BUILDING STRONG FAMILIES IN RURAL TENNESSEE BSF The Process, the Program, the Product

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BUILDING STRONG FAMILIES IN RURAL TENNESSEE
(BSF) The Process, the Program, the Product

• Edwina Chappell, PhD
• Cindy Cothran, MS
• Kathryn Bowen, PhD
• August 6, 2009
• Grants Session
• Federal Funding Seminar Hosted by Congressman
  Lincoln Davis
• Manchester, TN

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Learning Objectives

• We want to share
• Lessons learned from our grant-seeking
  experiences
• A description of our grant project
• Preliminary outcomes for children and families

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Learning Objectives (continued)

• In addition
• We want your ideas about how we can keep this
  project going beyond the grant

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The Process

• Edwina Chappell, PhD
• Principal Investigator
• Tennessee Department of Mental Health and
  Developmental Disabilities
• Edwina.Chappell_at_tn.gov
• 615-741-9476

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Learning Objectives

• Where to Look for Grants, Especially for Projects
  Targeting Children and Youth
• How to Identify Critical Focus Areas in the Grant
  Opportunity Announcement
• How to Submit Your Grant Application
• What to Do after An Award Has Been Made

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Where to Look for Grants?

• Plethora of pathways to grant information
• Multiple grant-funding agencies/resources
• Your Commissioner/CEO, etc.
• TDMHDD is very fortunate to have a
  forward-thinking commissioner in Ms. Betts.

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How to Look for Grants

• What are the best funder options?
• Who is your target population?
• Do you have the staff/partners to meet the
  criteria designated in the Request for Proposals
  (RFP)/Request for Application (RFA)?
• Can you handle a match requirement?
• Is the funding opportunity worth applying for?
• Your answer to the aforementioned questions will
  significantly help you narrow the field and
  increase your chances of a hit!!!

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The Funder for BSF

• ACF
• Administration for Children and Families
• One of 11 agencies in the United States
  Department of Health and Human Services (HHS)
• SAMHSAs sister agency
• Official Name Administration for Children,
  Youth, and Families, Childrens Bureau, Office on
  Child Abuse and Neglect
• Link to grant opportunities http//www.acf.hhs.go
  v/programs/cb/programs_fund/index.htm. This is
  the website for the Children's Bureau
  Discretionary Grants. At a future date, they will
  post a link to the Grant Forecast at this
  website. Stay tuned!!

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Type of Grants Available Through ACF

• Usually smaller amounts when compared to SAMHSA
  a million or less
• Like SAMHSA grants, they tend to be reasonably
  obtainable

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Why We Sought an ACF Grant

• RFP came down from Commissioner Betts.
• I was familiar with the ACF, having submitted an
  application a couple of years before.
• At least one partner was also interested in
  pursuing this grant.
• This grant opportunity fit in with our target
  population and goals across partners.
• In short, it was worth the effort of submitting
  an application.

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Seeking the Grant Opportunity

• There are critical components in an RFA/RFP that
  you must attend to BEFORE you expend energy
  preparing a grant application.
• Focus on target population
• Funder/agency match
• Eligibility
• Award amount
• Number of awards
• Collaboration
• Cost sharing/match

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Critical Component Issues

• Examples

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Target Population

• On whom does the grant target?
• Adults
• Children and youth are the target population in
  our BSF grant.
• Native Americans?
• You work in Harlem!

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Funder/Agency Match

• Should you apply for a grant from the National
  Institute of Health (NIH) or the National
  Institute of Mental Health (NIMH)?
• More academically focused
• Evaluations very rigorous
• More research oriented
• Random clinical trials (RCTs)

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Eligibility

• Look at this area very closely on the RFA/RFP.
• Sometimes only governments
• Sometimes only non-profits
• Sometimes only existing grantees
• Sometimes anybody!!!!!

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Award Amount

• 1,000,000
• 500,000
• 400,000
• 10,000
• 5,000
• Is the amount worth the effort?

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Number of Awards

• 0-6
• 1-8
• Up to 24
• Up to 32
• Up to 100
• More award opportunities increase your
  probability of having a winning application
• Fewer award opportunities typically require more
  complete, solid grant applications

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Collaboration

• Often a requirement, especially with ACF grants
• Can you live with this?
• Can you work through turf issues?

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Cost Sharing (Match)

• Your contribution
• Can be in-kind
• Actual cash donations
• It cannot involve federal funds!!!!!

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Award Information for BSF Grant Opportunity -
Percentages
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Award Information for BSF Grant Opportunity -
Amounts
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How to Prepare the Grant Application

• Start with a workgroup, if possible, especially
  those you need at the table
• Come together, at least once face-to-face
• Start early, preferably very shortly after the
  announcement
• Have a conversation about whether to pursue
• Get verbal commitments
• Set timelines
• Work backwards When must the application be
  submitted?
• Write the grant
• Grant writer
• Workgroup
• Give homework
• Single individual
• Based on homework of workgroup
• Review the application
• Use criteria contained in the RFA/RFP
• Spelling/grammar check
• Aesthetics

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How Much Time for the

• Principal Investigator (PI) Also Known As (AKA)
  the Project Director
• At least 20 (10 will not cut it)
• Evaluation Component
• 20-25, especially in tough times when Return on
  Investment (ROI) is required
• 10-15 may no longer be acceptable, but these
  would be minimum amounts to be budgeted for
  evaluation

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Submitting Your Grant Application

• Check that all guidelines have been followed.
• Right number of pages
• Pages formatted properly
• All sections addressed
• Appropriate number of copies
• Make sure you meet the deadline
• Verify address for delivery
• 430 p.m. CDT, August 6, 2009, means 430 p.m.
  CDT, August 6, 2009!!!!
• No exceptions, no excuses!

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What to Do After the Award

• Scream, shout, cry respond in any appropriate
  manner that is decent and in order if in public
• Respond in any manner when in private
• Review your grant application
• When do you need to become operational (Know how
  the funding agency defines operational)
• Begin to familiarize yourself with acronyms
• Will your evaluators need to get approvals from
  an Institutional Review Board (IRB)?
• Watch your match!
• Solidify your partnership!!!!!!

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BSF Partnership

• Tennessee Department of Childrens Services (DCS)
• Governors Office of Childrens Care Coordination
  (GOCCC)
• Administrative Office of the Courts (AOC)
• Centerstone
• TDMHDD - lead agency

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Final Words of Wisdom

• Spread the word that YOU GOT A GRANT!!!!!!!
• Spread the word that YOU WANT TO MAINTAIN THE
  PROJECT BEYOND THE GRANT!!!!!!!

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The Program

• Cindy Cothran, MS
• Local Project Director
• Centerstone
• cindy.cothran_at_centerstone.org

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Our Purpose

• to prevent the unnecessary out-of-home placement
  of children through intensive, in-home
  intervention, and to teach families new
  problem-solving skills to prevent future crises.

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Who do we serve?

• Building Strong Families serves children and
  families in 8 southern middle Tennessee Counties
  
• 1) Bedford 2) Cannon 3) Coffee 4) Franklin
• 5) Grundy 6) Lincoln 7) Moore 8) Warren 
• BSF works with families who are at imminent risk
  of having their children placed outside the home
  due to parental substance abuse problems.
• BSF also helps reunify children with their
  family-of-origin after an out of home placement
  related to parental substance abuse.
• The whole family (as determined by themselves)
  serves are our client.
• ??Mother, grandmother and mothers 3 children
• ??Father, his girlfriend, his child and her
  child

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How do families get involved with BSF?

• Referrals come from sources who have the ability
  to place children outside the home.
• Workers from the Department of Childrens
  Services
• Juvenile Justice Workers
• Judges
• Referral workers call the Building Strong
  Families referral line anytime, 24/7.
• 1-877-463-6513
• The Project Director gathers information,
  determines eligibility and assigns an in-home
  specialist (or helps referral workers find better
  fitting alternatives).
• contact information safety risks parental
  substance abuse issues potential goals
• We do not maintain a waiting list as we cannot
  manage the safety of children/ families unless we
  are actively serving them.

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What does BSF do with families?

• Intensive In-home Family Preservation Services
  utilizing the HomeBuilders Model
• Interventions are voluntary
• Duration 2-8 weeks, 8 hours face to face weekly
  contact
• Availability 24 hours per day/ 7 days per week
• Create and maintain safety (our 1st priority)
• Meet families where they are physically and
  emotionally
• Treat families as experts in their own lives
• Connect families with needed services
• Build skills to avoid future crises

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The HomeBuilders Model

• Has been in use since 1974
• internationally renowned
• designated a "model family strengthening program"
  by the United States Office of Juvenile Justice
  and Delinquency Prevention and the Center for
  Substance Abuse Prevention
• The goal of the program is to remove the risk of
  harm to the child/ children instead of removing
  the child/children. The program gives families
  the chance to learn new behaviors, and helps them
  make better choices for their children.
• Child safety is ensured through small caseloads,
  program intensity, and 24-hour a day service
  availability.

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HomeBuilders Model key elements

• Intervention at the crisis point. Families are
  contacted within 24 hours of being referred.
• Treatment in the natural settingServices take
  place in the client's home or community, where
  the problems are occurring, where they need to be
  resolved.
• Accessibility and responsivenessWe are on call
  to clients 24 hours a day, 7 days a week.
  Families are given as much time as they need,
  when they need it. This accessibility also allows
  close monitoring of potentially dangerous
  situations.

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HomeBuilders Model key elements

• IntensityServices are time-limited and
  concentrated in a period targeted at 4 weeks. The
  service is designed to resolve the immediate
  crisis, and teach the skills necessary for the
  family to remain together.
• Low caseloadsEach specialist carries only 2 to 3
  cases at a time which allows for increased
  service intensity. Specialists have the time to
  teach needed skills and to help families meet
  their basic hard service needs. Services are
  concentrated to take advantage of the time when
  families are experiencing the most pain, and have
  the most motivation to change.

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HomeBuilders Model key elements

• Research-based interventionsSpecialists use a
  range of research-based interventions, including
  crisis intervention, motivational interviewing,
  parent education, skill building and
  cognitive/behavioral therapy.
• FlexibilityServices are provided when/ where
  clients wish. We provide a range of services,
  from helping clients meet basic needs of food,
  clothing and shelter, to the most sophisticated
  therapeutic techniques. We teach families basic
  skills such as gaining housing, budgeting, and
  dealing with the social services system. We also
  educate families in areas such as child
  development, parenting skills, anger management,
  other mood management skills, communications,
  relapse prevention and assertiveness.

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An example intervention

• Anna (a pseudonym) and her 4 children were
  referred to BSF by Children's Protective Service
  (CPS) after Anna was seen kicking her children in
  a public place. CPS drug-tested Anna when she
  appeared impaired at a home visit. Anna tested
  positive for marijuana and meth. The drug use
  paired with Annas drug use placed the children a
  imminent risk of placement in foster care. Anna
  admitted kicking the children, stating that she
  "just lost control when they wouldnt listen to
  me". A single parent, she supported the family by
  part-time employment and public assistance.
  Raising 4 children alone was overwhelming, and
  financial problems were never ending. "I had
  kids, but I wasn't a mom," Anna explained.
• Anna agreed to work with BSF so that she could
  keep her children at home. The first goal of BSF
  was to help Anna to reduce her feelings of
  frustration that led to the physical and verbal
  abuse. Anna screamed at her children often, and
  when she became overwhelmed she used drugs and
  struck out physically at them. The specialist
  listened at length to Anna's difficulties,
  assessing what led to the abuse.

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Example, continued

• The specialist helped Anna set more realistic
  expectations for herself and her children and
  taught her skills to decrease her anger and to
  stay calm. Anna was taught better parenting
  skills using Active Parenting Now, which she and
  her specialist role-played to improve retention.
  Due to growing up in an abusive alcoholic
  family, Anna had no appropriate role models for
  parenting. Anna learned to structure her daily
  routine by teaching her to prepare for activities
  and organize her home. This resulted in less
  anxiety and frustration for Anna and the
  children. In addition, Anna was taught "active
  listening", a skill that enhances understanding
  and relationships.
• With the help of BSF, Anna scheduled and attended
  a substance abuse evaluation. At the
  recommendation of the substance abuse counselor,
  she began attending intensive outpatient
  services. Anna admitted that she had a substance
  abuse problem and identified her lack of coping
  skills as a reason she continually relapsed.
• By the end of the intervention, Anna also began a
  technical school, utilizing the new communication
  skills she learned with BSF.

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What participants say.

• My IHS always knew what we needed and helped us
  get it. My daughter has not had any trouble since
  the program. (first participant in BSF)
• My IHS has been the biggest help to me and my
  daughter throughout my whole situation. I would
  recommend BSF for anyone that needs help.
• I was very satisfied with the program the
  visits, resources and education.
• The program slowed me down so that I could take
  time to make more time with my family. I think my
  family is in for great times together now. Thank
  you.
• My specialist helped me with my needs. She helped
  me with drug and alcohol issues and my anger
  management. She has really been helpful with my
  family. I could call her anytime of the day.
• Making goals and with BSF help, I was able to
  accomplish them.
• Instead of seeing all my wrongs, she saw my
  strengths and how I could use them to better my
  life.

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The Product

• Kathryn Bowen, PhD
• Lead Evaluator
• Centerstone Research Institute
• kathryn.bowen_at_centerstone.org

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Long Term Outcomes (Examples)

• SAFETY
• Children are protected from abuse and neglect.
• PERMANENCY
• Children have permanency and stability in their
  living situations.
• Children are able to stay out of state custody.
• Children are reunified sooner with their
  families.
• WELL-BEING
• Families have enhanced capacity to provide for
  their childrens needs.
• Improved family functioning.
• Improved mental health functioning.
• Improved employment and/or educational
  /vocational status.
• Risk factors are reduced and protective factors
  are increased.
• REGIONAL PARTNERSHIP/ SERVICE CAPACITY
• Targeted counties have a new or increased ability
  to address parental substance abuse and its
  effect on children.

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Short-Term Outcomes (Examples)

• CHILD/YOUTH OUTCOMES
• Increase in number of children who are able to
  remain in the parents/ caregivers custody until
  program discharge.
• ADULT OUTCOMES
• Increase in number of parents who receive a
  referral, complete an intake, enter and
  successfully complete substance abuse treatment.
• Increase in number of parents who are employed or
  are in an educational/vocational program .
• FAMILY/RELATIONSHIP OUTCOMES
• Increase in number of families who have improved
  functioning in service plan goal areas, e.g.,
  primary medical care, dental care, mental health
  care, residential, transportation, family life,
  parenting, child care, domestic violence
  services, social/recreational, legal, etc.
•  Parents and youths perception of improved
  family functioning.
• REGIONAL PARTNERSHIP/ SERVICE CAPACITY
• Increase in percentage of frontline staff and
  supervisors reporting better understanding of
  local partners policies and services.
• Increase in knowledge of cross-agency referral
  process .
•  

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BSF Evaluation

• BSF Referral Counties

• Participants Enrolled in Evaluation

• 54- intake interviews (parent/caregivers)
• 47- discharge interviews
• 23- 6-month follow-up interviews
• 10- 12-month follow-up interviews

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Demographics

• 72- Adults Interviewed
• 46- Biological Mothers (63)
• 16- Biological Fathers (22)
• 5- Grandmothers (6)
• 5- Other (next of kin, significant other,
  etc.)

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Current Evaluation Numbers

• 54- Families
• 4- families currently open
• 42- families completed BSF (84 completion rate)
• 51 hours- average number direct contact hours
• 34 days- average number of days case is open
• 50 adults/adolescents- referred to substance
  abuse treatment (60 from BSF staff)
• 16- adults completed substance abuse treatment
  (32)

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CHILDREN/YOUTH

• 105- Index Children
• 82- children/youth remained in the home and did
  not enter State Custody (42 families)
• 23- youth 13-17 years
• 37-children 5-12 years
• 15-children Preschool (2-4 years)
• 7- children 1 year or younger
• 7-children/youth (open)
• 8- children/youth entered State Custody
• 1 youth ran away
• 7- children were from families who did not
  complete BSF (moved, custody change, etc.)

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Family Functioning (Adult Perspective n58)
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Family Functioning (Youth Perspective n24)
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Any Questions?
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Thanks for coming!

• Please complete an evaluation form before leaving!