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9. How are the contractors monitored? <br />The contractors are reimbursed on a unit cost basis; payment is made for only the units of services <br />rendered. In addition to programmatic monitoring, in person fiscal monitoring is conducted by the <br />DOH staff annually. Routinely invoices are checked against the department's billing data system for <br />potential discrepancies; periodically the program will run ad hoc reports to identify any outliers and <br />reconciliation are made with the agency. <br />The Department conducts regular program monitoring for all 6 providers. Monitoring not only <br />includes validation for the outcomes reported, but record review, staff interviews, and shadowing <br />home visitors into consumer homes. <br />10. Do you measure/confirm abuse? <br />The Healthy Start pars professional home visitor is the eyes and ears in the home. Any reports <br />made to CWS for suspected child abuse and neglect are made because there is another advocate <br />in the home supporting parents and observing nurturing principles for healthy families. We have <br />currently engaged in a new curriculum that provides a pre and post test for nurturing parenting. The <br />field of prevention continues to grow and develop better interventions and strategies for measuring <br />outcomes. <br />Any program engaging in prevention is challenged in how to demonstrate effectiveness. How do <br />you provide evidence that something bad has not occurred? The outcome measurements provided <br />above (see #8) are what the program has developed so far. This annual Variance report is limited <br />because of the self reporting nature of the report by each contracted provider. <br />Currently, contracted providers are required to report on a quarterly basis the cases that are <br />referred to CWS for suspected abuse or neglect. The outcome of the CWS investigation is not <br />consistently known by the Healthy Start worker due to confidentiality issues. If the child has been <br />removed from the home, programs generally assume that CWS confirmed the allegation. However, <br />it is expected that reports to CWS for allegations of suspected abuse or neglect will occur because <br />of the close relationship and observational opportunities afforded the home visitor. <br />Healthy Start <br />FAQ -9- <br />