RFGA RE HOME VISITN SE MARICOPA WITH AECDHB FTF.PDF

M FIRST THINGS FIRST
4000 North Central Avenue, Suite 800, Phoenix, Ari2ona 85012
€02,77.1,5100 877,803.7234 azftf,gov
Chair May 21, 2018 TRANSMITTED BY EMAIL
Nadine Mathis Basha
Vice chair Ms, Denise Voiles
Gerald Szostak Maricopa County Department of Public Health
4041 N. Central Ave., Suite 1400
Members Phoenix, Arizona 85012
Gayle Burns denisevoilesPmail.maricooa,eqv
Amelia Flores
Rev. Dr. Darren Hawkins RE: Request for Grant Applications (RFGA) FTF-RC011-19-0612-00
Dr, Sherry Markel Contract number: FTF-RC011-19-0612-04
Heidi Quinlan
Ruth Solomon Dear Ms. Voiles:
Helena Whitney
Your Home Visitation application for the Southeast Maricopa Regional Partnership
Ex-Officio Members 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, 2018
through June 30, 2019 and the amount of the grant award is $217,830.
Michael Trailor
Director, DES Additionally, pursuant to the insurance requirements contained in the Uniform
Terms and Conditions in the RFGA, it is your responsibility to ensure that all
Dr. Cara Christ required coverage, in the types and amounts stated, shall be maintained in full
Director, DHS force and effect during the term of this contract and shall not serve to limit any
liabilities or any other contractor obligations. The applicable certificate of
Chief Executive Officer insurance must be submitted to this office, to my attention no later than July 15,
Marilee Dal Pra 2018, Please include the contract number in the description section 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
cornmur tf. ov 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 imartin@azftf,gov.
Sincerely,
geacige 1italed4
Jeanne Martin
Procurement Specialist
R EADV FOR SCHOOL. SET FOR L1FL

C-86-18 ATTACHED TO AND A PART OF
Arizona Early Childhood Development and Health Board
First Things First (FTF)
Request for Grant Application (RFGA)
FTF-RC011-19-0612-00
Contract Number: FTF RC011-19-0612-04
Home Visitation (Nurse Family Parnership)
Southeast Maricopa Region
IN WITNESS WHEREOF, the parties agree to enter into this RFGA 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

Gran
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-RC011-19-0612-00 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 20 th 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
2nd Quarter (October 1 - December 31) Due: January 20
3rd 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 grants@azfttgov 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-RC011-19-0612-00 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. §§ 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. § 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. § 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 PG MS. 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-RC011-19-0612-00 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-RC011-19-0612-00 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 local 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 lndemnitee 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-RC011-19-0612-00 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-RC011-19-0612-00 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-RC011-19-0612-00 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@azftf.gov .
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-RC011-19-0612-00 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-RC011-19-0612-00 T&C Page 9 of 9

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 Grnqkgreement, 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: j602) 506-6782
86-6000472 E-Mail: DeniseVoiles@mail.maricocia.Rov
APPLICANT ASSURANCES
Author*zed Official to initial the following
GE AL
To adhere to the most current version of the Conditions. Copies of this document are available by
Standards of Practice documents (available at 0, emailing grartw@agtf,gov. .
ht9://www.fiestthing5f r -
toolkit) To accept funds and administer the programs in
ii 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.
4,271"5To maintain internal controls, including policies and
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-RC011-19-0612-00 Page 2 of 227

--21, .0•1 To maintain documentation for employees working
To follow established personnel policies related
across multiple funding sources to ensure the amount
to salary scales, fringe benefits, and travel
of time charged to each employee does not exceed
reimbursement.
00%.
77,
To use generally accepted accounting principles
To have fiscal control and fund accounting procedures
IGAAP),
*2 in place to ensure proper disbursement of and
4
To perform required financial and compliance accounting for any funds paid to subcontractors.
audits in accordance with federal law and /9
TH HHHHHini HirAHHHHH HH EpHrrttHILH Hill HHHHiy, if
guidelines, including the Single Audit Act and 2
an employer.
CFR Part 200.
47; To maintain a system of contract administration to
ensure conformance with the Grant Terms and
Conditions.
MAT IC
To consult with FIT in the planning of public
To use proven, effective and/or evidence based
awareness/marketing strategies such as websites,
programs.
advertising or media campaigns.
To maintain the personnel qualifications outlined
EVALUATION
in the Standards of Practice with subsequent
hires. Ofc /2 To provide regular and timely reporting and to
participate in all pertinent First Things First research
/ To comply with any applicable federal, state, and
nd evaluation efforts.
local health and safety requirements that apply
to the facilities used for a program. If an evaluation study has been conducted on the
proposed program, a copy of the evaluation report (if
W To actively participate in the Quality Assurance
available) will be submitted to First Things First.
S process, including assessments,
AO if funds are being requested to conduct an evaluation
To coordinate, to the extent possible, with other study, approval by First Things First Research and
programs in the same geographic area that serve
Evaluation team will be obtained prior to
similar target populations.
implementation.
To coordinate with First Things First during the
If the evaluation study will include a tribal
length of the program period.
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 FTFH 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.
tg-o4
This grant shall henceforth be referred to as Grant No,
Arizona Early Childhopid Developmentdnd Health B
Awarded this LIA V tri , 20 1
i.st Authorized Designee
FTE-RC011-19-0612-00 Page 3 of 221

Application Cover Sheet
From: MARICOPA COUNTY
RFGA Number: FTF-RC011-19-0612-00
Strategy: HOME VISITATION
(SOUTHEAST MARICOPA)
Requested Amount: $217,830
FTF-RC011-19-0612-00 Page 1 of 227

FTF-RC011 -19-0612-00
HOME VISITATION
SE 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..— 8-26
SECTION D — Personnel - Program Personnel Table and ... 27-28
Program Organizational Chart 29
SECTION E — Implementation Plan 30-47
SECTION F — Line-Item Budget and 48
Budget Narrative 49-53
SECTION G — Fiscal Information - Funding Sources and Controls... 54-55
SECTION H — Program Evaluation Information — Program Evaluation and 56-57
Profile - Agency/Organization Profile 58-60
ATTACHMENT A — NFP National Service Office Implementation Agreement 61-89
ATTACHMENT B — Program Implementation Instruments and Tools .. 90-148
ATTACHMENT C - Home Visitation SFY19 FTF Data Reporting Requirements 149-165
ATTACHMENT D — Request for Grant Application Amendment (For Original
Copy) 166-167
ATTACHMENT E — Public Health Grants Indirect Cost Plan FY17-18 (For Original
Copy) 168-174
ATTACHMENT F— Single Audit Rep, Maricopa County, Year Ended June 30, 2016
(For Original Copy) 175-226
FTF-RC011-19-0612-00 Page 4 of 227

Maricopa County Department of Public Health (MCDPH) will provide Nurse-Family Partnership
(NFP) home visitation services to twenty-five (25) low-income, first-time pregnant women in all
zip codes of the Southeast 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 have one or more of the following high risk
factors: a personal or family history of substance misuse/abuse, history of food or housing
insecurity, absence of co-parent or reliable support system, teen-aged or family at risk for child
abuse and neglect. In addition, age-appropriate developmental and sensory screenings will be
provided to 25 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 parts of the Southeast Region since 2013 with funding from Maternal Infant
Early Childhood Home Visitation (MIECHV). However, MIECHV funding does not cover the
following zip codes: 85215, 85233, 85234, 85295, 85296, 85297, 85298 and the Southeast Region
has consistently shown a higher demand for NFP services than our current funding can
accommodate. The two current NHV is this area both have full case loads of 25 clients.
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 Southeast
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-RC011-19-0612-00 Page 5 of 227

1.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 Southeast Region since 2013 with funding from Maternal Infant
Early Childhood Home Visitation (MIECHV). However, MIECHV funding does not cover the
following zip codes: 85215, 85233, 85234, 85295, 85296, 85297, 85298 and the Southeast Region
has consistently shown a higher demand for NFP services than our current funding can
accommodate. The two current NHV is this area both have full case loads of 25 clients. In the
past twelve months NFP has forwarded 29 NFP eligible referrals from the SE region to Parents
Partners Plus because of either full caseloads or the client lived in one of the seven zip codes not
funded by M1ECHV. 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.
11. A. 1. a. MCDPH NIP 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.
FTF-RC011-19-0612-00 Page 6 of 227

ILA. Lb. 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
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 NIP 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
FTF-RC011-19-0612-00 Page 7 of 227

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 provides technical support for grant subcontracts (ie: Intergovernmental
Agreements with MINS) 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 expand implementation
of the Nurse-Family Partnership (NFP) program to all zip codes of the First Things First (FTF)
Southeast Region with the addition of one Nurse Home Visitor (NHV) who will provide intensive
family support to 25 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 NIP
model fidelity.
Priority for outreach and recruitment will target first time pregnant women who are: low income,
have a personal or family history of substance misuse or abuse, history of food and or housing
insecurity, teen-aged or family at risk for abuse and neglect. Eligibility at intake will be
determined based on the NIP model eligibility requirements and a high risk assessment checklist
completed by the NHV. 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
FTF-RC011-19-0612-00 Page 8 of 227

assessments, gathering baseline information and updating it regularly throughout the duration of
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: 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 NIP. 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 NIP
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 supervision practice 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 NIP
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
FTF-RC011-19-0612-00 Page 9 of 227

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, 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
FIT-RC011-19-0612-00 Page 10 of 227

week, and occur throughout the pregnancy and the first two years of her child's life (length of
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 N FP
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 Report400%. (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 NEP 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
FIT-RCD11-19-0612-00 Page 11 of 227

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
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 NIP 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, assisted by a mental health consultant. The NFP supervisor
has a set schedule of weekly one to one supervisions with each NF-IV. 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.
FTF-RC011-19-0612-00 Page 12 of 227

(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 plan for the CAB 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 NIP
for 8.5 years and three additional NHVs have been with NFP for 5.5 years.
1.8.2. MCDPH and the NFP National Service Office have had an Implementation Agreement
(Attachment A) in effect since 2009. The current Agreement is due to for renewal October 31,
2018.
FTF-RC011-19-0612-00 Page 13 of 227

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
NFP 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 1st-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
months of age & as for the children in the program
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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 1st 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 rd 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 1st 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 violence.
Strengths and 3 rd or 4th home visit Assesses parent's strengths & risks, and aids
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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
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program, not all children are
regularly provided routine and high quality sensory screenings.
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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 2"
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 proposes to build and maintain a caseload of 25 low-income, first-time
pregnant women, prioritizing those who have one or more of the following high risk factors: a
personal or family history of substance misuse and abuse, history of food or housing insecurity,
absence of co-parent or reliable support system, teen-aged or family at risk for abuse/ neglect.
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 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
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funding to expand NFP by one NHV, 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 Southeast Region since 2013 with funding from
Maternal Infant Early Childhood Home Visitation (MIECHV). However, MIECHV funding does not
cover the following zip codes: 85215, 85233, 85234, 85295, 85296, 85297, 85298 and the
Southeast Region has consistently shown a higher demand for NFP services than our current
funding can accommodate. In the past twelve months NFP has forwarded 29 NFP eligible
referrals from the SE region to Parents Partners Plus because of either full caseloads or the client
lived in one of the seven zip codes not funded by MIECHV.
As demonstrated by the overflow of NFP eligible referrals in the region, MCDPH has established
successful recruitment strategies in the Southeast Maricopa Region. Examples of three successful
strategies are: 1) MCDPH NFP co-locates office space at the Arizona Associates for Women's
Health, Mesa 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 NHV
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.
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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.C2. 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 SE Maricopa Region for four 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 NIP 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, which leverages our program's ability to provide relationship continuity and
trust building, an essential component when working with hard to reach populations.
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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, NIP 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 twenty-five (25) low-income, first-time pregnant women, prioritizing those
who have one or more of the following high risk factors: a personal or family history of substance
misuse/abuse, history of food and/or housing insecurity, absence of co-parent or reliable support
system, teen-aged and/or family at risk for abuse/ neglect in the SE Maricopa Region. In addition,
age-appropriate developmental and sensory screenings will be provided to 25 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. MCDPH will not be utilizing sub-contractors in the implementation of the grant.
I.E. MCDPH NIP 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
FTF-RC011-19-0612-00 Page 20 of 227

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
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.
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Coordination with Strong Families CCII 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.
I.E.].. 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
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. NFP 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.
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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 NFP 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 Cal process, MCDPH utilizes the Standards of Quality for
Family Strengthening and Support (https://www.nationalfannilysupportnetwork.orastandards-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. (Attachment C)
II. Staffing/Personnel
II. A. Complete the Program Organization Chart (Section D - Personnel)
II. 13.1. 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 hinders 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
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instrumental in the recruitment, selection and training a new Nurse Supervisor to assist with this
expansion.
II.B.2 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, NH'!,
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 IBCLC 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
opportunities for coordination, AHCCCS health coverage, Parent Partners Plus, Continuous Quality
Improvement, Cultural Responsiveness and mandated reporting.
IL 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
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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
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
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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-RC011-19-0612-00 Page 26 of 227

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
N ame/
(include qualifications that align with Key Roles and Responsibilities through the
Position Title
the Standards of Practice) program
TBH/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 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-RC011-19-0612-00 Page 27 of 227

Hana 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 Personnel - 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
FTF-RC011-19-0612-00 Page 28 of 227

Program Organization Chart
Include a Program Organization Chart that represents all personnel involved in program implementation -
those that are fully or partially funded through the program and those that are provided in-kind to support
some aspect of the program. The chart should illustrate administrative, supervisory, financial, and data
collecting/reporting positions - and should differentiate between the funded and in-kind positions in some
manner, such as a different background color in the chart. If subcontracting with an agency - list the agency
(preferably in another color); the total number of positions involved in program implementation; and
identify who has supervisory oversight of the subcontractor.
Example:
FTF-RC011-19-0612-00 Page 29 of 227

of
the the level or professional Documentation tracking
fulfill include a
ensure include continuous descriptions posting database acceptance
to and should ongoing Supporting process
program to align plan should ongoing, and Job Job HR Job
that completed as initial Will or dates weekly, of
proposed program implementation such Task(s) of quarterly, award 9/1/18
the be will Terms orientation, Completed range (daily, annually) upon by
of proposed the population. task etc.) Timeframe Be date, frequency monthly, Initiated Completed
time, target the needed. including A grant;
implementation the of first date quarterly, as 227
the the to the rows staff) RN of
for operations for Note: bi-monthly, support Person(s)/Roles Responsible Voiles, RN Manager) 30
timelines delivery plan. additional Nurse Supervisor) Stoat, Page
and implemented service the 2019 Denise (NFP Tracy (Nurse
and activities in weekly, Plan 30, Add administrative
tasks, be will of onset addressed (e.g. —June activities. tools. implementation Visitor
day-to-day the place Implementation 2018 and and activity Home
activities, program for be take 1. service the
the must July - following assessments program Nurse Educator
the proposed timelines will the direct complete for
define demonstrates components activity to for to HR Health
and the if anticipated the limited (supervisors, curriculum, procedures Task(s) actions to initiated
identify Plan Work. following often not on or descriptions Supervisor, reviewed conducted
to of the and the how but staff all training and steps job Nurse requisitions
is Plan Implementation Scope for and including of policies specific posted Applications interviews
and/or start-up when training and of assignments Submit (NHV), Job Job Hiring
for timelines - and of set 1. 2. 3. 4. 5. 6.
Implementation The Practice required and demonstrates Infrastructure certifications, staff
acceptable. hiring development/updating of
the implementation. of activities work
of Standards activities that not Recruitment, development, Determination of
purpose applicable specificity are met Organizational The Activity unit strategy implementation FTF-RC011-19-0612-00
effective strategy additional until o o o major for Recruitment
The All of I. a

file on issued
Orientation successfully developmental Fingerprint when successfully
Procedures System completed and Cord sensory training
& Policies Completed Checklist Certifications completed training Tracker of application clearance Certification completed screening
NFP Copy
8/1/18 by Trainer 5 every
by annually Vision Master with
Completed Updated 10/1/18 & Hearing Arizona 10/1/18 recertification years
227
of 31
Voiles, Sloat Voiles Stoat Voiles Stoat Page
Denise Tracy Denise Tracy Denise Tracy
FTF & A Submit
reflect complete Procedures, Appropriate Learning Developmental Families: model g Near clearance
to Employee & Food Educator Developmental Early NFP ACES training. Educator Educator screening
Procedures for: Collaboration Connections Educator New Policies Linguistically Home Safety, Health Arizona SOP, Strengthening complete: Health fingerprint Health sensory
& Procedures & Health MCDPH Program COI, Work and Toddler to Visitation Framework. ASQ:SE-2, Caregiving and and vision
Policies & Social Supervisor, and & Report, Supervisor & Introduction SOP, Supervisor 3, ASQ: to Keys Supervisor valid Supervisor &
current Policies Coordination Family Inclusiveness County review Culturally to Duty Infant AZ Home Screening Factors 1, for hearing
requirements. Nurse Visitation/Community Expenditures Nurse Nurse Unit NCAST Nurse application Nurse
Update- Develop • • • NHV, Maricopa Orientation, including Services, NHV, complete Guidelines, Standards, Sensory Protective & NHV training Home, NHV, card. NHV, complete training
1. 2. 1. 2. 3. 4.
Procedures Orientation
& & FTF-RC011-19-0612-00
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
227
Voiles of 32
Voiles Sloat Voiles Stoat Supervisor Stoat Nurse Supervisor Page
Denise Tracy Denise Tracy Nurse Denise Tracy TRH
employment in October NHV's target with MlECHV
Childhood Protective training NFP on region by full. are
Educator Early Educator A Two-Generational Family Educator SOP Denver, experienced based in area served
Health transcripts, Health for Health Screening delivery Supervisor in 2 NI-IV caseloads
and Arizona and Families: Quality and service Unit with to service currently
the in submit profile. and of Support Sensory completes 2018 NSO clients referrals not MIECHV
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 15-19, NI-IV Supervisor population priority funded
1. 2. 3. 4. 1.
Orientation Orientation
& & Assignment FTF-RC011-19-0612-00
Training Training Training Training Staff

Form
Documentation Referral approval
Collateral NFP notice
FTF form
Supporting Updated materials Updated Written Approval Order
httpl/www.firstthingsfirst.org/grants/grantee- Will or
dates weekly,
Task(s) Completed of (doily, quarterly,
activities) eframe range annually)
Tim Be date, frequency monthly, 8/1/18 8/1/18
following A
Guide, 227
the of 33
to Branding Person(s)/Roles Responsible Voiles Voiles Page
limited
not FTF to served Denise Denise
but (refer be to the
(including etc. activity in to zip for
flyers population codes campaign codes eligible items
area link) the zip zip materials Coordinated
brochures, same target complete eligible marketing eligible materials NFP of funding promotional
geographic - to to & collateral Visitation FTF community,
and materials Guide, activities outreach Task(s) actions additional national NFP collateral extension to due FTF to in
Branding outreach of or of branding and of Home of region approval marketing approved
population collateral partners steps N50 facilitate FTF forms to System the
FTF NFP to of Approval in for when
target of to targeted with specific Notify region Addition referral FTF Notification Referral codes Submit program Order
the approval (refer of of
to releases alignment set 1. 2. 3. 4. 1. 2.
and
Marketing news implementation and
and development and work
resources) and Coordination of strategy
Outreach The Media Plan Activity unit implementation FTF-RC011-19-0612-00
o o o o major for Marketing Outreach
II. a

from System from System
Quarterly Meetings & to Referral Database Database Log & to Referral Database
at Referral Visitation Referrals Referral Visitation
Attendance Coordination of Log Home Coordinated Outreach Outreach WIC of Log Home Coordinated Outreach
outreach
Monthly 8/1/18 Daily Monthly Weekly
227
of
Voiles, Educator Voiles Educator Educator Educator Page 34
Denise Nurse TRH Supervisor Health Denise Health Health Health
participant of utilization of in health crisis in codes all to the in for and page date, people
and programs, reporting of plans codes. sources centers, centers, pantries, zip with referring clinics material System, Facebook of referrals
Visitation increase outreach development and care zip health organizations, food assistance area collaborate on WIC marketing Referral WIC including number as
Home to shared the visiting efforts, and data Health area referral resource based homes, service to staff visiting on ads activities activity, well
with System in support home planning collection and service potential family community faith Place emergency additional continue WIC programs, distributing Coordinated media of as source
Referral participate efforts, of list strategic for information Medicaid eligible and offices, schools, centers, Maggie's hospitals, of ) will training by social outreach type database each
cooperatively contact in forms Arizona NFP current (DES NFP WIC visitation monthly, Visitation NFP all target, NFP in from
Work Coordinated enrollment, recruitment shared engage shared required Notify additional Notify region providers, pregnancy MOMobile, Goodwill, organizations region the MCDPH MCDPH home region Home posting regularly Document outreach reached received
of
3. 4. 5. 6. 7.
FTF-RC011-19-0612-00
Outreach Outreach Outreach Outreach Outreach

occur) Documentation Home
to are population to Coordinated
they Report referrals System
when target and Supporting Referral of Visitation Referral
Log
and
often strategy Will or weekly, 7/1/18
(how of type Task(s) Completed dates of quarterly, on
Work by range (daily, annually) starting
of Timeframe Be date, frequency monthly,
Scope determined A Daily
and/or as 227 of
services 35
Practice of Person(s)/Roles Responsible Administrative Voiles Nurse Page
of Assistant Denise TBH Supervisor
Standards discontinuation
activities) applicable the in or activity WIC? for Visitation
as required etc. completion the eligible Home
following surveys, complete income pregnant? to
the (Frequency/duration) processes, activities e.g., - to area? by mother? weeks Visitor refer System
to limited referral and assessments, service Task(s) actions service defined 28 Home eligible
not and elements the or steps Eligibility: the as time first than Nurse not Referral
but occur screenings, ending in income a less to is
will enrollment program for specific NFP code Woman Woman Assign woman Coordinated
(including of Determine Zip Low If
intake, ongoing elements, processes set • • • • • •
Delivery services/programming of of and 1.
model
Implementation Implementation core Determination work of for
Service/Program When e.g., Activity unit strategy implementation referrals FTF-RC011-19-0612-00
o o o - o major for eligibility
III. a Screen

Nurse
Form for schedule
Checklist Report calendar Report
Visitor
Referral Referral Outlook Home Enrollment
call,
phone Visit
initial referral Home
During each Daily Initial
227
Visitor Visitor Visitor of 36
Home Home Home Page
Nurse Nurse Nurse
support neglect. Coordinated contacted screen usual and
insecurity other Risk to the visit, participant, voluntary questions information.
and abuse/ High be order offer of
housing Use for Visitation will in length and policy,
Eligibility or involvement risk at additional Home eligibility referral indicated, visit. goals, nurse answer demographic
Risk woman food Substance family meet to NFP receiving if then home of confidentiality reporting,
High of of co-parent and/or not refer meet and 1st program, Collect
Additional pregnant history history of does then System. that of days the responsibilities mandatory given.
or or Eligibility schedule of information,
of Age Current Current Absence systems Teen-aged woman If Eligibility Referral women working Risk and purpose of consent
Determine • • • • • • Pregnant 2 within High program Explain schedule, releases participation, if enroll
2. for visit
•
for Enrollment Visit
referrals Referral and Home FTF-RC011-19-0612-00
Screen eligibility Contact Intake Initial

file
Report Service in
Report Encounter Services Content Family Documents
Summary Visitor Report to Report & Spent Date Due Review
Visit Home Quality Referrals Quality Time Report Forms Chart Completed Goal and
in at and months
schedule days six
visit pregnancy 90 every
Per Within least
227
Visitor Visitor of
37
Home Home Page
Nurse Nurse
weeks visits, and and to quality and topic pregnancy. on
2 planning interventions, education resources on behavior health each referring high coverage. Anxiety, educational based
every Visit-to-Visit client focused own on community to pregnancy. in
then desires. in provide and her based culture, and access care hydration objectives
weeks, client utilize guidance resources, relevant goals, relationship abilities promote child. and increase health depression, during promote with timeframes.
4 for as will for and family needed. and her of coordination needs services, to and for Violence that promote plan and
weekly or child Visitor Guidelines assessments, diverse identify as therapeutic parent's protect that identified affordable needed. parent services, screenings items to goal steps
visits of Home quality, referrals in the to and service as with care Partner client bottle action
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. individualized
1. 2. 3. 4. 5. 6. 7. Develop assessments,
to
Visitor visits helping and
Home home pregnancy by improve health. Service FTF-RC011-19-0612-00
Plan
Nurse delivers improve outcomes parent prenatal Family Goal

of Report Encounter Services Content Report
STAR Review Summary Visitor Report to Report & Spent Date Due
Documentation completed Assessment Chart Visit Home Quality Referrals Quality Time Report Forms
36 weeks, months in Phase
Pregnancy 8 Infancy 18 Schedule Toddler
months, Visit &
Initial, weeks, 12 Per Infancy
227
Visitor Visitor of 38
Home Home Page
Nurse Nurse
work promote 2 2 until visits, and read and topic,
and stress every planning interventions, education resources to infant's skills, physical in promoting child health, individual and
Assessment, factors and then monthly Visit-to-Visit in client provide ability promote individuals of child on parent services. educational sleep.
risk weeks, then relevant their to language emotional, network, nurturonce based with safe
Risks exercise, 6 for months, desires. utilize guidance resources, goals, promote cues; child appropriate positive works obtain promote promote
& reduce diet, 21 client will for and family needed. to infant's and social and coordination and to that to
Strengths and healthy postpartum is child as or Visitor Guidelines assessments, diverse Identify as parent to attachment, regulation development. engaging and relationships promotes needs, providers items sleeper
complete recognize care, weekly until age Home quality, referrals with respond and family and service client blanket
to health Visits weeks of years Nurse Electronic possible high materials. and Works and trust behavioral cognitive Promotes parent's healthy Assesses provides identified community Provide i.e.
visit, 5th parent prenatal management. 1. 2. 3. 4. 5. 6.
By with
will to provide giving,
Risk Visitor visits by care
& Home home child parent and FTPRC011-19-0612-00
Strengths Assessment Nurse deliver improve development helping sensitive competent

Database Content
Report Services Content Visit Services
Screening to Report & & to Report
Quality Spent Spent
ASO 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
227
Visitor Visitor Visitor of
39
Home Home Home Page
Nurse Nurse Nurse
hard a to when services support child a and be to of means visits, and education
shares provides navigation outcomes. education for development to to talking literacy. appropriate with to First book. life pregnancy a planning interventions, resources
and and and children receiving medical on parent and and book a Blocks activities Child's a like promoting as Visit-to-Visit in client provide
screenings, provider, referral or impact vision. to age share Building family. library your make would employment guidance relevant
care services support Monitors already referred and strategies reading development providing to every local card. are Language to they child, goals. utilize resources, goals,
sensory provides of and child the hearing of how of copy to on parent how the and will for and family needed
and health provision guidance development. behaviors, directly about in provide importance language by teaching or Reader information library a lessons-You Learning to envision and education, client's Visitor Guidelines assessments, diverse Identify as
developmental and parent, tracks be should parent challenges and - reading and child. to link a obtain PIPE & opportunity parent themselves Home quality, referrals
parents to results and anticipatory child to due child Educate Educate literacy promote Promote books young Provide Becoming Provide to how Utilize Teacher Offer Help planning, accomplishing Nurse Electronic possible high materials. and
with of to for
Conducts results of services, Offers concerning screen signs evaluation. 1. 2. 3. 4. 5. 6. 7. 1. 2.
copy not or
will to life-
& & Visitor visits
Screenings parental
Developmental Language Home home FTF-RC011-19-0612-00
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
227
Visitor Visitor Visitor of
Home Health Staff Home Supervisor Home Supervisor Page 40
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-RC011-19-0612-00
Mental Consultation Family Connections Assess Satisfaction

and & System
Councils, national Documentation database records and trainings Nurse record in
entities, Access records in sign log Visitation Referral emails, calls joint NFP sign
Partnership Supporting in sign Referral Coordinated log of conference meetings, Arizona Consultant
government MCDPH FTF Meeting WIC Home referral Record with
Regional Will or weekly, -
FTF tribal or Task(s) Completed dates of quarterly, quarterly quarterly
partners, state range (daily, annually) of of
grant initiatives, Timeframe Be date„ frequency monthly, Monthly Minimum Daily Minimum
A
(FTF 227
system coalitions, Health of 41
Person(s)/Roles Responsible Nurse Nurse Nurse Nurse Page
childhood alliances, TBH Supervisor, Outreach Educator TBH Supervisor TBH Supervisor TBH Supervisor
activities) early the county-based and WIC
applicable of part etc.), activity on to MCDPH by referrals. Southwest agencies
following efforts: a or the report work increase planning System
the as are that community communities, complete and Visitation meetings, strategic with Referral visiting with implementing
to collaboration coordination, etc. to monthly Home building, in collaborate home collaborate NFP
limited not of organizations non-profits, faith volunteers, Task(s) actions meetings requested with attending system engage to Coordinated WIC all to other
but unit/team other entities, or as by and continue for continue and
(including implementation across meetings, consultants, steps FTF implementation collaborate System outreach, retention will Visitation intake will
including professional specific regional to shared NFP central NFP Development
Collaboration and for organization, partners partner partners, of set Attend program Continue Coordination increase participant reporting. MCDPH Home the as serving MCDPH Human state. the
process grant organizations, 1. 2. data 3. & 4. in
and the your external regional sub-grant work
Describe Within With FTF model With of strategy
Coordination • • • Activity unit implementation FTF-RC011-19-0612-00
o major for • Collaboration Collaboration Collaboration Collaboration
11/. a

Report
database Screening database
minutes minutes Access Report Access Services to Associate report Calendar In Sign Calendar In Sign
Meeting Meeting review Chart MCDPH Referral Developmental Report MCDPH Referrals Business Agreement Referrals Outlook Meeting Outlook Meeting
quarterly quarterly quarterly quarterly
of of of
Minimum Minimum Minimum Minimum Yearly Monthly Quarterly
227
Visitors Nurse 42 of
Nurse Supervisor Nurse Supervisor Home Nurse Supervisor Nurse Supervisor Educator Nurse Supervisor Nurse Supervisor Nurse Supervisor, Manager Page
TBH TBH Nurse TB!-! TB!-! Health TBH TBH TBH
and Council by and how and Well
welfare roles information Program family with plan list, capacity, referrals group, Support
child referrals, Prevention participation the of Communicate to contact services. for CQ1
with messaging, Intervention behalf Centers shared information, plans Families workgroup Family
discuss Abuse council Early on Resource a share accessing Medicaid Maricopa
communicate information, Child dispersing and communicating appropriate. quarterly. maintain to to Strong in clinical in
and quarterly. regional education, families Arizona as staff Family together, meetings barriers AHCCCS participate ACE participate Alliance.
with exchange least with to with services with and with care of workgroup, to Valley
Coordinate to at Coordinate supporting materials Coordination referrals, supervisory Coordination work quarterly process Coordination to Continue Visit Continue West
1. system resources 2. by and 3. making coordinating AzEIP 4. programs attend referral 5. coordination 6. Child 1. Alliance,
FTF-RC011-19-0612-00
Coordination Coordination Coordination Coordination Coordination Coordination Network

chart
staffing, Documentation Notes Case & Report Report Observation notes Act Act
Meeting Study Study
meetings, work Supporting Supervision Conference Supervision Visit Supervision Do, documentation Do, documentation
team Team Joint Report Plan, Plan,
ongoing Will or weekly, hour month month
supervision, inform Task(s) dates of quarterly, one 90 per 90 per quarterly needed
to etc.) Completed range (daily, annually) supervision Conference twice meeting twice supervision month of as &
individual Timeframe Be date, frequency monthly, Monthly week each Case minutes Team minutes Field quarterly per Twice Minimum Quarterly
(e.g. feedback, A 1:1
staff Visitor 227 of
participant Person(s)/Roles Responsible Manager Supervisor Home Supervisor Supervisor 43 Page
administrative
surveys, Nurse Nurse Nurse Nurse Nurse
and
staff, collection, essential year CQ1staff
line data activity reflective with and nurse activities conferences. administrative each with
supervisors, (e.g., the and development supervision theories, the to staff professional project consult
methods procedures complete the essential supervisory case Q1 and
CQ1 and to administrative clinical of supervision, outreach facilitate one of Plan outcomes
directors/managers, policies Task(s) actions professional visitors integration development specific supervision and and role the minimum decision strategy and
etc.) current and program or steps Supervisor facilitate home through clinical field assistant to inform CQ1
(CQI) program shadowing, of specific Nurse and nurse demonstrate professional role one-to-one and office supervision essential choose will to MCDPH performance
Improvement and implementation updating of set Provide supervision role Provide reflection, visitor meetings Provide reflective development Program data on Follow improve
including and 1. the to 2. facilitate home including team 3. & 1. based 2. to
Quality supervision observation program review work
of of
Continuous Staff reviews, Review Ongoing Activity unit strategy implementation FTF-RCO11-19-0612-00
o o o major for Supervision Supervision Supervision
V. a CQ1 CQI

Reports
Exception Reports Report review
Data Fidelity Outcomes Reports Chart
Monthly Monthly
227
of
Supervisor Supervisor 44
Nurse Page
NSO Consultant Nurse Nurse
data phase are input and staff plan to of
monitor every efforts data other share improvement of data guidance interventions
MCDPH at model quality program achievement. accurate and reports; assessment available and
& the The and reports quality education and
Office to interactions, outcome timely Penelope Penelope team of ongoing compare outcomes
Service fidelity program. and ensure of with implementation for needs; continuing
and the client and interpret methods program
National quality throughout on focused implementation Oversee utilization reports and appropriately Ensure strategies. Develop development appropriate Evaluate
NFP for and Read staff
1. 1. 2. 3. 4. 5.
FTF-RC011-19-0612-00
Review Review

Documentation
assessment Quarterly
log reports Reports
Reports
Supporting Orientation Completed forms Penelope Penelope Data Completed Reports
Will or dates weekly,
Task(s) Completed of (daily, quarterly, annually) 2018
range 1st,
Timeframe Be date, frequency monthly, October Monthly Quarterly
A Daily Daily
227
Visitor Visitor of
Person(s)/Roles Responsible Home Supervisor Home Assistant Supervisor Supervisor 45 Page
Information Management
Offices Nurse Nurse Nurse Office Nurse Analyst Nurse
National within
and activity techniques collecting visits be
State the on must
forms month
FTF, complete interviewing neutrality collected practice
to to assessment previous FTF
reports Task(s) actions basic and data month improve by
on enters from current required
narrative or visitor confidentiality, complete visit data to as
and steps home Visitors home assistant All visit. of day reports PGMS
Evaluation data specific nurse every the fifth Penelope to
and of applicable of consistency, Home Administrative of by data
submission if set Educate Nurse at data week entered Utilize Enters
Reporting entry of 1
data and evaluation, work FTF
Collection, Ongoing Reporting External of strategy Collected NFP to & & to reports
Data Activity unit implementation Collection Data entered Penelope Access Reports data FTF-RC011-19-0612-00
o o o major for Client MCDPH database Report narrative Quarterly
VI. a Data Data NSO Run

Documentation FTF to
spreadsheet notes notes notes Submitted modification FTF to
Supporting Budget Supervision Supervision Supervision Invoice Budget submitted
Will or dates weekly,
Task(s) Completed of (daily, quarterly, annually)
range
Timeframe Be date, frequency monthly, Monthly Monthly Monthly Monthly Monthly needed
A As
227
of
Person(s)/Roles Responsible Supervisor, Manager Supervisor Manager Supervisor Manager Supervisor Manager Manager Page 46
Nurse Nurse Accountant Nurse Nurse Nurse Nurse Nurse Nurse Nurse Information Management Analyst Accountant
of
activity use the may needed
the appropriate Nurse-Family with that as
complete agreements. contract issues month incurred modifications
to ensure the to Partnership national the for costs
Task(s) actions to budget fidelity contract and costs for FTF budget
or the with FTF state, program item to submit
steps and Nurse-Family local, of line Invoice &
specific monitor compliance model the of sustainability Reconcile Submit Prepare
Management of and informed
set Prepare funds. Ensure Partnership Monitor agency. Be affect 1. 2. 1.
and 1. 2. 3.
Oversight budget work
of Reimbursements Modifications of
Financial Review Activity unit strategy implementation FTF-RC011-19-0612-00
VII. o o o major a for Budget Monitor Monitor Monitor Reimbursements Modifications

Documentation
Supporting
Will or weekly,
dates quarterly,
Task(s) Completed of (daily, annually)
range
Timeframe Be date, frequency monthly,
A
227
above. of
47
listed Person(s)/Roles Responsible Page
not
program
proposed activity
the the
with complete
associated to
Task(s) actions
activities or
steps
and
specific
components of
set
additional
work
any of strategy
Other Include Activity unit implementation FTF-RC011-19-0612-00
major for
VIII. a

FY19 Line-Item Budget — Southeast Maricopa
Budget period: July 1, 2018 —June 30, 2019
Budget Category Line Item Description Requested Funds Total Cost
PERSONNEL SERVICES Personnel Services Sub Total , $110,047
Salaries 0.25 FIE Supervisor $22,190
0.1 FTE Admin Assist $2,967
0.25 FTE Outreach Worker $9,396
1 FTE Nurse Home Visitor $75,494
EMPLOYEE RELATED EXPENSES Employee Related Expenses Sub Total $39,425
Fringe Benefits or Other ERE Variable 19.45% Fixed $11,856/FIE
1
PROFESSIONAL AND OUTSIDE SERVICES Professional & Outside Services Sub Total $27,854
Contracted Services NSO Expansion plus Annual Fees $17,082
NHV Orientation Training $5,261
Nurse Supervisor Training $5,511
TRAVEL Travel Sub Total $5,066
In-State Travel Mileage $2,136
Out-of-State Travel NSO Orientation and Training $2,930
AID TO ORGANIZATIONS OR INDIVIDUALS Aid to Organizations or Individuals Sub Total .
Subgrants or Subcontracts to
organizations/agencies/entities
On:MR OPERATING EXPENSES Other Operating Expenses Sub Total $7,256
• Telephones/Communications Services $975
• General Office Supplies $390
• Food $50
• Rent/Occupancy $1,495
• Software (including IT supplies) $263
• Printing/Copying $1,625
• Professional Development (Staff $600
Training, Conferences, Workshops,
Training Fees for Staff)
• Program Materials $1,425
• Program Supplies $433
NON-CAPITAL EQUIPMENT Non-Capital Sub Total $8,379
Equipment $4,999 or less in value Vision and Hearing Screening Equip $6,238
Laptop Computer $2,141
Subtotal Direct Program Costs: 198,027 $198,027
ADMINISTRATIVE/INDIRECT COSTS Total Ad m in/Indirect $19,803
Indirect/Admin Costs 19,803
Total $217,830 $217,830
3ftb
Authorized Signature Date
FTF-RC011-19-0612-00 Page 48 of 227

FY19 Budget Narrative — Southeast 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: Year 1: $110,047 Year 2: $ 119,511 Year 3: $ 122,483 Year 4: $125,530
The salary rate for each position was determined according to MCDPH market range levels. Nurse salaries
are determined by years 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 year.
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 $42.51 x 2088 annual hours, 25%
of which will be charged to this grant for the 12-month grant cycle, or
Year 1: $22,190 Year 2: $22,745 Year 3: $23,314 Year 4: $23,896.
Nurse Home Visitors (NHV) TBD
The NHV will provide home-based preventive intervention with 25 young families/year. 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. Year 1 anticipates hiring savings of one month's salary.
Year 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
Years 2 -4: will reflect a 2.5% salary increase per year, 100% of which will be charged to this grant for the
12 -month grant cycle, or Year 2: $84,094 Year 3: $86,181 Year 4: $88,320'
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 Year 1: $2,967 Year 2: $3,041 Year 3: $3,117 Year 4:
$3,195.
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 health
education in Phoenix Union High School Pregnant & Parenting classes, coordination of client socializations
and graduations, participation in the hi-weekly NFP team meeting and the bi-weekly case conference, and
outreach and collaboration with other agencies serving pregnant women and young mothers in South
Phoenix 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 Year 1: $9,396 Year 2: $9,631 Year 3: $9,872 Year 4: $10,118
FTF-RC011-19-0612-00 Page 49 of 227

Employee Related Expenses: Year 1: $39,425 Year 2: $42,215 Year 3: $42,793 Year 4: $43,386
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.
Year 1: $21,404 Year 2: $23,245 Year 3: $23,823 Year 4: $24,416
Fixed Benefits are calculated @ $11,856 per 1 FTE, for medical and dental coverage.
Year 1: $18,021 Year 2: $18,970 Year 3: $18,970 Year 4: $18,970
Professional and Outside Services: Year 1: $27,854 Year 2: $19,169 Year 3: $19,169 Year 4: $19,169
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 (FTC)) 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 NFP
National Service Office; Policy and Government Affairs, including advocacy and educational work at
federal and state levels.
=$8,088.00/ 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 NIP 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 =$3,174.00
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 NIP 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 8( Three training from
the National Service Office. The cost of training in the first year includes: NHV Initial Education Tuition+
Education Materials = $5,261. Budgeted each year in case of staff turnover.
Travel Year 1: $5,066 Years 2-4: $3,601
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:
FTF-RC011-19-0612-00 Page 50 of 227

$0445 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 = $4001 12 month grant cycle
Year 1-4: $2,136
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 year 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
Year 1: $2,930 Year 2-4: $1,465/yr
Aid to Organizations or Individuals: None.
Other Operating Expenses: Year 1: $7,256 Year 2: $8,051 Year 3: $7,151 Year 4: $7,151
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:
$975/12 month
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: $390/12 month grant cycle
Food:
MCDPH will host 1 socialization event in the first year, and 4 per year in the following three years,
@$50.00 per event: Year 1: $50.00 Year 2-4: $200.00/yr
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/ 12 month grant cycle
Software Year 1 Software Fee x 1 NHV: $263
Printing/Copying:
Cost of printing handouts and program facilitators for clients.
25 families x $ 65/ 12 month grant cycle: $1,625/ 12 month grant cycle
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
FTF-RC011-19-0612-00 Page 51 of 227

attend the DANCE Fundamentals program after the first year 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. Year 2 DANCE Fundamentals = $780.00 x 1.25 FTE
(NHV + 0.25 Nurse Supervisor) = $975. Years 3-4 DANCE Recertification = $60,00 x 1.25 FTE = $75/ 12
month grant cycle. Total: Yr 1: $600 Yr 2: $1,575 Yr 3-4: $675
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: $55.00 x 25
families: $1,375/ 12 month grant cycle. Socialization Event Education Materials: $50.00/ event.
Year 1 = $1,425 Years 2-4= $1,575/ 12 month grant cycle
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: $433.00/ NHV Year 1 and $216
subsequent years.
Non-Capital Equipment: Year 1: $8,379 Year 2-4: $0
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 + $584.02) x 0.5= $2,620
Plusoptix + Accessories = ($6,441.69 + $794.50) x 0.5 = $3,618
Laptops: A one-time purchase x 1 NHV. Cost based on most recent purchase in August 2017. Laptop:
$2,141
Administrative/Indirect Costs: Year 1: $ 19,802 Year 2: $ 19,255 Year 3: $ 19,520 Year 4: $ 19,884
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. (Attachment E, for original only )
FTF-RC011-19-0612-00 Page 52 of 227

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.
Authorized Signature Date 3/(A_
FTF-RC011-19-0612-00 Page 53 of 227

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.
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 $1,570,496
Infant Early Childhood Partnership infrastructure and programming on
Home Visitation which to expand into full FTF Regions.
Total: $1,570,496
B. 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
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
FTF-RC011-19-0612-00 Page 54 of 227

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 ../l'ibr
FTF-RC011-19-0612-00 Page 55 of 227

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:llwww.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 X No
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.
FTF-RC011-19-0612-00 Page 56 of 227

1. Purpose, Intended Outcomes, and Research Questions
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.
FTF-RC011-19-0612-00 Page 57 of 227

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 DeniseVoiles(amail.maricopa.gov
City, State, Zip Phoenix, AZ 85012
Phone (602) 506-6896 Ext County Maricopa
Employer Identification Number (EIN): 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 FIN changes, please go to
https://gao.az.govisitesidefault/files/GAO-W-9 072815-5%265%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:Pwww.ozredistrictina.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? $ 29,458,806.00
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 F, 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-RC011-19-0612-00 Page 58 of 227

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: Southeast Maricopa Region; low-income, first-time pregnant women
who have one or more of the following high risk factors: a personal or family history of substance misuse/abuse,
history of food or housing insecurity, absence of co-parent or reliable support system, teen-aged or family at risk for
child abuse and neglect.
Brief Program Description (250 words or less):
Maricopa County Department of Public Health (MCDPH) proposes to expand implementation
of the Nurse-Family Partnership (NFP) program to all zip codes of the First Things First (FTF)
Southeast Maricopa Region with the addition of one Nurse Home Visitor (NHV) who will
provide intensive family support to 25 high risk pregnant women. In addition, age-appropriate
developmental and sensory screenings will be provided to 25 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, NFP's 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: 25
Secondary Strategy:
Developmental and Sensory Screening
Number of children served: 25
FIT-RC011-19-0612-00 Page 59 of 227

C. Contact Information:
The First Things First Partner Grant Management System (PGMS) 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 PGIVIS.
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 denisevoiles@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 denisevoiles@mail.maricopa.gov
Title/Position: Phone:
Nurse Supervisor 602-506-6782
Physical Address (if different than the agency address):
Name: Erna:
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-RC011-19-0612-00 Page 60 of 227