MIECHV Data Collection Manual

Transcription

1 MIECHV Data Collection Manual Nurse-Family Partnership Florida Maternal, Infant and Early Childhood Home Visiting Program December 8, 2015

2 Table of Contents Introduction Introduction... 1 Timeframes for Completing MIECHV Forms and Assessments... 1 MIECHV Forms/Assessments and Instructions Household Profile... 2 Instructions: Household Profile... 3 Household Profile - UPDATE... 4 Instructions: Household Profile UPDATE... 5 Home Visit Encounter MIECHV Supplement... 6 Instructions: Home Visit Encounter MIECHV Supplement... 7 Infant Record... 8 Instructions: Infant Record... 9 Benchmark Evaluation Instructions: Benchmark Evaluation Perceived Stress Scale Instructions: Perceived Stress Scale Domestic Violence Assessment Instructions: Domestic Violence Assessment Appendix Income Guidance Note: When this manual is revised, revisions are highlighted in yellow so that users can easily identify changes from previous versions.

3 I. Introduction The Florida Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program is funded by the federal government through the Health Resources and Services Administration (HRSA). As such, there are federally mandated reporting requirements that must be met in order for funding to continue. These requirements include annual reporting of demographics and other characteristics of individuals participating in the program. Additionally, the Florida MIECHV Program must evaluate program performance and outcomes through careful measurement and annual reporting on 35 Performance Measures, which are detailed in the Florida MIECHV Benchmark Plan. Data are also collected to inform quality improvement efforts, which are outlined in the Florida MIECHV Continuous Quality Improvement (CQI) Plan. Nurse Home Visitors can use forms specially designed for MIECHV NFP sites to collect all data required for MIECHV. This manual provides detailed guidance on use of these forms. The Nurse-Family Partnership National Service Office requires data collection specific to the NFP program model. These data are used whenever possible for federal reporting, reducing the need for additional data collection substantially and avoiding redundancies as much as possible. The Florida MIECHV Program has developed a web-based ETO data system called the Florida Home Visiting Information System (FLOHVIS). FLOHVIS will capture data required for MIECHV, and also connects to the NFP ETO data system to access all data for a complete picture of program implementation by NFP sites. Data entry into FLOHVIS was designed to match up with the NFP MIECHV Forms, making it easy to enter and search for data in the system. Nurse Home Visitors may also choose to use laptop or tablet computers in the home to enter data directly into the system. Questions about FLOHVIS can be directed to Virginia Holland via at flohvis@fahsc.org. II. Timeframes for Completing NFP MIECHV Forms and Assessments FORM/ASSESSMENT # times completed for each family Household Profile 1 Enrollment Household Profile - UPDATE 2 Home Visit Encounter - MIECHV Supplement multiple 12 months Post-Enrollment 24 months Post-Enrollment WHEN IS IT COMPLETED? At every home visit as needed Infant Record 1 As soon as infant s Social Security Number has been issued. Benchmark Evaluation 3 Perceived Stress Scale 2 Domestic Violence Assessment as needed Child age 2 months Child age 6 months Child age 12 months Child age 2 months Child age 12 months After completion of the NFP Relationship Assessment and at any time that the status of the safety plan changes. Timely Data Collection and Data Entry MIECHV Forms and Assessments should be completed within one month of the designated timeframe. For example, if the form is to be completed at Child Age 2 Months, then the data collection period is the whole month that the child is two months old. If the form is to be completed at 6 Months Post- Enrollment, then data can be collected anytime during the month after the six-month anniversary of enrollment. It is required that paper forms and assessment tools be completed within 48 hours of the home visit (24 hours is recommended) and that they be entered into FLOHVIS within one week. 1

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5 Florida MIECHV Program: Nurse-Family Partnership Household Profile Client ID: Client Name: DOB: Date: NHV ID: NHV Name: Household Information 1. Client SSN: If client does not have a SSN, enter If client has a SSN but you have not obtained it yet, enter High Priority Populations Answer Options Yes to any question below indicates a Yes answer for that item 2. Child abuse/child welfare system Yes No 3. Substance Abuse Yes No Does client have a history of child abuse or neglect? Has abuse/neglect resulted in involvement with child welfare system? Does client have current or previous substance abuse problems? Does she need substance abuse treatment? 4. Tobacco Use Yes No Does anyone living in the home use tobacco? 5. Low Student Achievement Yes No Does client feel that she has/had low achievement in school? (Possible probe: Are you satisfied/dissatisfied with your level of achievement in school? ) 6. During the past 12 months, what was your yearly total household income before taxes? Include your income, your spouse s or partner s income, and any other income you may have received. All information will be kept private and will not affect any services you are now getting. $ 7. How many people depend on this income? # people If income cannot be determined, indicate the primary reason: Key family member(s) will not disclose income Client is in foster care Other: 8. What kind of health insurance coverage do you have now? Private health insurance from your job or the job of your spouse, partner, or parents Private health insurance purchased directly from an insurance company by you or someone else Medicaid (see question 8b) Florida KidCare Tri-Care or other military health care Medicare 8b. During the month before you got pregnant with your new baby, did you have Medicaid? Yes No Other: No insurance coverage 2

6 Instructions Household Profile The Household Profile should be completed within one month of enrollment. Section/Item Instructions 1. Client SSN This is a required field in FLOHVIS. Social Security Numbers are needed from every Client and every Target Child enrolled. These numbers help to link data sets required for program evaluation and continued funding of the program. If Client does not have a SSN, enter If Client has a SSN but you have not obtained it yet, enter but update this field as soon as possible. High Priority Populations Some of these items may be difficult to ask during the first home visit, hence the one month window for completing this form. These data are extremely important for federal reporting and should not be omitted for any reason. The shortened name of the field used in FLOHVIS is provided in the left column, with the yes/no answer options in the middle. On the right side are questions to clarify the intent of each item or to suggest ways to phrase the question. The Nurse Home Visitor has flexibility in how the information is obtained. 2. Child abuse/ child welfare system 3. Substance abuse 4. Tobacco Use 5. Low Student Achievement 6. Household income (Additional guidance in Appendix) 7. # people Income cannot be determined 8. Client health insurance Client has a history of abuse or neglect or has had involvement with child welfare services either as a child or as an adult (based on self-report). Client has a history of substance abuse or has been identified as needing substance abuse services through a substance abuse screening administered upon enrollment (based on selfreport). Client or another household member uses tobacco products in the home or has been identified as using tobacco through a substance abuse screening administered during intake (based on self-report). The suggested prompt was changed to better match the definition above; it now includes anyone in the household who uses tobacco in any form. Client perceives herself as having low student achievement (based on self-report). Include money income that supports the family enrolled in home visiting services before taxes. Do not include noncash benefits (such as public housing, Medicaid, and food stamps). Examples of money income : Wages/earnings, unemployment compensation, workers' compensation, Social Security, Supplemental Security Income, public assistance, veterans' payments, survivor benefits, pension or retirement income, interest, rents, educational assistance, alimony, child support, assistance from outside the household, and other miscellaneous sources. Include people in the household who are part of the family enrolled in home visiting services and who depend upon the income reported in Question 5. Non-relatives such as housemates should not be included. In rare circumstances, it may not be possible to determine household income. If either Question 6 or Question 7 is left blank, then complete this question. Choose one. Indicate what type of health insurance coverage the Client has currently. Choose one. If the Client has Medicaid, ask question #8b. If the Client receives health care services at a safety net health care provider such as a Federally Qualified Health Center, mark no insurance coverage. 3

7 Florida MIECHV Program: Nurse-Family Partnership Household Profile - UPDATE Client ID: Client Name: DOB: Date: NHV ID: NHV Name: Timeframe of Update: 12 Months Post-Enrollment 24 Months Post-Enrollment Other Household Information 1. During the past 12 months, what was your yearly total household income before taxes? Include your income, your spouse s or partner s income, and any other income you may have received. All information will be kept private and will not affect any services you are now getting. $ 2. How many people depend on this income? # people If income cannot be determined, indicate the primary reason: Key family member(s) will not disclose income Client is in foster care Other: 3. What kind of health insurance coverage do you have now? Private health insurance from your job or the job of your spouse, partner, or parents Private health insurance purchased directly from an insurance company by you or someone else Medicaid (see question 3b) Florida KidCare Tri-Care or other military health care Medicare Other: * If the woman is pregnant or less than eight weeks postpartum, ask: 3b. During the month before you got pregnant with your new baby, did you have Medicaid? Yes No No insurance coverage 4. What kind of health insurance coverage does your child have now? Private health insurance from your job or the job of your spouse, partner, or parents Private health insurance purchased directly from an insurance company by you or someone else Medicaid Florida KidCare Tri-Care or other military health care Medicare Other No insurance coverage 4

8 Instructions Household Profile - UPDATE The Household Profile UPDATE should be completed two times per family over the course of the program at 12 Months Post-Enrollment and 24 Months Post-Enrollment. New in 2015: Complete this form at some time between October and January. If one of the post-enrollment timeframes is not due during that time, complete it with the timeframe Other. Then complete it again when the next post-enrollment timeframe is due. Section/Item 1. Household income (Additional guidance in Appendix) Instructions Include money income that supports the family enrolled in home visiting services before taxes. Do not include noncash benefits (such as public housing, Medicaid, and food stamps). Examples of money income : Wages/earnings, unemployment compensation, workers' compensation, Social Security, Supplemental Security Income, public assistance, veterans' payments, survivor benefits, pension or retirement income, interest, rents, educational assistance, alimony, child support, assistance from outside the household, and other miscellaneous sources. 2. # people Income cannot be determined 3. Client health insurance 4. Child Health Insurance Include people in the household who are part of the family enrolled in home visiting services and who depend upon the income reported in Question 5. Non-relatives such as housemates should not be included. In rare circumstances, it may not be possible to determine household income. If either Question 1 or Question 2 is left blank, then complete this question. Choose one. Indicate what type of health insurance coverage the Client has currently. Choose one. If the Client has Medicaid and is pregnant or gave birth less than eight weeks ago, ask question #3b. If the Client receives health care services at a safety net health care provider such as a Federally Qualified Health Center, mark no insurance coverage. Indicate what type of health insurance coverage the child has at enrollment. Choose one. If the child receives health care services at a safety net health care provider such as a Federally Qualified Health Center, mark no insurance coverage. Florida MIECHV Program: Nurse-Family Partnership 5

9 Home Visit Encounter MIECHV Supplement Client ID: Client Name: DOB: Date: NHV ID: NHV Name: Safety Topics Discussed at Home Visit (check all that apply) Safe Sleep Shaken Baby Syndrome Traumatic Brain Injury Car Seat/Passenger Safety Poison Safety Fire Safety Water Safety Playground Safety Child Injury requiring medical attention Choking Home Safety This section is to be completed at first home visit of the month during the child s first year of life. 1. How old is the child now? 1 month old 5 months old 9 months old 2 months old 6 months old 10 months old 3 months old 7 months old 11 months old 4 months old 8 months old 12 months old 2. In the past month, have you seen a doctor, nurse or other medical professional? No Yes Where was the care provided? (check all that apply) Emergency room Doctor s Office County Health Department or Federally Qualified Health Center (a clinic) Urgent Care Other 3. In the past month, has your child seen a doctor, nurse or other medical professional? Instructions No Yes Was the visit for: (check all that apply) a regular (well-child) checkup treating an injury diagnosing and treating an illness immunization special healthcare needs other Where was the care provided? (check all that apply) Emergency room Doctor s Office County Health Department or Federally Qualified Health Center (a clinic) Urgent Care Other 6

10 Home Visit Encounter MIECHV Supplement The MIECHV Supplement to the Home Visit Encounter can be used at every home visit, if needed. During the first year of the child s life, Nurse Home Visitors ask important questions about health care utilization at the first home visit of every month. At other times, only the safety topics that were discussed during the visit are recorded. Section/Item Safety Topics Mark any topic discussed at that home visit. Instructions These questions are only completed during the first year of the child s life. Please complete these questions at the first home visit of the month, every month from child age one to 12 months. 1. How old is the child? Mark child age (which month of the 12 months that the questions are required). 2. In the past month, have you seen a doctor, nurse or other medical professional? 3. In the past month, has your child seen a doctor, nurse or other medical professional? If the answer is Yes, mark all the places where Client received care. For example: If she first went to the Emergency Room and then followed up at a doctor s office, record both. If she had two separate events, and received care in three different types of places, mark all three. If the child was seen ( Yes response): First record the reason or reasons for the visit(s). Then record the place or places where the child received care. See examples above for further clarification. 7

11 Florida MIECHV Program: Nurse-Family Partnership Infant Record Client ID: Client Name: DOB: Date: NHV ID: NHV Name: Infant #1 Infant First Name: Infant Last Name: Infant SSN: For multiple births: Infant #2 Infant First Name: Infant Last Name: Infant SSN: Infant #3 Infant First Name: Infant Last Name: Infant SSN: Reminder: If there are multiple births, enter a separate NFP Infant Record TouchPoint for each infant. 8

12 Instructions Infant Record The Infant Record should be completed one time per family after the birth of the target child. Complete it as soon as the target child is issued a social security number. For twins or triplets, all information can be captured on one form, but each child s information should be entered into FLOHVIS in a separate NFP Infant Record TouchPoint. Do not complete this form for subsequent children born into the family only for the target child. Infant First Name Infant Last Name Infant SSN Enter Infant Names exactly as they are entered in NFP ETO. This field was moved from the Benchmark Evaluation (2 month) to the Infant Record. This is a required field in FLOHVIS. Social Security Numbers are needed from every Target Child enrolled. 9

13 Florida MIECHV Program: Nurse-Family Partnership Benchmark Evaluation Client ID: Client Name: DOB: Date: NHV ID: NHV Name: Child Age: 2 Months 2 Months 6 Months 12 Months 1. How many cigarettes do you smoke on an average day now? (A pack has 20 cigarettes.) 2. How many times a week do you take a multivitamin, a prenatal vitamin, or a folic acid vitamin? 3. What kind of health insurance coverage does your child have now? 6 Months 41 cigarettes or more 21 to 40 cigarettes 11 to 20 cigarettes 6 to 10 cigarettes 1 to 5 cigarettes Less than 1 cigarette I don t smoke now I don t take a multivitamin, prenatal vitamin, or folic acid 1 to 3 times a week 4 to 6 times a week Every day of the week Private health insurance from your job or the job of your spouse, partner, or parents Private health insurance purchased directly from an insurance company by you or someone else Medicaid Florida KidCare Tri-Care or other military health care Medicare Other No insurance coverage 1. What kind of health insurance coverage do you have now? 2. What kind of health insurance coverage does your child have now? Private health insurance from your job or the job of your spouse, partner, or parents Private health insurance purchased directly from an insurance company by you or someone else Medicaid (see question 1b) * If the woman is pregnant or less than Florida KidCare Tri-Care or other military health care Medicare 8 weeks postpartum, ask: 1b. During the month before you got pregnant with your new baby, did you Other: have Medicaid? Yes No insurance coverage No Private health insurance from your job or the job of your spouse, partner, or parents Private health insurance purchased directly from an insurance company by you or someone else Medicaid Florida KidCare Tri-Care or other military health care Medicare Other No insurance coverage 10

14 Florida MIECHV Program: Nurse-Family Partnership Benchmark Evaluation Client ID: Client Name: DOB: Date: NHV ID: NHV Name: 12 Months 1. How many cigarettes do you smoke on an average day now? (A pack has 20 cigarettes.) 41 cigarettes or more 21 to 40 cigarettes 11 to 20 cigarettes 6 to 10 cigarettes 1 to 5 cigarettes Less than 1 cigarette I don t smoke now 2. How many times a week do you take a multivitamin, a prenatal vitamin, or a folic acid vitamin? I don t take a multivitamin, prenatal vitamin, or folic acid 1 to 3 times a week 4 to 6 times a week Every day of the week 3. During the past 12 months, what was your yearly total household income before taxes? Include your income, your spouse s or partner s income, and any other income you may have received. All information will be kept private and will not affect any services you are now getting. $ 4. How many people depend on this income? # people If income cannot be determined, indicate the primary reason: Key family member(s) will not disclose income Client is in foster care Other: 5. What kind of health insurance coverage do you have now? Private health insurance from your job or the job of your spouse, partner, or parents Private health insurance purchased directly from an insurance company by you or someone else Medicaid (see question 5b) * If the woman is pregnant or less than Florida KidCare Tri-Care or other military health care Medicare 8 weeks postpartum, ask: 5b. During the month before you got pregnant with your new baby, did you Other: have Medicaid? Yes No insurance coverage No 6. What kind of health insurance coverage does your child have now? Private health insurance from your job or the job of your spouse, partner, or parents Private health insurance purchased directly from an insurance company by you or someone else Medicaid Florida KidCare Tri-Care or other military health care Medicare Other No insurance coverage 7. Since you had [child s name], have you been pregnant? No Yes When did the pregnancy begin? / / 11

15 Instructions Benchmark Evaluation This Benchmark Evaluation should be completed three times per family at the specified timeframe. Each timeframe requires different questions to be asked. 2 Months Section/Item 1. Cigarette Smoking 3. Child Health Insurance 6 Months Section/Item 1. Client Health Insurance 2. Child Health Insurance 12 Months Section/Item 1. Cigarette Smoking 3. Household income (Additional guidance in Appendix) 4. # people Income cannot be determined 5. Client Health Insurance 6. Child Health Insurance Instructions This question only asks about cigarettes; it does NOT include use of cigars, thin cigars, cigarillos, or e-cigarettes. Indicate what type of health insurance coverage the child has. Choose one. If the child receives health care services at a safety net health care provider such as a Federally Qualified Health Center, mark no insurance coverage. Instructions Indicate what type of health insurance coverage the Client has currently. Choose one. If the Client has Medicaid and is pregnant or gave birth less than eight weeks ago, ask question #1b. If the Client receives health care services at a safety net health care provider such as a Federally Qualified Health Center, mark no insurance coverage. Indicate what type of health insurance coverage the child has. Choose one. If the child receives health care services at a safety net health care provider such as a Federally Qualified Health Center, mark no insurance coverage. Instructions This question only asks about cigarettes; it does NOT include use of cigars, thin cigars, cigarillos, or e-cigarettes. Include money income that supports the family enrolled in home visiting services before taxes. Do not include noncash benefits (such as public housing, Medicaid, and food stamps). Examples of money income : Wages/earnings, unemployment compensation, workers' compensation, Social Security, Supplemental Security Income, public assistance, veterans' payments, survivor benefits, pension or retirement income, interest, rents, educational assistance, alimony, child support, assistance from outside the household, and other miscellaneous sources. Include people in the household who are part of the family enrolled in home visiting services and who depend upon the income reported in Question 5. Non-relatives such as housemates should not be included. In rare circumstances, it may not be possible to determine household income. If either Question 3 or Question 4 is left blank, then complete this question. Choose one. Indicate what type of health insurance coverage the Client has currently. Choose one. If the Client has Medicaid and is pregnant or gave birth less than eight weeks ago, ask question #5b. If the Participant receives health care services at a safety net health care provider such as a Federally Qualified Health Center, mark no insurance coverage. Indicate what type of health insurance coverage the child has. Choose one. If the child receives health care services at a safety net health care provider such as a Federally Qualified Health Center, mark no insurance coverage. 12

16 Florida MIECHV Program: Nurse-Family Partnership Perceived Stress Scale Client ID: Client Name: DOB: Date: NHV ID: NHV Name: Child Age: 2 Months 12 Months The questions in this scale ask you about your feelings and thoughts during the last month. In each case, you will be asked to indicate how often you felt or thought a certain way. Circle the number that best reflects your experience. In the last month, how often have you: Never Almost Never Sometimes Fairly Often Very Often 1. Been upset because of something that happened unexpectedly? 2. Felt that you were unable to control the important things in your life? Felt nervous and "stressed"? Felt confident about your ability to handle your personal problems? Felt that things were going your way? Found that you could not cope with all the things that you had to do? Been able to control irritations in your life? Felt that you were on top of things? Been angered because of things that were outside of your control? 10. Felt difficulties were piling up so high that you could not overcome them?

17 Instructions Perceived Stress Scale The Perceived Stress Scale should be completed at child age 2 months and again at child age 12 months. What is the Perceived Stress Scale? The Perceived Stress Scale (PSS) is the most widely used psychological instrument for measuring the perception of stress. It is a measure of the degree to which situations in one s life are appraised as stressful. Items were designed to tap how unpredictable, uncontrollable, and overloaded respondents find their lives. The scale also includes a number of direct queries about current levels of experienced stress. The PSS was designed for use in community samples with at least a junior high school education. The items are easy to understand, and the response alternatives are simple to grasp. Moreover, the questions are of a general nature and hence are relatively free of content specific to any subpopulation group. The questions in the PSS ask about feelings and thoughts during the last month. In each case, respondents are asked how often they felt a certain way. Scoring: PSS scores are obtained by reversing responses (e.g., 0 = 4, 1 = 3, 2 = 2, 3 = 1 & 4 = 0) to the four positively stated items (items 4, 5, 7, & 8) and then summing across all scale items. Sources: The PSS Scale is reprinted with permission of the American Sociological Association, from Cohen, S., Kamarck, T., and Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, Cohen, S. and Williamson, G. Perceived Stress in a Probability Sample of the United States. Spacapan, S. and Oskamp, S. (Eds.) The Social Psychology of Health. Newbury Park, CA: Sage,

18 Florida MIECHV Program: Nurse-Family Partnership Domestic Violence Assessment Client ID: Client Name: DOB: Date: NHV ID: NHV Name: Review of NFP Relationship Assessment 1. Date of NFP Relationship Assessment / / 2. Did the NFP Relationship Assessment identify the presence of or risk for domestic violence? Yes Make a referral and complete Safety Planning section below No 2a. If risk=yes and you did not make a referral because Client is already receiving appropriate services, check here and describe those services. Client already receiving appropriate services Safety Planning No safety plan in place 3. Safety Plan Status (choose one) Safety planning in progress Complete #4 below Safety plan complete Complete #4 below 4. Date of Safety Plan Status / / Notes Reminders: If domestic violence is present or identified as a risk, safety planning should begin as soon as possible. Complete a new form/touchpoint any time the status of the safety plan changes. 15

19 Instructions Domestic Violence Assessment This form should be completed every time the NFP Relationship Assessment is completed and any time that the status of the safety plan changes. Safety planning is critical in cases where a Client is vulnerable to domestic violence (aka Intimate Partner Violence). A safety plan should be developed as soon as possible once a Client is assessed as being vulnerable to domestic violence. The home visitor does not have to develop the safety plan herself. In fact, it is often preferable that a trained Domestic Violence advocate work with the Client on the safety plan. Section/Item Instructions Review of NFP Relationship Assessment This section is to be completed every time the NFP Relationship Assessment is completed. 1. Date of NFP Relationship Assessment 2. Presence of/risk for DV Identified Record the date when the NFP Relationship Assessment was completed. Based on the outcome of the NFP Relationship Assessment, the Nurse Home Visitor indicates whether the assessment identified the presence of or risk for domestic violence. 2a. Referral not made If the answer to #2=Yes and you did not make a referral because the Client is already receiving appropriate services, check the box and describe those services. Be sure that the services are specifically geared toward addressing intimate partner violence. Safety Planning This section is to be completed if the answer to #2 is Yes and any time the status of the safety plan changes. Indicate the status of the Client s safety plan. 3. Safety Plan Status Safety planning in progress is the correct option to choose if safety planning has begun, but more is to be done before the plan is considered complete. If No safety plan in place or Safety planning in progress is selected, be sure to complete this assessment again when the status of the safety plan status improves. Similarly, if a safety plan becomes inadequate for the Client s situation, complete this assessment again and indicate the status change. 4. Date of Safety Plan Notes Record date that the safety plan was started/completed. Leave this blank if answer to #1 is no safety plan. Record any case notes as needed. 16

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21 Appendix

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23 Income Guidance Questions to be completed at each interval 1) During the past 12 months, what was your yearly total household income before taxes? Include your income, your spouse s or partner s income, and any other income you may have received. (All information will be kept private and will not affect any services you are now getting.) 2) How many people depend on this income? 3) If income cannot be determined, indicate the primary reason: a. Key family member(s) would not disclose income. b. Participant is in foster care. c. Other reason: Guidance for completing each question: Question 1 - Include money income that supports the family enrolled in home visiting services before taxes. - Do not include noncash benefits (such as public housing, Medicaid, and food stamps). Examples of money income : Wages/earnings, unemployment compensation, workers' compensation, Social Security, Supplemental Security Income, public assistance, veterans' payments, survivor benefits, pension or retirement income, interest, rents, educational assistance, alimony, child support, assistance from outside the household, and other miscellaneous sources. Question 2 - Include people in the household who are part of the family enrolled in home visiting services and who depend upon the income reported in Question 1. - Non-relatives such as housemates should not be included. Family enrolled in home visiting services Includes primary caregiver, spouse or partner, target child and any other dependents. Question 3 - In rare circumstances, it may not be possible to determine household income. If either Question 1 or Question 2 is left blank, complete Question 3 to indicate the primary reason. 17

24 Frequently Asked Questions/Concerns for Income Collection Do we count a pregnant woman as one or two people? A pregnant woman should be counted as two people. How do we count families who are homeless and staying with friends/family? Only include the people who are considered part of the family enrolled in home visiting services. Include any money those people receive to support themselves, including cash from friends or family. Do not count housing costs or food expenses provided by others. What if the primary caregiver and child live in a home with the primary caregiver s parents or other family members? We are looking at economic self-sufficiency for the family enrolled in home visiting services. If the Participant s parents provide housing and food, this is similar to the non-cash benefits provided by housing assistance and food stamps. Therefore, only include money income that the Participant receives and only include the Participant and child (plus partner and other children, if applicable) in the count of people dependent on the income. What if the family claims to have $0 income? This would be accurate in very few scenarios, e.g. a minor Participant who is financially dependent upon her parent(s). However, any money income such as a cash allowance provided to the Participant could be counted. If a Participant refuses to share income information or claims $0 when you know that isn t possible, please leave the amount blank and document why income information cannot be determined in question #3. Minors/parents don t disclose income because they don t think it s relevant. Devise some helpful language for explaining why this information is needed and how it will be used. Key points would be that the funder of the program requires this information be reported so that we can describe the economic situation of the families served. Emphasize that a goal of the program is to improve the family s economic situation during the time they are enrolled. We will ask about income each year to see how things have changed over time. Reiterate that the information will not affect their participation in the program. If families are completing the information themselves on a paper form and do not compete these questions, then the home visitor will need to review them in conversation. It s very challenging to get income information on the first visit because the family does not feel comfortable with the home visitor yet. Our funding requires that these questions are completed within the first 30 days after enrollment. If you are providing weekly visits in the beginning, you could consider delaying these questions until the second or third visit after the family is more comfortable with the home visitor. The risk to this approach is that if the family disengages from the program before these questions are complete, then there will be missing data for this family. Income changes from month to month, it s not reflective of the entire year to only ask about income from the previous month. If the family cannot estimate an annual amount, you may ask about the previous month and multiply by 12 as a way to make it easier for the family to respond. While using the previous month times 12 may not accurately reflect the entire years income, it is a common way to estimate annual income and is an acceptable way to complete these questions if an annual estimate cannot be given. 18

25 Tips from the Field for Income Collection Ask the income questions in the same manner you would ask any other demographic question. If you show discomfort or apologize for asking, you may unintentionally introduce doubt or mistrust into the exchange. Help the Participant to calculate weekly or monthly income and then multiply by the appropriate amount to estimate annual income. When contacting the Participant to schedule the intake visit, tell them it would helpful if they would gather some personal information in preparation for the visit. The enrollment paperwork includes basic information about the family, such as recent income. 19