Site visit and key informant data collection: Partner survey (Appendix C)

OMB No.: 0970-0527

Expiration Date: 05/31/2022

Partner Survey

Regional Partnership Grants National
Cross-Site Evaluation

Public reporting burden for this collection of information is estimated to average 25 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number (0970-0527).

February 2020

INTRODUCTION

The Regional Partnership Grants (RPG) program supports interagency collaborations and program integration designed to increase the well-being, improve the permanency, and enhance the safety of children who are in, or at risk of, out-of-home placements as a result of a parent or caretaker’s substance abuse. The Children’s Bureau within the U.S. Department of Health and Human Services, Administration for Children and Families (ACF) has contracted with Mathematica to complete the national cross-site evaluation of the program. The evaluation will describe the interventions that were implemented, the nature of the partnerships, the types of services provided, and their impacts.

You are being asked to complete this survey because you were identified as a representative of a partner organization working with the RPG grantee, [RPG_GRANTEE]. Representatives from partner organizations are asked to complete this survey to provide information about their own organizations, relationships with the grantee and other collaborating organizations, and program implementation. The length of this survey is different for different people, but on average it should take about 25 minutes.

Your participation in this survey is important and will help us understand more about the partnerships implementing RPG-funded programs. Please provide responses for your organization, [PARTNER ORGANIZATION]. If you represent a specific branch or program within your organization that is engaged with the RPG partnership, rather than the organization as a whole, please provide information about that branch or program rather than the organization as a whole. If you are unsure of how to answer a question, please give the best answer you can rather than leaving it blank.

Your responses will be kept private and used only for research purposes. They will be combined with the responses of other staff and reported in the aggregate; and no individual names will be reported. Participation in the survey is completely voluntary and you may choose to skip any question.

If you have any questions about the survey, please contact the team at Mathematica by emailing RPGSurveys@mathematica-mpr.com or calling 866-627-9538 (toll-free).

Please read and answer the statement below.

i1. I have read the introduction and understand that the information I provide will be kept private and used only for research purposes. My responses will be combined with the responses of other staff and no individual names will be reported.

1  I agree with the above statement and will complete the survey GO TO SURVEY ON

NEXT PAGE

0  I do not agree with the above statement and will not complete the survey STOP HERE

A. YOUR ORGANIZATION

The first questions are about your organization, [PARTNER ORGANIZATION].

A1. Which of the following best describes your organization?

select only one

1  Child welfare services provider

2  Substance abuse treatment provider

3  Mental health services provider

4  School district, school, or early childhood education or services provider

5  Housing/homeless services provider

6  Medical or dental services provider

7  University

8  Court/judicial agency

9  Corrections or law enforcement agency

10  Home visiting services provider

11  Department in state or tribal government

12  Department in local government

13  Foundation

14  Research/evaluation organization

15  Mental health and substance abuse treatment provider

16  Community resource organization

17  Substance abuse prevention organization

99  Other (specify)

A2. What are the main activities your organization conducts in general?

select all that apply

1  Regulation and oversight

2  Child welfare services

3  Substance abuse treatment

4  Family therapy

5  Medical or dental services

6  Education or early childhood intervention

7  Legal processes

8  Law enforcement

9  Home visiting

10  Funding

11  Evaluation

12  Program planning and policy development

13  Advocacy

14  Case management/coordination

15  Research

16  Education (General)

17  Housing

18  Mental health services

19  Substance abuse prevention

20  Recovery support

99  Other (specify)

A3. Does your organization currently provide program/other services or plan to serve [RPG NAME] clients?

select only one

1  Currently provides services to [RPG NAME] clients

2  Plans to provide services to [RPG NAME] clients

3  No

A4. Did your organization receive any funding for [RPG NAME] this fiscal year?

1  Yes

0  No GO TO A5

A4a. Approximately how much funding did your organization receive this fiscal year? Your best estimate is fine.

$ | | , | | | | , | | | | AMOUNT OF FUNDING RECEIVED

d □ Don’t know

A5. Which of the following in-kind resources is your organization contributing to [RPG NAME] this fiscal year?

Select all that apply

1  Staff time

2  Office space

3  Volunteers

4  Office supplies

5  Program materials

6  Computer/Internet, telephone, or fax service

7  Information

8  Transportation

97  None of these

99  Other (specify)

B. PERSPECTIVES ON GOALS AND RELATIONSHIPS IN THE PARTNERSHIP

PARTNER GOALS

B1. In your own words, what are the main goals of the [RPG NAME] partnership?

B2. Do you currently serve on a steering, implementation, governance, or some other committee for the [RPG NAME] grant?

1  Yes

0  No

B3. Other than formal [RPG NAME] partnership meetings that you may attend, how frequently does your organization communicate about [RPG NAME] with the organizations listed below? Please indicate if you do not communicate at all, if you communicate infrequently (a few times each month), or if you communicate regularly (every day or nearly every day) with that partner. Please choose the answer that best represents the frequency of communication. Please do not complete the row that is listed for your own organization.

	SELECT ONE PER ROW
	WE DO NOT COMMUNICATE AT ALL	WE COMMUNICATE INFREQUENTLY (A FEW TIMES EACH MONTH)	WE COMMUNICATE REGULARLY (EVERY DAY OR NEARLY EVERY DAY)
[ROSTER OF ORGANIZATIONS]	1 	2 	3 
	1 	2 	3 
	1 	2 	3 
	1 	2 	3 
	1 	2 	3 
	1 	2 	3 
	1 	2 	3 

B3a. Next, please indicate if you were previously working with a member of the [RPG NAME] partnership prior to the beginning of the [RPG NAME] grant in 2017

	SELECT ONE PER ROW
	YES	NO
[ROSTER OF ORGANIZATIONS]	1 	0 
	1 	0 
	1 	0 
	1 	0 
	1 	0 
	1 	0 
	1 	0 

B4. To what extent do you disagree or agree with each of the following statements about the current status of the collaboration among [RPG NAME] partner organizations?

SELECT ONE PER ROW

	STRONGLY DISAGREE	DISAGREE	AGREE	STRONGLY AGREE
a. Our collaborative effort was started because we wanted to do something about an important problem	1 	2 	3 	4 
b. Our [RPG NAME] program’s top priority was having a concrete impact on the real problem	1 	2 	3 	4 
c. The organizations involved in our [RPG NAME] program included those organizations affected by the issue	1 	2 	3 	4 
d. Participation was not dominated by any one group or sector	1 	2 	3 	4 
e. Our partner organizations have access to credible information that supports problem solving and decision making	1 	2 	3 	4 
f. [RPG NAME] partner organizations agree on what decisions will be made by the group	1 	2 	3 	4 
g. Partner organizations agree to work together on this issue	1 	2 	3 	4 
h. Organizations involved in our [RPG NAME] program have set ground rules and norms about how we will work	1 	2 	3 	4 
i. We have a method for communicating the activities and decisions of the group to all partner organizations	1 	2 	3 	4 
j. There are clearly defined roles for [RPG NAME] partner organizations	1 	2 	3 	4 
k. Partner organizations are more interested in getting a good decision for the [RPG NAME] program than improving the position of their own organization	1 	2 	3 	4 
l. Staff who participate in [RPG NAME] program meetings are effective liaisons between their home organizations and the group	1 	2 	3 	4 
m. Partner organizations trust each other sufficiently to honestly and accurately share information, perceptions, and feedback	1 	2 	3 	4 
n. Partner organizations are willing to let go of an idea for one that appears to have more merit	1 	2 	3 	4 
o. Partner organizations are willing to devote whatever effort is necessary to achieve the goals	1 	2 	3 	4 
p. Divergent opinions are expressed and listened to	1 	2 	3 	4 
q. The openness and credibility of the process helps partner organizations set aside doubts and skepticism	1 	2 	3 	4 
r. Our group sets aside vested interests to achieve our common goal	1 	2 	3 	4 
s. Our group has an effective decision making process	1 	2 	3 	4 
t. Our group is effective in obtaining the resources it needs to accomplish its objectives	1 	2 	3 	4 
u. The time and effort of the collaboration is directed at achieving our goals rather than keeping the collaboration in business	1 	2 	3 	4 

B6. Indicate the degree to which you disagree or agree with each of the following statements about [RPG NAME] programming:

SELECT ONE PER ROW

	STRONGLY DISAGREE	DISAGREE	AGREE	STRONGLY AGREE	DOES NOT APPLY/ DON’T KNOW
a. We developed strategies to recruit community participation	1 	2 	3 	4 	98 
b. Community members are included in program planning and development	1 	2 	3 	4 	98 
c. We developed formal mechanisms to solicit support and input from community members and consumers	1 	2 	3 	4 	98 
d. Front-line staff have up-to-date resource directories for family support centers and resources	1 	2 	3 	4 	98 
e. Community-wide accountability systems are used to monitor substance abuse and child welfare issues	1 	2 	3 	4 	98 
f. Consumers, patients in recovery, and program graduates have active roles in planning, developing, implementing, and monitoring services	1 	2 	3 	4 	98 

c. partnership outputs

C1. Indicate the degree to which you disagree or agree with each of the following statements about [RPG NAME] programming:

SELECT ONE PER ROW

	STRONGLY DISAGREE	DISAGREE	AGREE	STRONGLY AGREE	DOES NOT APPLY/ DON’T KNOW
a. Services provided to families are coordinated across multiple partners	1 	2 	3 	4 	98 
b. Case management is coordinated across both substance abuse treatment providers and child welfare agencies	1 	2 	3 	4 	98 
c. Families receiving joint case management receive regular cross-agency assessments	1 	2 	3 	4 	98 
d. Staff from both substance abuse treatment providers and child welfare agencies participate in joint case management activities such as family team conferences, case plan reviews, or intake or permanency staffings	1 	2 	3 	4 	98 
e. Judicial officers and attorneys are viewed as partners in developing new approaches to serve families with substance use disorders in the child welfare system	1 	2 	3 	4 	98 
f. Substance abuse and child welfare agencies and the courts have negotiated shared principles or goal statements	1 	2 	3 	4 	98 
g. Region/partnership developed responses to conflicting time frames associated with child welfare services, substance abuse treatment, Temporary Assistance for Needy Families, and child development	1 	2 	3 	4 	98 
h. Substance abuse treatment and child protective service case plans are coordinated	1 	2 	3 	4 	98 
i. Formal working agreements have been developed on how courts, child welfare, and treatment agencies will share client information	1 	2 	3 	4 	98 
j. Data tracking child welfare and substance abuse clients across systems is used to monitor outcomes	1 	2 	3 	4 	98 
k. Substance abuse agencies, child welfare agencies, and court systems have developed shared outcomes for families and agree on how to use information on outcomes with families	1 	2 	3 	4 	98 
l. Joint training programs for the three main systems staff have been developed to help staff and providers work together effectively	1 	2 	3 	4 	98 

C2. Below is a list of organizations identified as part of your [RPG NAME] partnership. Which [RPG NAME]-related services does your organization coordinate with or collaborate on with each organization? Please do not complete the row that lists your own organization.

SELECT ALL THAT APPLY PER ROW

	SCREENING AND/OR ASSESSMENT	RPG PROGRAM REFERRALS	CASE MANAGEMENT OR COORDINATION	SUBSTANCE ABUSE TREATMENT	MENTAL HEALTH / TRAUMA SERVICES	OTHER SOCIAL OR FAMILY SERVICES	WE DO NOT COLLABORATE WITH THIS ORGANIZATION ON ANY OF THESE SERVICES
[ROSTER OF ORGANIZATIONS]	1 	2 	3 	4 	5 	6 	97 
	1 	2 	3 	4 	5 	6 	97 
	1 	2 	3 	4 	5 	6 	97 
	1 	2 	3 	4 	5 	6 	97 
	1 	2 	3 	4 	5 	6 	97 
	1 	2 	3 	4 	5 	6 	97 
	1 	2 	3 	4 	5 	6 	97 
	1 	2 	3 	4 	5 	6 	97 
	1 	2 	3 	4 	5 	6 	97 

D1. Thank you for your participation in this survey. If there is anything else that you would like to tell us about your work on the [RPG NAME] program or about the partnership as a whole, please share it here.

Thank you for completing the Regional Partnership Grant Partner Survey!