The Child FIRST Central Program Office trains and certifies affiliate sites to implement this evidenced-based intervention and become part of the Child FIRST National Network. During the twelve-month start-up, new affiliate sites participate in a Learning Collaborative which includes both intensive training and site-based weekly to biweekly clinical consultation. Child FIRST plans for new states to begin with a minimum of three agencies, with four home visiting teams each, serving different geographic localities. The operating budget for a typical implementing agency averages $615,000/year, though costs will vary depending on local salary and geographic spread.
The Child FIRST Central Program Office is responsible for:
- pre-launch planning projected at a cost of $240,000;
- start-up training of three new sites within a state projected at $257,000; and
- ongoing data analysis, quality assurance, certification, and training projected at $107,000 annually.
Child FIRST has developed a fee schedule per implementing agency that reflects these costs. In addition, the Central Program Office will establish a Child FIRST State Office providing local oversight, clinical consultation, technical assistance, and state network support, at a cost of $106,000 annually.
Following the growth pattern in Connecticut, Child FIRST expects to start operations of sites in new states with funding from a combination of sources, including federal grants, national and local philanthropy, and/or state government support. The sustainability of Child FIRST sites will come primarily from these sources and Medicaid reimbursement.
The Child FIRST Central Program Office will be funded through a combination of start-up and annual fees from Network members, state contracts, and private philanthropy. Child FIRST will work with key state stakeholders to develop their state funding package both for start-up and ongoing sustainability.
Over the next three years, Child FIRST seeks to expand its network beyond Connecticut to at least two new states. As of April 2012, Child FIRST had 10 affiliate sites with 24 home visiting teams. By January 2013, Child FIRST will have 15 Connecticut sites, one in each of the 15 areas of the state Department of Children and Families, with a total of at least 38 home visiting teams. By June 2015, Child FIRST will have added six sites in two new states with 24 teams, for a national total of 21 sites and 62 teams. Over this three year period (2012-2015), the Child FIRST network will increase its capacity to provide services from approximately 650 families to almost 1,500. Child FIRST will need approximately $1.7 million over the next three years - at a cumulative annual growth rate (CAGR) of 21% - to build a strong Central Program Office, and establish and support new state networks, compared to a 33% CAGR in number of teams and capacity, evidence of cost efficiencies with growth.
Child FIRST also intends to conduct a second randomized controlled trial (RCT) - at a total cost of up to $1.2 million - to document outcomes across multiple program sites, within designated risk groups, for children prenatally to age 6 years old. Although Child FIRST currently has cost-benefit data that shows that the model is cost neutral within a single year, this RCT will follow children longitudinally, documenting long-term savings through prevention of costly disability. An important intended impact is to drive public policy toward a focus on optimizing early brain development.