Final Report to the Secretary Guidance

U.S. Department of Health and Human Services

Administration for Children and Families

Office of Early Childhood Development

Tribal Maternal, Infant, and Early Childhood

Home Visiting Program

Guidance for Submitting a

Final Report to the Secretary

U.S. Department of Health and Human Services

Administration for Children and Families

Office of Early Childhood Development

330 C Street SW

Washington, DC 20201

Tribal Maternal, Infant, and Early Childhood Home Visiting Program

Background Information:

Guidance for Submitting a Final Report to the Secretary

Section 511(e)(8)(A) of the Social Security Act requires that grant recipients under the MIECHV program for states and jurisdictions submit an Annual Report to the Secretary of Health and Human Services (HHS) regarding the program and activities carried out under the program, including such data and information as the Secretary shall require. Section 511 (h)(2)(A) further states that the requirements for the MIECHV grants to tribes, tribal organizations, and urban Indian organizations are to be consistent, to the greatest extent practicable, with the requirements for grantees under the MIECHV program for states and jurisdictions. Tribal MIECHV recipients have been notified by the Administration for Children and Families (ACF) that in each year of their grant, except the first year, they must comply with the requirement for submitting an Annual Report to the Secretary that should describe activities carried out under the program during the past reporting period, or, in the case of the Final Report to the Secretary, throughout their project period.

This document provides guidance to grant recipients when submitting a Final Report to the Secretary. Reports shall be submitted via GrantSolutions.gov per instructions given to each recipient by ACF as part of their cooperative agreement.

Any questions and comments regarding this guidance may be addressed to:

Anne Bergan

Senior Policy Analyst

Tribal Home Visiting Program

Administration for Children and Families, HHS

Mary E. Switzer Building

330 C Street, SW, Suite 3014F

Washington, DC 20201

anne.bergan@acf.hhs.gov

(202) 260-8515

Guidance for Submitting a Final Report to the Secretary

In the final year of their grants, Tribal MIECHV grant recipients must provide a written report to the Secretary regarding the program and activities carried out under their cooperative agreement during the entire project period. The seven sections below represent the primary grant activities on which to report.

The audience for the Final Report to the Secretary (FRS) is the Secretary of HHS and ACF. As such, it is critical that you provide a comprehensive, well-written response that addresses each of the sections below. There are other reports that grant recipients submit, including semi-annual program performance, quarterly, performance, and demographic and service utilization data reports. While these reports are important, the objectives for the FRS are to:

• Provide rich, contextual information that grantees wish to share about their programs.

• Reduce redundancies and burden in other types of Tribal MIECHV reporting.

• Use information provided by grant recipients to help inform program support and future policy decisions.

The goal of the FRS is to tell the story of your program, your community, and the families you served throughout the entire life of your grant. By doing so, you are providing valuable information to HHS regarding your assessment of the challenges, successes, and lessons learned over the years.

Section 1: Meeting Home Visiting Program Goals and Objectives

Please summarize whether you met the goals and objectives you set out to accomplish when you developed your Implementation Plan. Your goals and objectives are at the heart of all the activities you will be reporting on.

• List each program goal and objective identified in your Implementation Plan.

• Share whether you have met your goals and objectives, and what contributed to your successes.

• If you encountered any challenges, describe barriers to progress, and the strategies and steps you have taken to overcome them. 

Section 2: Report on the Implementation of Home Visiting Program in Targeted Community(ies)

Please provide final information and reflections regarding the planning and implementation of your home visiting program, as identified in your Implementation Plan. Please address each of the items listed below. Where applicable, discuss any barriers or challenges you encountered, and the steps taken to overcome these barriers and challenges. If respondents were not part of the program during planning phases, please consult with staff who were or review your program’s Implementation Plan including the Community Needs and Readiness Assessment section for guidance.

• Thinking back to when you conducted your community needs and readiness assessment for your home visiting program, and the years of implementation afterwards, please provide a summary that includes:

  • Was conducting a needs assessment useful? If so, how? If the needs assessment was not useful, why do you think that is?

  • What do you see as your biggest successes related to the needs assessment and its use to support and shape program implementation? Did you have any particular successes or lessons learned relating to engaging your community in the assessment?

  • What do you see as your biggest challenges related to the needs assessment and its use to support and shape program implementation?

• What lessons have you learned around implementing your home visiting program that may serve you in implementing similar programs moving forward?

• Please describe lessons learned around engaging with the broader community(ies) (e.g., partner agencies, local advisory committee, community members, tribal leadership, leadership within your organization, partner agencies, the families you serve) around your home visiting program. How have these partners’ involvement helped or hindered the implementation of your program?

• Please describe how your community’s involvement will help sustain your program.

• Please report on your work with the developer of the home visiting model(s) you implemented during the project, including:

  • A summary of any technical assistance (TA) and support, curriculum and materials, and professional development received from the model(s). How did the support of the model developer(s) impact the implementation of your home visiting program?

  • If the model developer(s) did not provide the support or involvement you needed, please describe the challenges you encountered and how you think that may have impacted the implementation of your program.

• Please reflect overall on any challenges and successes you had supporting the home visiting workforce. Summarize your efforts to provide support and professional development to staff. Describe activities implemented over the project period and outcomes related to:

  • Staff recruitment and hiring (if the ending of your grant has impacted recruiting staff, please describe)

  • Professional development and support of staff well-being

  • Staff retention (if the ending of your grant has impacted retaining staff, please describe)

  • Trainings to ensure well-trained, competent staff beyond what the model developer provided and any other activities during the life of this grant

  • High-quality reflective, clinical, and administrative supervision

  • Infant and early childhood mental health consultation

  • Particular successes and challenges you had in supporting the home visiting workforce in the context of your tribe or organization.

• Please describe your efforts to recruit, engage, and retain program participants. Discuss your referral partners, and what has been your most successful recruitment strategy. If possible, discuss and provide data on:

  • Recruitment of families

  • Engaging families

  • Retention of families

  • Participant completion of the program

  • If you did not meet your capacity, please provide reflections on the possible reasons why this may have occurred, and the lessons learned for the future.

• Please summarize your activities related to providing high-quality home visiting program services. How did you:

  • Ensure the selected home visiting model(s), adaptations, enhancements, and supplements were implemented with fidelity?

  • Develop and document program operations, policies, and procedures to support implementation fidelity and program quality?

• Please describe the actions you took throughout the project towards the development of a coordinated early childhood system, including coordination and collaboration between your home visiting program and other programs and resources for pregnant people, expectant fathers, young children, and families in the community(ies).

  • Describe the actions you took throughout the project to maximize referrals and services between your program and others in the community.

  • Describe the partnerships you developed and provide any updates on these collaborations, and how you will continue to partner with them beyond this grant.

• If applicable, please provide any testimonials, success stories, photos, and videos you would like to share regarding the implementation of your home visiting program.

• Please describe your activities associated with the American Rescue Plan Act (ARPA) supplements. In the table below, please report how you used your supplemental ARPA funds in the areas listed. If you did not use ARPA funds for a particular area, you can answer no. For answers that are yes, please provide an update and summary on how you have used these funds.

How have the ARPA funds been used in the following areas identified by the legislation?	Yes/No	If you answered yes, please provide a description below how the funds were used in this area
Serving families with home visits, whether in person or virtually
Staff costs associated with home visits (including hazard pay)
Training for home visitors on virtual home visits, emergency preparedness, and domestic violence
Helping enrolled families acquire technology needed to conduct a virtual home visit, including Wi-Fi access or cell phone minutes
Providing emergency supplies to enrolled families, including formula, food, water, hand soap and sanitizer, and diapers and diapering supplies
Coordinating with and providing reimbursement to diaper banks when using them to provide emergency supplies
Providing prepaid grocery cards to an eligible family

Section 3: Report on Performance Measurement Data Development, Collection and Reporting

The MIECHV legislation for tribal grant recipients had strong requirements for grantees to create performance measurement plans to collect and report data on legislatively defined benchmarks. The purpose of this section is to learn about grant recipients’ experiences with the performance measurement process.

• Please describe what you learned from going through the entire performance data collection, analysis, and reporting process, including developing your plan and collecting and reporting data. What were your lessons learned? What would you do differently knowing what you know now?

• In looking at your Tribal Home Visiting Form 2 data, what do you think were your program’s biggest successes? Were there successes that the data did not capture?

• Which aspects of your Tribal Home Visiting Form 2 data indicated a need for improvement from your perspective? Please describe any challenges that made improvement in this area particularly difficult.

• Now that you have reported your program’s performance data:

• What would you recommend HHS do to support effective performance measurement by grant recipients in the future?

• What would you change about the performance measurement requirements?

• What methods of TA were most useful (i.e., targeted TA, webinars, Communities of Learning, meetings, etc.)? What methods were least useful?

• What additional supports would have been helpful?

Section 4: Report on Rigorous Evaluation Activities

The purpose of evaluating home visiting in your community was to learn how well it worked in your community, build capacity within your community, and add to the body of evidence about effective interventions in American Indian and Alaska Native communities. The information you provide about your evaluation experience will also help the federal program to learn how it can best support the development of knowledge about what works in home visiting in tribal communities.

For those grant recipients not participating in the multi-site implementation evaluation of Tribal MIECHV (MUSE) please respond below. MUSE participants, please complete your section below or jump to the section using this link.

• Thinking about activities that have occurred during the grant, please discuss the phases of your evaluation activities in the timeline below.

Evaluation Timeline

• Please list your evaluation questions and reflect on each evaluation phases:

Phase 1: Evaluation Planning

• Please describe your team’s experience during your evaluation planning

• Activities conducted to engage community members in the evaluation

• Developing the evaluation plan

• Engaging in the ACF review and approval process

• Developing, submitting, and gaining approval of the Institutional Review Board (IRB) application

Phase 2: Evaluation Implementation

• Please describe your team’s reflections on conducting the evaluation and any evaluation activities that took place during the project.

• Please note the following (if applicable):

• The number of participants enrolled in the evaluation and progress in enrolling your targeted sample

• Data collected, including the number of participants for whom data were collected, the response rate, and the type of data collected/measures used

• Activities to engage and inform community members of the evaluation’s progress.

Phase 3: Conducting Analysis and Writing the Final Report/Dissemination

(Please provide as much information as possible on your analysis and findings.)

• Please describe your team’s experience:

• Conducting planned analysis

• Reviewing findings

• Engaging community and stakeholders in interpreting findings

• Please describe key evaluation findings

• Please note your progress towards writing your final report

• Dissemination of evaluation findings (e.g., reports or presentations provided to program stakeholders and community members; presentations at research, evaluation, or practitioner conferences; and work on articles for scholarly journals or other publications.) If applicable, please attach any examples you wish to share.

Evaluation Successes and Challenges

• Please describe the top two successes your team experienced with rigorous evaluation.

• Please describe the top two challenges your team experienced with rigorous evaluation data. How did you address those challenges? 

For those grantees participating in the multi-site implementation evaluation of Tribal MIECHV

(MUSE):

• Please reflect on your grant’s participation in the MUSE study over the last six years, your roles in the study, and the value of the study. 

  • How has your involvement in MUSE met your expectations when we began?

  • What might you change about your participation in the study or in the study itself?

  • Given your experience, what are your thoughts for potential future cross-site evaluation activities (e.g., topics, methods, engagement)?

Section 5: Report on Continuous Quality Improvement Activities

All Tribal MIECHV grant recipients conduct Continuous Quality Improvement (CQI) activities, whether through individual CQI projects or as part of CQI Collaboratives. In this section, we would like to know about recipients’ experience learning about and using CQI processes with their teams.

• Please describe your team’s experience engaging in CQI activities, including the CQI Collaboratives.

• Please reflect on and share the CQI accomplishments experienced by your team. For example, did the tests you implemented result in any improvements? Did you adopt these changes, and do they continue to have the desired result?

• Please describe any challenges you encountered during the CQI process. How did you address these challenges?

• What has your team learned in your CQI projects during your grant?

• What are your team’s next steps in your CQI work?

Section 6: Dissemination

Throughout the entire project, there may have been many opportunities to share valuable information and engage with multiple audiences through dissemination. Below, please summarize the dissemination activities of your program that you wish to highlight. You can provide copies of or links to reports or materials developed for dissemination you would like to highlight. Relevant dissemination materials and products could include:

• Newsletters (electronic or print)

• Pamphlets, brochures, or fact sheets

• Web and social media-based products (blogs, podcasts, video clips, etc.)

• Digital stories or videos

• Presentations and posters

Section 7: Technical Assistance Supports

Please describe how various TA supports assisted your program over the years of your grant. TA supports can include support by the ACF federal team as well as contracted TA providers or other entities (e.g., model developers). This information will be very helpful for ACF to assess the effectiveness of TA supports and identify any areas that need attention.

• Please describe any TA support or training you requested and/or received from ACF, Tribal MIECHV programmatic or evaluation technical assistance providers, model developers, or any other source related to the topics above. Were your technical assistance and training needs met? If not, what additional supports would be helpful to you?