NC Linking Actions to Unmet Needs in Children’s Health
93.243 / Substance Abuse and Mental Health Services – Projects of Regional and National SignificanceState Project/Program: / NC Linking Actions to Unmet Needs in Children’s Health
U. S. Department of Health and Human Services
Federal Authorization: /42 United States Code Section 701-709
State Authorization: /N/A
N. C. Department of Health and Human Services
Division of Public Health
Marshall Tyson
(919) 707-5640
Agency Contact Person – Financial:
Ryan Schultz
Chief Budget Officer
(919) 707-5080
/ N. C. DHHS Confirmation Reports:
SFY 2016 audit confirmation reports for payments made to Counties, Local Management Entities (LMEs), Managed Care Organizations (MCOs), Boards of Education, Councils of Government, District Health Departments and DHSR Grant Subrecipients will be available by mid-October at the following web address: http://www.ncdhhs.gov/control/auditconfirms.htm. At this site, click on the link entitled “Audit Confirmation Reports (State Fiscal Year 2015-2016). Additionally, audit confirmation reports for Nongovernmental entities receiving financial assistance from DHHS are found at the same website except select “Non-Governmental Audit Confirmation Reports (State Fiscal Years 2014-2016).”
The auditor should not consider the Supplement to be “safe harbor” for identifying audit procedures to apply in a particular engagement, but the auditor should be prepared to justify departures from the suggested procedures. The auditor can consider the supplement a “safe harbor” for identification of compliance requirements to be tested if the auditor performs reasonable procedures to ensure that the requirements in the Supplement are current. The grantor agency may elect to review audit working papers to determine that audit tests are adequate.
I. PROGRAM OBJECTIVES
The purpose of NC Linking Actions to Unmet Needs in Children’s Health is to promote the wellness of young children, birth to 8 years of age. The project defines wellness as optimal functioning across all developmental domains, including physical, social, emotional, cognitive and behavioral health. For this project behavioral health includes mental health and positive development free from substance abuse and other negative behavior. The goal of NC Linking Actions to Unmet Needs in Children’s Health is to create a shared vision for the wellness of young children that drives the development of State and locally-based networks for the coordination of key child-serving systems and the integration of behavioral and physical health services. The expected result is for children to be thriving in safe, supportive environments and entering school ready to learn and able to succeed.
NC Linking Actions to Unmet Needs in Children’s Health, through a public health approach, seeks to improve outcomes at the individual and community levels by addressing risk factors that can lead to negative outcomes. Through local implementation in Alamance County the project will promote protective factors that support resilience and healthy development which can protect individuals from later social, emotional, cognitive, physical and behavioral problems.
Since the project defines child wellness as optimal functioning across all developmental domains, the goal is to work across disciplines and with those involved in the lives of young children to come to a shared understanding of healthy child development and young child wellness.
II. PROGRAM PROCEDURES
The NC Linking Actions to Unmet Needs in Children’s Health is administered by the North Carolina Department of Health and Human Services—Division of Public Health, Women’s and Children’s Health Section, Children and Youth Branch.
SAMHSA’s program guidelines require the selection of a lead local agency to support implementation and project activities at a local level. The selection process was guided through an application process. Through an Agreement Addendum, the Alamance County Health Department, as the local lead agency is expected to implement a range of evidence-based programs and practices at the local level to support young child wellness. The programs or practices to be implemented should enhance, improve and/or building upon existing services, or address gaps in services to young children and their families. To support these objectives, local implementation will support strategies in the following five areas:
1. Use of developmental assessments in a range of child-serving settings (e.g. primary care, child care, early childhood education, and behavioral health programs); assessments should be used to facilitate appropriate referrals throughout the child-serving system,
2. Integration of behavioral health programs and practices into primary care,
3. Home visiting programs,
4. Mental health consultation in primary care, child care or early education settings,
5. Family strengthening and parent skills training.
These five strategies are requirements of the federal project model. According to SAMHSA, local grantees may tailor evidence-based programs or practices to address their particular needs or the needs of the communities they serve.
The project activities will be designed to increase public awareness and knowledge of child wellness, particularly among parents and other early childhood caregivers. In addition, Alamance County must implement a local workforce development strategy to enhance the expertise of primary care providers, mental and behavioral health providers, child welfare providers, child care providers, early childhood educators and primary grade educators related to young child wellness and health child development.
NC LAUNCH activities should support cross-sector collaboration and systems integration efforts at the State and local levels to ensure that resources are shared, used efficiently, and are aligned with both State and local strategic plans for young children.
The local efforts of this project will be supported through a local Council on Young Child Wellness whose involvement is supported through documentation including letters of support and Memorandums of Agreement from local stakeholders.
Alamance County will also support the implementation of the Attachment and Behavioral Catch-Up (ABC) Learning Collaborative led by Duke University’s Center for Child & Family Health. This effort will provide training and skill development to a select group of mental health providers who are interested in providing services to young children.
The project shall:
1. Implement a range of evidence-based programs/practices at the local level to support young child wellness. The programs or practices to be implemented should enhance, improve and/or build upon existing services, or address gaps in services to young children and their families. See Attachment I: Budget and Budget Narrative for specific activities to be implemented during Year One.
2. Select evidence-based practices and programs that meet the specific needs of their communities, and which build upon and/or enhance current services and programs or gaps in service.
3. Implement and or subcontract for practices in the following five areas as outlined in Attachment I: Budget and Budget Narrative:
(a) Use of developmental assessments in a range of child-serving settings (e.g. primary care, child care, early childhood education, and behavioral health programs); assessments should be used to facilitate appropriate referrals throughout the child-serving system,
(b) Integration of behavioral health programs and practices into primary care,
(c) Home visiting programs,
(d) Mental health consultation (e.g. in primary care, child care or early education settings),
(e) Family strengthening and parent skills training.
4. Implement Attachment and Behavioral Catch-Up (ABC) Learning Collaborative through a subcontract with Duke University Psychiatry and Behavioral Sciences’ Evidence-Based Practice Implementation Center. This will provide training and skill development to a select group of mental health providers who are interested in providing services to young children.
5. Hire a Local Young Child Wellness Coordinator within two months from the start of local project. The Contractor shall coordinate with the State LAUNCH Coordinator to include State representatives on the interview and selection committee. Through the implementation of NC LAUNCH, activities at the local level include the expansion and enhancement of evidence-based programs and practices intended to promote the wellness of young children and their families as well as infrastructure reform and workforce development activities. Leadership at the local level will be provided by the Local Young Child Wellness Coordinator and the Local Council on Young Child Wellness. Hiring for this position will require review and approval by SAMHSA.
6. Maintain an Oversight Council on Young Child Wellness, to include, but not limited to, representatives from Health (including the private sector), Mental Health, Child Welfare, Substance Abuse Prevention, Early Childhood Education and Local Education Agencies (Head Start, Early Head Start and Part C) or integrate these functions into an existing body whose primary function is young child wellness. Within two months of the start of the local project, agencies/organizations that serve on the local Oversight Council on Young Child Wellness must sign a Memorandum of Agreement (MOA). The MOA must describe the specific roles and responsibilities of each of the partners in the collaboration and their roles on the Local Council on Young Child Wellness. The engagement of community stakeholders may include, but are not limited to, working with the Council to develop environmental scans and strategic plans, participation in oversight of the development and implementation of local level services and activities that support Project LAUNCH, and participation in infrastructure/systems reform, policy development and/or workforce development activities at the local level.
7. Maintain an environmental scan (using SAMHSA guidance and templates). The document should map out the public and private systems and programs (including Federal, State, local and private grants) that serve children from birth to 8 years of age and their families at the local level.
8. Maintain a local strategic plan (using SAMHSA guidance and templates), which incorporates findings from the initial needs assessment, describes an approach to address gaps and unmet needs to address young child wellness, and explains how program resources will be used to address these needs. The local plan will be developed within four months of the grant award and must link with the State strategic plan to support young child wellness. Within four months of initial funding, this plan must be submitted to Federal Project Staff for their review and approval. Further federal funding will be contingent on the approval of this plan. It is important to note that the strategic planning process for NC LAUNCH will continue over the course of the grant. While an initial plan is completed during the initial stages of the project, there is an expectation that the plan will be developed and refined over the life of the project.
9. Cooperate with and provide local level data for LAUNCH evaluation efforts to the independent Project LAUNCH evaluator through a subcontract with the University of North Carolina at Greensboro. The Contractor agrees to participate in all aspects of the Project LAUNCH evaluation to support a grantee-specific evaluation, a national cross-site evaluation and the collection of reporting of data under SAMHSA’s obligations to meet the requirements of the Government Performance and Results Act (GPRA). The Contractor is expected to design and implement comprehensive evaluations of their Project LAUNCH programs. Local-level evaluations should include process, outcome, and cost evaluation components. The process evaluation will assess the implementation of the project, including the fidelity to chosen practices and programs. The process evaluation should also include mechanisms for using data to make program improvements. The outcomes component of the evaluation should aim to demonstrate potential linkages between project activities and improved outcomes both at the State/Territorial/Tribal and local levels, as identified in the LAUNCH logic models. Cost evaluation should include, at a minimum, costs of implementing the program (and individual program components) and cost per person served.
10. Maintain an evaluation plan through a subcontract with the University of North Carolina at Greensboro that supports the local and state level strategic plan. The subcontract shall assure that State, local and SAMHSA data collection and reporting requirements are met. The local evaluation plan will be developed with four months of the grant award.
11. Assure that the local Young Child Wellness Coordinator and local Project LAUNCH/Triple P Manager maintain a regular schedule of meetings with the State Coordinator to ensure coordination and create linkages between local and state efforts. The State LAUNCH Coordinator shall be included on all meetings of the Local LAUNCH Council.
Funds for this program are 100% Federal funding from the Substance Abuse and Mental Health Services Administration.
III. COMPLIANCE REQUIREMENTS
A. Activities Allowed or Unallowed
NC Linking Actions to Unmet Needs in Children’s Health funds may be used to provide direct client services.
Allowed
Salaries and operating costs to support the project according to model fidelity per the Substance Abuse and Mental Health Services Administration.
Unallowed
Funds may NOT be used:
To supplant existing services supported by federal, State or local funds.
B. Allowable Costs/Cost Principles
All grantees that expend State funds (including federal funds passed through the N. C. Department of Health and Human Services) are required to comply with the cost principles described in the N. C. Administrative Code at 09 NCAC 03M .0201.
C. Cash Management
Compliance Requirements – When entities are funded on a reimbursement basis, program costs must be paid for by entity funds before reimbursement is requested from a State agency. When funds are advanced, recipients may be required to follow specific procedures.
Local Governments and Public Authorities
All local governments and public authorities are required to follow cash procedures for State funds outlined in the State’s Budget and Fiscal Control Act (General Statute 159-34) and rules, policies, and procedures established by the Local Government Commission. Additionally, the State-awarding agency may specify their own requirements for the management of State funds and these requirements can be found in Part 10 of this Compliance Section.
Nonprofit Organizations
The specific requirements for the cash management of State funds will be specified by the State-awarding agency. The auditor will find the requirements in the contract and grant agreements, administrative manuals published by the awarding State agency and also cash management requirements can be found in the program specific requirements in Part 10 of this Section.
For any program for which an awarding State agency has established rules, policies and procedures for cash management, recipients should also establish similar procedures for subrecipients.
Audit Objectives – Determine whether:
1. The recipient/subrecipient followed procedures established by the applicable laws, regulations, statutes, and agency requirements.