EXHIBIT A – Performance Matrix Contract Number:
Contract Period:
Agency Name:
Centinela Hospital/Great Beginnings for Black Babies
Project Name:
Welcome Baby
Project Length:
January 2014– June 2014
Fiscal Period 1 (January 16, 2014 – June 30, 2014) Q1 = 7/01/13-9/30/13
Q3 = 1/01/14-3/31/14
Q2 = 10/01/13-12/31/13
Q4 = 4/01/14-6/30/14
Revision Date:
Project Description: The Welcome Baby program is a voluntary, universally provided hospital and home-based intervention for pregnant and postpartum women. The program includes up to nine engagement points: three prenatal; a hospital visit; and 5 postpartum. A universal risk screening is conducted at the Welcome Baby hospital visit with all participating families to help identify those needing additional support. Families receive client-centered, strength-based information and support during each visit on topics such as breastfeeding, bonding and attachment, home safety, the importance of health coverage and establishing a medical home, well-child visits and immunizations, smoking cessation, child development, and perinatal depression. The program aims to 1) increase breastfeeding; 2) ensure families receive appropriate health and developmental care; and 3) improve connections between families and needed resources and support.
Performance Objectives
Due Date
Measureable, observable, and attainable objectives including: (1) Outcomes –Changes in health/mental health status, developmental status, attitudes, behaviors, knowledge, skills, practices, or policies; (2) Outputs -- The direct result of activities and typically expressed as the number or scope of services and/or products that are delivered or produced; and/or, (3) Major Deliverables -- Tangible products that are submitted in fulfillment of contract requirements.
Date Objective will be completed.
Quantity by Quarter Q1 (Jul-Sep)
Q2 (Oct-Dec)
Q3 (Jan-Mar)
Q4 (Apr-Jun)
Finalize WB personnel job descriptions with F5LA approval prior to posting
1/16/14
NA
N/A
1
NA
Attend Best Start Community Partnership meetings on a monthly or quarterly basis to provide Welcome Baby (WB) program status/updates
6/30/14
NA
NA
1
1
Collaborate with Oversight Entity and communicate on a monthly basis at minimum to ensure standardized implementation of Welcome Baby
6/30/14
NA
NA
1
1
Coordinate on a monthly basis with the Oversight Entity and F5LA in data collection and other evaluation-related activities, as needed
6/30/14
NA
NA
1
1
Participate in Cross-Site Peer Learning and Technical Assistance efforts led by the Oversight Entity on a quarterly basis
6/30/14
NA
NA
NA
1
-1-
EXHIBIT A – Performance Matrix
Performance Objectives
Due Date
Measureable, observable, and attainable objectives including: (1) Outcomes –Changes in health/mental health status, developmental status, attitudes, behaviors, knowledge, skills, practices, or policies; (2) Outputs -- The direct result of activities and typically expressed as the number or scope of services and/or products that are delivered or produced; and/or, (3) Major Deliverables -- Tangible products that are submitted in fulfillment of contract requirements.
Date Objective will be completed.
Quantity by Quarter Q1 (Jul-Sep)
Q2 (Oct-Dec)
Q3 (Jan-Mar)
Q4 (Apr-Jun)
NA
NA
NA
1
Complete and submit a plan in coordination with the Oversight Entity, local Select Home Visitation program(s), and F5LA for a referral pathway between WB, Select Home Visitation Program(s), and other local home visitation programs
6/30/14
Work with F5LA Research & Evaluation team to incorporate and implement any revisions in data collection activities related to evaluation with support of Oversight Entity
6/30/14
NA
NA
NA
1
Complete and submit the online “Getting Better Data” Report on a semi-annual basis
6/30/14
NA
NA
NA
1
Complete and submit a Quarterly Report (template to be provided by F5LA), to include but not limited to updates on: WB Training participation and completion ; professional development activities; outreach and communication efforts; success and/or limitations of key messages and supportive materials used in WB; description of technical assistance needs and support received; status of the Confidentiality and Data Sharing protocol; data collection and other evaluation-related activities; referral pathway development and efforts; program implementation successes and lessons learned; and coordination and work with local Best Start Community Partnership(s), Oversight Entity and other local home visitation programs.
6/30/14
NA
NA
1
1
Goal I: Support pregnant women to receive needed mental health, dental services, and other needed resources
Achieve an acceptance rate of 40% of women approached in hospital for participation
6/30/14
NA
NA
NA
1
Achieve an acceptance rate of 30% of women living within a Best Start Community and approached prenatally for participation
6/30/14
NA
NA
NA
1
Achieve 50 % rate for pregnant women enrolled prenatally that will receive referral for dental screening within the prenatal period if no dental services were received within the past year
6/30/14
NA
NA
NA
1
-2-
EXHIBIT A – Performance Matrix Performance Objectives
Due Date
Measureable, observable, and attainable objectives including: (1) Outcomes –Changes in health/mental health status, developmental status, attitudes, behaviors, knowledge, skills, practices, or policies; (2) Outputs -- The direct result of activities and typically expressed as the number or scope of services and/or products that are delivered or produced; and/or, (3) Major Deliverables -- Tangible products that are submitted in fulfillment of contract requirements.
Date Objective will be completed.
Quantity by Quarter Q1 (Jul-Sep)
Q2 (Oct-Dec)
Q3 (Jan-Mar)
Q4 (Apr-Jun)
Achieve 80 % rate for prenatal women that will receive at least one referral during pregnancy
6/30/14
NA
NA
NA
1
Achieve 80 % rate for prenatal referrals made that will be followed up by 2 Month Postpartum Telephone Assessment
6/30/14
NA
NA
NA
1
Achieve 80% rate for program participants enrolled by 27 weeks that will receive a prenatal Telephone Assessment between 28-32 weeks of pregnancy.
6/30/14
NA
NA
NA
NA
Achieve 80% rate for all program participants that will receive home safety and security information by the 9 month home visit.
6/30/14
NA
NA
NA
NA
Achieve 80% rate for of all program participants that will receive at least one home safety item or conduct at least one improvement by the 9 month visit.
6/30/14
NA
NA
NA
NA
Achieve 30% rate of program participants that will initiate exclusive breastfeeding at time of hospital visit
6/30/14
NA
NA
NA
1
Achieve 40% rate for women enrolled prenatally that will initiate exclusive breastfeeding at time of hospital visit
6/30/14
NA
NA
NA
1
Achieve 50% rate for program participants that will initiate any breastfeeding at time of hospital visit
6/30/14
NA
NA
NA
1
Achieve 50% rate for program participants that will be exclusively breastfeeding at the nurse home visit
6/30/14
NA
NA
NA
1
Goal II: Achieve as safe and healthy of a home environment as possible
Goal III: Increase breastfeeding initiation, exclusivity and duration rates
-3-
EXHIBIT A – Performance Matrix Performance Objectives
Due Date
Measureable, observable, and attainable objectives including: (1) Outcomes –Changes in health/mental health status, developmental status, attitudes, behaviors, knowledge, skills, practices, or policies; (2) Outputs -- The direct result of activities and typically expressed as the number or scope of services and/or products that are delivered or produced; and/or, (3) Major Deliverables -- Tangible products that are submitted in fulfillment of contract requirements.
Date Objective will be completed.
Quantity by Quarter Q1 (Jul-Sep)
Q2 (Oct-Dec)
Q3 (Jan-Mar)
Q4 (Apr-Jun)
Achieve 60% rate for program participants that will be providing any breastfeeding at the time of the nurse home visit
6/30/14
NA
NA
NA
1
Achieve 40% rate for program participants that will be exclusively breastfeeding at the 2 month postpartum telephone assessment
6/30/14
NA
NA
NA
1
Achieve 60% rate for program participants that will be providing any breastfeeding at the time of the postpartum 2 Month telephone assessment
6/30/14
NA
NA
NA
1
6/30/14
NA
NA
NA
1
Achieve 30% rate for program participants that will be providing any breastfeeding at the time of the 3-4 month visit
6/30/14
NA
NA
NA
1
Achieve 30% rate for program participants who initiated exclusive breastfeeding at time of hospital visit and will still be exclusively breastfeeding at the 3-4 month visit
6/30/14
NA
NA
NA
1
Achieve 30% of program participants who initiated any breastfeeding at time of hospital visit and will still be breastfeeding at the 3-4 month visit
6/30/14
NA
NA
NA
1
Achieve 30% of program participants who initiated breastfeeding at time of hospital visit and will still be breastfeeding at the 9 month visit
6/30/14
NA
NA
NA
N/A
Achieve 30% rate for program participants that will be exclusively breastfeeding at the time of the 3-4 month visit
Goal IV: Provide education and support services for families at postpartum engagement points (Hospital visit, nurse visit, 2-4 week postpartum visit, two month telephone assessment, 3-4 month postpartum visit, and 9 month postpartum visit) Achieve 80% rate for all program participants receiving a nurse home visit that will schedule a pediatric well-baby visit appointment within 2 weeks
6/30/14
NA
NA
NA
1
Achieve 80% rate for program participants receiving a nurse home visit that will receive a 2-4 week postpartum visit by the Parent Coach
6/30/14
NA
NA
NA
1
-4-
EXHIBIT A – Performance Matrix
Performance Objectives
Due Date
Measureable, observable, and attainable objectives including: (1) Outcomes –Changes in health/mental health status, developmental status, attitudes, behaviors, knowledge, skills, practices, or policies; (2) Outputs -- The direct result of activities and typically expressed as the number or scope of services and/or products that are delivered or produced; and/or, (3) Major Deliverables -- Tangible products that are submitted in fulfillment of contract requirements.
Date Objective will be completed.
Quantity by Quarter Q1 (Jul-Sep)
Q2 (Oct-Dec)
Q3 (Jan-Mar)
Q4 (Apr-Jun)
Achieve 60% rate for program participants receiving 2 Month telephone assessment that will receive postpartum care within the 3-8 week time period for HEDIS
6/30/14
NA
NA
NA
1
Achieve 60% rate for program participants receiving 2-4 week postpartum visit that will be given options for ongoing emergency and other care
6/30/14
NA
NA
NA
1
Achieve 80% rate for program participants receiving 2-4 week postpartum visit by a Parent Coach that will be told of local food resources, such as farmer’s markets, and use of WIC coupons
6/30/14
NA
NA
NA
1
Achieve 60% rate for Medi-Cal eligible infants that will have health insurance by the 2 Month telephone assessment.
6/30/14
NA
NA
NA
1
Achieve 80% rate for program participants visited postpartum (Hospital visit, nurse visit, 2-4 week postpartum visit, 3-4 month postpartum visit, and 9 month postpartum visit) that will be assessed for parent-infant attachment.
6/30/14
NA
NA
NA
N/A
Achieve 80% rate for program participants receiving a 3-4 month home visit that will receive an ASQ screening at that visit
6/30/14
NA
NA
NA
1
Achieve 80% rate for babies receiving 2-4 week postpartum visit that will have or be helped to schedule appointment for 2 month well-baby visit
6/30/14
NA
NA
NA
1
Achieve 80% rate for program participants receiving a 9 month home visit that will receive an ASQ screening at that visit
6/30/14
NA
NA
NA
NA
6/30/14
NA
NA
NA
NA
Goal V: Promote healthy physical and emotional development in 100% of infants visited
Achieve 60% rate for babies receiving a 9 month visit that are up to date on immunizations
-5-
EXHIBIT A – Performance Matrix Performance Objectives
Due Date
Measureable, observable, and attainable objectives including: (1) Outcomes –Changes in health/mental health status, developmental status, attitudes, behaviors, knowledge, skills, practices, or policies; (2) Outputs -- The direct result of activities and typically expressed as the number or scope of services and/or products that are delivered or produced; and/or, (3) Major Deliverables -- Tangible products that are submitted in fulfillment of contract requirements.
Date Objective will be completed.
Quantity by Quarter Q1 (Jul-Sep)
Q2 (Oct-Dec)
Q3 (Jan-Mar)
Q4 (Apr-Jun)
Achieve 70% rate for babies receiving a 9 month visit that will have a medical provider
6/30/14
NA
NA
NA
NA
Achieve 70% rate for babies receiving a 9 month visit that will still have health coverage
6/30/14
NA
NA
NA
NA
6/30/14
NA
NA
NA
N/A
Goal VI: Obtain feedback from clients on their satisfaction with the program upon completion of visits
Achieve 75% rate for families who complete satisfaction survey that are pleased with services received.
Goal VII: Create or enhance existing linkages with social service, educational and healthcare agencies to obtain needed services
Achieve 80% rate for postpartum women to receive at least one referral at or before the 9 month visit.
6/30/14
NA
NA
NA
N/A
Achieve 80% rate for referrals made postpartum to be followed up at or before the 9 month visit.
6/30/14
NA
NA
NA
N/A
Track and report program retention and attrition rates
6/30/14
NA
NA
N/A
1
-6-
