Exhibit A - Statement of Work (SOW) Template NFP.DOCX

Exhibit A

Statement of Work [Vendor Legal Name including DBA if appropriate] Maternal Infant Early Childhood Home Visiting Program

CDEC Program Contract Manager

· Name: Brittany Martens Title: MIECHV Program Manager Email: brittany.martens@state.co.us

Abbreviations

· ACF- Administration for Children and Families

· BS- Business Support

· CDEC– Colorado Department of Early Childhood

· CO- Colorado

· CQI- Continuous Quality Improvement

· EHR- Electronic Health Record

· FY- Fiscal Year

· HIPAA- Health Insurance Portability and Accountability Act

· HR- Human Resources

· HRSA- Health Resources and Services Administration

· HV- Home Visitor

· IIK- Invest in Kids

· MIECHV- Maternal Infant Early Childhood Home Visiting Program

· NFP- Nurse-Family Partnership

· NHV- Nurse Home Visitor

· NHVP- Nurse Home Visitor Program

· NM- Nurse Manager

· NS- Nurse Supervisor

· PD- Professional Development

· SOW- Statement of Work

Glossary

· Changent – The Nurse Family Partnership National Service Office name.

· Contractor - Refers to the [Vendor Legal Name], including all staff and representatives. For the purposes of this Statement of Work, the terms "Organization" and "Site" are used interchangeably with "Contractor" to refer to the entity responsible for the delivery of MIECHV/HIPPY services and compliance with all contractual obligations.

· EPIC is the electronic health record (EHR) system used for managing patient information and facilitating various healthcare processes, including referrals.

· FLO Database is the nickname given by Changent to the Penelope cloud-based case management and data collection platform.

· Invest in Kids- Organization that serves as the State and Model Intermediary.

· OnBase- platform utilized by the Colorado Department of Early Childhood (CDEC) to digitize, manage, and automate records, documents, and workflows. This platform serves as a vendor invoice submission hub that MIECHV vendors must use.

· Power BI: The reporting platform utilized by Changent that pulls data from FLO’ into standard reports

· Patagonia: The electronic health record utilized by sites for all nursing documentation of NFP home visits

· PHQ-9: standardized depression screening tool

Introduction/Background

· The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program provides pregnant women and families, particularly those considered at-risk, with the necessary resources and skills to raise physically, socially, and emotionally healthy and ready-to-learn children. From birth to kindergarten entry, the Health Resources and Services Administration (HRSA), in partnership with the Administration for Children and Families, funds states, territories, and tribal entities to develop and implement evidence-based, voluntary programs that best meet the needs of their communities.

· Colorado’s goal is to fund and support prevention services for families at risk of entering the child welfare system by implementing and expanding evidence-based home visiting programs with fidelity to the evidence-based model, using Continuous Quality Improvement plans to improve service delivery, and collecting program data that show progress towards the intended goals. MIECHV requires grantees to demonstrate measurable improvement in at least four benchmark domains.

· MIECHV benchmarks include:

· Improvement in maternal and newborn health,

· Reduction in child injuries, abuse, and neglect,

· Improved school readiness and achievement,

· Reduction in crime or domestic violence,

· Improved family economic self-sufficiency, and

· Improved coordination and referral for other community resources and support.

Scope of Work

· [SITE NAME] Nurse-Family Partnership, referred to in this SOW as the Contractor, shall positively impact pregnancy outcomes, child health and development, and economic self-sufficiency of enrolled families by delivering high-quality nursing services that comply with NFP model fidelity.

The NFP Implementing Agency shall provide NFP services for the funded caseload size.

The NFP Implementing Agency's goal for this project is to improve maternal and child health, prevent child abuse and neglect, encourage positive parenting, and promote child health and school readiness by providing high-quality NFP home visiting services to the funded caseload of MIECHV-eligible families.

The NFP Implementing Agency acknowledges that MIECHV funds shall not be utilized for:

· Direct medical, dental, or legal services for clients, as this is unallowable under the federal MIECHV program.

· Employee incentives, entertainment, gifts, employee lunches, membership dues, and company leave payouts are unallowable costs.

The NFP Implementing Agency shall recruit and retain families in the program and prioritize enrollment for those who meet MIECHV-funded eligibility:

· Eligible families with pregnant women and birthing people who have not attained age 2

· Eligible families that have a history of child abuse or neglect, or have had interactions with child welfare services

· Eligible families that have a history of substance misuse or need substance abuse treatment

· Eligible families that have users of tobacco inside the home

· Eligible families that are or have children with low student achievement

· Eligible families that have children with developmental delays or disabilities

· Eligible families that include individuals who are serving or formerly served in the Armed Forces, including such families that have members of the Armed Forces who have had multiple deployments outside of the United States

Period of Performance

· October 01, 2026 – September 30, 2027

Where Services Will Be Performed

· Provide the Nurse Family Partnership to a minimum caseload of [Insert Number] parents/families throughout Colorado.

Maternal, Infant, Early Childhood Home Visiting Program (MIECHV) Work Plan

Work Plan

Outcomes, Benchmarks, and Milestones

Outcome Statement #1: SITE NAME NFP shall positively impact pregnancy outcomes, child health and development, and economic self-sufficiency of enrolled families in the specified service area by delivering high-quality nursing services that comply with model fidelity.

At-risk criteria are as follows:

· Low-income families

· Families with pregnant women under the age of 21

· Families with a history of child abuse or neglect, or with interactions with child welfare services

· Families with a history of substance abuse or a need for substance abuse treatment

· Families where someone uses tobacco products in the home

· Families with children who have developmental delays or disabilities

· Families with children with low student achievement

· Families with individuals who are serving or formerly served in the United States armed forces

MIECHV NFP Nurse Home Visitors (NHV) MIECHV NFP Business Support (BS)

Personnel Operating Travel

Complete at least one in-person visit per enrolled family during the program year.

A1-3: Implementation of the Nurse Family Partnership Program to fidelity, defined as meeting or exceeding the criteria for compliance with NFP model elements and collection of required family outcomes data.

If the program is not aligned with fidelity, work with Invest in Kids to complete the NFP Collaborative Success Plan and participate in regular follow-up to support progress and improvement.

Participation in monthly check-ins.

Participation in site visits (minimum of one per year) with Invest in Kids.

Benchmark reporting will include the percentage of families who show improvements in maternal and child health outcomes, child health and development, families’ economic self-sufficiency, and maternal life-course development, using data collected in accordance with NFP and MIECHV requirements.

Verbal or written presentation of quarterly change strategy tested, data metric monitored, challenges experienced, and plans for adaptation, abandonment, adoption, and/or expansion of change strategies planned for next quarter.

Programs submit Form 4 (service provision and staffing data) quarterly in accordance with Invest in Kids, CDEC, and HRSA deadlines.

Programs submit monthly data (service provision and staffing) in accordance with State Intermediary Invest in Kids and CDEC deadlines.

IIK collects, reports, and aggregates data to be shared.

# of staff who attended

Operating

Financial Staff (Adjust titles as needed) Travel, Personnel and/or indirect

Grant orientation for new staff has been completed within 90 days of hire.

Work Plan

Outcomes, Benchmarks, and Milestones

Outcome Statement #2: Enhanced Wrap-Around Service Delivery and External Resource Referral and Follow-up.

# of staff in attendance

B2-1: 2 CFR 200.334 (Record retention requirements) applies to MIECHV, requiring 3-year retention.

· Policy and Procedure for Background Checks

· Fiscal policies & procedures

· Personnel policies & procedures

· Time & Effort policy and reports

· Voluntary Nature of Enrollment

· Early Intervention

· Transition Planning

· Dual Enrollment

· High-Quality Supervision

· Disengaged Families

B2-4: HIPAA compliance and data safety.

· CDEC Invoice Template

· Expenditure Report for the invoiced period

· Copies of all supporting Invoices and receipts

· Corresponding Time & Effort reports for all grant-funded staff

The plan must align with the state intermediary guidelines and budget per family, per year.

Supplies and Operating

Schedule/Milestones

· Program Performance: The overall Period of Performance is October 01, 2026 – September 30, 2027.

· Family Services & Caseload: Throughout the performance period, recruit and maintain a minimum caseload of [Insert Number] families, delivering the NFP Home Visit Program to fidelity, which includes regular home visits in accordance with NFP fidelity and MIECHV requirements. This includes completion of all required screenings (caregiver depression and anxiety, caregiver intimate partner violence, and child developmental assessments and observations) within specified MIECHV and NFP timelines and provision of appropriate and timely referrals to community services.

· Staffing and Support: Develop and implement a staff recruitment and retention plan. Maintain 100% of staff with current RN licenses and certifications. Ensure all staff complete NFP training, adhere to Changent guidelines, and participate in weekly Reflective Supervision (RS) and joint visit observations.

· Compliance, Data, and Quality: Collect, accurately enter, and ensure confirmation of all MIECHV benchmark, service, staffing and demographic data in the NFP Flo database and/or CDEC/IIK data report template by required deadlines. Submit all necessary reports to the State Department and State Intermediary on time. Actively engage in Continuous Quality Improvement (CQI) initiatives and model fidelity monitoring.

· Client Retention and Community Coordination: Establish and maintain therapeutic relationships with clients to meet retention goals. Individualize the program delivery to meet client needs. Coordinate with the State Intermediary and other home visiting programs, maintain a resource list, and attend all mandatory calls/meetings.

Acceptance Criteria

The acceptance of all deliverables shall reside with the CDEC, (specific program). The designated program manager shall monitor all deliverables in order to ensure the completeness of each stage of the project and that the scope of work has been met. The CDEC program manager shall either sign off on the approval, or reply to the vendor, in writing, advising what tasks must still be accomplished.

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