SAFECARE SITE APPLICATION

GUIDE BOOK

1.0 Organization(s)/System(s) Profile and Experience.

1.1 Your application may include a single agency or a collaboration among agencies/organizations. In this section, please provide a description of each of the organization or collaborative that is applying for this SafeCare Training opportunity. For each organization, please briefly describe the organizational structure and size, number of employees, history of providing related services, and the types of clients served.

1.2 If your application includes a collaboration of agencies/organizations, describe the partnership that is applying and the specificroles each organization will play in the implementation of SafeCare.For example, some organizations may provide funding for services and provide referrals (e.g., a county child welfare office), whereas others may conduct SafeCare with families. Include a graphic if useful.

1.3 If any of the organizations on this application have successfully collaborated with the other organizations in the past, describe that collaboration and how that experience will aid in the implementation of SafeCare.

2.0 Service system in which SafeCare will be implemented

2.1 There are various service systems in which SafeCare services are offered to families, including child welfare offices (e.g., family preservation services) or prevention services. Describe the service system(s) in which your organization will implement SafeCare.

2.2SafeCare is an evidence based program focused on helping parents develop skills in the areas of parent-child interaction, home safety, and child health. SafeCare addresses basic parenting skills to help parents build a solid foundation for their children’s health and wellbeing. Research conducted on SafeCare has shown that it is most effective among parents of young children (0-5 years old) with a history of, or risk for, neglect and/or physical abuse. With this in mind, describe the population that will receive SafeCarefrom your organization.What eligibility and exclusion criteria will your organization use to determine whether a family will receive SafeCare services?

2.3 Yes/No; If yes, include the number of referrals your organization receives that contain the SafeCare characteristics you described in section 2.2. One of the key problems with implementation of any new programs is a lack of referrals.It is critical that you demonstrate an ability to identify and serve clients who are appropriate for SafeCare.Be sure only to include referrals that would receive SafeCare.

2.4 If you are currently providing services to the targeted SafeCare population (parents of children ages 0-5), describe what services clients currentlyreceive. Please indicate whether a specific curriculum or structured intervention is used, the number of sessions clients receive, and how often families are served (e.g., weekly, monthly, biweekly).Implementing a new program such as SafeCare will work best when SafeCare replaces your current service.If SafeCare is being added to your existing services, and not replacing them, you must justify how you staff will have time to complete 18 additional sessions, and how your funding source will allow for 18 additional sessions.

2.5SafeCare does not address all the needs of a family. For example, SafeCare does not specifically target children with extreme externalizing behavior or children’s special needs related to developmental disabilities (e.g., Autism Spectrum Disorders or Down syndrome). These more specific needs will require an intervention targeting the child’s special needs and behavior. However, SafeCare can be implemented to provide families with additional skills that complement special services. Please describe any other services that will be delivered by the SafeCare provider during home visits.Additionally, if your family preservation program provides services for 6 months, please describe what providers may do when not providing SafeCare (which takes about 18-20 sessions).Note, we anticipate clients may be referred to additional services for substance use, mental health, domestic violence, etc. If these are not delivered by the SafeCare home visitor, they do not need to be described.

2.6 List the organization(s)/institution(s) that you receive referrals from, how referrals flow to your organization, and how they are assigned to providers.Your agency must have an adequate referral base for the targeted population to be served by SafeCare.

3.0 Staffing plan for SafeCare implementation

3.1 Consider the characteristics listed below when determining who will serve each SafeCare role and how home visitors will be organized into teams for randomization.

Administrators, Supervisors/Managers, & Leadership should take the following steps:

  • Become familiar with NSTRC’s training process and implementation model to ensure that requirements can be met.
  • Ensure that managers and staff are committed to both workshop training and in-field support
  • Commit to ongoing coaching (i.e., fidelity monitoring) and ensure that staff have time to receive/provide coaching
  • Ensure that caseloads for SafeCare Home Visitors are appropriate and that staff can complete all other work assignments while doing SafeCare

When choosing SafeCare Home Visitors, a good candidate is someone who:

  • has good communication and interpersonal skills
  • is comfortable delivering interventions to families in the home setting​
  • is open to learning and implementing new curricula or intervention programs
  • is open to or has prior experience delivering a highly structured intervention protocol
  • is able to be both creative and flexible in delivering services to families
  • understands the importance of program fidelity
  • is open and responsive to coachingand constructive feedback

When choosing SafeCare Coaches, a good candidate is someone who:

  • Has the qualities of a good Home Visitor listed above
  • Is willing and able to master the SafeCare Home Visiting model prior to coach training, including working with a minimum of one family to becomeHV certified (required before Coach training)
  • Is good with communication and interpersonal skills
  • Understands the importance of program fidelity
  • Is committed to ongoing work with Home Visitors to ensure the model is conducted properly (ongoing fidelity monitoring is a requirement for SafeCare implementation)
  • Coaches typically work with 4-8 home visitors at one time, and should be allowed to devote 25-50% of their time to coaching

When choosing SafeCare Trainers, a good candidate is someone who:

  • Has the qualities of a good Coach listed above
  • Can maintain their role as a Coach by supporting Home Visitors
  • Is organized, engaging, knowledgeable, a role model, and responds effectively to all staff
  • Is capable of identifying new home visitors and coach trainees along with agency administrators
  • Trainers must be certified as a coach before being trained as a TrainerH

When choosing a Local Coordinator, a good candidate is someone who:

  • Can attendandbecertifiedintheSafeCare®(SC)HomeVisitor,CoachandTrainer Training
  • Has leverage across all organizations at your implementation site and can keep open and constant communication with the trainees and administration
  • Can Providetheon-siteoverallcoordinationofservices

3.2SafeCare is an example of an Evidence-Based Practice (EBP). Unlike most of the services delivered in child welfare, EBPs arehighly structured, may involve data collection, and involve coaching/quality assurance to assist with adherence to the protocol. Prior experiences with EBPs may help your staff/agency understand and facilitate SafeCare implementation.If your organization or staff have implemented or delivered an EBP in the past, describe how that experience will aid in SafeCare implementation.

3.3It is important that staff, supervisors, and administrators be informed of the implementation and motivated to participate and support the success of the implementation. This includes talking with everyone regarding their role in the implementation process. If you have already discussed SafeCare implementation with your staff, describe any questions/concerns that were raised and how they were address.

3.4 Indicate whether your organization anticipates providing SafeCare services to Spanish-only speaking clients. If so, include the number of referrals you receive annually for Spanish-only speaking clients. Will you have Spanish speaking staff to deliver SafeCare to these families? If not, what is your plan to work with these families?

4.0 Sustainment and Spread of SC:

4.1 One of the goals of this project is for your organization to expand SafeCare implementation by training additional staff.If your site is selected, three of your staff will be trained as coach/trainers. They will be expected to provide ongoing coaching for your trained staff, and to expand your SafeCare implementation by training at least 12 additional staff. Describe how your organization will reach the additional staff goal. Where will the new trainees sit among the organizations involved in your site’s SafeCare implementation?

4.2 Considering the time required to train and coach additional staff outlined below, describe how time will be allotted for training and support in reference to any other job duties coaches/trainers may have. Note that “training” new home visitors is not simply conducting the workshop. Trainees must be prepared prior to training and supported closely after training.

Trainers training new Home Visitors and Coaches:Home visitor training includes a 4-day workshop. Coach training requires a 2-day workshop.

Coaching Home Visitors:Coaching Home Visitors requires more time at the onset of implementation and wanes as Home Visitors become more knowledgeable in SafeCare and complete certification. Coaching a Home Visitor requires reviewing a Home Visitor’s session fidelity (1 to 1.5 hours), preparing for the coaching session (.25 hours), and conducting the coaching session (.5 to 1 hour) for a total of approximately 2 hours. In order to become certified, a Home Visitor must perform at 85% fidelity or higher on 9 different sessions (3 sessions per module). The time it takes for a Home Visitor to become certified depends on the Home Visitor’s caseload and the frequency at which they have SafeCare visits with each family. After a Home Visitor achieves certification, coaching responsibilities decrease to about 2 hours a month for monthly fidelity monitoring. In addition, weekly check-ins should occur to determine if a formal coaching session is needed in-between these monthly fidelity checks (e.g., if a HV has a difficult session).Once a Home Visitor is 2 years post-certification, their fidelity monitoring drops to quarterly, further reducing a coach’s time commitment.

Supporting Coaches: Supporting Coaches requires more time with new trainees but lessens as Coaches become more knowledgeable in SafeCare and completes certification. Supporting a Coach requires reviewing a HV session for reliability (1 to 1.5 hours), preparing for a coach support session (.25 hours), and conducting the coach support session (.5 to 1 hour) for a total of approximately 2 hours. For Coaches to become certified, they must receive 85% or greater reliability on HV fidelity on 2 sessions in each of the 3 modules (a total of 6 sessions) and 85% or greater fidelity on the corresponding coaching session. After a Coach achieves certification, trainer responsibilities decrease to about 3 hoursa month for monthly fidelity monitoring. In addition, weekly check-ins should occur to determine if a formal coach support session is needed in-between these monthly maintenance checks (e.g., if a Coach has a difficult coaching session). Once a Coach is 6 months post-certification, their HV fidelity reliability and coach session fidelity drops to quarterly, further reducing a trainer’s support time commitment.

4.3 Coaching is a core component of the SafeCare implementation and is typically not covered in the reimbursement received for the home-visiting portion of the model. Coaching takes time, and must be accounted for in a coach’s workload. Successful implementations of SafeCare have included external funding of coach/trainers to ensure those individuals have sufficient time to carry out coaching and training. Describe coaches and trainers activities will be funded.

1.0Supplies you will need:

5.1 As part of this grant funded implementation, each Home Visitor will be provided with the essential session supplies (e.g. hard and electronic SafeCare manuals and documents, and Home Visitor Tool Kit including clipboard, calculator, baby doll, tape measure). Your agency will be required to supplement these materials with health and safety supplies(e.g. toys, gloves, screwdriver, digital thermometer)as well as photocopies of SafeCare documents for families costing approximately $20 per family. In addition, you providers will need to have high-speed internet access and Java installed to use the SafeCare Training Portal. Prior to workshop training, trainees will use the portal to complete 7 hours of on-line training and quizzes. During implementation, providers will use the portal to upload audio recordings of family sessions as part of fidelity monitoring by their coach or trainer. Please indicate in the application that your organization(s) understands the required supplies and technical resources for SafeCare implementation and has the resources to provide them.