2 Attachment 2_Pilot Test Questionnaire_FINAL

Home Visiting Cost Reporting Tool

Pilot Test Questionnaire

Please submit your written responses to the questions below to Ben Yarnoff at RTI International (email: byarnoff@rti.org or fax: 919-990-8454).

1. Approximately how long did it take you to complete the reporting tool including time spent gathering the relevant information?

___ hours ____minutes

2. Did you have difficulty reporting the requested information for any cost categories? If yes, please provide an explanation of what difficulties you experienced.

____ Yes ____ No

Comments:

3. Were you able to provide estimates of the time spent by staff (as a percentage of their total home visiting time) on different activities?

____ Yes ____ No

Comments:

4. Were you able to provide estimates of the portion of home visiting costs that were funded by the Federal Home Visiting Program?

____ Yes ____ No

Comments:

5. Does your agency have any home visiting-related costs that were not accounted for in the cost reporting tool? If yes, please describe those costs.

____ Yes ____ No

Comments:

6. Do you have any other feedback or comments on aspects of the cost reporting tool that you thought worked well?

7. Do you have any other feedback or comments on aspects of the cost reporting tool that you thought did not work well? If yes, do you have any suggestions about how to improve these areas?

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