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Promising Program Seal

Child First

Blueprints Program Rating: Promising

A two-generation home visitation program which works to heal and protect young children and their families from the devastating effects of chronic stress and trauma. It provides psychotherapeutic services and intensive care coordination, while building adult reflective and executive capacity, to prevent or diminish serious emotional disturbance, developmental and learning disabilities, and abuse and neglect among young children.

Initial Training and Technical Assistance

  • Start-up fee for new agencies: $25,000
  • Start-up training fees: $16,000 for Clinical Director/Supervisor; $10,000 for each Clinician and Care Coordinator

Curriculum and Materials

  • All curricula are included in training fees
  • Sites must purchase copyrighted assessment forms

Materials Available in Other Language: All assessments and family materials are available in Spanish, however, the Manual, Toolkit, Distance Learning, and Learning Collborative materials are only in English.

Licensing

Once initial training is completed, $15,000 annually plus $5,000 for each Clinician Team (a Clinical Team includes a Clinician and Care Coordinator)

Other Start-Up Costs

  • Computers and other setup for new employees (will vary depending on what the agency need to purchase)
  • Child First data system (Child First Comprehensive Clinical Record-CFCR) planning and setup
  • Child First Clinical Teams from an affiliate agency should be located together. Space requirements include officers for confidential conversations and an available meeting room for group supervision. Children and families are not seen in the office.
  • Staff time for participation in training
  • Video cameras for Teams
  • Therapeutic toys for home visits

Ongoing Curriculum and Materials

Assessments that are administered at baseline, 6 months, and discharge. The cost for assessments per team is estimated at a high of $900/year.

Staffing

Qualifications:

  • Master's level licensed Clinical Director/Supervisor, with 5 years' relevant experience
  • Master's level licensed Mental Health/Child Development Clinician, preferably with 3 years' experience
  • Bachelor's level Care Coordinator, who is familiar with community to be served and available services.
  • Staff must be multicultural/multilingual reflecting population to be served. Salaries vary depending on local labor market.

Ratios:

  • A full-time Clinical Director/Supervisor can oversee 4-5 teams
  • A Child First Team (includes a full-time Mental Health/Child Development Clinician and a full-time Care Coordinator working together) typically carries a caseload of 12-16 families

Time to Deliver Intervention:

  • Families receive visits twice per week during the assessment period (first month) and then once a week or more, depending on the needs of the child and family. Visits last 1-1.5 hours.
  • After assessment, Clinicians and Care Coordinators may visit together or separately, based on the individual family needs.
  • Services generally continue for six to twelve months but can go longer depending on the needs of the family.

Other Implementation Costs

  • Clinician and Care Coordinator travel for weekly visits with each family reimbursed on a per mile basis.
  • Child First expects some involvement of the agency leadership. Senior leaders are invited to attend training and are expected to participate in quarterly calls or in-person meetings with other Sr. Leaders.
  • Site will likely require some administrative support for data systems and reporting (up to .5 FTE) and for inquiries and referral (.25 – 1.0 FTE).

Ongoing Training and Technical Assistance

Training cost is included in annual licensing fees, except in the case of training for new staff due to turnover where a fee may be charged.

Fidelity Monitoring and Evaluation

Currently included in annual licensing fees. Child First system user fees may be charged to sites in the future.

Other Implementation Support and Fidelity Monitoring Costs

None.

Child First works with a regional or state partner to build and support the infrastructure necessary to support a regional or state Child First network of sites. Replication of the Child First model usually occurs at various sites simultaneously for two reasons: (1) so there is a critical mass of teams to be trained as part of a Learning Collaborative, and (2) so that Child First is implemented as part of a larger early childhood system.

Year One Cost Example

The following Year 1 costs are based on an affiliate agency that trains one Clinical Director/Supervisor and four Child First Teams to serve 60 families in the first year of implementation. The example assumes that the program is implemented in a community service agency with appropriate space for private and group meetings and equipment for clinicians. Staffing costs include estimated salary and benefits for the level of experience required for the position. Staffing expenses will vary based on the local labor market.

Start-up Fee
$25,000
Start-up Training Cost - Supervisor
$16,000
Start-up Training Cost - Clinical Teams ($10,000 x 8 staff)
$80,000
Assessment - $900 x 4
$3,600
Staffing Costs for Full-Time Clinical Director
$100,000
Staffing Costs for Full-Time Child Development Clinician ($75,000 x 4)
$300,000
Staffing Costs for Full-Time Care Coordinator ($55,000 x 4)
$220,000
Travel
$10,000
Overhead and Office at 20% of staff
$124,000

Total Year One Cost
$878,600

For one community agency serving 60 families, the first year expense would be $14,643 per family. The costs would decrease significantly in subsequent years as the initial start-up and training fees are start-up costs that would not be incurred beyond year 1. Child First analysis of average cost per family in Connecticut implementation is $8,000 per family.