs within the PAT guidelines and discuss strategies for you to consider during the preliminary planning process. You will be sent a PAT program plan to complete before training, and that plan has to be approved by our office. So you fill it out, send it to us, and then we will approve it, and then you can actually register for the training. That process can take up to three to four weeks.

The PAT supervisor and parent educators then attend the Born To Learn institute. During the institute, participants complete daily assessments to demonstrate an understanding of the program material and to become certified PAT parent educators. Successful completion of training automatically affiliates your program with the Parents As Teachers national center, and you will be certified for one year. In order to maintain the PAT certification for subsequent years, supervisors and parent educators complete a requisite number of in-service hours or wraparound training and pay a recertification fee of $40. So Parents As Teachers is a national model, but when you implement it in your community, it becomes a local program.

There are resources available to help you better understand how to implement a PAT program. Two especially helpful resources are the How To Implement A PAT Program booklet, and the PAT standards and quality indicators. Both are available at the Illinois PAT website, www.opfibti.org/PAT, and the PAT national website, www.parentsasteachers.org.

Thank you for your interest in PAT, and I look forward to working with you and the Department of Human Services as we work to increase home visiting services for Illinois families. And next will be Jeanne Anderson talking about Nurse Family Partnership.

MS. ANDERSON:

Thanks. So I'm going to tell you a little bit about the Nurse Family Partnership.

There are three guiding goals in the Nurse Family Partnership program. It's what the evidence -- it's an evidence-based model, and these are the outcomes that were found to be the ones that were needed to focus on, and they're to improve pregnancy outcomes, improve child health and development, and improve parents' economic self sufficiency.

NFP has strong theoretical underpinnings. Self-efficacy theory, the mother's ability to change certain behaviors by learning to draw upon her own strengths and successes. The human ecology theory, the mother's and the child's social context are profound influences on the mother's life, and the attachment theory, that sensitive parental caregiving is a major influence on the child's growing sense of security in the world.

NFP services, competencies, education and guidelines are focused on those families that were most at risk and needing to be served, and we found that these were often teens and they were often unmarried. The median age is about 19 to 20 years from across the nation for participants in Nurse Family Partnership programs.

The outcomes proven to assist in helping families achieve health, self-sufficiency, and early attachment and bonding were improving the parental health, starting early in pregnancy to achieve healthy births, preferably 16 to 20 weeks and no later than 28 weeks. And part of the reason we like to see that is because when you talk about behavioral change around smoking cessation, diet, and exercise, the earlier in pregnancy when you start, of course, the better you have when it comes to healthy birth outcomes. Improving infant and toddler development and health and safety, assisting families in moving towards self-sufficiency and creating early parental prenatal and infant attachment and bonding.

Key program components. We serve low income first time parents and their children. Nurse home visitors are highly educated, they're usually Bachelors level nurses, and the supervisor is preferably Master's preferred.

Visits begin early in pregnancy and continue the first two years of the child's life. Nurses follow developmentally appropriate guidelines that are structured around cultural sensitivity. There's a clinical information system that the programs will input their data, and it helps you monitor your program implementation to make sure that you're on course to achieving outcomes, and there's a powerful relationship between the nurses and the client that's strength oriented, and it's centered around the client's goals.

Nurse Family Partnership referrals. Eligibility is the first time pregnant low income women, no later than the 28th week of gestation, and realistically by the 25th week is preferred at 16 to 20 weeks. Likely referral partners -- and you people all probably know this little list better than I do -- with clinics, family planning, pregnancy testing centers, obstetricians, pediatricians, particularly those who serve low income Medicaid clients, prenatal care providers in your community that are -- that the clinics are community based, and hospitals, school and school health nurses, churches and, of course, self referrals.

Client enrollment and caseload building. One RN usually carries 25 participants. 50 percent enrollment means one RN needs about 50 referrals in order to achieve a caseload, and it's critical to take into account that over time there is attrition. The bottom line is that an agency needs about 58 referrals per nurse over nine months to meet caseload expectations. A four-nurse home visitor team will need about 232 to probably 250 referrals over the first nine months of program replication.

So what does it look like? A typical program consists of one nurse supervisor, an MSN preferred, four nurse home visitors, BSN preferred, and one administrative clerical support staff.

The elements of the Nurse Family Partnership model that assure fidelity is that the services offered make sense to the eligible women. The services are flexible, and the guidelines support the unique needs and culture and wants of the families. Mothers enroll voluntarily early in pregnancy. Nurse Family Partnership encourages ideal enrollment between 16 and 20 weeks, and I know I've said that a lot, but it really is the preference because of the behavior changes that you want to make during the pregnancy. This allows time for establishing a relationship that allows for healthy behavior changes in smoking, diet, substance abuse and adequate prenatal care that impacts positive birth outcomes. The earlier the services begin, the better.

Frequent home visits by nurses for two and a half years. Typically home visits occur weekly for the first four to six weeks of a participant entering the program, and then every other week until the birth of the baby, and then weekly for about four to six weeks, then biweekly until the baby is two. From 21 to 24 months, they become monthly home visits. And the home visitors and families really decide on the visiting schedule that best meets the needs of that particular family.

Powerful relationships foster client strengths and are oriented around client goals. The nurse home visitors, with their clinical and nursing education and background, are trained in cultural sensitivity, health in clinical assessments, and partnering with individuals to improve health outcomes. In addition to the nursing education that comes for the RN that she automatically comes with, Nurse Family Partnership provides specialized nursing education in the areas of reflective practice, reflective supervision, and practice coaching, which includes a motivational interview.

NFP has visit by visit guidelines, to the total of 64, which is the maximum that usually somebody can have when they're in the program. That keeps the interventions focused, while addressing the uniqueness of each family.

Nurse Family Partnership uses a CIS reporting system that allows for evaluation in achieving fidelity to the model and comparable outcomes. Nurse Family Partnership uses the system to assure that the Nurse Family Partnership services are in keeping with the evidence-based practices.

So if we think about what do those guidelines look like, these are the five domains that guidelines are structured around: Personal health, which includes health maintenance practices, nutrition and exercise, substance abuse and mental health functioning; environmental health, which is the home and safety; work, school and neighborhood home and safety; life course development, around family planning and delay of subsequent pregnancies, education and livelihood; the maternal role, the mothering role, the physical care of an infant and behavior and emotional care, which is the attachment and bonding; family and friends, nurses will help folks look at who is in their life and what are those kinds of folks like.

So personal network and relationships, and also assistance with child care decisions. And then the health and human services is service utilization to help the mom learn how to access the resources in her community.

So what does the national service office of Nurse Family Partnership do? We do a number of different things. In this particular case, it will be done in collaboration with the Illinois Department of Human Services. What we provide specialized nursing education in Denver for all home visiting staff. There are two on-line components to that and two face-to-face visits in Denver. For the supervisor, it's the first two days of the two weeks face-to-face, but the supervisors are encouraged, particularly if this is a new program for you, to stay for all five days, and then the home visitors would come for the three days on each of those trips.

Nurse Family Partnerships provides technical assistance by nurse consultants, program managers and program developers throughout the life of the program, which is regular calls and assistance. Nurse Family Partnership provides a data specialist to assist in all data training and collection needs. That's somebody who will know about Illinois and be able to help you with the CIS collecting that you're doing at your site in this state.

Nurse Family Partnership provides ongoing support at the state and federal levels to assure funding for home visiting programs -- all home visiting programs at a federal level and state level. Nurse Family Partnership works in close collaboration with your state to assure that all data and program information is shared, so that you receive the necessary information that you need to implement a quality evidence-based Nurse Family Partnership program.

So Nurse Family Partnership -- this is a first-time venture for us, I'm very excited about it -- in close collaboration with DHS is looking to see how we can work together to assist families in reaching their dreams here in Illinois. The one thing I would like to add is that once the application process for DHS is completed, there is another NFP application process that you will go through. The very good thing to the authors who did this is that within the context of the DHS application, you're going to be responding to a lot of the things that are already on that NFP application.

And that's Nurse Family Partnership.

MR. SCHUBERT: Okay. Now it's your turn.


NEW SPEAKER:
When I looked up your program on your website, it was suggested that there will be -- to implement a new Nurse Family Partnership would require a minimum of 100-family participation.

MS. ANDERSON:
Yes.


NEW SPEAKER:
Okay. Are there other such restrictions with the two other programs? Do you have a requirement of how many families must be served in your program per year?

MS. PALMER:
It's not so much how many must be served within a year as how many families are in need that you would be able to access. In other words, you need to have enough families available to support the number of home visitors that you are requesting, if that makes sense.


NEW SPEAKER:
Yeah, it does. It makes sense. I mean, you wouldn't hire too many people if you don't have enough families.

MS. PALMER:
Exactly. So we want --

NEW SPEAKER:
But you don't have a required number of families that should be served in a period of a year?

MS. PALMER:
No.

MS. ELDREDGE:
Parents As Teachers doesn't -- isn't in the -- for what Andrea just said, that's accurate; however, to maintain your certificate, you have to serve at least five families in order to maintain your PAT certification. So for instance, a supervisor could be trained as a dual, supervisor and parent educator, and serve a caseload of five or more families. If it got reduced down below five, then we wouldn't be able to recertify.

NEW SPEAKER:
Thank you.

MR. SCHUBERT:
Okay.


NEW SPEAKER:
On Nurse Family Partnerships, I just wanted to clarify, at one point you talked about the phases of visits, and you mentioned biweekly at one stage. Can you clarify what you mean by biweekly? Is that twice a week or once every other week?

MS. ANDERSON:
It's every other week. So it would be weekly, every other week, weekly, and then right towards the end, it goes to monthly.

NEW SPEAKER:
Okay. Thank you.

MS. ANDERSON:
Does that make sense?

NEW SPEAKER:
Uh-huh.

MS. ANDERSON:
Okay.

MR. SCHUBERT:
Any more questions? There was another hand up there.


NEW SPEAKER:
Can we get -- I'm having trouble speaking. Can we get on the website and see who is funded locally?

MR. SCHUBERT:
Yes. Now, having said that, you will be able to find Healthy Families Illinois programs on the DHS website, which -- state board or Ounce website to get PAT?

MS. ELDREDGE:
You know, actually the national website, I think, is the best bet for Parents As Teachers, so that's the www.parentsasteachers.org. When that home page comes up, there's a map of the United States. You click on that, and then it will pull up a larger map, click on Illinois, and it will list the programs.

MS. ANDERSON:
As for Nurse Family Partnership, go to the website, www.nursefamilypartnership.org, and it will have at the top -- I believe it says site maps, and when you click on that, it will drop down the list of states and -- a map with a list of states.

MR. SCHUBERT:
And for Nurse Family Partnership, it's really easy. There's only two. There are about 40 Healthy Families Illinois programs, and goodness, I want to say 90 Parents As Teachers programs, but that may not be right.

MS. ELDREDGE:
There are about 220.

MR. SCHUBERT:
Ninety was not right.

MS. ELDREDGE:
There are 220 across the state, and then there's the differentiation in terms of within Illinois, some are prevention initiatives, and that's the 90 to a hundred that are prevention initiative programs. But that information you would have to probably get from ISBE, because that's not on the national website. They don't differentiate in terms of funding.

MR. SCHUBERT:
ISBE, which is Illinois State Board of Education.


NEW SPEAKER:
Healthy Families Illinois website, when I go to that map to look to see who the providers might be in our service area, I see only the contact person.

MS. PALMER:
Right. I was going to say, that's not where you would find ours. Ours are on the DHS website. You go to the DHS website, go to Healthy Families Illinois, and then you will find a list of providers for Illinois.


NEW SPEAKER:
On the very end of your PowerPoint, there was a map, and I'm just guessing from that that our section of east central Illinois doesn't have very many.

MS. PALMER:
Where are you?

NEW SPEAKER:
We're at Mattoon, Illinois.

MS. PALMER:
What county is that?

NEW SPEAKER:
That would be Coles County.

MS. PALMER:
No, there is not one.

NEW SPEAKER:
Thank you.


NEW SPEAKER:
So this RFP is for new programs?

MR. SCHUBERT:
New or expansion.

NEW SPEAKER:
Or expansion?

MR. SCHUBERT:
Right.


NEW SPEAKER:
When you gave the numbers earlier, that includes all three programs or per program?

MR. SCHUBERT:
For the award amounts?

NEW SPEAKER:
Yeah.

MR. SCHUBERT:
Altogether, we have a million and a half dollars to award. The range will go from 50 to 500,000, and we think this will be a dozen awards, between six and eight. It all depends on how much money people ask for. So it could be more than that if we get a lot of small requests.

NEW SPEAKER:
That being said, if there's only two Nurse Family programs and there are 220 of another program, some money can be appropriated most likely to a program that you only have two in the state.

MR. SCHUBERT:
All depends on the strength of the proposals that we get in.


NEW SPEAKER:
The figures that you're talking about, the dollar figures, these refer to the first-year award so that that shortens your --

MR. SCHUBERT:
That's a good question. It's an annual number. So on an annual basis, we would expect it to be between 50 and $500,000.

NEW SPEAKER:
So really, when we size it, we should be thinking about that second budget we develop for a full fiscal year, and then the initial award is prorated sort of on that?

MR. SCHUBERT:
Along with your startup costs, because you have to buy computers and furniture and all of that kind of stuff once. So you do that in your first startup budget.


NEW SPEAKER:
On the Nurse Family Partnerships, I understand that your minimum caseload expectation is a hundred families, but --

MS. ANDERSON:
That's minimum caseload capacity for the program. Minimum caseload is 25 for the nurses. So if you have four nurses, it comes to a hundred.

NEW SPEAKER:
But your model was this four nurse and supervisor, and would you be able -- does that model support a smaller scale staff? Or because of the caseload cap, it can only be done with four visitors and one supervisor?

MS. ANDERSON:
I'm not sure I understand your question.

NEW SPEAKER:
Well, we're in a rural area. We're going to have --

MS. ANDERSON:
Oh, okay. So you're wondering if you could start with less than four nurses?

NEW SPEAKER:
Yes, ma'am.

MS. ANDERSON:
Right at this time, the Nurse Family Partnership NSL office has determined that for what we call a flagship, a brand new program in a brand new place, that we would want to see probably the four nurse team. And that's because, to be very -- what we found across the country is for folks to have smaller teams, they've tried this a couple of times, that they become very isolated, and it becomes very hard to have that sort of networking that you need. And if you have a larger team with a larger nucleus, like the four, then in fact you have a better chance of being able to implement with fidelity to the model. But that's a really good question.

NEW SPEAKER:
It's difficult to support in a rural area. And to do that, we would have to cover a much larger geographic area, and the costs would go up.

MR. SCHUBERT:
Yep.

MS. ANDERSON:
Uh-huh.

MR. SCHUBERT:
Other questions? They're cheaper than phone calls, ask them now.


NEW SPEAKER:
Can you apply for more than one?

MR. SCHUBERT:
Well, we're assuming that each proposal will have just one modeling.

NEW SPEAKER:
You can write two separate proposals?

MR. SCHUBERT:
If you want to.


Let me make sure I take care of a couple housekeeping things while you may be pondering another question, which is to ask: Did everybody sign in?

And if you have additional questions after today, use the e-mail address that's in the RFP, which I can't remember off the top of my head, to submit questions. We monitor it all the time, and then we will post the responses on the website.


MS. PALMER:
It's on Page 7 of the RFP.

MR. SCHUBERT:
Yeah. It's in there a couple of times.

MS. PALMER:
It's Page 6, Section -- Part 1, Section I, under Questions, and the address is DHS.CHPRFP@illinois, spelled out, dot gov.

MR. SCHUBERT:
Other questions?


NEW SPEAKER:
If you're going to be talking about an expansion proposal --

MR. SCHUBERT:
Yep.

NEW SPEAKER:
-- are there any limits? Because I'll be honest, I haven't read everything that's in there yet. Are there any limits on the type of supplies or anything like that that you could ask for or propose in your budget? Are there any limits of anything like that?

MR. SCHUBERT:
I don't think so. If you need addition -- it would have to be in keeping with the staff expansion that you were proposing, so if you wanted to add two people, then you're going to need supplies and overhead and all the other things that go along with adding two people.

NEW SPEAKER:
We're wanting laptops to put into this proposal for the Cornerstone, and I just wanted to make sure.

MR. SCHUBERT:
Ask for what you need.

NEW SPEAKER:
Okay. We lost our laptops with the upgrade.

MR. SCHUBERT:
Other questions?


NEW SPEAKER:
The Cornerstone requires connectivity, does it not?

MR. SCHUBERT:
Say a little bit more what you mean.

NEW SPEAKER:
You can't enter it as a standalone. You need to be connected to the internet to do your entry.

MR. SCHUBERT:
It is not a web based system. Cornerstone is not web based, so it is possible to copy data onto a laptop, take the laptop out to a remote location, enter data, go back to the central office, reconnect the laptop and upload the data. So it's not web based. We're working on it.


Other questions? Well, then, we'll let everybody get on the road before the weather gets bad. Thank you, everybody. Happy holidays and best of luck.


STATE OF ILLINOIS )
) SS

COUNTY OF SANGAMON )

I, Christina J. Riebeling, do hereby
certify that I am a Certified Shorthand Reporter,
Certified Court Reporter and Notary Public within and
for the County of Sangamon and State of Illinois, and
that I reported by stenographic means the proceedings
and had on the hearing of the above-entitled cause on
December 18, 2008, and that the foregoing is a true
and correct transcript of my shorthand notes so taken.
Dated this 22nd day of December, A.D., 2008.

Certified Shorthand Reporter
Certified Court Reporter
Notary Public
(CSR # 084-004006)

My commission expires:
November 16, 2010