RFGA RE HOME VISITATION NFP EAST MARICOPA WITH FTF.PDF

FIRST THINGS FIRST
4000 North Central Avenue, Suite 800, Phoenix, Arizona 85012
802.771.5100 l 877.803.724 I azftEgov
Chair May 21, 2018 TRANSMITTED BY EMAIL
Nadine Mathis easha
Vice Chair Ms. Denise Voiles
Gerald Szostak Maricopa County Department of Public Health
4041 N. Central Ave,, Ste 1400
members Phoenix, Arizona 85012
Gayle Burns denisevolles@mailmariccipa.gov
Amelia Flares
Rev. Dr, Darren Hawkins RE: Request for Grant Applications (JIMA) FTF-RC035-19-0609-00
Dr. Sherry Markel Contract number: FTF-RC035-19-0609-05
Heidi Quinlan
Ruth Solomon Dear Ms. Voles:
Helena Whitney
Ex-Officio Members Your Home Visitation application for the East Maricopa Regional Partnership
Council of the Arizona Early Childhood Development and Health Board (First
Hon. Diane Douglas Things First) has been accepted. A countersigned copy of the Offer and
Superintendent, ADE Acceptance form is attached. The initial grant period shall be from July 1,
Michael Trallor 2018 through June 30, 201,9 and the amount of the grant award is $355,363.
Director, DES
Additionally, pursuant to the insurance requirements contained in the Uniform
Dr. Cara Christ Terms and Conditions in the PIMA, it is your responsibility to ensure that all
Director, OHS required coverage, in the types and amounts stated, shall be maintained in full
force and effect during the term of this contract and shall not serve to limit
Chief Executive officer any liabilities or any other contractor obligations. The applicable certificate of
Marilee Dal Pra Insurance must be submitted to this office, to my attention no later than July
15, 2018. Plez _acktIe contract nu ber 1 in the IuMise.cj_ c t on of the
certificate,
Per the RFGA and as part of the enhanced data requirements, our evaluation
unit will be in contact to schedule a required data training tailored to your
specific strategy requirements.
As a reminder, pursuant to the Acknowledgement of FTF Funding section of
the RFGA, First Things First reserves the right to review and approve all
publications funded or partially funded through this contract. First Things First
has decided to exercise this right, Please contact our Communications Division
at communicatio @azftf.gov for approval of publications and/or media.
Congratulations on your contract award. First Things First looks forward to
working with you if you have any questions, please contact me at 602-771-
5114 or via e-mail at jmartIn@azftf.eov.
Sincerely,
9eak:4e Wareeo
Jeanne Martin
Procurement Specialist
READY FOR SCHOOL. SET FOR LIFE.

C-86- ATTACHED TO AND A PART OF
Arizona Early Childhood Development and Health Board
(AECDHB) First Things First (FTF)
Home Visitation — East 11/laricopa
Request for Grant Application (RFGA) — FTF-RC035-19-0609-00,
Contract Number: FTF-RC036-19-0609-05
IN WITNESS WHEREOF, the parties agree to enter into this RFGA Contract and its
Amendments:
FOR AND ON BEHALF OF
MARICOPA COUNTY
By
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Attorney for Maricopa County
Date

1. Grant Agreement. The Request for Grant Applicants (RFGA), the Offer and Acceptance and Statement
of Assurances (Offer and Acceptance), and the grantee's grant application, together with all exhibits,
incorporated documents and amendments, constitute the Grant Agreement.
2. Term. The term of this Grant Agreement is July 1, 2018 through June 30, 2019, unless terminated,
cancelled or renewed as otherwise provided herein. This Grant Agreement shall be effective only if a
First Things First authorized designee has signed the Offer and Acceptance or another official grant
form indicating acceptance of the Offer.
3. Renewal. The parties may renew the Grant Agreement as indicated in the Available Funding section of
the RFGA.
4. Services. The grantee shall complete the program and implementation plan described in its grant
application and approved by First Things First. In providing these services, the grantee shall follow the
Scope of Work, the Standards of Practice and the Data Security, Submission and Suppression Guidelines
and Requirements for Collaborators found in and/or referenced in the RFGA.
5. Reimbursement/Payment.
5.1. The grantee shall be paid on a cost-reimbursement basis for expenses approved in the budget.
Payment is conditioned upon receipt by First Things First of timely, accurate and complete (i)
reimbursement documents, (ii) Program Narrative Reports and (iii) Data Submission Reports
submitted via the First Things First Partner Grant Management System (PGMS).
5.2. The grantee shall submit reimbursement requests at least quarterly, though not more
frequently than monthly. The grantee shall submit a final reimbursement request marked
"final" no more than forty-five (45) days after the Grant Agreement end date. Expenses
eligible for reimbursement must be paid, accrued or obligated by the grantee by the Grant
Agreement term end date. Final payment shall be contingent upon receipt of all fiscal,
programmatic, and data reports required of the grantee under this Grant Agreement. Requests
for reimbursement received later than forty-five (45) days after the Grant Agreement end date
will not be paid.
5.3. If awarded a grant, the grantee must have sufficient funds to meet obligations for at least
sixty (60) days while awaiting reimbursements. If an exception is requested to this
requirement, it should be provided in writing in the grant application describing the
justification and need for alternative considerations, which will be separately considered during
the application review and may not be approved. Requests for exceptions to reimbursement-
based payments submitted after awards are also made are subject to separate review and may
not be approved.
5.4. Funds awarded to the grantee under this Grant Agreement shall only be used to fulfill the
grantee's responsibilities under this Grant Agreement. Therefore, if the full amount of the
grant award is not expended for any reason, including due to completion of the work at a lower
cost than budgeted or ending of the work before completion, the grantee will only receive the
amount of the grant award spent in accordance with the Grant Agreement and will not receive
the full original award. If the grantee is under budget, the parties may amend the Grant
FTF-RC035-19-0609-00 T&C Page 1 of 9

Agreement to increase the contracted service units so as to use the full amount of the original
grant award.
5.5. If the grantee receives reimbursement for expenditures that are disallowed by an audit
exception by First Things First, the state or the federal government, the grantee shall promptly
repay the funds to First Things First.
6. Quarterly Program Narrative and Data Submission Reports.
6.1. At a minimum, the Grantee shall submit quarterly one Program Narrative Report and one Data
Submission Report by the 20th of the month following the quarter via PGMS. Failure to submit
timely reports will result in suspension of reimbursement. The reports shall contain such
information as deemed necessary by First Things First.
6.2. Program Narrative and Data Submission Reports are due:
1st Quarter (July 1 - September 30) Due: October 20
2 nd Quarter (October 1 - December 31) Due: January 20
3 rd Quarter (January 1 - March 31) Due: April 20
4th Quarter (April 1 - June 30) Due: July 20
6.3. If the grantee provides services to more than one First Things First region (multi-regional
strategies), the grantee shall collect, store and report the data for the Data Submission Reports
separately for each region served.
7. FTF Grants Uniform Terms and Conditions. First Things First's Grants Uniform Terms and Conditions
(revision date December 2017) are hereby incorporated by reference into this Grant Agreement as if
fully set forth herein. Copies of this document are available by emailing grantsPazftf.gov or by calling
the First Things First Procurement Specialist at 602-771-5114.
8. Working on Tribal Land. If the grantee performs any work under this Grant Agreement on sovereign
land of a tribe, the grantee shall comply with any requirements set forth by the tribal government in
relation to essential functions of the grant operation, including data collection. It is a material
requirement of this Grant Agreement that the grantee follow all First Things First tribal policies and
procedures including the Tribal Data Policy as applicable, obtain all appropriate parental consents and
obtain appropriate tribal approvals as designated by tribal authorities, which approval may include a
requirement to participate in cultural education and community orientation classes.
9. Non-Discrimination. The provisions of State Executive Order 2009-09 are incorporated herein by
reference. These provisions mandate, in part, that contractors will not discriminate against any
employee or applicant for employment because of race, age, color, religion, sex or national origin. The
grantee shall also comply with all other applicable state and federal statutes, regulations and executive
orders concerning non-discrimination practices, including the Americans with Disabilities Act and
Federal Executive Order No. 13279— Equal Protection of the Laws for Faith-Based and Community
Organizations.
10. Nonprofit Corporation Audit Reports. As required by A.R.S. § 35-181.03, if the grantee is a nonprofit
corporation that receives in excess of two hundred fifty thousand dollars ($250,000) in state assistance
in any fiscal year, the grantee shall file with First Things First for each such fiscal year at the grantee's
expense either audited financial statements prepared in accordance with federal single audit
FTF-RC035-19-0609-00 T&C Page 2 of 9

regulations or financial statements prepared in accordance with generally accepted accounting
principles and audited by an independent certified public accountant.
11. Records. Pursuant to A.R.S. 55 8-1174 and 35-214, the grantee shall retain and shall contractually
require each subcontractor and subgrantee to retain all books, accounts, reports, files and other
records "records") relating to the Grant Agreement for a period of five years after the completion of
the Grant Agreement. All records shall be subject to inspection and audit by the State (including First
Things First) and by an independent auditor at all reasonable times. Upon request, the grantee shall
produce any or all such records at First Things First's main office in Phoenix, Arizona.
Notwithstanding the foregoing paragraph, pursuant to 2 C.F.R. 5 200.333, if the grant includes federal
pass-through funds, then the grantee shall retain and shall contractually require each subcontractor
and subgrantee to retain all records pertaining to the federal pass-through funds for a period of three
years from the date of submission of the final expenditure report and until any litigation, claims or
audit findings involving the records have been resolved and final action taken. All such records shall be
accessible and subject to audit in accordance with 2 C.F.R. 5 200.336. This paragraph does not apply to
a grantee, subgrantee or subcontractor that is a federal agency.
12. Non-Availability of Funds. Every payment obligation of First Things First under this Grant Agreement is
conditioned upon the availability of funds appropriated or allocated for the payment of such obligation.
If funds are not allocated and available for the continuance of this Grant Agreement, this Grant
Agreement may be terminated by First Things First at the end of the period for which funds are
available. No liability shall accrue to First Things First in the event this provision is exercised, and First
Things First shall not be obligated or liable for any future payments or for any damages as a result of
termination under this paragraph.
13. Grant Administration and Operation.
13.1. Advertising, Publishing and Promotion of Grant. The grantee shall not use, advertise or
promote information for commercial benefit concerning this Grant Agreement without the
prior written approval of First Things First.
13.2. Review of Printed Materials. First Things First must review and approve all grantee publications
and/or media funded or partially funded through this Grant Agreement for compliance with
this Grant Agreement. The grantee shall submit to First Things First via PGMS all print and
electronic materials related to the programs and services funded under this Grant Agreement
before publicly distributing those materials so that First Things First may first review and
approve prior to release. If deemed necessary by First Things First, the grantee shall revise the
materials as indicated by First Things First before publicly distributing the materials. First
Things First shall have full and complete rights to reproduce, duplicate, disclose, perform, and
otherwise use all materials prepared under this Grant Agreement.
13.3. Acknowledgment of FTF Funding. The grantee shall recognize First Things First as a funding
source of programs and services funded in whole or part under this Grant Agreement in all
publicly distributed print or electronic materials related to those programs and services. The
grantee shall make this recognition in a manner described in First Things First's most current
protocol and style guide. First Things First will post any updates to the protocol and style guide
under the Grantee Resources section of PGMS. The grantee shall also recognize First Things
First as a funding source of programs and services funded in whole or part under this Grant
FTF-RC035-19-0609-00 T&C Page 3 of 9

Agreement in all formal oral presentations and media interviews related to those programs and
services.
13.4. Public Awareness Efforts. The grantee shall consult with First Things First in the planning of
public awareness/marketing strategies, such as websites, advertising or media campaigns,
related to the programs or services funded under this Grant Agreement.
13.5. Ownership of Materials and Data. Any materials and data required to be collected, delivered or
created under this Grant Agreement, including but not limited to reports, computer programs
and other deliverables are the sole property of the State (First Things First). The grantee shall
not use or release these materials or data without the prior written consent of First Things
First. The grantee is not entitled to a patent or copyright on these materials and data and may
not transfer the patent or copyright to anyone else.
13.6. Ownership of Intellectual Property. Any and all intellectual property, including but not limited
to copyright, invention, trademark, trade name, service mark and/or trade secrets created or
conceived pursuant to or as a result of this Grant Agreement and any related subcontract or
subgrant ("Intellectual Property"), shall be work made for hire and First Things First shall be
considered the creator of such Intellectual Property, First Things First shall own (for and on
behalf of the State) the entire right, title and interest to the Intellectual Property throughout
the world. The grantee shall notify First Things First, within thirty (30) days, of the creation of
any Intellectual Property by it or its subcontractor(s) and subgrantee(s). The grantee, on behalf
of itself and any subcontractor(s) and subgrantee(s), agrees to execute any and all document(s)
necessary to assure ownership of the Intellectual Property vests in the State and shall take no
affirmative action that might have the effect of vesting all or part of the Intellectual Property in
any entity other than the State. The Intellectual Property shall not be disclosed by the grantee
or its subcontractor(s) and subgrantee(s) to any entity not the State without the express
written authorization of First Things First.
13.7. Fund Management. The grantee must maintain any funds received under this Grant
Agreement on other than a cost reimbursement basis in separate ledger accounts and cannot
mix these funds with other sources. The grantee must manage all funds according to applicable
regulations for administrative requirements, cost principles and audits. The grantee shall
maintain proper audit trails for all reports related to this Grant Agreement.
13.8. Sectarian Purposes. Funds provided under this Grant Agreement may not be expended for any
sectarian purpose or activity, including religious worship or instruction. Additionally, the
grantee shall implement the programs or services funded under this Grant Agreement
consistent with the First Amendment of the United States Constitution. With respect to these
programs or services, the grantee also shall not discriminate against any program or service
beneficiary or applicant on the basis of religion. First Things First reserves the right to verify or
monitor compliance with this paragraph. The grantee shall repay any funds awarded under this
Grant Agreement that the grantee spends in violation of this paragraph.
14. Relationship of Parties. The grantee under this Grant Agreement is an independent contractor. Neither
party to this Grant Agreement shall be deemed to be the employee or agent of the other party.
15. Indemnification,
15.1. Not Government Agency. This paragraph applies if the grantee is not a governmental entity.
To the extent allowed by law, the grantee shall defend, indemnify and hold harmless the
State FTF-RC035-19-0609-00 T&C Page 4 of 9

of Arizona and its departments, agencies, boards, commissions, universities, officers, officials,
agents and employees ("State") from and against any and all claims, actions, liabilities,
damages, losses, costs or expenses (including court costs, attorneys' fees and costs of claim
processing, investigation and litigation) ("Claims") for bodily injury or personal injury (including
death) or loss or damage to tangible or intangible property caused, or alleged to be caused, in
whole or in part, by the negligent or willful acts or omissions of the grantee or any of its
owners, officers, directors, agents, employees, volunteers, subcontractors or subgrantees. This
indemnity includes any Claim or amount arising out of, or recovered under, the Workers'
Compensation Law or arising out of the failure of the grantee to conform to any federal, state
or focal law, statute, ordinance, rule, regulation or court decree. It is the specific intention of
the parties that the State shall, in all instances, except for Claims arising solely from the
negligent or willful acts or omissions of the State, be indemnified by the grantee from and
against any and all Claims. It is agreed that the grantee will be responsible for primary loss
investigation, defense and judgment costs where this indemnification is applicable. In
consideration of the award of this grant, the grantee agrees to waive all rights of subrogation
against the State for losses arising from the work performed by the grantee for the State.
15.2. Government Agency. This paragraph applies if the grantee is a governmental entity and is not a
department, agency, board, commission or university of the State of Arizona. Each party (as
"Indemnitor") agrees to indemnify, defend and hold harmless the other party (as "Indemnitee")
from and against any and all Claims arising out of bodily injury of any person (including death)
or property damage but only to the extent that such Claims which result in vicarious/derivative
Liability to the Indemnitee are caused by the act, omission, negligence, misconduct or other
fault of the Indemnitor or any of its officers, officials, agents, employees or volunteers.
15.3. Patent and Copyright. The grantee shall indemnify and hold harmless the State against any
liability, including costs and expenses, for infringement of any patent, trademark or copyright
arising out of grant performance or use by the State of materials furnished or work performed
under this Grant Agreement. The State shall reasonably notify the grantee of any claim for
which it may be liable under this paragraph. This paragraph does not apply if the grantee is
insured pursuant to A.R.S. § 41-621.
15.4. Subcontractors. The grantee shall contractually require its subcontractors and subgrantees, if
any, to defend, indemnify and hold harmless the State as described in this Section unless the
subcontractor or subgrantee is a state agency.
16. Insurance.
16.1. In the event the grantee is a governmental entity, then the insurance requirements in this
Section do not apply, except that such governmental entity grantee shall provide a Certificate
of Self-Insurance. If the governmental entity grantee is a department, agency, board,
commission or university of the State of Arizona, then the Certificate of Self-Insurance
requirement does not apply either.
16.2. The grantee shall procure and maintain until all of its obligations have been discharged or
satisfied, including any warranty periods under this Grant Agreement, insurance in the amounts
stated below against claims for injury to persons or damage to property which may arise from
or in connection with the performance of the work hereunder by the grantee , including its
agents, representatives, employees, volunteers or subcontractors. The grantee shall require
and ensure that all of its subcontractors comply with this Section as well.
FTF-RC035-19-0609-00 T&C Page 5 of 9

16.3. The insurance requirements herein are minimum requirements for this Grant Agreement and in
no way limit the indemnity covenants. First Things First in no way warrants that these
minimum requirements are sufficient to protect the grantee from liabilities that might arise out
of the performance of the work under this Grant Agreement by the grantee, including its
agents, representatives, employees, volunteers or subcontractors, and the grantee is free to
purchase additional insurance. The minimum insurance requirements are as follows:
Commercial General Liability (CGL) — Occurrence Form
Policy shall include bodily injury, property damage, personal and advertising injury and broad
form contractual liability coverage.
General Aggregate $2,000,000
Products — Completed Operations Aggregate $1,000,000
Personal and Advertising Injury $1,000,000
Damage to Rented Premises $50,000
Each Occurrence $1,000,000
The policy shall include coverage for sexual abuse and molestation (SAM). This coverage may
be sub-limited to no less than $500,000. The limits may be included with the General Liability
limit, provided by separate endorsement with its own limits or provided as separate coverage
included with the professional liability.
The grantee must provide the following statement on its Certificate(s) of Insurance: "Sexual
Abuse and Molestation coverage is included" or "Sexual Abuse and Molestation coverage is not
excluded."
The policy shall be endorsed to include the State of Arizona and its departments, agencies,
boards, commissions, universities, officers, officials, agents and employees as additional
insureds with respect to liability arising out of the activities performed by or on behalf of the
grantee.
The policy shall contain a waiver of subrogation endorsement in favor of the State of Arizona
and its departments, agencies, boards, commissions, universities, officers, officials, agents and
employees for losses arising from work performed by or on behalf of the grantee.
Business Automobile Liability
Bodily Injury and Property Damage for any owned, hired, and/or non-owned vehicles used in
the performance of this Grant Agreement.
Combined Single Limit (CSL) $1,000,000
The policy shall be endorsed to include the State of Arizona and its departments, agencies,
boards, commissions, universities, officers, officials, agents and employees as additional
insureds with respect to liability arising out of the activities performed by or on behalf of the
grantee involving automobiles owned, hired and/or non-owned by the grantee."
The policy shall contain a waiver of subrogation endorsement in favor of the State of Arizona
and its departments, agencies, boards, commissions, universities, officers, officials, agents and
employees for losses arising from work performed by or on behalf of the grantee.
FTF-RC035-19-0609-00 T&C Page 6 of 9

Workers' Compensation and Employers' Liability
Workers' Compensation Statutory
Employers' Liability
Each Accident $1,000,000
Disease — Each Employee $1,000,000
Disease — Policy Limit $1,000,000
The policy shall contain a waiver of subrogation in favor of the State of Arizona and its
departments, agencies, boards, commissions, universities, officers, officials, agents and
employees for losses arising from work performed by or on behalf of the grantee.
This requirement shall not apply to each grantee or subcontractor exempt under A.R.S. Chapter
23, Title 6 (§ 23-901 et seq.) when such grantee or subcontractor executes the appropriate
waiver (Sole Proprietor/independent Contractor) form.
Professional Liability (Errors and Omissions Liability)
Each Claim $2,000,000
• Annual Aggregate $2,000,000
If sexual abuse and molestation (SAM) coverage is being provided under this policy then the
grantee must provide the following statement on its certificate(s) of insurance: "Sexual Abuse
and Molestation coverage is included" or "Sexual Abuse and Molestation coverage is not
excluded." This coverage may be sub-limited to no less than $500,000.
In the event that the professional liability insurance required by this Grant Agreement is written
on a claims-made basis, the grantee warrants that any retroactive date under the policy shall
precede the effective date of this Grant Agreement and that either continuous coverage will be
maintained or an extended discovery period will be exercised for a period of two (2) years
beginning at the time work under this Grant Agreement is completed.
The policy shall cover professional misconduct or wrongful acts for the positions of
professionals/Key Personnel identified in this Grant Agreement.
16.4. Additional Insurance Requirements. The policies shall include, or be endorsed to include, the
following provisions:
The grantee's policies shall stipulate that the insurance afforded the grantee shall be primary
and that any insurance carried by First Things First, its agents, officials, employees or the State
of Arizona shall be excess and not contributory insurance, as provided by A.R.S. § 41-621(E).
Insurance provided by the grantee shall not limit the grantee's liability assumed under the
indemnification provisions of this Grant Agreement.
16.5. Notice of Cancellation. Applicable to all insurance policies required within the Insurance
Requirements of this Grant Agreement, the grantee's insurance shall not be permitted to
expire, be suspended, be canceled, or be materially changed for any reason without thirty (30)
days prior written notice to the State of Arizona. Within two (2) business days of receipt, the
grantee must provide notice to the State of Arizona if it receives notice of a policy that has
FTF-RC035-19-0609-00 T&C Page 7 of 9

been or will be suspended, canceled, materially changed for any reason, has expired, or will be
expiring. Such notice shall be sent directly to First Things First, Fiscal Specialist via hand-
delivery or certified mail, return receipt requested, to 4000 N. Central, Suite 800, Phoenix, AZ
85012, or via email to grants@azfttgov.
16.6. Acceptability of Insurers. The grantee's insurance shall be placed with companies licensed in
the State of Arizona or on hold approved non-admitted status on the Arizona Department of
Insurance List of Qualified Unauthorized Insurers. Insurers shall have an "A.M. Best" rating of
not less than A- VII. The State of Arizona in no way warrants that the above-required minimum
insurer rating is sufficient to protect the grantee from potential insurer insolvency.
16.7. Verification of Coverage. The grantee shall furnish the State of Arizona with certificates of
insurance (valid ACORD form or equivalent approved by the State of Arizona) as required by
this Grant Agreement. An authorized representative of the insurer shall sign the certificates.
All certificates and endorsements are to be received and approved by the State of Arizona
before work commences. The State of Arizona's receipt of any certificates of insurance or
policy endorsements that do not comply with this Grant Agreement shall not waive or
otherwise affect the requirements of this Grant Agreement. Each insurance policy required by
this Grant Agreement must be in effect at or prior to commencement of work under this Grant
Agreement. Failure to maintain the insurance policies as required by this Grant Agreement or
to provide evidence of renewal is a material breach of the Grant Agreement.
All certificates required by this Grant Agreement shall be sent directly to First Things First, Fiscal
Specialist, 4000 N. Central, Suite 800, Phoenix, AZ 85012. The State of Arizona program/grant
number and program description shall be noted on the certificate of insurance. The State of
Arizona reserves the right to require complete copies of all insurance policies required by this
Grant Agreement at any time. DO NOT SEND CERTIFICATES OF INSURANCE TO THE STATE OF
ARIZONA'S RISK MANAGEMENT SECTION.
16.8. Subcontractors. The grantee's certificate(s) shall include all subcontractors as insureds under
its policies or grantee shall be responsible for ensuring and/or verifying that all subcontractors
have valid and collectable insurance as evidenced by the certificates of insurance and
endorsements for each subcontractor. All coverages for subcontractors shall be subject to the
minimum requirements identified above. First Things First reserves the right to require, at any
time throughout the life of the Grant Agreement, proof from the grantee that its
subcontractors have the required coverage.
16.9. This Section assumes the grant award is for more than $50,000, that the grantee will be using
vehicles beyond commuting in order to provide the services under the Grant Agreement, that
the grantee will be working with children in order to provide the services under the Grant
Agreement, and that the grantee will be providing professional services in order to provide the
services under the Grant Agreement. If any of these assumptions do not apply to this Grant
Agreement, then upon agreement of First Things First, the insurance requirements will be
reduced or removed in part from the Grant Agreement as appropriate.
16.10. If the Grant Agreement requires the grantee to handle money on behalf of the State, the
grantee shall also procure and maintain a fidelity insurance policy, consistent with the State of
Arizona Risk Management Insurance Modules, that includes third party fidelity coverage.
FTF-RC035-19-0609-00 T&C Page 8 of 9

16.11. If the Grant Agreement requires the grantee to provide information technology (IT) services,
the grantee shall also procure and maintain errors and omissions coverages, consistent with the
State of Arizona Risk Management Insurance Modules, including technology errors and
omissions, network security/privacy and media liability.
16.12. The grantee understands and agrees that First Things First, in consultation with the Department
of Administration, Risk Management Section or in accordance with its published Insurance
Modules, reserves the right to review or make modifications to the insurance limits, required
coverages, or endorsements throughout the life of this Grant Agreement, as deemed
necessary. Such action will not require a formal grant amendment, but may be made by
administrative action.
17. Notices. Notices to the grantee required by this Grant Agreement shall be made by First Things First to
the person indicated on the Offer and Acceptance form submitted by the grantee unless otherwise
stated in the Grant Agreement. Notices to First Things First required by the Grant Agreement shall be
made by the grantee to an authorized First Things First representative, unless otherwise stated. An
authorized First Things First representative and an authorized grantee representative may change their
respective person to whom notice shall be given by written notice to the other and an amendment to
the Grant Agreement shall not be necessary.
FTF-RC035-19-0609-00 T&C Page 9 of 9

Application Cover Sheet
From MARICOPA COUNTY
RFGA Number: FTF-RC035-19-0609-00
Strategy: HOME VISITATION (EAST MARICOPA)
Requested Amount: $355,363
ORIGINAL
FTF-RC035-19-0609-00 Page 1 of 232

ta.
FIRST THINGS FIRST
OFFER and ACCEPTANCE
and
STATEMENT of ASSURANCES
TO THE STATE OF ARIZONA, ARIZONA EARLY CHILDHOOD DEVELOPMENT AND HEALTH BOARD:
APPLICANT OFFER
By signing and initialing below, the applicant hereby offers and agrees to complete the program and
implementation plan described in Its grant application and approved by the Arizona Early Childhood
Development and Health Board and to be bound by and comply with the Grant Terms and Conditions
contained in the RFGA and with all other documents constituting the Grant Agreement, Including the
following Assurances.
MarIcopa County by and through its
Department of Public Health
Applicant Name (Agency/Organization) Signature of Authorized Official
4041 N. Central Avenue, Ste 1400 Max Porter
Address Printed Name
Phoenix AZ 85012 Acting Department Director
City State Zip Title
Arizona Transaction Privilege (Sales) Tax Point of Contact Concerning this Application;
License No:
Name; Denise Voiles
Federal Employer Identification No: Phone: (602 506-6782
86:6000472, DeniseVoiles(mail.maricooa.eov
APPLICANT ASSURANCES
Authorized Official to initial the following:
VAL
To adhere to the most current version of the Conditions. Copies of this document are available by
Standards of Practice documents (available at i() emailing fq3 n stAWszftf..gpy .
httOrtwww.firatblrgsfirst,orderotsistratesv-
tvlkit) To accept funds and administer the programs in
accordance with all applicable federal and state
) To adhere to the Data Security, Submission and statutes and regulations and Grant Agreement
Suppression Guidelines and Requirements for requirements.
Collaborators, as applicable.
To maintain Internal controls, Including policies and
71 To review and adhere to the most recent version of procedures, for assuring compliance with applicable
the First Things First Grants Uniform Terms and cost principles and other Grant Agreement
requirements.
FTF-RC035-19-0609-00 Page 2 of 232

To follow established personnel policies related To maintain documentation for employees working
"4/1/ to salary scales, fringe benefits, and travel across multiple funding sources to ensure the amount
reimbursement. time charged to each employee does not exceed
d O0% ,
To use generally accepted accounting principles
{GAAP). To have fiscal control and fund accounting procedures
in place to ensure proper disbursement of and
To perform required financial and compliance * accountinglor any funds paid to subcontractors.
audits in accordance with federal law and
guidelines, Including the Single Audit Act and 2 To maintain enrollment and participate In &verify, If
CFR Part 200. an employer.
2 To maintain a system of contract administration to
ensure conformance with the Grant Terms and
Conditions.
PROGRAMMATIC
ilTo
To use proven, effective and/or evidence based consult with FTF in the planning of public
programs. awareness/marketing strategies such as websites,
xlz advertising or media campaigns,
To maintain the personnel qualifications outlined
in the Standards of Practice with subsequent EVAL TION
"fres To provide regular a nd timely reporting and to
To comply with any applicable federal, state, and participate In all pertinent First Things First research
local health and safety requirements that apply and evaluation efforts.
to the facilities used for a program, If an evaluation study has been conducted on the
To actively participate In the Quality Assurance proposed program, a copy of the evaluation report (if
process, Including assessments, available) will be submitted to First Things First.
To coordinate, to the extent possible, with other /9 funds are being requested to conduct an evaluation
programs In the same geographic area that serve study, approval by First Things First Research and
i similar target populations. EValuation team will be obtained prior to
"i) .. L Implementation.
To coordinate with First Things First during the
length of the program period, If the evaluation study will Include a tribal
community, approval by First Things First Research
To acknowledge funding from FTF In publicly and Evaluation team and Tribal Affairs division will be
distributed materials in compliance with FTF's obtained prior to implementation,
brand guidelines and submit such materials in
advance for review.
ACCEPTANCE OF APPLICATION AND OFFER
The grant application is hereby accepted. The applicant is now bound to perform the program and
implementation plan described in the grant application and approved by the Arizona Early Childhood
Development and Health Board and to comply with the Grant Terms and Conditions contained in the RFGA
and with all other documents constituting the Grant Agreement, including the Assurances above,
This grant shall henceforth be referred to as Grant No. 13)12,FLO,3 lq-OVX)
Arizona Early Childh od Development id Health (3,00
Awarded this of _ 20 &r.
ings First Authorized Designee
FTF-RC035-19-0609-00
Page 3 of 232

FTF-RC035-19-0609-00
HOME VISITATION
EAST MARICOPA
TABLE OF CONTENTS
Page
TITLE No.s
Application Cover Sheet 1
Offer and Acceptance and Statement of Assurances 2
Applicant Assurances 3
Table of Contents 4
SECTION A — Executive Summary 5
SECTION B — Capacity for Addressing Needs and Implementing the Strategy 6-8
SECTION C — Program Description 8-27
SECTION D — Personnel - Program Personnel Table and 28-29
Program Organizational Chart 30
SECTION E — Implementation Plan 31-49
SECTION F — Line-Item Budget and 50
Budget Narrative 51-55
SECTION G — Fiscal Information - Funding Sources and Controls... 56-57
SECTION H — Program Evaluation Information — Program Evaluation and 58-59
Profile - Agency/Organization Profile 60-62
ATTACHMENT A — NFP National Service Office implementation Agreement .. ..... 63-91
ATTACHMENT B — Program Implementation Instruments and Tools 92-150
ATTACHMENT C - Home Visitation SFY19 FTF Data Reporting Requirements 151-167
ATTACHMENT D — Notice of Intent Award Letter 168-169
ATTACHMENT E — Request for Grant Application Amendment
(For Original Copy) 170-171
ATTACHMENT F — Public Health Grants Indirect Cost Plan FY17-1
(For Original Copy) 172-178
ATTACHMENT G — Single Audit Rep, Maricopa County, Year Ended June 30,
2016 (For Original Copy) 179-231
FTF-RC035-19-0609-00 Page 4 of 232

Maricopa County Department of Public Health (MCDPH) in collaboration with Southwest Human
Development (SWHD) will provide Nurse-Family Partnership (NFP) home visitation services to fifty
(50) low-income, first-time pregnant women prioritizing the targeted areas of the East Maricopa
Region. Knowing that resources are limited for home visitation services and that there are several
home visiting models in the region, we propose to focus on a small but high risk subset of the
total number the Regional Council desires to serve. This program will prioritize pregnant
women who are in the high poverty/high needs geographic area of Chandler, Guadalupe, South
Scottsdale and Tempe, and who have one or more of the following high risk factors: poverty, at
risk or history of abuse and neglect, maternal depression, parental substance abuse, parental
incarceration, and poor relationships with caregivers, food or housing insecurity, reliable
support system, and teens. In addition, age-appropriate developmental and sensory screenings
will be provided to 50 children of enrolled families throughout the first 2 years of their life. The
design of NFP to focus on first-time pregnant women and their families is an 'upstream approach'
that capitalizes on a time in a women's life when interventions and behavior changes may have
the most lasting impact, affecting both current and subsequent pregnancies.
MCDPH has an eight year history of implementing NFP in Maricopa County, working closely with
the NFP National Service Office (NSO) to ensure fidelity to the model. MCDPH has been
implementing NFP in 85251, 85281 & 85282 in the East Region since 2013 with funding from
Maternal Infant Early Childhood Home Visitation (MIECHV). However, MIECHV funding does not
cover the remainder of the East Maricopa Region. MCDPH currently is serving 32 families in those
3 East Maricopa zip codes.
Implementation of the NFP model with FTF funding will utilize the following Curriculum: NFP Visit-
to-Visit Guidelines; Screening tools: Generalized Anxiety Disorder -7, Patient Health Questionnaire
-9, Ages and Stages Questionnaire- 3, Ages and Stages Questionnaire: Social Emotional -2,
Otoacoustic Emissions, PlusOptix; Assessments: Demographics, Maternal Health, Health Habits,
Infant Birth, Infant Health Care, Clinical Intimate Partner Violence, Strengths and Risks Framework,
Use of Government and Community Services, Dyadic Assessment and Natural Caregiver —Child
Experiences, Client Dismissal, Home Visit Encounter, Referrals to Services; and a Survey: Nursing
Client Survey.
The NFP model utilizes a two-generational approach with first-time mothers, fathers, and their
infants, identifying both mother and child as clients, working to meet the needs of the family
holistically through education, support and care in order to promote a healthy pregnancy,
responsible and competent parenting, and economic self-sufficiency. By instilling confidence and
empowering the family to achieve a better life for their children and themselves, NFP's outcomes
include long-term family improvements in child health and development, school readiness,
reducing incidence of child maltreatment, and economic self-sufficiency. By helping to break the
cycle of poverty, we propose to play a role in helping to improve the lives of the East Maricopa
region's most vulnerable members, building a stronger, high-quality early childhood system, and
leaving a positive impact on this and future generations.
FTF-RC035-19-0609-00 Page 5 of 232

I.A. The vision of MCDPH, "A healthy and safe community" is carried out by the organizational
mission "to protect and promote the health and well-being of Maricopa County residents and
visitors." This vision and mission are in alignment with the FTF Strategic Directions including the
priority system roles for this strategy: information and education for families, supports and
services for families, access to quality health care coverage and services, and early screening and
intervention. These four strategies are incorporated throughout the health department in
multiple ways, from direct services like providing immunizations, dental sealants, child care health
consultants and maternal child health home visitation, to community mobilizing like the Safe Kids
Coalition, the Preventative Health Collaborative or the Health Improvement Partnership of
Maricopa County, to advocating for health and safety policies, such as the Safe Routes to Schools
project. These are also all in alignment with the intended outcomes of NFP: long-term family
improvements in child health and development, school readiness, reducing incidence of child
maltreatment, and economic self-sufficiency.
II. A. MCDPH has been implementing NFP in Maricopa County since 2009 with a solid history of
model fidelity, organizational support and staff retention. Specifically, MCDPH has been
implementing NFP in parts of the East Maricopa Region since 2012 with funding from Maternal
Infant Early Childhood Home Visitation (MIECHV). However, MIECHV funding only covers 3 zip
codes: 85251, 85281, and 85282. The remainder of the region is not served by NFP. MCDPH
currently serves 32 families in those zip codes. MCDPH home visitation programs have been
providing developmental screenings for over 30 years through the Newborn Intensive Care
Program. Nurse home visitors (NHV) have the professional capability to incorporate development
and sensory screenings into their practice.
II. A. 1. a. MCDPH NFP has served this target population for over eight years in several regions
throughout Maricopa County. NFP NHVs have experience working with high risk populations as
evidenced by our current client characteristics which include: 36% under the age of 20 years and
74% under the age of 24 years at time of enrollment, 18% with household history of substance
abuse, 80% unmarried, 75% on Medicaid, 90% on WIC, 62% Hispanic or Latina, 5% American
Indian or Alaska Native, 10 % Black or African American. The NFP model is designed to serve hard-
to-reach populations, incorporating best practices to engage the client in services that support
behavior change and self-efficacy. MCDPH NFP has experienced a very low staff turn-over rate
(Nurse Supervisor and three out of seven NHVs have been with the program for 8.5 years, three
out of seven NHVs have been with the program for 5.5 years) which leverages the program's
ability to provide relationship continuity and trust building, an essential component when
working with hard to reach populations.
II.A. 1.b. MCDPH has 8.5 years of implementation experience applying the NFP Model Elements in
practice, also known as fidelity, which is monitored annually by the NFP National Service Office.
Applying the model elements in practice provides a high level of confidence that the outcomes
achieved by families who enroll in the program will be comparable to those achieved by families in
the three randomized, controlled trials and outcomes from ongoing research on the program. By
FTF-RC035-19-0609-00 Page 6 of 232

instilling confidence and empowering the mother to achieve a better life for her children and
herself, NFP's outcomes include long-term family improvements in child health and
development, school readiness, reducing incidence of child maltreatment, and economic self-
sufficiency.
II.A.1.c. MCDPH NFP has a strong foundation of coordination efforts with partners throughout
Maricopa County. For example, MCDPH has participated in the FTF coordinated referral system
since its inception in South Phoenix in 2010 and continues to work very closely with the current
provider, Parents Partners Plus to coordinate referral distribution and ensure that families receive
home visitation services at the appropriate intervention level. MCDPH also has a strong history of
collaborating with Southwest Human Development in the implementation of NFP which has
combined the strengths from each organization to ensure the highest quality of services possible.
In addition, MCDPH Office of Family Health staff are active members of the Maricopa Family
Support Alliance, the Statewide Task Force for the Prevention of Prenatal Exposure to Alcohol and
Other Drugs, the Parents as Teachers Advisory Committee, the Safe Sleep Task Force, and the ACE
Coalition and Clinical Practice Workgroup, just to name a few.
Ill. MCDPH has a well-defined organizational capacity and infrastructure that supports
implementation of maternal child health home visitation programs. NFP is one of four maternal
child health programs within the Office of Family Health (OFH), in the Division of Community
Health Action (CHA) which also includes the Office of Oral Health and Women Infant Children
(WIC) services. The OFH has a strong history of contract performance and experience, including
current contracts with federal, state, and city grantors with a current annual budget of $4.1 million
and 35 staff members. This includes lead screening of children living in homes with lead hazards;
assisting high-risk pregnant women with access to prenatal care though outreach and case
management services; education and family intervention services; community health nursing for
developmental follow-up of at-risk infants and toddlers; and Newborn Screening follow-up.
The NFP Nurse Supervisor reports directly to the OFH Nurse Manager, working closely with the
other OFH program supervisors from the Healthy Start program, Newborn Intensive Care Follow-
Up Program and the Lead Hazard Outreach Program. The OFH Nurse Manager and program
supervisors meet monthly as a team to discuss administrative and programmatic issues. This
provides regular opportunity for the programs to collaborate and work with synergy towards
improving maternal child health in Maricopa County.
The NFP Nurse Supervisor works in conjunction with the OFH Nurse Manager to access MCDPH
Administrative Services such as IT Support, Budget & Finance, Grants Management, Human
Resources and Procurement. Each of these systems has policies and procedures in place to
support the financial and contractual oversight of programs. Finance & Budget provides a Division
level accountant to monitor all program budgets and to facilitate the submission of financial
reimbursement requests for each program. Human Resources facilitates all employee
recruitment, hiring and personnel issues (timesheets, benefits management, FMLA, etc). Grants
Management facilitates and provides technical support for grant subcontracts (ie:
FTF-RC035-19-0609-00 Page 7 of 232

Intergovernmental Agreements with ADHS) and Procurement solicits bids and provides technical
support for contracted services.
OFH Monthly meetings with Finance & Budget staff occur to review each program budget
expenditures and projections. The Finance & Budget accountant provides daily feedback to both
the OFH Nurse Manager and the Nurse Supervisor regarding expenditures and budget tracking.
The Nurse Manager and Nurse Supervisor meet monthly to review budgets and provide
accountability.
I. A. Maricopa County Department of Public Health (MCDPH) proposes to collaborate with
Southwest Human Development to expand implementation of the Nurse-Family Partnership
(NFP) program to all zip codes of the First Things First (FTF) East Maricopa Region with the addition
of two Nurse Home Visitor (NHV) who will provide intensive family support to 50 high risk
pregnant women. MCDPH has over eight years of experience implementing NFP with fidelity to
the model; this expansion is designed to adhere to the FTF Home Visitation Standards of Practice,
most of which are inherently met when maintaining NFP model fidelity.
Priority for outreach and recruitment will target first time pregnant women who are: in the high
poverty/high needs geographic area of Chandler, Guadalupe, South Scottsdale and Tempe, and
who have one or more of the following high risk factors: poverty, at risk or history of abuse and
neglect, maternal depression, parental substance abuse, parental incarceration, and poor
relationships with caregivers, food or housing insecurity, no reliable support system, and teens.
Eligibility at intake will be determined based on the NFP model eligibility requirements and a high
risk assessment checklist completed by the NHV during the first contact by phone. Enrollment will
occur during the first home visit when the NHV will explain the components of the program,
participation and confidentiality policies, obtain the consent to receive services and the release of
information, and begin data collection and program assessments.
From pregnancy until the child turns two years of age, the NHV will provide client and family
centered home visits forming a much-needed, trusting relationship with these vulnerable first-
time moms, The NFP home visit schedule is divided into four stages: 1) Getting to know each
other (the first four weeks): visits take place once a week; Pregnancy: visits take place every other
week for the remainder of the pregnancy; Postpartum: visits take place once a week for the first
six weeks after the baby comes home; Infancy and Toddler: visits take place every other week
until the baby is 21 months old; Wrapping It Up (the last 4 months): visits take place once a month
until the baby's second birthday.
Within the first 90 days of enrollment, the NHV will collaborate with the client to create an
individualized service plan that identifies client and family goals and the steps necessary to
achieving those goals. During each home visit the NHV will complete client and family
assessments, gathering baseline information and updating it regularly throughout the duration of
FTF-RC035-19-0609-00 Page 8 of 232

the program, complete developmental and sensory screenings at designated intervals, provide
referrals to community services when indicated, including follow-up and documentation of
services received. Additionally, at each home visit the NHV will provide evidence based health and
developmental education and support, including ongoing discussion and activities regarding the
importance of early language and literacy.
In order to promote family social connections, group activities for enrolled clients will be
scheduled quarterly and take place at locations and times convenient for families. For example, a
past socialization activity was held in a local park with a special presentation given by Raising a
Reader, an early literacy and family program for children ages 0-8 that helps families develop
book-sharing routines with their child; 46 clients and their family members attended this event
and each client received an age appropriate children's book. Activities will be designed to
promote family to family networking and will include agenda topics requested and vetted by the
clients and families. Family engagement and client retention is addressed through several
strategies: NFP research shows that varying the schedule to meet client needs increased their
interest and commitment to staying in the program, explicit discussions with the family about
participation and positive outcomes from remaining in the program until their child is 2 years of
age, utilizing motivational interviewing to elicit from the family their own good motivations for
making changes in their and their child's own interest.
MCDPH NFP has a strong foundation of coordination and collaboration relationships throughout
Maricopa County. For example, MCDPH has participated in the FTF coordinated referral system
since its inception in South Phoenix in 2010 and continues to work very closely with the current
provider, Parents Partners Plus to coordinate referral distribution. MCDPH also has a strong
history of collaborating with Southwest Human Development in the implementation of NFP. NFP
NHVs coordinate with the Department of Child Safety when enrolled families are also DCS
involved, and also as mandated reporters have at times been the referral source to DCS. MCDPH
will follow the FTF Child Welfare Policy, ensuring that all clients participate and remain in NFP
voluntarily and not to duplicate DCS mandated services.
Lastly, the NFP Model is inherently designed to meet the FTF home visitation staff standards and
the supervisory standards. NHV and Supervisory staff will have a minimum of a bachelor's degree
and complete NFP model training prior to serving families. Systems are already in place to ensure
staff complete background checks and fingerprint clearance card. MCDPH has a history of
prioritizing professional development; in addition to all of the required training and certifications,
in the past three years MCDPH has facilitated one staff member completing her International
Certified Breastfeeding Lactation Consultant (ICBLC) and four staff obtaining their Infant Mental
Health Endorsement. MCDPH NFP prioritizes reflective practice and supervision which has
contributed to a high level of staff retention; the current Nurse Supervisor and three NHVs have
been with the NFP program for 8.5 years and three additional NHVs have been with the NFP
program for 5.5 years.
I.B.1. The Nurse-Family Partnership model utilizes a two-generational approach with first-time
mothers and their infants, identifying both mother and child as clients, working to meet the needs
of the family holistically through education, support and care in order to promote a healthy
FTF-RC035-19-0609-00 Page 9 of 232

pregnancy, responsible and competent parenting, and economic self-sufficiency. By instilling
confidence and empowering the mother to achieve a better life for her children and herself, NFP's
outcomes include long-term family improvements in child health and development, school
readiness, reducing incidence of child maltreatment, and economic self-sufficiency.
The NFP model is designed to foster attachment between the mother and infant (John Bowlby's
attachment theory), the mother's sense of self-efficacy (Albert Bandura's self-efficacy theory),
and the mother's social support system (Uri Bronfenbrenner's human ecology theory). The
program uses specially trained, registered nurses to conduct home visits with low-income, first-
time pregnant women. The visits systematically address the social, emotional, health and
economic aspects of the women's lives. The nurses help women improve their health during
pregnancy, develop skills in caring for their child, access necessary public services, and work to
become self-sufficient (finishing school, finding a job). Fathers are encouraged to participate in
visits and activities, nurturing the family as the primary context for child development.
This intensive level of NFP support is focused on: Preventive health and prenatal practices for the
mother—Helping to connect the woman to insurance & prenatal care, increase awareness of and
improve her diet, and reduce her use of cigarettes, alcohol and illegal substances, prepare
emotionally for the arrival of the baby by educating her on the birth process, breastfeeding and
potential postpartum depression. Health and development education and care for both mother
and child—providing individualized parent coaching aimed at increasing awareness of specific
child development milestones and behaviors, and encouraging parents to use praise and other
nonviolent techniques. Life coaching for the mother and her family— Encouraging women to
develop a vision for her own future, stay in school, find employment and plan future pregnancies.
When the family and father of the child are present, NHV engage them in the visits as well,
nurturing the family as the primary context for child development.
Client-Centered -the NHV is constantly adapting to ensure the visit and materials are relevant and
valued by the parent. Supporting the client's growth and needs is the focus. Relational - the
relationship between the NHV and the client is the primary tool used for learning and growth in
each family served. Strengths-Based- the intervention is based on solid adult learning and
behavior change theory. Adults and adolescents make changes most successfully when they are
building on their own knowledge, strengths and successes. Multi-Dimensional- the life of each
program participant is viewed holistically, and what the program offers is tied to multiple aspects
of personal and family functioning: personal and environmental health, parenting, and life course
development, relationships with family and friends, and community connections.
In order to ensure fidelity to the NFP model, the NHV and supervisor must adhere to the 19 Model
Elements. Applying the model elements in practice provides a high level of confidence that the
outcomes achieved by families who enroll in the program will be comparable to those achieved
by families in the three randomized, controlled trials and outcomes from ongoing research on
the program. The MCDPH NFP program is designed accordingly and on-going quality assurance is
monitored by NFP National Service Office which generates an annual MCDPH Fidelity Report.
The location of the program is in the client's home, visits start during pregnancy, prior to the 28th
week, and occur throughout the pregnancy and the first two years of her child's life (length of
FIF-RC035-19-0609-00 Page 10 of 232

service provision) and in accordance with the NFP visit schedule frequency, the intensity is one to
one visits with one NHV to one mother/family.
The 19 Model Elements are: (1) Client participates voluntarily in the Nurse-Family Partnership
program. Voluntary enrollment promotes building trust between the client and her nurse home
visitor. Choosing to participate empowers the client and builds self-efficacy, MCDPH Fidelity
Report -100%. (2) Client is a first-time mother. Nurse-Family Partnership is designed to take
advantage of the ecological transition, the window of opportunity, in a first-time mother's life. At
this time of developmental change, a woman is feeling vulnerable and more open to support.
MCDPH Fidelity Report-100%. (3) Client meets low-income criteria at intake. MCDPH NFP
defines low income as being income eligible for Women, Infant, and Children (WIC). Vulnerable,
low-income women show the greatest benefit from the program. MCDPH Fidelity Report-100%.
(4) Client is enrolled early in her pregnancy and receives her first home visit by 28 weeks of
pregnancy. Early enrollment allows time for the client and NHV to establish a relationship before
the birth of the child, allowing time to address prenatal health behaviors which affect birth
outcomes and the child's neurodevelopment. Program dissemination data show that earlier entry
into the program is related to longer stays during the infancy phase, increasing the client's
exposure to the program and offering more opportunity for behavior change. MCDPH Fidelity
Report-100%. (5) Client is visited one-to-one: one NHV visitor to one first-time mother/family.
The NHV engages in a therapeutic nurse-client relationship focused on promoting the client's
abilities and behavior change to protect and promote her own health and the well-being of her
child. Clients are encouraged to invite family members to participate in the visit as appropriate. In
particular, fathers are encouraged to be part of visits when possible. MCDPH Fidelity Report-
100%. (6) Client is visited in her home as defined by the client, or in a location of the client's
choice. Visiting the client in her home allows the NHV a better opportunity to observe, assess and
understand the client's context and challenges within the home situation. MCDPH Fidelity Report-
99%. (7) Client is visited throughout her pregnancy and the first two years of her child's life in
accordance with the standard NFP visit schedule or an alternative visit schedule agreed upon
between the client and nurse. Recent NFP studies have shown increased client retention when
the visit schedule is adjusted to client needs. In the standard NIP visit schedule, prenatal visits
occur once a week for the first four weeks, then every other week until the baby is born.
Postpartum visits occur weekly for the first six weeks and then every other week until the baby is
21 months. From 21-24 months visits are monthly. To meet the needs of the individual family, the
nurse home visitor may increase or reduce the frequency of visits, and is encouraged to visit in the
evening or on weekends based on nursing assessment and client request,
(8) Nurse home visitors and nurse supervisors are registered professional nurses with a
minimum of a Baccalaureate degree in nursing. A Baccalaureate degree in Nursing is considered
to be the standard educational entry into public health work. Public health nurses operate with a
high degree of autonomy and interface with complex, high risk clients. MCDPH Fidelity Report-
100%. (9) Nurse home visitors and nurse supervisors participate in and complete all education
required by the NFP NSO. In addition, a minimum of one current NFP administrator participates
in and completes the Administration Orientation required by NFP NSO. MCDPH Fidelity Report-
100%. (10) Nurse home visitors use professional knowledge, nursing judgment, nursing skills,
screening tools and assessments, frameworks, guidance and the NFP Visit-to-Visit Guidelines to
FTF-RC035-19-0609-00 Page 11 of 232

individualize the program to the strengths and risks of each family and apportion time across the
defined program domains. NHVs apply client-centered principles and use strength-based
approaches and communication techniques in working with families to individualize the program
to meet the client's needs within the NFP domains: personal health, environmental health, life
course, maternal role, friends and family, health and human services. MCDPH Fidelity Report-
100%
(11) Nurse home visitors and supervisors apply nursing theory, nursing process and nursing
standards of practice to their clinical practice and the theoretical framework that underpins the
program, emphasizing Self-Efficacy, Human Ecology and Attachment theories, through current
clinical methods. The clinical methods that are taught in the education sessions and promoted in
the NFP Visit-to-Visit Guidelines are an expression of these theories. MCDPH Fidelity Report –
100%. (12) A full-time nurse home visitor carries a caseload of 25 or more active clients. MCDPH
Fidelity Report-25.5 clients. NFP implemented through FTF will maintain caseloads not to exceed
25 clients. (13) NFP agencies are required to employ a NFP nurse supervisor at all times. The
MCDPH NFP Nurse Supervisor has been with the program since 2009. MCDPH Fidelity Report-
100%. (14) Nurse supervisors provide nurse home visitors clinical supervision with reflection,
demonstrate integration of the theories, and facilitate professional development essential to
the nurse home visitor role through specific supervisory activities including one-to-one clinical
supervision, case conferences, team meetings and field supervision. MCDPH NFP has scheduled
NFP staff meetings every Wednesday at 9 AM; two times per month are team meetings, and two
times per month are case conferences, supported by a mental health consultant. The NFP
supervisor has a set schedule of weekly one to one supervisions with each NHV. MCDPH Fidelity
Report-Average 1:1 meetings per NHV 42/year, Number of Case Conferences-25/year, Number of
team meetings-23/year. (15) Nurse home visitors and nurse supervisors collect data as specified
by the Nurse-Family Partnership National Service Office and ensure that it is accurately entered
into the NFP data collection system in a timely manner. As described in the Data Reporting
Requirements Attachment. (16) NFP nurse home visitors and supervisors use data and NFP
reports to assess and guide program implementation, enhance program quality, demonstrate
program fidelity and inform clinical practice and supervision. As described in the Data Reporting
Requirements Attachment.
(17) A Nurse-Family Partnership implementing agency is located in and operated by an
organization known in the community for being a successful provider of prevention services to
low-income families. Maricopa County Department of Public Health is a long-standing provider of
prevention services to low-income families. Services have included Healthy Start, Lead Hazard
Prevention, Oral Health, WIC and other nutrition education programs, Newborn Intensive Care
follow-up Program, Community Health Nursing, Childcare Nurse Consultation, Immunizations,
Healthcare for the Homeless, Refugee Health, and Clinical Service for STD/HIV and TB health care.
(18) A Nurse-Family Partnership implementing agency convenes a long-term Community
Advisory Board that reflects the community composition and meets at least quarterly to
implement a community support system for the program and to promote program quality and
sustainability. The past year the Community Advisory Board has been meeting in conjunction with
the Preventive Health Collaborative (PHC) to facilitate a larger community network. The future of
the PHC is unknown due to funding uncertainty which will require a new strategy plan for the CAB
FTF-RC035-19-0609-00 Page 12 of 232

going forward. MCDPH Fidelity Report — Active CAB. (19) Adequate organizational support and
structure shall be in place to support nurse home visitors and nurse supervisors to implement
the program with fidelity to the model. MCDPH has provided necessary infrastructure to
implement NFP for the past 8 years; this includes office space, desks, and filing cabinets, phones,
and data support. MCDPH NFP has an outstanding record of staff retention with the Nurse
Manager with NFP for 5 years, the current Nurse Supervisor and three NHVs have been with NFP
for 8.5 years and three additional NHVs have been with NFP for 5.5 years.
1.9.2. MCDPH and the NFP National Service Office have had an Implementation Agreement in
effect since 2009. The current Agreement is due to for renewal October 31, 2018.
(Attachment A)
FTF-RC035-19-0609-00 Page 13 of 232

I.B.3. List and provide a copy of instruments and tools used as part of program implementation
such as all screening and assessment tools and surveys conducted. (Attachment B)
Instrument Delivery Time Frame How Used to Support the Implementation
of the Strategy
Curriculum
N FP Visit to Visit Every Visit Help maintain consistency in implementing the
Guidelines Nurse-Family Partnership model
Ensure comprehensive and essential
information is introduced to clients
Provide the flexibility needed to meet clients'
needs and desires, as well as program goals
Offer a framework that helps nurses and clients
avoid focusing solely on the day-to-day
challenges clients are facing
Introduce content that supports clients in
developing the knowledge, skills and self-
efficacy to obtain the three Nurse-Family
Partnership outcome goals of:
• Improved pregnancy outcome through
practice of good health-related
behaviors
• Improved child health and development
• Improved economic self-sufficiency
Screening
Generalized Once in 1st -5th visit Screens parent for level of anxiety
Anxiety Disorder- then
7 As needed
Patient Health Once in 15t-5th visit Screens parent for perinatal depression
Questionnaire-9 36 weeks pregnancy
1-8 weeks post-
partum
4-6 months of age
One year postpartum
then as needed
Ages & Stages 4 months, 10 months, Screen child's developmental milestones. Helps
Questionnaire:3 18 months & 24 track child health and development outcomes
FTF-RC035-19-0609-00 Page 14 of 232

months of age & as for the children in the program
needed
Ages & Stages 6 months, 12 months, Screen child's social —emotional development
Questionnaire 18 months, 24 months
Social Emotional - of age & as needed
2
Hearing-OAE 1 year, 2 years of age Support early detection of child's hearing
& as needed challenges
Vision-PlusOptix 1 year & 2 years of Support early detection of child's vision
age challenges
& as needed
Assessments
Demographics Intake Compile information on the social and
6 months, 12 months, economic characteristics of the parent. It can
18 months, 24 months provide information that will prompt you to
of age conduct in-depth clinical assessments and
interventions.
Maternal Health 15t home visit Collects clinical information to better assist
parent during pregnancy and information about
the risk characteristics of clients served in the
program.
Health Habits 3 rci or 4th visit Tracks changes in substance use providing
36 weeks of important clinical information and allows
pregnancy demonstration of outcomes for the program.
One year postpartum
Infant Birth 15t visit after birth Collects information about birth outcomes for
parent and babies, initiation of breastfeeding,
and parent's use of emergency/urgent care
services in pregnancy.
Infant Health 6, 12, 18, 24 months Gathers information on breastfeeding and the
Care of age child's general health, developmental
milestones, immunization status, visits to
emergency room/urgent care centers, and
hospitalizations over time. Tracks child health
and developmental outcomes for children.
Clinical Intimate 5th-7th Visit Identify the extent to which clients served by
Partner Violence the program have experienced intimate partner
16 months of age
FTF-RC035-19-0609-00 Page 15 of 232

violence.
Strengths and 3 rd or 4th home visit Assesses parent's strengths & risks, and aids
Risks Framework 36 weeks pregnancy planning individualized interventions.
8 weeks postpartum
12 & 18 months of
age
Use of Intake Records what government and community
Government & Infant Birth resources the parent and child are receiving.
Community 6, 12,18 & 24 months Reflects referrals and to connect parent to
Services of age services.
Dyadic 1-3 months of age Records observations which assist the nurse in
Assessment of 8-10 months of age identifying areas for growth, enhancement and
Natural 15-17 months of age strength when a caregiver interacts with the
Caregiver-child 21-23 months of age child. These observations guide nursing
Experiences interventions that build parenting skills and
promote child development.
Client Dismissal Discharge of client Records discharge of family from the program
and the reason.
Home Visit Every Visit Records the duration, location, participant
Encounter engagement, program content covered, and
length of each visit. Collects prenatal care, well-
child care, insurance status and ER visits &
hospitalizations.
Referrals to As needed Records information when home visits result in
Services referral to government or community services.
Survey
Nursing Client 36 weeks pregnancy Assess parent perspectives about NFP and the
Survey 1 year of age nurse home visitor
I.B.4. The following adaptations to the Nurse-Family Partnership model have been discussed with
the National Service Office Nurse Consultant. These adaptions are enhancements that remain in
alignment with the NFP Model Elements and therefore are within MCDPH's scope of discretion for
implementation.
Hearing Screening - OAE Instrument based hearing screening is a required secondary strategy for
home visitation. While sensory screening (hearing and vision) are a required component of the
FTF-RC035-19-0609-00 Page 16 of 232

Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program, not all children are
regularly provided routine and high quality sensory screenings.
Children will be screened at one & two years of age with exceptions as noted in the
Developmental & Sensory Screening Standards of Practice. Results will be reported to the Arizona
Department of Health Services. If screening fails it will be repeated within 6-8 weeks. If the 2nd
screening fails the family will be provided referral and navigation services to secure an
appointment with a primary care physician. Results of the evaluation will be determined and
further referral and services to an audiologist will be completed as needed.
Vision Screening-Instrument based vision screening is a required secondary strategy for home
visitation. While sensory screening (hearing and vision) are a required component of the Early and
Periodic Screening, Diagnosis and Treatment (EPSDT) program, not all children are regularly
provided routine and high quality sensory screenings.
Children will be screened at one & two years of age with exceptions as noted in the
Developmental & Sensory Screening Standards of Practice. If screening fails the family will be
provided referral and navigation services to secure an appointment with a primary care physician.
Results of the evaluation will be determined and further referral and services will be completed as
needed.
Family Social Connection Events- Social opportunities is a required strategy implementation
standard for home visitation and social connections is a protective factor for strengthening
families. Events will be provided for families to gather and network in the community at least
quarterly. Family feedback will be sought to inform the topic, time and location of the event.
Adverse Childhood Experiences Score- This screening tool is used to help identify parents who
may be in need of more intense services and to help them better understand how their own
childhood experiences influence their life course and parenting. Adverse childhood experiences
will be introduced at approximately the 4th home visit and the screening will be done at the
following visit for parents who are 18 years of age or older.
Nurse Home Visitors will be trained with the NEAR @ Home Toolkit which provides guidance to
address the ACE's of young at-risk families. The most powerful people for reducing ACE scores in
the next generation are parenting adults. Families will be informed about ACE's and their effects in
order to support them in their own resilience as well as protecting their children from adverse
experiences. Goals for the home visitor are to build skills and increase compassion, patience, and
stamina in their work with families.
I.C.1. MCDPH NFP in collaboration with SWHD proposes to build and maintain a caseload of 50
low-income, first-time pregnant women who are in the high poverty/high needs geographic
area of Chandler, Guadalupe, South Scottsdale and Tempe, and who have one or more of the
following high risk factors: poverty, at risk or history of abuse and neglect, maternal depression,
parental substance abuse, parental incarceration, and poor relationships with caregivers, food
or housing insecurity, reliable support system, and teens. The design of NFP to focus on first-
FTF-RC035-19-0609-00 Page 17 of 232

time pregnant women is an 'upstream approach' that capitalizes on a time in a women's life when
interventions may have the most lasting impact — affecting both the current pregnancy and future
pregnancies. Knowing that resources are limited for home visitation services and that there are
several home visiting models in the region, it is important to identify the most appropriate model
for the identified risk level. With this additional funding to expand NFP by two NHV's, MCDPH will
refine the focus to identify the highest risk eligible women by creating a High Risk Eligibility
checklist in addition to the established NFP eligibility criteria, both of which are identified in the
Implementation Plan. Once a woman is identified as NFP eligible based on NFP criteria, the NHV
will further identify the high risk factors to identify NFP as the best home visiting program for this
client.
MCDPH has been implementing NFP in parts of the East Maricopa Region since 2012 with funding
from Maternal Infant Early Childhood Home Visitation (MIECHV). However, MIECHV funding only
covers 3 zip codes: 85251, 85281, and 85282. The remainder of the region is not served by NFP.
MCDPH currently serves 32 families in those 3 zip codes. MCDPH has established successful
recruitment strategies in the East Maricopa Region. Examples of three successful strategies are:
1) MCDPH NFP co-locates office space at the Arizona Associates for Women's Health, East Valley
Clinic which allows for the NHVs to develop and maintain relationships with local obstetricians and
their office staff; 2) a formalized process with MCDPH WIC offices that has increased the number
of home visitation referrals. MCDPH NFP implemented a new strategy two years ago to
accommodate the MCDPH WIC administration's request to reduce the number of outreach staff
coming to clinics. NFP worked with WIC administrators to implement a MCDPH WIC wide formal
procedures that facilitates WIC staff to offer and make a generalized referral for any family
wanting more information about home visiting services. WIC sends all home visiting referrals
directly to MCDPH NFP, they are screened for NFP due to the narrow eligibility requirements
(referrals are divided between MCDPH and Southwest Human Development (SWHD) NFP
programs); if not eligible for NFP, the referral is sent to Parent Partners Plus (PPP). MCDPH has
sent 297 referrals to PPP in the past 2 years resulting in a successful collaboration. Lastly, 3)
MCDPH and SWHD NFP identified that referrals initially contacted directly by the assigned NE-IV
were more likely to schedule a home visit and complete enrollment than referrals that were first
contacted by PPP staff. Having the NHV make the initial contact allowed the home visit to be
scheduled with just one phone call to the client as opposed to at least two phone calls, and also
allowed the client and NHV to begin building rapport at first contact, simplifying the process for
the client. Both SWHD and MCDPH NFP coordinated with PPP to formalize this process for NFP
eligible referrals.
In addition, MCDPH will continue outreach to Family Resource Centers, AHCCCS health plans, high
schools, pregnancy centers, healthcare providers, DES staff, community health centers, behavioral
health providers, substance abuse treatment centers, pregnancy crisis centers and homes,
Goodwill, and childbirth educators. MCDPH NFP will seek to strengthen our relationship and
explore opportunities for collaboration with the National Council on Alcoholism and Drug
Dependence. The NCADD provides services to pregnant and parenting women with substance
issues.
FTF-RC035-19-0609-00 Page 18 of 232

Strategies for client retention are focused on four activities: Adaptation and flexibility -The NFP
model has a "standard" schedule of home visit delivery. While every effort is made to follow that
schedule, offering a family flexibility at enrollment, infancy 8 weeks, and at one year has been
shown to increase client retention. The majority of families will choose to follow the standard
schedule. Explicit discussion about participation-N HVs share with clients the outcomes for moms
and babies being most positive if they stay in the program until their child is two years old. They
explore with clients who show signs of dropping, what the client sees as the benefits and
difficulties of staying in the program and what would make the program better meet their needs.
Motivational Interviewing- NHVs learn and use the four principles of MI in their work with clients -
1) Resist the Righting Reflex, 2)Understand and explore the patient's own motivations, 3) Listen
with empathy, 4) Empower the client, encouraging hope and optimism. This style of
communication elicits from clients their own good motivations for making changes in their and
their child's own interest. Supporting Client Engagement-NHV's will complete the client
engagement learning module that explores understanding and supporting client engagement, and
improving client engagement. Specific strategies for initial contacts include:
• Making first contact within 48 hours of receiving the referral, being purposeful and aware
of body language, eye contact, tone of voice and to listen without distraction. Approach
client with perspective that you may not know or understand her yet, but you are
interested in learning and accepting. Be culturally sensitive by applying 4 A's: Acknowledge,
Awareness, Ask, and Act.
• Understanding who may influence the client's decision to enroll and providing information
to that person and if possible meeting that person.
• Asking and listening to any past experiences client may have had with previous programs
and provide opportunity for client to voice her concerns regarding NFP.
• Asking client about her interests, needs, and what is most important to her during this time
in her life and then sharing what the program can offer that aligns with her interests and
needs. Be cautious of the context in which you use the word "help."
• Obtaining only necessary contact information to reach client on the first visit. Ask the client
if she sees value in participating in the program and what might be barriers to her
participation.
I.C.2. MCDPH NFP has served this hard-to-reach target population for over eight years in several
regions of Maricopa County, including the successful implementation of NFP in a limited portion of
the East Maricopa Region for 6 years with MIECHV funding. NFP NHVs have experience working
with high risk populations as evidenced by current client characteristics that include: 36% under
the age of 20 years and 74% under the age of 24 years at time of enrollment, 18% with household
history of substance abuse, 80% unmarried, 75% on Medicaid, 90% on WIC, 62% Hispanic or
Latina, 5% American Indian or Alaska Native, 10 % Black or African American. The NFP model is
designed to serve hard-to-reach populations, incorporating best practices to engage the client in
services that support behavior change and self-efficacy. MCDPH NIP has experienced a very low
staff turn-over rate, which leverages our program's ability to provide relationship continuity and
trust building, an essential component when working with hard to reach populations.
FTF-RC035-19-0609-00 Page 19 of 232

I.C.3. NFP is a client and family centered, strengths-based intervention program that appreciates
and values cultural differences. Assessments provide information about a families' culture,
beliefs and practices and allows the NHV to understand and be competent to work effectively
with each family. Every effort will be made to hire staff who are linguistically and culturally
competent for the population to be served and are responsive to regional and cultural factors.
NHV's convey cultural competence by visiting the client in their home, and fostering a powerful
bond between NHV and mother through frequent and prolonged visiting services. Staff attends
quarterly meetings that include presentations on cultural competence and sensitivity. The NFP
program is gender responsive in its service to pregnant women and women of childbearing age
by providing safe opportunities to share with the home visitor without fear of negative
consequences. The program provides opportunities for success in which clients can produce
something of value to themselves by improving their parenting skills. The NFP model creates an
environment based on safety, respect and dignity. Early and intensive support by skilled home
visitors for vulnerable women is the strategy adopted to deliver multi-generational outcomes that
benefit communities.
Annually, NFP staff will be provided cultural competency education through classes offered by the
Department of Public Health. As part of the program's continuous quality improvement process,
The Standards of Quality for Family Strengthening and Support: Embracing Diversity section will
be utilized to ensure the program 1) acknowledges and respects the diversity of families, 2)
enhances the ability of families to participate in a diverse society, and 3) engages in ongoing staff
learning and adaptation of practices to address diversity. The Office of Family Health Nurse
Manager, Tracy Sloat is a certified trainer for The Standards of Quality.
I.C.4. The proposed units of service to reach will be to provide Nurse-Family Partnership home
visitation services to fifty (50) low-income, first-time pregnant womenprioritize pregnant women
who are in the high poverty/high needs geographic area of Chandler, Guadalupe, South
Scottsdale and Tempe, and who have one or more of the following high risk factors: poverty, at
risk or history of abuse and neglect, maternal depression, parental substance abuse, parental
incarceration, and poor relationships with caregivers, food or housing insecurity, reliable
support system, and teens in the East Maricopa Region. In addition, age-appropriate
developmental and sensory screenings will be provided to 50 children of enrolled families
throughout their first 2 years of life. The design of NFP to focus on first-time pregnant women is
an 'upstream approach' that capitalizes on a time in a women's life when interventions may have
the most lasting impact — affecting both the current pregnancy and all future pregnancies.
Knowing that resources are limited for home visitation services and that there are several home
visiting models in the region, we propose to focus on a small but high risk subset of the total
number the Council desires to serve.
I.D.1. MCDPH proposes to subcontract with the Nurse-Family Partnership program at Southwest
Human Development, (SINHD) to implement services in the East Maricopa Region. (Attachment D)
The sub-contractors components of implementation will include:
• Recruitment of one Nurse Home Visitor to serve 25 families, ensuring compliance with
Home Visitation Staff Standards and completion of all required FTF & NFP model training.
FTF-RC035-19-0609-00 Page 20 of 232

• Outreach & marketing to the target population and geographic area will be coordinated
with MCDPH outreach staff.
• Work cooperatively with the Home Visitation Coordinated Referral System and coordinate
with MCDPH on referrals & staff assignments.
• Provide Home Visiting services for the duration of the contract and maintain a caseload of
up to 25 participants following the defined scope of work, target population and
geographic area to serve.
• Implement services according to the Home Visitation Standards of Practice, the
Developmental and Sensory Screening Standards of Practice, as well as FTF Mandated
Reporting, Child Welfare and Food Service Policies.
• Coordinate and collaborate with MCDPH as well as external partners that are part of the
early childhood community.
• Participate in CQI through reflective supervision weekly, team meetings twice per month,
and case conference twice per month per the NFP model components.
• Participate in the ADHS CQI workgroup with MCDPH, and select at a minimum one 01
project each year.
• Provide data entry to Penelope for all assessments and indicators for clients in their
caseload.
• Submit a monthly data report to MCDPH utilizing the FTF Data Requirements for Home
Visitation template for any data requirements not captured in Penelope.
ID. 2. SWHD offers a wide range of home visitation programs which provide parents of young
children with information and education on parenting, child development, and physical and
emotional health-while also assisting them in accessing a wide range of community resources.
Examples include Nurse-Family Partnership, Newborn-intensive Care Program (NICP), Healthy
Families, The Fussy Baby Line, Early Head Start, Head Start, Early Intervention, Smooth Way Home,
and the Good Fit Infant Mental Health Program.
I.D. 3. Monitoring for compliance will include monthly meetings of the supervisors for at least the
first 6 months of implementation, followed by quarterly meetings throughout the contract period.
MCDPH will create a report template based on the FTF Data Reporting Document that includes all
FTF data requirements. SWHD will be required to submit the report monthly to MCDPH for
monitoring of program implementation, outcome achievement, fidelity to the NFP model, and
compliance with the sub contract. Any data points not able to be entered to the model data
system and accessed by FTF, will be entered to an MCDPH ACCESS database. MCDPH will collect
and combine those data points from SWHD for reporting to FTF quarterly.
SWHD currently serves the Phoenix North & Phoenix South Regions which border the East
Maricopa Region.
I.D. 4. SWHD currently serves the Phoenix North & Phoenix South Regions which border the East
Maricopa Region. SWHD has extensive experience in providing individualized support to families
with young children, especially those who are at risk due to factors such as poverty, teen
parenthood, few resources, mental health issues, exposure to domestic violence, lack of
education, or challenges with food, transportation, and housing.
FTF-RC035-19-0609-00 Page 21 of 232

I.D. 5. SWHD will collaborate with MCDPH to coordinate effective implementation and
achievement of outcomes through frequent communication to exchange information, discuss
referrals, share outreach, roles, and resources. The programs will work together to increase
participant retention and engage in strategic planning and data reporting. The programs will
coordinate with community partners to facilitate care coordination, healthcare and other
emergency services for families.
I.E. MCDPH NFP will interface with the following entities to support coordination and
collaboration, to build and strengthen capacity, maximize resources and support a shared vision
for a coordinated, responsive and effective early childhood system.
Collaborate with the Home Visitation Coordination System by attending meetings, working
together to increase shared outreach, system building, to increase client retention and engage in
strategic planning and data reporting. With the funding of a Health Educator/Outreach position
MCDPH NFP will be in an enhanced position to work together to achieve common goals. MCDPH
has participated in the Home Visitation Coordination System since funded by FTF in South Phoenix
in 2010.
Collaborate with MCDPH WIC and the Home Visitation Coordination System by serving as the
central point of entry for referrals coming from the clinics. Three additional questions are added to
the Home Visitation Referral form to screen out families not eligible for NFP. 1. Are you pregnant?
2. Are you a first time Mom? 3. Ages of your children? NFP has the most restrictive criteria so by
quickly screening WIC referrals with those questions, the ineligible referrals can be referred on to
Parent Partner's Plus. This successful collaboration has resulted in 297 referrals from MCDPH to
PPP over the past 2 years.
Collaborate in Maricopa County with Southwest Human Development in the implementation of
the Community Advisory Board and with other NFP Implementing Agencies in the state to
coordinate referrals, share forms, trainings and to accept and send transfers of NFP clients moving
within the state.
Coordinate and communicate with the Child Welfare System to exchange information, discuss
referrals, roles and resources quarterly. This has been an informal coordination, with
communication occurring when the NFP family is receiving DCS services and the NHV reaches out
to them to coordinate and share information. NHV's will attend a DCS family staffing when notified
and available. MCDPH NFP strongly desires to strengthen this relationship for the benefit of
families and staff.
Plan to establish coordination with Child Abuse Prevention Councils when present in the region by
supporting education, dispersing messaging, information and materials to families and
participating on councils. NFP is a prevention program and has been shown to reduce the
incidence of child abuse and neglect. The trauma informed work we do educating and supporting
families is in concert with the CAP councils.
Coordination with AzEIP by communicating on behalf of the family and coordinating services as
needed and appropriate. Communicate with AzEIP supervisory staff quarterly. MCDPH home
FTF-RC035-19-0609-00 Page 22 of 232

visiting programs have a long history of partnering with AzEIP through the NICP program and NFP.
Nurse Home Visitors are very experienced at developmental screenings and the referral process.
An added responsibility per FTF SOP and data collection requirements will be to monitor the
timeline for receiving services from AzEIP and the primary care provider.
Plan to enhance coordination with the Family Resource Centers to plan how programs can work
together, maintain shared contact lists, and attend quarterly meetings to share information,
capacity, referral process and barriers to accessing services. Coordination has been informal to
date historically with emphasis on the referral process and sharing resource center calendars with
families. Coordination with AHCCCS Health Plans for referrals and coordination of care.
Agreements are in place with most health plans to refer eligible women to NFP and share
information as needed for coordination of care. The flow of referrals is currently inconsistent, plan
is to strengthen this relationship.
Coordination with Strong Families CQI workgroup, Well Child Visit workgroup and ACE clinical
workgroup. Continue to attend meetings, exchange information, includes planning activities and
making decisions informed by data. Network with Maricopa Family Support Alliance and the West
Valley Alliance to exchange information for mutual benefit and information sharing Increases
understanding of the current system of services.
11.1. MCDPH NFP has been a member of the Home Visitation System since its early iteration in
2010. In the past 2 years MCDPH NFP has sent 297 referrals to the Home Visitation Coordinated
Referral System and will continue to work to ensure families are connected with the best
possible match for services. MCDPH NFP will participate by adhering to the following: 1) a Home
Visitation program director, manager, or supervisor will attend a minimum of 75 percent of the
member meetings; 2) share referrals, reporting, and waitlists; 3) participate in shared outreach
and recruitment efforts; 4) work to cooperatively to increase participant retention; 5) support the
development and maintenance of a shared contact list of Home Visitation programs; 6) engage in
strategic planning efforts; and 7) utilize shared documents and forms for the collection and
reporting of required information and data.
I.F. One of the most consistent barriers in home visitation programs is related to recruitment,
family engagement and retention of clients. Experience has informed us that regular outreach
efforts are required to maintain a steady flow of referrals. The outreach staff will be working to
ensure the flow of referrals continues. MCDPH coordinates outreach with the Home Visiting
Coordination System and attends the quarterly meetings regularly. In a study to determine how
to improve family engagement and client retention, varying the schedule to meet client needs
increased their interest and commitment to staying in the program. In the new Visit Guidance,
nurses are reminded to check regularly with clients to see if the standard schedule still works for
the client or if the client needs a modified schedule (more frequent or less frequent). Other
strategies for family retention are focused on explicit discussions with the family about
participation and positive outcomes from remaining in the program until their child is 2 years of
age, utilizing motivational interviewing to elicit from the family their own good motivations for
making changes in their and their child's own interest. Strategies for family engagement focus on
FTF-RC035-19-0609-00 Page 23 of 232

the first contact with the client: make contact within 48 hours of receiving referral, understanding
who may influence the client's decision to enroll, asking and listening to past experiences with
other programs and allowing client to voice any concerns, asking about family interests, needs and
what is most important to her during this time in her life, and how the program can align with her
needs, obtain only necessary contact information for enrollment.
Community resources are often limited for the services the underserved require. In particular
mental health services are limited for the un-insured and the under-insured. In addition the
stigma associated with seeking mental health services and the frustration of prior encounters with
the system are both barriers to receiving services even when available. NIP staff recently
completed a 5 part education module on Mental Health Depression & Anxiety. This included
maternal risk factors for depression, parenting interactions with depression and anxiety,
assessment skills, introducing mental health screenings and sharing results, knowledge of
conditions, the role of the NHV and how the nursing process is implemented.
The role of the NHV is never to replace a referral to, or services from behavioral health. However,
the NHV encounters mental health histories and diagnoses as well as new concerning behaviors
every day on visits with this at risk population of pregnant women and new mothers. The NHV
must have knowledge of what she is observing, and how to support the client until services can
be received. Support is provided for nurses through mental health consultation and reflective
practice in weekly supervision and in case conferences
I.G. MCDPH Office of Performance Improvement provides Continuous Quality Improvement
(CQI) technical support to the NIP team, including ongoing training in CQI techniques, such as the
Plan, Study Do, Act (PDSA) cycle. The current NFP supervisor attends and participates in the
monthly Strong Families CQI team meeting and works closely with the Strong Families CQI
coordinator. An example of a previous PDSA cycle, NHVs worked to increase the number of weeks
on average that each client breastfed. After analyzing baseline data, the NFP team implemented a
CQI strategy for 6 months which resulted in a 2.5 week increase in the duration of breastfeeding,
on average. Currently, the NFP team is going through a PDSA process in order to improve the
documentation of completed well child exam visits for NFP clients.
As an additional component of the NFP COI process, MCDPH utilizes the Standards of Quality for
Family Strengthening and Support (https://www.nationalfamilysupportnetwork ,ordstandards-of-
quality) as promoted by the Maricopa Family Support Alliance. These Standards are based on two
important family-centered frameworks: The Principles of Family Support Practice (Family Support,
America) and The Strengthening Families Approach: Five Protective Factors Framework (Center for
the Study of Social Policy, 2005). The Standards of Quality for Family Strengthening and Support
focus on five important areas related to program quality: Family Centeredness, Family
Strengthening, Embracing Diversity, Community Building, and Evaluation.
H. Download, complete, and submit the FTF Data Reporting Requirements document for this
strategy. The FTF Data Requirements document must be completed and submitted with your
application.
FIT-RC035-19-0609-00 Page 24 of 232

II. A. Complete the Program Organization Chart (Section D - Personnel)
II. B.1. Primary responsibility for NFP success lies with the Community Health Action Division
Director, Toby Urvater, MSW, the Office of Family Health Nurse Manager, Tracy Sloat, RN MN and
the NFP Supervisor, Denise Voiles, RN, MSN. Ms. Urvater and Ms. Sloat have over 5 years of
experience administrating the NFP program and both have attended the NFP National Service
Office Administrator Orientation in Denver, Colorado. Tracy Sloat, Nurse Manager, provides
ongoing administrative and monthly reflective supervision to Denise Voiles, Nurse Supervisor; in
addition, she facilitates an organizational environment that supports NFP implementation within
the agency and promotes the benefits of the program to the wider community, including state
policymakers and funders who invest in the program's development. Denise Voiles has been
implementing and supervising NFP since its inception at MCDPH, over eight years ago. She will be
instrumental in the recruitment, selection and training a new Nurse Supervisor to assist with this
expansion.
Tracy Sloat, Nurse Manager, provides ongoing administrative and monthly reflective
supervision to Denise Voiles, Nurse Supervisor. The Nurse Supervisor provides administrative and
reflective supervision to all program staff, including weekly one to one meetings with each NHV.
The Nurse Supervisor helps to assure work conditions and community relationships on which NHV
depend are supportive, and reinforces belief in the value of NFP and the NHV's ability to become
and remain competent practitioners of the model. The Nurse Supervisor provides administrative
and reflective supervision for the Office Assistant and the Educator /Outreach worker every two
weeks.
The NFP NSO provides education for nurse supervisors, nurse home visitors, and administrators.
The NHV and Supervisor complete Unit 1, a 40 hour by distance learning, Unit 2, a 5 day face to
face training in Denver, Co. followed by Unit 3, a 10 hour distance learning. The Supervisor
completes Unit 4, an additional face to face training of 3 days and on line trainings specific to the
role. Additional self-study includes NCAST, Keys to Caregiving, Beginning Rhythms, and Promoting
Mental Health during Pregnancy. At approximately 6-9 months after Unit 2, NHV & Supervisor
complete Dyadic Assessment of Naturalistic Caregiver-Child Experiences training. Supervisor, NHV,
and Educator/Outreach staff, will complete agency and community provided trainings include:
ASQ: 3 & ASQ: SE-2, AZ Infant Toddler Developmental Guidelines, AZ Learning Standards,
Strengthening Families: Protective Factors Framework, and Standards of Quality for Family
Strengthening & Support. The Nurse Supervisor, Denise Voiles is a certified trainer for the
Strengthening Families and ASQ: 3, ASQ: SE training and The Nurse Administrator, Tracy Sloat is
a certified trainer for Standards of Quality training.
Ongoing professional development opportunities include local trainings offered through Arizona
Strong Families, Infant Toddler Mental Health Coalition of Arizona, Prevent Child Abuse Arizona
and First Things First. Recent opportunities have resulted in 1BCLC completion by 1 NHV, and
Infant Toddler Mental Health Endorsement by 4 staff. Recent Office of Family Health Quarterly
Meetings included presentations on public health topics, local community services and
FTF-RC035-19-0609-00 Page 25 of 232

opportunities for coordination, AHCCCS health coverage, Parent Partners Plus, Continuous Quality
Improvement, Cultural Responsiveness and mandated reporting.
II. C. Complete the Program Personnel Table (Section D - Personnel)
II. D. Recruitment begins with written job descriptions and job requisitions for the new positions
of Nurse Supervisor, NHV, and Health Educator/Outreach Worker to be prepared and submitted to
MCDPH Human Resources upon notification of award. The job openings will be posted to the
Maricopa.gov employment website and on the Nurse-Family Partnership employment site. The
Nurse Recruiter at NFP NSO will be advised and will assist in nurse recruitment nationally.
Applicants will be screened for minimum requirements and interviews scheduled for selected
applicants. A panel of 2-3 interviewers including the current Nurse Administrator and Nurse
Supervisor will conduct the interviews and make selections based on experience, knowledge,
strong time management skills, clear and succinct communication skills, and personal qualities
such as being self-aware, independent, reflective, flexible, culturally and linguistically reflective of
the target population, and have an enthusiasm for working with children and families.
On hiring, staff will complete an agency orientation including policies, agency mission and values,
confidentiality, Essentials in Public Health, immunization screening, expected employee behavior,
emergency procedures, defensive driving, and customer service. Program orientation is
conducted by the Nurse Supervisor including job and office environment expectations, workers
injury protocol, teleworking policies and procedures, FTF Home Visitation Standards of Practice
and the FTF Developmental and Sensory Screening Standards of Practice, fingerprint clearance
procedure, skills self- assessment specific to the role, equipment orientation and check-out. Staff
will be assisted to register with the AZ Early Childhood Workforce Registry and attend training on
the Arizona Infant and Toddler Developmental Guidelines and Introduction to the Arizona Early
Learning Standards. The Supervisor will work with the staff to develop a schedule for the distance
learning model training and for shadow visits with experienced NHV's. Training on the required
screening tools will be scheduled: ASQ and ASQ SE, Otoacoustic Emissions, and PlusOptix.
NFP has a clearly documented training plan that a NHV must complete including a two week self-
study program that prepares them for the NFP Core Education sessions that NFP NSO provides in
Denver, Colorado covering the NFP curriculum, documentation and data collection processes. New
supervisors complete the same training as well as specific and intensive training regarding their
job responsibilities. On completion of NFP Unit 2 in Denver, the NHV will be assigned referrals to
contact, screen, and enroll for services.
II.E. In alignment with the Standards of Practice, the Nurse Supervisor will ensure that staff
professional development meets all criteria for Home Visitation Staff Standards, including the
information provided above regarding recruitment and orientation. In addition, staff will receive
at least 12 hours annually of professional development including Principles of Family Support, the
Protective Factors Framework, and the Two-Generational Approach, mandated reporting,
culturally responsive service delivery. Additional continuing professional development focuses on
FTF-RC035-19-0609-00 Page 26 of 232

identified areas of need either in an individual or a team. For example, IBCLC training, Childbirth
Education Training, Mental Health First Aid, Perinatal Mood Disorder, Infant Brain Development,
and Intimate Partner Violence Training for Home Visitors, Personal Safety, Trauma Informed Care,
Adverse Childhood Events, Oral Health, Early literacy, and Stress Management. A survey of staff is
taken yearly that helps to inform priority topics for professional development for the coming year.
While training does take time away from face to face time with clients, the value in increasing
awareness and knowledge as well as providing tools for NHV to use in the field with clients is
essential for quality services. Not all staff will attend every non-required community training
offered. Selection will be informed by individual staff identified areas of need, as well as value to
the program.
II.F. The addition of the Health Educator/Outreach staff person will be essential to program
success. The on-going need for referrals require considerable energy to build and maintain
important partnerships. NHV's need information about community resources as well as good
relationships with service agency personnel in order to facilitate client access to community
services and support. Typically, many agencies that provide services can also refer clients to Nurse-
Family Partnership. Therefore, a critical activity for the Health Educator/Outreach staff person
during program start-up is to connect with community agencies to promote community awareness
of the program and generate program referrals.
The Health Educator/Outreach staff person will work closely with the Home Visitation
Coordination System in regards to outreach and will participate in their outreach as needed.
Increasing referrals to the program will result in more families being provided with home visiting
services either by NFP or a program with the best match for that family. Increasing knowledge and
relationships with community services will provide a stronger safety net for enrolled families.
Examples of typical community resources used by NFP families include: childcare information, CPR
training, dental and medical services, DV shelters, GED and other continuing education classes,
family planning, homeless shelters, job training, legal aid, Medicaid enrollment, and smoking
cessation.
FTF-RC035-19-0609-00 Page 27 of 232

Program Personnel Table
In the following table, provide a list of all personnel or positions employed by the applicant that will be fully
or partially funded through the program. Expand as needed. For Key Personnel, include the name and
position title; pertinent background/experience that specifically relates to the program, including degrees,
field of study, number of years in the field, and other qualifications that align with the Standards of Practice
requirements; and their roles and responsibilities. If the position is to be hired (TBH), then describe the
desired background/experience/degrees and field of study. For all personnel, provide the Full Time
Equivalent (FTE) for each position.
Key Personnel - those individuals directly responsible for program implementation/services and are fully or partially
funded through the proposed program.
Background/Experience* FTEs funded
Name/
(include quaiifications that align with Key Roles and Responsibilities through the
Position Title
the Standards of Practice) program
TRH/Supervisor Bachelor of Science in Nursing, Provide program oversight, primary 0_25
Registered Nurse licensed in support and supervision of NFP staff,
Arizona data analyzing and reporting, quality
2 years of program supervisory improvement, ensure program fidelity
experience to the NFP model and the FTF SOP.
Experience in Public Health, Responsibilities include NHV
Maternal-Child Health, or related observation in the home quarterly,
nursing experience reflective supervision weekly,
development of professional
development plan with staff annually.
TBH/Nurse Home Bachelor of Science in Nursing, Maintain highest standards in clinical 1.0
Visitor Registered Nurse licensed in practice, Provide home visits with
Arizona fidelity to the NFP Model, and the FTF
Knowledge of prenatal health, SOP. Recruitment and management of
infant and toddler growth and a caseload of up to 25 clients, develop
development, health, socio- therapeutic relationships with high risk
economic and cultural factors pregnant and parenting women and
which impact maternal child families, assess physical, emotional,
health and families, community social and environmental needs of
resources, ability to provide families, assists in establishing goals
family-centered care in a culturally and outcomes, Provide education,
competent manner support and referral sources to
families, maintain timely and accurate
data collection and documentation,
maintain community relationships to
support client referrals.
TBH/Health Bachelor's Degree in education, Outreach, marketing, educational 0.25
Educator/Outreach social work, public health or activities and relationship building with
related field. community partners to facilitate
referrals, coordinate client health
education and socialization events.
FTF-RC035-19-0609-00 Page 28 of 232

Nana Hehman/ Bachelor in History Daily data entry, monthly report 0.10
Administrative Experience in inventory compilations, data quality monitoring
Assistant management, customer service, and assist with administrative tasks as
sales, data entry and needed
management
Additional Personne - those individuals partially funded through the proposed program but who do not directly
implement or have direct oversight of the program.
0
Total Number of FTEs funded or partially funded through program: 1.6
* Resumes and/or job descriptions for key personnel may be requested at any time but unless otherwise
indicated, they do not need to be submitted. If awarded and the program undergoes changes in staff, a
Staff Change Notification form along with an updated version of this Program Personnel Table will need
to be submitted to First Things First within 14 days of the proposed change.
FTF-RC035-19-0609-00 Page 29 of 232

Program Organization Chart
Nurse !Manager .
Tracy Sloat RN
In Kind
Accountant ,
Ray Fattish
1! Kind
Subcontractor
S Will)
artir5e iorrie vi5itor 1.0 FIE
Wfhlrt staff ./4a5 fiE
FTF-RC035-19-0609-00 Page 30 of 232

effective additional level until professional Documentation
a or
strategy
ensure the include continuous
to the include should ongoing Supporting
fulfill
program and should ongoing, and
to completed as initial Will or weekly,
proposed align plan be such Task(s) of dates quarterly,
the that will Terms orientation, Completed range (daily, annually)
of program implementation task etc.) Timeframe Be dote, frequency monthly,
the needed. including A
implementation proposed the population. date quarterly, 232
time, the as staff) of
for the first target Note: rows support 31
of the the plan. bi-monthly, 2019 additional Page
timelines operations for to the Plan
and delivery in weekly, 30, Add administrative
tasks, and implemented addressed (e.g. —June activities. tools. implementation
activities be service be place Implementation 2018 and and activity
activities, will onset of must take 1, following service program the
the day-to-day program the will July direct assessments complete
define for components activity to the for to
and the proposed timelines the limited (supervisors, curriculum, procedures Task(s) actions
identify demonstrates the following often not on or
to If anticipated the how but staff training and steps
is Plan Work. for and including of all policies
Plan of the and of assignments specific
Scope and timelines when - training of
Implementation Implementation start-up and and certifications, staff set
and/or demonstrates Infrastructure hiring development/updating of
the The Practice for activities acceptable. work
of of required that Recruitment development, Determination of
purpose implementation. applicable specificity not Organizational The Activity unit strategy implementation FTF-RC035-19-0609-00
Standards activities are o o o major for
The All of met I. a

file
of on
subcontract tracking Procedures
descriptions posting database acceptance &
Approved Job Job HR process Job Policies
of of
award award 9/1/18 8/1/18
upon upon by by annually
Initiated grant; 8/1/201B initiated grant; Completed Completed Updated
232
RN RN Manager) 32 of
Voiles, Nurse Sloat, Voiles Stoat Voiles, Stoat Page
Denise (NFP Supervisor) Tracy (Nurse Denise Tracy Denise Tracy
NFP of FTF Reporting, FTF- Visitor FTF
25 of target units FTF- in follow Sensory staff in approval Home reflect
implement caseload work, serve, described to and Mandated policies. visitation described for Nurse Educator to
to a of to area expectation FTF as Supervisors for Health Procedures for: Collaboration Connections
SWHD carry scope as Developmental as Service home training signatures HR to & Procedures &
with to NHV reflect geographic requirements reflect & well as Food reflect required for of Board descriptions Supervisor, initiated reviewed Policies & Social
subcontract 1 will and will Visitation SOP'S, and will and SWHD MC conducted current Policies Coordination Family Inclusiveness
with data RC035-19-0609-00. Welfare, RC035-19-0609-00. to to job Nurse requisitions posted requirements.
Draft services families. Subcontract population service, Subcontract Home Screening Child Subcontract standards Submit Submit Submit (NHV), Job Job Applications Interviews Hiring Update Develop • • •
1. 2. 3. 4. 5. 6. 1. 2. 3. 4. 5. 6. 1. 2.
subcontract Procedures
& FTF-RC035-19-0609-00
Create Recruitment Policies

submitted form successfully developmental Fingerprint issued when successfully
and Request Approvals Orientation System completed and Card sensory training
Completed Data Tribal Signed Completed Checklist Certifications completed training Tracker of Copy application clearance Certification completed screening
NFP
and tribal by Trainer 5
recruiting of Vision every
& Master with -
Upon enrollment members 10/1/18 Hearing Arizona 10/1/18 recertification years
232
of
33
Voiles Sloat Voiles Stoat Voiles Sloat Page
Denise Tracy Denise Tracy Denise Tracy
the Data parental as cultural complete Learning & A @ Submit clearance
from tribal Tribal approvals approval in classes. Employee Procedures, Appropriate Food Educator Developmental Families: model Near Educator Educator screening
First the appropriate tribal which participate Educator & Home Developmental Early NFP ACES training.
members Things orientation New Policies Linguistically Safety, Health Arizona SOP, Strengthening complete: Health fingerprint Health sensory
enrolls First including all appropriate authorities, to Health MCDPH Program CQl, Work and Toddler to Visitation Framework. ASQ:SE-2, Caregiving and and vision
or all obtain requirement community Supervisor, and & Report, Supervisor & Introduction SOP, Supervisor 3, ASQ: to Keys Supervisor valid for Supervisor &
recruits follow procedures applicable, obtain tribal County review Culturally to Duty Visitation/Community Infant AZ Home Screening Factors 1, hearing
will and and by a and Nurse Orientation, Expenditures Nurse Guidelines, Standards, Nurse & Unit NCAST Nurse application Nurse
MCDPH they as designated include education NHV, Maricopa including Services, NHV, complete Sensory Protective NHV training Home, NI-IV, card. NHV, complete training
If tribe policies Policy consents may 1. 2. 3. 4.
1.
Procedures Orientation
& & FTF-RC035-19-0609-00
Policies Training Training

site completion completion Partnership System Report
on of of
Verification Certificate Certificate Nurse-Family Certification Tracker Demographic
NFP
first
after
1/1/19 1/1/19 1/1/19 Annually training 10/20/18 Daily
232
of
Voiles Sloat Voiles Stoat Voiles Sloat Nurse 34 Page
Denise Tracy Denise Tracy Nurse Supervisor Denise Tracy T8H Supervisor
employment in October NHV's target with MIECHV
Childhood Protective training NFP on region by full.
Educator Early Educator Family Educator SOP Denver, based in served are
Health transcripts, Health A Two-Generational for Health Screening delivery Supervisor 2 in experienced NHV area caseloads
and Arizona submit profile. and Families: Quality and service Unit with to service currently
the in and of Support Sensory completes 2018 NSO clients referrals not M1ECHV
Supervisor account Registry, create Supervisor Strengthening Framework, Standards & Supervisor Reporting SOP & responsive 2-4, NFP assign geographic codes unless
Nurse an a and Nurse Strengthening Nurse Visitation Developmental Supervisor October complete 2018 co-enrolling & zip to NFP,
NHV, Create Workforce history NHV, complete Factors Approach NHV, complete Mandated Home Culturally Nurse Denver, NHV 1.5-19, NHV Supervisor population priority funded
1. 2. 3. 4. 1.
Orientation Orientation
& & Assignment FTF-RC035-19-0609-00
Training Training Training Training Staff

Form from System
grantee- Documentation Referral approval Quarterly Meetings & to Referral
Collateral NFP FrF notice at Referral Visitation
grants Supporting Updated materials Updated Written Approval form Order Attendance Coordination of Home Coordinated
Log
Will or dates weekly,
http://www.firstthingsfirst.org Task(s) Completed of (daily, quarterly,
activities) range annually)
Tirneframe Be date, frequency monthly, 8/1/18 8/1/18 Monthly
following A
Guide, 232
the Roles 35 of
to Branding Responsible Voiles Voiles Voiles, Educator Page
limited Person(s)/ Nurse Supervisor
not FTF to served Denise Denise Denise TBH Health
but (refer be to the
(including etc. activity in to zip for participant and of utilization of
flyers population the codes campaign codes eligible items programs,
area link) zip zip materials Coordinated Visitation increase outreach development and reporting
geographic brochures, same target to complete eligible marketing eligible materials NFP of funding promotional to the visiting efforts, and
- Guide, activities outreach to additional & collateral Visitation extension FTF to FTF community, Home System shared in support home planning collection data and
and materials Task(s) actions national branding NFP collateral due to in with of
population Branding outreach of or of NSO facilitate and of Home to of region approval marketing approved Referral participate efforts, list strategic for information
collateral FTF partners steps NFP to FTF of forms Approval System the for when cooperatively contact in forms
target of to targeted with specific Notify region Addition referral FTF Notification Referral in codes Submit program Order Work Coordinated enrollment, recruitment shared engage shared required
the approval (refer of of of
to releases alignment set I. 2. 3. 4. 1. 2. 3.
and
Marketing news implementation and -
and development and work
resources) and Coordination of strategy
Outreach The Media Plan Activity unit implementation FTF-RC035-19-0609-00
o o o o major for Marketing Outreach Outreach
H. a

Plan from System
Outreach Database Database Log & to Referral Database
Referrals Referral Visitation
Completed Outreach Outreach WIC of Log Home Coordinated Outreach
outreach
8/1/18 8/1/18 Daily Monthly Weekly
232
of
Voiles Voiles Educator Educator Educator 36 Page
Denise Denise Health Health Health
and health crisis in codes all to the in for and page date, people
coordinate of plans codes. in sources centers, centers, pantries, zip with referring clinics material System, Facebook of referrals
to care zip health organizations, food assistance area collaborate on WIC marketing Referral WIC including number as
SWHD NFP Health area referral resource based homes, service to staff WIC visiting on ads activities activity, well as
with for service potential family community faith Place emergency additional continue training programs, distributing Coordinated media of database source
activities Medicaid eligible and offices, schools, centers, Maggie's hospitals, of ) will by social outreach type each
cooperatively outreach Arizona NFP current (DES NFP WIC visitation monthly, Visitation NFP all target, NFP in from
Work share Notify additional Notify region providers, pregnancy MOMobile, Goodwill, organizations region the MCDPH MCDPH home region Home posting regularly Document outreach reached received
1. 2. 3. 4. 5.
with (SWHO)
outreach subcontractor FT1-RC035-19-0609-00
Plan Outreach Outreach Outreach Outreach

occur Documentation Home Form
to are population to Coordinated
they Report referrals System Checklist
when target Supporting Referral of Visitation Referral Referral
and and Log
often strategy Will or weekly, 7/1/18 call,
(how of Task(s) dates of quarterly, on phone
type Completed (daily, annually)
Work by range starting initial referral
of Timeframe Be date, frequency monthly,
Scope determined A Daily During each
and/or as 232
Visitor of
services 37
Practice of Person(s)/Roles Responsible Administrative Voiles Nurse Home Page
of i Assistant Denise TBH Supervisor Nurse
Standards discontinuation
the activity WIC? support family Coordinated
activities) applicable in or for Visitation insecurity other or Risk
as required etc completion the eligible Home Eligibility and depression welfare High
following surveys, complete income pregnant? to housing Use child additional Visitation
the (Frequency/duration) processes, activities e.g., - to area? by mother? weeks Visitor refer System Risk High or Substance involvement maternal with Home
to limited referral and assessments, service Task(s) actions service defined 28 Home eligible food of of of neglect. meet to
not and elements the or Eligibility: the as time first than Nurse not Referral Additional history history co-parent history involvement abuse/ not does refer System.
but occur screenings, ending steps in income a less to is or or of or of for then
will enrollment program for specific NFP code Woman Woman Assign woman Coordinated Determine Current Current Absence systems Current History risk woman Eligibility Referral
(including of Determine Zip Low If at If
intake, ongoing elements, processes set • • • • • • 2. • • • • • •
Delivery services/programming of of and 1.
model
Implementation Implementation core Determination work of for for
Service/Program When e.g., Activity unit strategy implementation referrals referrals FTF-RC035-19-0609-00
o o o - o major for eligibility eligibility
Ill. a • Screen Screen

Nurse
for schedule Report Encounter Services Content Report
Report calendar Visitor Report Summary Visitor Report to Report & Date
Spent Due
Referral Outlook Home Enrollment Visit Home Quality Referrals Quality Time Report Forms
in
Visit schedule
Home
visit pregnancy
Daily Initial Per
232
Visitor Visitor Visitor of 38
Home Home Home Page
Nurse Nurse Nurse
screen usual and weeks visits, and and to quality and topic, pregnancy.
contacted to the visit, voluntary information. 2 planning interventions, education resources on behavior health each referring high coverage. anxiety, educational
be order offer of participant, questions every Visit-to-Visit client focused own on community to pregnancy. in
will in length and policy, then desires. in provide and her based culture, and access care hydration
eligibility referral indicated, visit. goals, nurse answer demographic weeks, client utilize guidance resources, relevant goals, relationship abilities promote child. and increase health depression, during promote
NFP receiving if then home of confidentiality reporting, 4 for as will for and family . needed and other coordination needs services, to and for Violence that promote
meet of and 1st program, Collect weekly or child Visitor Guidelines assessments, diverse Identify as therapeutic parent's protect that and identified affordable needed. parent services, screenings items to
that days Eligibility schedule the of responsibilities information, mandatory given. visits of Home quality, referrals in the to service as with care Partner client bottle
women working Risk and purpose of consent Home birth until Nurse Electronic possible high materials. and Engages promoting change well-being Provides parent's supports, resources, Works health Performs Intimate Provide water i.e.
Pregnant 2 within High program Explain schedule, releases participation, if enroll 1. 2. 3. 4. 5. 6. 7.
for visit
to
Enrollment Visit Visitor visits pregnancy helping
Referral and Home Home home by improve health. 1TF-RC035-19-0609-00
Contact Intake Initial Nurse delivers improve outcomes parent prenatal

file
Service in Report
Family Documents of Report Encounter Services Content
Review STAR Review Summary Visitor Report to Report & Spent Date Due
Chart Completed Goal and Documentation completed Assessment Chart Visit Home Quality Referrals Quality Time Report Forms
at and months 36 weeks, months in Phase
days six Pregnancy 8 Infancy 18 Schedule Toddler
90 every months, Visit &
Within least initial, weeks, 12 Per Infancy
232
Visitor Visitor Visitor of
39
Home Home Home Page
Nurse Nurse Nurse
on work promote 2 2 until visits, and read and topic,
every education resources to infant's physical in individual and
based and stress then monthly planning interventions, ability skills, promoting child of health, on educational sleep.
objectives Assessment, factors and weeks, then Visit-to-Visit in client provide their promote individuals child based parent services.
timeframes. Risks risk exercise, 6 for months, desires. utilize guidance resources, relevant goals, to cues; language emotional, network, nurturance positive with obtain promote safe
with plan & reduce diet, will for and family promote child and appropriate social and coordination works to that promote
goal and Strengths and healthy postpartum 21 is client as Visitor Guidelines assessments, diverse needed. to parent infant's attachment, regulation development. and promotes and providers items to
steps child or identify as to engaging family relationships and service needs, sleeper
individualized action complete recognize care, weekly until age of Home quality, referrals with respond and client blanket
to health Visits weeks years Nurse Electronic possible high materials. and Works and trust behavioral cognitive Promotes parent's healthy Assesses provides identified community Provide i.e.
Develop assessments, visit, 5th parent prenatal management. 1. 2. 3. 4. 5. 6.
By with
will to provide giving.
and Risk Visitor visits by care
Service & Home home child parent and FIT-RC035-19-0609-00
Family Plan Goal Strengths Assessment Nurse deliver improve development helping sensitive competent

Database Content
Report Services Content Visit Services
Screening to Report & & to Report
Quality Spent Spent
ASQ Sensory Referrals Quality Time Report Time Report Referrals Quality
24 & 6,12,18,24 of
18 years years
10, 4, at 2 & 2 &
at Visit Visit
ASQ:3 months ASQ:SE-2 months Hearing-I Vision-1 age. Every Every
232
Visitor Visitor Visitor of
40
Home Home Home Page
Nurse Nurse Nurse
hard to support child a be of visits, and
shares a navigation outcomes. education when services development to to literacy. with to and First to life pregnancy means education resources
provides for receiving medical parent talking and appropriate book Blocks activities book. a like a as planning interventions, client
screenings, provider, and and and children or on vision. to and age a family. library Child's make would promoting Visit-to-Visit in provide
referral services support Monitors already referred impact and strategies reading development share to Building every local your are to they child, employment utilize guidance resources, relevant goals,
sensory care provides of and child the of providing how of to on card. Language parent how the and goals. will for and family
and health provision guidance development. directly about hearing in provide importance language by teaching copy or Reader library a lessons-You Learning to envision and education, client's Visitor Guidelines assessments, diverse identify needed as
and parent, behaviors, be parent and reading to link a information obtain opportunity
developmental parents to tracks to should challenges - promote and child. to PIPE & parent themselves accomplishing Home quality, referrals
with results and anticipatory child due child Educate of Educate literacy to Promote books young Provide Becoming Provide how Utilize Teacher Offer Help for planning, Nurse Electronic possible high materials. and
Conducts results of copy services, Offers concerning screen signs evaluation. 1. 2. 3. 4. 5. 5. 7. 1. 2.
not or
& will to life-
Screenings & Visitor visits
Developmental Language Home home parental FTF-13C035-19-0609-00
Sensory Early Literacy Nurse deliver improve course.

Case Minutes database database
& Report
Meeting Meeting Access Access
Team Conference Team MCDPH MCDPH
case year pregnancy age of
monthly each of months
conferences times weeks 12
Twice Four 36 Child
232
Visitor Visitor Visitor of
Home Health Staff Home Supervisor Home Supervisor Page 41
Nurse Mental Consultant Outreach Nurse Nurse Nurse Nurse
other
Supervisor conferences dyads. other with event. review
infant and meet appropriate. and
Nurse case parent disorder to activities, other or as survey
with during mood families for event Policy
particular concerns. practice. for satisfaction making.
consultation Visitors perinatal community screening Service
Home for on health reflective opportunities the Food participant decision
Health Nurse needed in in presentations, FTF
Mental and as and Education behavioral Support Provide families Follow Provide future
for
1. 2.
Health Social Participant FTF-R0335-19-0609-00
Mental Consultation Family Connections Assess Satisfaction

chart
staffing, Documentation Case
Agenda Notes & Report Report Observation notes
meetings, work Supporting Reports invoices Meeting Supervision Meeting Conference Supervision Visit Supervision
team Data Team Joint Report
ongoing Will or weekly, hour month month
supervision, inform Task(s) dates of quarterly, 6 quarterly contract one 90 per 90 per
to etc.) Completed range (daily, annually) first for then supervision Conference twice meeting twice supervision month
individual feedback, Timeframe Be date, frequency monthly, Monthly months, throughout Monthly week each Case minutes Team minutes Field quarterly per Twice
(e.g. A 1:1
staff participant Roles 232 of
RN Home 42
administrative Person(s)/ Responsible Nurse Stoat Stoat, Nurse Nurse Page
surveys, TBH Supervisor Tracy Tracy TBH Supervisor TBH Visitor
and
staff, collection, fidelity, months, essential
line data activity model 6 compliance, and reflective with and nurse activities conferences, administrative
supervisors (e.g., the NFP first for SOP reporting outcomes and development supervision theories, the to staff professional
methods procedures complete for monthly contract data the essential supervisory case
CQI and to FTF and program administrative clinical of supervision, outreach facilitate
directors/managers, policies Task(s) actions subcontractor-SWHD throughout Evaluate professional visitors integration development specific supervision. and role the
etc.) current or steps compliance, responsibility, Supervisor facilitate through clinical field assistant and to
(CQI) program shadowing, and program of specific Monitor contract quarterly financial requirements. interventions Nurse and home nurse demonstrate professional role one-to-one and office supervision essential
Improvement including and implementation updating of set 1. then Provide supervision role the Provide reflection, facilitate visitor including meetings Provide reflective development
and 1. to 2. home team 3. &
Quality supervision observation program review work
of of
Continuous Staff reviews, Review Ongoing Activity unit strategy implementation FTF-RC035-19-0609-00
a a c major for Monitor Supervision Supervision Supervision
IV. a

Act Act Reports
Study Study Reports Report
Do, documentation Do, documentation Exception review
Plan, Plan, Data Fidelity Outcomes Reports Chart
quarterly needed
of as &
Minimum Quarterly Monthly Monthly
232
of
43
Nurse Supervisor Nurse Supervisor Nurse Consultant Nurse Supervisor Nurse Supervisor Page
TBH TBH NSO TBH TBH
year staff data phase input and staff plan of
each CQ1 monitor every are data other of to data guidance
with efforts share improvement interventions
project consult MCDPH at program achievement. accurate and assessment available and
Ql one and & model quality and reports reports; quality and
of Plan outcomes Office the to The interactions, outcome timely Penelope of ongoing compare education outcomes
minimum decision strategy and Service fidelity program. and ensure Penelope team for needs; continuing
and the client of interpret with implementation methods program
choose inform CQ1 performance National on implementation and utilization and
will to data MCDPH NFP quality throughout focused Oversee reports Read appropriately Ensure strategies. Develop development appropriate staff. Evaluate
on for and
Program Follow improve 1. 2. 3. 4. 5. 6.
1. based 2. to
FTF-RC035-19-0609-00
CQI CQI Review Review

and &
Councils, national Documentation database records
entities, agenda Access records in in sign
Partnership Supporting Meeting MCDPH sign Meeting
government FTF
Regional Will or dates weekly,
FTF tribal or Task(s) Completed of (daily, quarterly 6 first quarterly contract quarterly
partners, state range annually) for then of
grant initiatives, Timeframe Be date, frequency monthly, Monthly months, throughout Monthly Minimum
A
(FTF 232
system coalitions, of 44
Person(s)/Roles Responsible Voiles Nurse Stoat Nurse Health Educator/Outreach Nurse Page
childhood alliances Denise TBH Supervisor Tracy TBH Supervisor, TBH TBH Supervisor
activities) early based
applicable the of county etc.), activity information, The retention The to emergency on to and
following efforts: as part a or the coordinate outcomes resources. participant reporting. partners other report work increase planning
the to are that community communities, etc. complete to of exchange and data and and Visitation meetings, strategic
limited collaboration coordination, to SVVHD achievement to roles, increase and community healthcare monthly requested Home building, in
not of organizations non-profits, faith volunteers, Task(s) actions and outreach, to planning with meetings as with attending system engage
but implementation unit/team other entities, or steps Subcontractor, communication share together strategic coordinate coordination, FTF collaborate by outreach, and
(including across including meetings, professional consultants, specific with implementation frequent referrals, work in families. regional implementation to System shared retention
and partner partners, of will engage will care for Continue Coordination reporting.
Collaboration for organization, partners grant set Collaborate effective through discuss programs and programs facilitate services Attend program increase participant data
process organizations, 1. 2.
and the your external regional sub-grant work
Describe Within With FTF model With of strategy
Coordination • • • Activity unit implementation FTF-RC035-19-0609-00
o major for Collaborate Collaboration Collaboration
V. a

System Report
and trainings Nurse record database Screening database
log Visitation Referral emails, calls joint NFP in sign minutes minutes Access Report Access Services to Associate report Calendar In Sign
Referral WIC Home Coordinated log referral of Record conference meetings, Arizona Consultant Meeting Meeting review Chart MCDPH Referral Developmental Report MCDPH Referrals Business Agreement Referrals Outlook Meeting
with
quarterly quarterly quarterly quarterly quarterly
of of of of
Daily Minimum Minimum Minimum Minimum Minimum Yearly Monthly
232
Home Outreach of 45
Nurse Supervisor Nurse Supervisor Nurse Supervisor Nurse Supervisor Nurse Visitors Nurse Supervisor Nurse Supervisor Health Educator/ Nurse Supervisor Nurse Supervisor Page
TBH TBH TBH TBH TBH TBH TBH TBH TBH TBH
WIC agencies and Council by and how and Well
MCDPH by referrals. Southwest welfare roles information Program family with plan list, capacity, referrals group,
with System visiting with implementing child referrals, Prevention participation the of Communicate to contact services. for COI
Referral home with messaging, Intervention behalf Centers shared information, plans Families workgroup
collaborate WIC collaborate NFP discuss Abuse council on Resource a accessing Medicaid
to Coordinated all to other communicate Child dispersing and Early appropriate. quarterly. maintain share to to Strong clinical
continue for continue and information, quarterly. regional Arizona communicating as Family barriers AHCCCS in ACE
will Visitation intake will and with with education, families with services staff with together, meetings and with care participate workgroup,
NFP central NFP Development exchange least at to referrals, supervisory work quarterly process of to
MCDPH Home as MCDPH state. Coordinate to Coordinate supporting materials Coordination coordinating Coordination Coordination coordination Continue Visit
3. the & serving 4. Human the in 1. system resources 2. by and 3. making AzEIP 4. programs attend referral 5. 6. Child
Collaboration Collaboration Coordination Coordination Coordination Coordination Coordination Coordination FTF-RC035-19-0609-00

Calendar In
Sign
Outlook Meeting
Quarterly
232
RN of
46
Nurse Supervisor, Stoat, Page
TB!-! Tracy
Support
Family
Maricopa
in workgroup
participate
Sleep
to Safe
Continue
Alliance,
1.
FTF-RC035-19-0609-00
Network

Documentation Report Request
Data log assessment reports Reports Data Approvals
Supporting Completed Orientation Completed Penelope Penelope Completed Completed
form forms
Will or dates weekly, and
Task(s) Completed of (daily, quarterly, annually) 2018 recruitment tribal of
range 1st,
Timeframe Be date, frequency monthly, 8/1/2018 October to enrollment members
A Daily Daily Prior
232
Home Home of
Person(s)/Roles Responsible Voiles Nurse Nurse Nurse Nurse Assistant Voiles Stoat Page 47
Offices Denise TBH Supervisor T8H Visitor TBH Supervisor TBH Visitor Office Denise Tracy
National a as within and and by
and activity techniques collecting be tribe and
State the subcontractor-SWHO Requirements visits on must the policies as consents designated a
forms month from Policy include education
FTF, complete interviewing neutrality collected tribal parental as
to to for Reporting assessment previous members First Data may cultural
reports Task(s) actions form Data basic on and data from month Things Tribal appropriate approvals approval in classes
narrative or Report visitor confidentiality, complete enters data current enrolls First the tribal which participate
and steps Data Visitation home visit assistant All of day or all including all orientation
Evaluation data specific Home Visitors home visit. fifth recruits follow obtain appropriate to
and of applicable of monthly FTF nurse consistency, Home every the of by will authorities,
submission if set Create using template Educate Nurse at data Administrative week entered MCDPH they procedures applicable, obtain tribal requirement community
Reporting entry of 1 If
data and evalualon, work
Collection, Ongoing Reporting External of strategy Collected NFP to & from
Data Activity unit implementation Collection Collection Data entered Penelope Access Collection FTF-RC035-19-0609-00
0 o o major for MCDPH database
VI. a Data Data Client Data NSO Data Tribes

Quarterly
Reports
Data Completed Reports
Monthly Quarterly
232
Nurse of 48
Nurse Supervisor Supervisor Information Management Analyst Nurse Supervisor Page
TBH TBH
practice FTF
improve by
to required
reports as
PGMS
Penelope to
data
Utilize Enters
FTF
to
& reports
Reports data FTF-K035-19-0609-00
Run Report narrative Quarterly

FTF
Documentation to
spreadsheet notes notes notes Submitted modification FTF
to
Supporting Budget Invoice Supervision Supervision Supervision invoice Budget submitted
Will or weekly,
dates
Task(s) Completed of (daily, quarterly,
range annually)
Tirneframe Be date, frequency monthly, Monthly Monthly Monthly Monthly Monthly Monthly needed
A As
232
RN RN RN RN RN RN of 49
Person(s)/Roles Responsible Nurse Stoat, Nurse Stoat, Nurse Stoat, Nurse Sloat, Nurse Sloat, Sloat, Management Page
TBH Supervisor Tracy Accountant TBH Supervisor Tracy TBH Supervisor Tracy TBH Supervisor Tracy TBH Supervisor Tracy Tracy Information Analyst Accountant
of
activity use ensure the may
to with that needed
the appropriate invoices Nurse-Family contract issues as
complete agreements.
ensure and the national month incurred
to to budget to contract Partnership the costs modifications
Task(s) actions budget fidelity and for
or with FTF state, program costs for FTF budget
steps the subcontractor-SWHD funds and Nurse-Family local, of item to
monitor of compliance model of ability line invoice submit
specific use the &
Management of and informed sustain Reconcile Submit Prepare
set Prepare funds. Monitor appropriate Ensure Partnership Monitor agency. Be affect
and 1. 2. 3. I 2. 1.
Oversight budget work
of Reimbursements Modifications of
Financial Review Activity unit strategy implementation
o o o major for Budget Monitor Monitor Monitor Monitor Reimbursements Modifications FTF-RC035-19-0609-00
VII. a

FY19 Line-Item Budget
Budget period: July 1, 2018 — June 30, 2019
.: udget <..tegs Vne:Itero:170.riPtiOn: :Re : qua& t e d Funds': .::: Taal 'Cott .
PERSONNEL SERVICES Personnel Services Sub Tool •$10;:it4:
Salaries 0.25 FTE Supervisor $21,647
0.1 FTC Admin Assist $2,967
0.25 FTE Outreach Worker $9,396
1 FTC Nurse Home Visitor $75,494
EMPLOYEE RELATED EXPENSES Employee Related Expenses Sub Total $39,319
Fringe Benefits or Other ERE Variable 19,45% Fixed $11,856/FTE
PROFESSIONAL AND OUTSIDE SERVICES Profes0o & OutsideServicesSub $23,p10
Total
Contracted Services NSO Expansion plus Annual Fees $13,038
NHV Orientation Training $5,261
Nurse Supervisor Training $5,511
TRAVEI, : Tra Sub Total . $5,067
In-State Travel Mileage $2,137
Out-of-State Travel NSO Orientation and Training $2,930
AID TO ORGANIZATIONS OR INDIVIDUALS Aid to.Organbations'or Individuals Sub Total $146,971
Subgrants or subcontracts to Southwest Human Development 1.0 $146,971
organizations/agencies/entities . FTE NIHV
aniga OPERATING EXPENSES Other Operating Expenses b Total 59510
0 Telephones/Communications Services $975
• General Office Supplies $390
• Food $50
• Rent/Occupancy $1,495
• Printing/Copying $750
• Professional Development (Staff $600
Training, Conferences, Workshops,
Training Fees for Staff)
• Program Materials $1,050
• Program Supplies $200
NON-CAPITAL EQUIPMENT Non-CapitaSub Total $6,Z38
Equipment $4,999 or less in value Vision and Hearing Screening Equip $6,238
biota . Direct P!togr'Zni Casts: . _ $336A18 $336,418
ADMINISTRATIVE/INDIRECT COSTS Total Admin/ ride 18,944
Indirect/Admin Costs L $18,944
Total $355,363 $355,363
Authorized Signature •L-1" Date
FIT-RC035-19-0609-00 Page SO of 232

FY19 Budget Narrative- East Maricopa
The budget narrative should provide a clear and concise description of how amounts were determined, including
calculations, for each proposed line item in the Line-Item Budget. If a budget category does not apply, either leave
blank or delete the category.
Personnel Services: YR 1: $109,504.00
The salary rate for each position was determined according to MCDPH market range levels. Nurse salaries are
determined by YRs of nursing experience. Cost elements to implement Nurse Family Partnership (NFP) with
fidelity to the model were obtained directly from the Nurse Family Partnership National Service Office (NSO).
Costs were adjusted for local salary ranges, the required state mileage rate, and current training and material
costs. The budget reflects an estimated 2.5% increase in salary per YR.
Nurse Supervisor: TBD
The nurse supervisor will ensure effective program management and provide clinical supervision of the MCDPH
nurse home visitors and data entry staff. With an hourly rate of $41.47 x 2088 annual hours, 25% of which will be
charged to this grant for the 12-month grant cycle, or
YR 1: 21,647
Nurse Home Visitors (NHV) TBD
The NHV will provide home -based preventive Intervention with 25 young families/YR. The NHV will assess status,
teach, make referrals, and nurture the development of young parents across several domains of functioning, by
developing a therapeutic relationship, The NHV will be a bilingual Spanish speaker. YR 1 anticipates hiring savings
of one month's salary.
YR 1: with an hourly rate of $39,00 x 2088 annual hours x $0,30/hr bilingual pay, 92% of which will be charged to
this grant for the 12-month grant cycle, or $75,494
Data Entry/Admin Assistant: Hana Hehman
The data entry staff will provide efficient, accurate, and thorough entry of program and home visit data Into the
national web-based Penelope and will support the nursing staff by organizing and storing NFP materials and client
files. With an hourly rate of $14.21 x 2088 annual hours, 10% of which will be charged to this grant for the 12-
month grant cycle, or YR 1: $2,967 .
Outreach/Health Educator Specialist: TBD
The Outreach/Educator Specialist will provide referral sources and assistance to families needing resources for
education, legal, child support, housing, food and career issues. Services will include coordination of client
socializations and graduations, participation in the bi-weekly NFP team meeting and the bi-weekly case
conference, and outreach and collaboration with other agencies serving pregnant women and young mothers in
the East Maricopa Region. With an hourly rate of 18.00 x 2088 annual hours, 25% of which will be charged to this
grant for the 12-month grant cycle, or YR 1: $9,396
Employee Related Expenses: YR 1: $39,319
Variable of 19.45% of total salaries for Medicare, social security, unemployment, worker's compensation, long
term disability, life insurance, and Arizona State Retirement System.
YR 1: $21,298
Fixed Benefits are calculated $11,856.00 per 1 FTE, x 1.52 FTE's for medical and dental coverage
YR 1: $18,021
Professional and Outside Services: YR 1: $23,810
FTF-RC035-19-0609-00 Page 51 of 232

National Service Office Fees; The following costs assume the award of one FTF grant, however costs would be
split across regions should MCDPH be awarded multiple FTF grants.
Annual program support: Nurse-Family Partnership National Service Office contributes to covering costs
associated with the following resources and services: Data system (ETD) operation and use; Reporting- NFP
routinely provides reports to agencies through (ETO) and the NFP Reporting Portal via the NFP Community;
Ongoing Nurse-Family Partnership nurse home visitor, supervisor, and administrator education; resource library;
conference calls; web forums; Nurse-Family Partnership Community resources; and maintenance of Visit-to-Visit
Guidelines and supporting materials; Community outreach materials. Also provided are the NFP marketing and
communications resources and guidance and a copy of the NFP Public Awareness Video, as well as updates and
regular monthly communications from the N FP National Service Office; Policy and Government Affairs, including
advocacy and educational work at federal and state levels. $8088 of which 50% will be charged to this budget.
$4,044.00/ 12 month grant cycle
Annual Nurse Consultation Fee: Nurse Family Partnership contributes to covering costs associated with a Nurse-
Family Partnership Nurse Consultant providing the following support to supervisors: Monitoring reports based on
the supervisor and her/his team's activity and performance and providing support with quality improvement
initiatives; Structured, routine support for the supervisor in operations and clinical issues; Periodic visits to the
supervisor and NFP team. Clinical and supervisory coaching and consultation with the supervisor.
$5,820.00/ 12 month grant cycle
Supervisor Expansion: A one-time NSO fee to employ an additional supervisor 43,174.00
Supervisor Initial Education Tuition
The NFP model requires that supervisors complete Units One through Four of the Supervisor Initial Training in
addition to Units One, Two, and Three of the Nurse initial Education Training. It will be a priority to hire a nurse
supervisor with previous NFP experience, Supervisor Initial Education Tuition Units One through Four + Education
Materials = $5,511.00
Nurse Initial Education Tuition
Implementation of the NFP model requires that a NHV complete Units One, Two & Three training from the
National Service Office. The cast of training in the first YR includes: NHV Initial Education Tuition+ Education
Materials = $5,261. Budgeted each YR in case of staff turnover.
YR 1: $5,067
In State Mileage
This line item covers the nurse home visitors', outreach health educator, and nurse supervisor's travel related to
client visits and community outreach. The cost is calculated as:
$0.445 per mile x 300 miles/month x 1 NHV = $1,602/ 12 month grant cycle
$0.445 per mile x 25 miles/month x 1 Nurse Supervisor = $134/ 12 month grant cycle
$0.445 per mile x 75 miles/month x 1 Outreach Health Educator = $401/ 12 month grant cycle
YR 1: $2,137
Out of State Travel
All travel is in compliance with First Things First Travel Policies. Travel to Denver for Unit 2 of the Nurse Initial
Education Tuition, including air travel ($400), meals ($50/day x 5 days $250), lodging ($180/night x 4 nights =
$720), and ground travel ($95). Total = $1,465.00. Budgeted each YR in case of staff turnover. Travel to Denver
for Unit 4 of the Supervisor Initial Education Tuition, including air travel ($400), meals ($50/day x 5 days = $250),
lodging ($180/night x 4 nights = $720), and ground travel ($95). Total = $1,465.00. Unit 2 travel budgeted lx
each YR in case of staff turnover.
YR 1: $2,930
FTF-RC035-19-0609-00 Page 52 of 232

Aid to Organizations or Individuals: YR 1-4: $146,971/YR
MCDPH will partner with Southwest Human Development to implement NEP; SWHD will provide 1 ETE NHV to
implement the full scope of NFP services with 25 clients in this region. The annual cost for SWHD will provide
salary ($88,555), ERE ($23,910), travel and training $3813,Professional Development $974, NSO annual dues
($7492), telephone ($524), Internet ($874), postage ($150), graphics ($450), rent ($3,067), supplies ($125), food
for socializations ($100), programmatic materials ($2326), laptop ($1250) and indirect within the allowable rate,
10% ($13,361).
Other Operating Expenses: YR 1: $5510
Telephone/Communication Services:
Includes phones, adaptors, and chargers. Cell phones are an essential element of home visiting program to ensure
the safety of the nurse home visitor and outreach worker. $65.00 x 1.25 FTE x 12 months: $975/YR
Office Supplies;
Essential supplies such as materials for organizing and storing files, as well as client file folders, paper, pens. 1
nurse home visitors x 12 months: $390/YR
Food:
MCDPH will host 1 socialization event in the first YR, and 4 per YR in the following three YRs, @$50.00 per event:
YR 1: $50.00
Rent
Nurse Home Visitors and Outreach Worker will have access to cubicles at MCDPH as a primary workspace:
$99.65/month x 1.25 FTE x 12 months= $1,495/ YR
Printing/Copying:
Cost of printing handouts and program facilitators for clients.
25 families x $ 30/ 12 month grant cycle: $750/ YR
Professional Development:
Additional specialized professional development that individuals or the team may identify as a need, including
attending conferences and receiving the Dyadic Assessment of Naturalistic Caregiver-child Experiences (DANCE)
Education Program. All NFP nurse home visitors and supervisors are required to attend the DANCE Fundamentals
program after the first YR of work, which trains nurses to observe and provide parenting pathways that guide
interventions. After initial education, DANCE users must demonstrate proficiency to continue using the DANCE in
clinical practice. The annual recertification fee of $60/user covers an on-line proficiency evaluation, access to the
DANCE website, and unlimited use of the DANCE materials (after proficiency Is demonstrated) until the user's
licensing end date. Costs include: Annual conference costs (Prevent Child Abuse Az, FTF) for NHV, Outreach
Worker and Supervisor = $400.00 x 1.5 FTE = $600.00 /12 month grant cycle. YR 2 DANCE Fundamentals =
$780.00 x 1.25 FTE (NHV + 0.25 Nurse Supervisor) = $975. YRs 3-4 DANCE Recertification = $60.00 x 1.25 FTE =
$75/ 12 month grant cycle. Total: YR 1: $600
Program Educational Materials
Support materials for families and for nurse home visitors to assist in the work they are doing with families beyond
NFP and PIPE handouts. The NFP program uses materials to assist in removing barriers, improve health education,
and reward healthy behavior including: completion of home visits, prenatal care, post-partum care and well child
care, up-to-date immunizations, etc. Our program strategy is to pair an appropriate item with a home visit theme.
It is also important for nurses to demonstrate how to nurture a relationship by acknowledging births, birthdays,
successes, NFP graduation, etc. with cards, photos, books, and developmental toys. Program Educational
Materials will also include education materials used and distributed at socialization events. Home Visitation
Education Materials: $40.00 x 25 families: $1,050/ 12 month grant cycle.
FTF-RC035-19-0609-00 Page 53 of 232

YR 1 = $1,050
Program and Medical Supplies:
Items needed for home visiting nursing activities such as growth charts, disposable measuring tapes, scale cloths,
hand sanitizer, gloves, surfaces wipes, thermometer covers, nursing bags, baby dolls, etc. Supply cost estimate
as recommended by the National Service Office; $200.00/ NI-IV YR 1
Non-Capital Equipment: YR 1: $6238
Vision and Hearing Screening
A one-time purchase of equipment necessary to implement the Vision and Hearing Screening requirement.
Cost was determined by quotes obtained February 2018. It is anticipated that cost will be shared with other
program funding.
OAE + Accessories = ($4,655.16 4. $584.02) X 0,5= $2,620
Plusoptix + Accessories = ($6,441.69 + $794.50) x 0,5 = $3,618
Administrative/indirect Costs: YR 1: $ 18,944.73
Applicants must list either Option A or Option B and provide proper Justification for expenses included:
X Option B - Federally Approved Indirect Costs: If your agency/organization has a federally approved
indirect cost rate agreement in place, applicants may include an allocation for indirect costs for up to 10% of
the direct costs. Applicants must provide a copy of their federally approved indirect cost rate agreement.
MCDPH has an established federally approved indirect cost rate for Federal awards of 16.6%. MCDPH is
requesting an allocation for indirect cost of 10%, as allowed by First Things First. MCDPH will not bill indirect on
the Line Item: Aid to Organizations or Individuals,
Authorized Signature Date
FTP-RC035-19-0609-00 Page 54 of 232

PAGE INTENTIONALLY LEFT BLANK
FTF-RC035-19-0609-00 Page 55 of 232

Funding Sources and Financial Controls
A. Funding Sources. In the following table, identify other funding/resources (including federal, state,
local and private funding) that the agency/organization will leverage to achieve the objectives of the
proposed program. First Things First (FTF) funding can be used to enhance or expand the program
funded by these additional funds, but FTF funding cannot supplant or be used to replace any existing
state or federal funding for early childhood development and health programs.
B.
Type of Funding (federal,
state, local, private) and Brief Description of How the Funding Helps Achieve the
Amount
Agency/Organization Program Objectives
Received From:
Federal, HRSA, Maternal This funding provides existing Nurse-Family
Infant Early Childhood Partnership infrastructure and programming on
Home Visitation which to expand into full FTF Regions. $1,570,496
1Total:
$1,570,496
C. Financial Controls.
Successful applicants will be expected to follow generally accepted accounting principles and be
consistent with policies, regulations, and procedures that apply uniformly to all costs charged and
expended by their agency/organization - across all funding sources.
Describe the financial controls and accountability measures the agency/organization will employ for
the use of FTF funding for the proposed program.
Maricopa County Department of Public Health (MCDPH) will use a centralized accounting
system to maintain its fiscal integrity through several levels
(Program/Division/Department/County) of financial controls and accountability measures.
MCDPH's Finance and Budget process starts at the program level, using the Maricopa County
(MC) Chart of Accounts. The program accounting specialist will conduct the program's financial
processing throughout the grant period, ensuring proper account classification and adequate
documentation for all expenditures. At the Division level, MCDPH will provide a Division
Accountant to monitor all program financial activity and to facilitate Reimbursement Request
Report submissions. Then, at the Department level, the Accounts Payable/Receivable and
FTF-RC035-19-0609-00 Page 56 of 232

Procurement units will process, review, and monitor all financial requests provided by the
program accounting specialist, The MCDPH Finance Manager conducts monthly meetings with
the Finance and Budget staff to review the program budget expenditures and its projections.
Finally, at the County level, the MC Finance Department will process issuance and receipts of
all payments. Throughout this entire accounting system, based on Generally Accepted
Accounting Principles (GAAP), there are several checks and balances. Before posting to MC's
financial system, all procurement and financial transactions undergo, at a minimum, 3 levels of
reviews and approvals, to ensure fiscal compliance as defined in provisions of the grant
agreement, MC policies and guidelines and State and Federal laws and regulations.
Authorized Signature Date
FTF-RC035-19-0609-00 Page 57 of 232

Program Evaluation
An evaluation study is a project that is conducted in order to answer questions about the services you
provide. There are several types of evaluations that can be conducted, including the following that are
most relevant in relation to program implementation:
• Process/implementation evaluation: Determines whether program activities have been
implemented as intended. This type of evaluation examines if the program is implemented
with fidelity.
• Outcome/effectiveness evaluation: Measures program effects in the target population by
assessing the progress in the outcomes or outcome objectives, which the program is supposed to
achieve. This type of evaluation examines if the program is achieving these intended
outcome(s).
Refer to the Types of Evaluation brochure created by the Centers for Disease Control and Prevention
(CDC) for additional information on program evaluations:
https://www.cdc.govistd/Program/pupestd/Types%20of%20Evaluation.pdf
The following questions are about whether your organization has or is planning to conduct an
evaluation study (with or without funding from First Things First).
A. Has an evaluation study been conducted on your program? (e.g., process evaluation, outcome or
impact evaluation study)? 0 Yes X No
If YES, include:
- One (1) copy of the evaluation report (if available) with your original application.
- A brief synopsis of the study's specific aims and results:
B. Are you planning on having an evaluation study conducted on the program proposed in this
application? 0 Yes XNo
If YES, please go to C. If No, stop here.
C. Will FTF funds be utilized to conduct the evaluation study?
0 Yes (Yes, funds are budgeted in the line-item budget and budget narrative for an evaluation study.)
0 No (No, we will be using other sources of funding for an evaluation study)
If YES, provide detailed responses to each of the following items: ** If No, stop here.
1. Purpose, Intended Outcomes, and Research Questions
FTF-RC035-19-0609-00 Page 58 of 232

2. Methodology and Design
3. Proposed Timeline and Party Responsible (e.g., external vendor/contractor or grant partner
program staff) to carry out the work
4. Intended Use of Findings and Dissemination Plan
if FTF funds are being requested for an evaluation study, the study will need approval by FTF's Research and
Evaluation team prior to implementation. Specifically, the applicant will be required to provide FTF with a
detailed summary of the work proposed (Refer to the Ownership of Intellectual Property section under the Grant
Terms and Conditions in this RFGA.) In those instances when the evaluation proposal is in its preliminary stages
and therefore lacks sufficient detail at the time of submission (e.g., Applicant is planning to get a vendor to
determine the method and design etc.), the grant partner will be required to submit a detailed study proposal
when it becomes available. This study proposal is subject to approval by FTF's Research and Evaluation division.
** If the data collection requirements or proposed evaluation will include data from a tribal community (e.g., data
gathering in tribal lands), appropriate tribal approvals must be in place prior to commencing data collection. In
instances when tribal data approvals are necessary, FTF's Research and Evaluation and Tribal Affairs divisions will
work with the grant partner to secure approvals from the tribe(s). (Refer to the Tribal Data Policy and the
Ownership of Intellectual Property sections under the Grant Terms and Conditions in this RFGA).
In instances when data gathering occurs in tribal lands, the applicant shall address how they will ensure a
culturally appropriate methodology (e.g., in- person interviews), and culturally responsive interaction with
participants and other stakeholders.
FTE-RC035-19-0609-00 Page 59 of 232

Agency/Organization Profile
A. Grantee Information:
Agency/Organization: Maricopa County through its Dept of Public Health Contact Person: Denise Voiles
Address 4041 N Central Avenue, Suite 1400 Position Nurse Supervisor
Address Email DeniseVoilesPmail.maricopa,gov
City, State, Zip Phoenix, AZ 85012
Phone (602) 506-6896 Ext County Maricopa
Employer Identification Number (FIN): 86-6000472
Agency Classification: State Agency X County Government Local Government Schools
Tribal Faith Based Non Profit Charitable Private Organization Other
Have you conducted business with First Things First using this EIN within the last year? X Yes No
if not or if there has been address or EIN changes, please go to
https://gao.az.gov/sites/default/files/GAO-W-9 072815-S%26S%26A.pdf
and download the State of Arizona Substitute W-9 Form, and submit with your application.
Congressional district (federal) in which agency provides most services: District # 4
Legislative district (state) in which agency provides most services: District # 15
Go to htto://www.azredistrictina.ora and click on Final Maps to
identify your congressional and legislative district.
Approximate federal funding (from a federal source) to be received in current fiscal year? $ 29,458,806
Agency's fiscal year-end date: June 30, 2018
Agency's accounting method: Cash X Accrual
Does your organization undergo an annual independent audit in accordance with 2 CFR Part 200, Subpart F?
(Attachment G, for original only) X Y
Contact information for firm conducting agency audit:
Audit firm: State of Arizona, Office of the Auditor General
Address: 2910 N 44th Street, Ste 410, Phoenix, AZ 85018
Phone: (602) 553-0333
FTF-RC035-19-0609-00 Page 60 of 232

B. Program Summary:
Program Name: N/A
(The specific name of the program if different from the name of the strategy, organization, or model, if none, then enter N/A)
Program Model: Nurse -Family Partnership
(The specific name of the program model that has been proposed. If none, then enter N/A)
Geographic Area and/or Target Population: East Maricopa Region; prioritize low-income, first-time pregnant
women who are in the high poverty/high needs geographic area of Chandler, Guadalupe, South Scottsdale and
Tempe, and who have one or more of the following high risk factors: poverty, at risk or history of abuse and neglect,
maternal depression, parental substance abuse, parental incarceration, and poor relationships with caregivers, food
or housing insecurity, reliable support system, and teens.
Brief Program Description (250 words or less):
Maricopa County Department of Public Health (MCDPH) in collaboration with Southwest
Human Development proposes to expand implementation of the Nurse-Family Partnership
(NFP) program to all zip codes of the First Things First (FTF) East Maricopa Region with the
addition of two Nurse Home Visitors (NHV) who will provide intensive family support to 50
high risk pregnant women. In addition, age-appropriate developmental and sensory
screenings will be provided to 50 children of enrolled families throughout the first 2 years of
their life. The Nurse-Family Partnership model utilizes a two-generational approach with
first-time mothers and their infants, identifying both mother and child as clients, working to
meet the needs of the family holistically through education, support and care in order to
promote a healthy pregnancy, responsible and competent parenting, and economic self-
sufficiency. By instilling confidence and empowering the mother to achieve a better life for
her children and herself, NFPis outcomes include long-term family improvements in child
health and development, school readiness, reducing incidence of child maltreatment, and
economic self-sufficiency.
Strategy and Proposed Service Units
Primary Strategy:
Home Visitation
Number of families served: 50
Secondary Strategy:
Developmental and Sensory Screening
Number of children served: 50
FTF-RC035-19-0609-00 Page 61 of 232

C Contact information:
The First Things First Partner Grant Management System (IDGMS) has four contact slots per contract. The same
person may be assigned to more than one slot.
Main Contact: is responsible for the overall program and will have access to all financial, programmatic, and
data reports in PGMS.
Program Contact: is responsible for program implementation and will have access to the program and data
reports in PGMS.
Finance Contact: is responsible for the submission of reimbursement requests through PGMS and will have
access to budget and reimbursement information in PGMS.
Evaluation Contact: is responsible for the program evaluation and data collection activities and will have access
to the data reports in PGMS.
PGMS Contacts
Name: Email:
Main Contact Denise Voiles denisevolles@mail.maricopa.gov
Title/Position: Phone:
Nurse Supervisor 602-506-6782
Physical Address (if different than the agency address):
same
Name: Email:
Program Contact Denise Voiles clenisevoiles@mail.maricopa.gov
Title/Position: Phone:
Nurse Supervisor 602-506-6782
Physical Address (if different than the agency address):
Name: Email:
Finance Contact Betty Harroun elizabethharroun@mail.maricopa.gov
Title/Position: Phone:
Business Management Analyst 602-506-6379
Physical Address (if different than the agency address):
Name: Email:
Evaluation Contact Denise Voiles denisevoiles@mail.maricopa.gov
Title/Position: Phone:
Nurse Supervisor 602-506-6782
Physical Address (if different than the agency address):
FTF-RC035-19-0609-00 Page 62 of 232