I Speak Fiscal; I Speak Program

I Speak Fiscal; I Speak Program


Hello, everyone and welcome to the HV-ImpACT
webinar, I Speak Fiscal I Speak Program, sponsored by HRSA. Today, we will be talking about collaboration
between MIECHV grants management and project management. So as we all enter the room today, I’d like
to welcome you to head over to the chat box on the left hand side and introduce yourself. Let us know where you’re coming from and what
your role is within MIECHV. And just to introduce you quickly to the room,
you should see the PowerPoint slides and you should hear my voice, I’m up in the corner. I’m Karen Cairone, Universal Technical Assistance
Manager. If you have any issues throughout this presentation
with either hearing, seeing, or anything else going on technology wise, please head to the
technical support box at the bottom, and we will immediately get you some support for
whatever might be happening. You have a note there about how to call in
through the phone if you’re having some issues with your computer speakers, and the other
things that you need to note before we get started– in the bottom left hand corner there
is a link for an evaluation that will also just pop up after the webinar is over, and
you also have a file share pod, and we have some information in the file share pod that
we would welcome you to download during the presentation or after the presentation. With that, I’m going to get started with our
webinar today. As we go through, please remember to mute
your computer speakers if you happen to be hearing any kind of echo. Again, use the technical support box if you
need anything from our team. Throughout the course of the presentation,
our webinar presenters will be asking questions of you and also welcoming you to chat with
each other and ask questions of us. So please do use the chat box to the left
so that we can have a nice interactive experience, and we are recording this. You will be able to access this presentation
in a couple of weeks on HRSA’s web site, so we will provide that information to you when
it is live and ready to go. Just a couple of things to remind you before
we get started. We really do value your feedback, so your
information that you would provide in our evaluation is essential to our continuing
to make improvements to our resources. One piece of feedback we received from participants
was that we would please offer the PowerPoint slides in a PDF format. You will see them down in the file share pod,
and we were able to offer them for you so that you can download them again either during
the presentation or after the presentation so that you’ll have all of the slides that
we’re about to show you today. The objectives of our time together today
will be to engage in discussion about how our internal fiscal and program collaboration
is essential to successful operation and implementation of the MIECHV program. We will then explore a very simple planning
guide which you can also find down in the file share pod. It’s a fill-able PDF that will hopefully help
you have better collaboration between your two sides of the program. And finally, we’ll learn about the experiences
of several MIECHV awardees including the US Virgin Islands, South Carolina, and Louisiana. So with that, I would like to introduce Loraine
Swanson Lucinski who is our project director, and she will be starting us off today. Thanks, Loraine. Thank you, Karen. Good afternoon, everyone. I’m glad to be able to be here to talk about
this very important subject today. We know that the MIECHV grants are complicated
and nuanced and need the expertise of many involved to run smoothly. We’re hoping today’s conversation about how
fiscal and program team members can work together more thoughtfully and more intentionally will
help us all strengthen the overall grants management of the MIECHV program in our states
and territories. As we talk today, you’ll notice that lots
of us use different language. I don’t know about you, but being in MIECHV
for a long time, I say MIECHV just naturally when I’m talking about my job, and people
look at me because they don’t know what that is. We’re so used to using our jargon. Depending on where you are in the MIECHV life
cycle, you may use terms like fiscal year, and PMS for payment management system. Many of us dream about these words– LIAs,
PMs, and CQI. OK, maybe you don’t dream, but we do use these
words a lot in our language. And it’s really important for us to consider
the ways that our foreign language expertise is shared amongst our team members. One of the handouts that we’ve included for
you as Karen mentioned is the Fiscal and Programmatic Collaboration Document, is the title of it,
and we put those together because we know that throughout the MIECHV awards cycle, there
are very important times when both fiscal and program staff can make significant contributions
to ensure the success of the award. Using this document, we believe, will help
you be able to consider how each of the different team members play important roles in managing
the MIECHV awards and what each team member contributes to various tasks and how collaboration
strengthens the process. I’d like to ask you to download that and look
at that as we consider the rest of this conversation today. We’ve tried to think about what are all of
the different aspects that require both fiscal and programmatic expertise to manage the MIECHV
grants? And on the slide here, you’ll see that there
are a number of different team members that we have to consider. And I know that this is different across the
country depending on how big the department or agency is that is working with your grants. When I first joined the state of Tennessee,
which is where I was at previously before EDC, there were large numbers of people that
touched the MIECHV grants, many of whom I was not sure exactly what their role is. A couple of weeks into the job, I was talking
about the newly awarded V89 grants. For many of you who manage the grants, you’ll
know that that is the competitive award number that was given to that grant application upon
receipt. So I was referencing V89 to talk about the
competitive application funding that was received. A fiscal colleague was talking about H25. I thought she was talking about something
completely different. We sat down and realized we were talking about
the same grant. However in her fiscal world, they did not
use the federal grants number on the NOA, they converted that to a state identifiable
number that meant within their system, and so we realized quickly that we needed to make
sure that we had a spreadsheet that aligned what was the terminology that we were using
to reference each of the MIECHV grants. That was a very small but important lesson,
because we realized quickly that everybody comes to this work with a slightly different
perspective, whether you’re looking at it from the fiscal angle or the programmatic
angle. And so things that I’d like you to do some
self-reflection about as we are here today, we know webinars are not conducive for
group dialogue, however I do hope that you’ll take a couple of minutes to think about who
are your team members who have a role with planning the fiscal resources to meet the
grant’s goals? Who are the team members who have a role with
disseminating the funds: you often have contract staff, grants management staff who really
help make sure– many of us have competitive processes in place that have to be followed,
and they help us make sure that those mechanisms are in place for disseminating the funds. For the people who have a role with operationally
monitoring the funds, who approves the invoices? Who approves the budget revision? Who are the people who have a role in ensuring
submission of the grants application? Making sure such things as a DUNS number and
SAM registration and grants.gov is all working and ready to go? Who are the people who have auditing and oversight
responsibility, so they’re reviewing fiscal practices of some recipients over time? Who has a role with ensuring the funds are
being used appropriately to implement the program and achieve outcomes? Who has a role with assuring reporting is
completed such as the PMS, the FFR, and the sub factor reports? And if you don’t know what those are, that’s
another reason to think about who are the people who do know within our state or territory
what those terms mean? And who has a role to ensure federal regulations
and requirements are being met? Who understands uniform guidance and can talk
about things such as the super circular? Those are all things that are very important
for us to consider as we think about managing the MIECHV grants. So some food for thought as you reflected
on who those people are on your team– which fiscal management team members do you know
and who do you need to know? Now would be a great time to write down information
about who you need to know. And if any of you are on from the fiscal management
team, which program team members do you know and who do not know? Again, those are important contacts to have. How often does your team meet to discuss requirements
and expectations of the federal MIECHV funding? I believe Tennessee Department of Health would
be comfortable with me letting you know we did not meet as an entire team until the first
time that we were having our three day on-site visit. In preparation for the three day on-site visit,
there are a lot of documents that are required to be submitted prior to attending. And as we met as a team to make sure we had
all of the necessary appropriate documents ready to submit, we had a realization that
this is the first time every single person who touched the MIECHV grants was together
in one room. It gave us quite an interesting experience
to realize that. I as the program director talked to all of
these people in various ways. However, they did not all talk together. So we realized we had a huge opportunity to
strengthen the communication and knowledge sharing and coordination between the team
members after the audit. I’m sure that many of you have success stories
to share as well. I will say that one of the things that I believe
helped us after the on-site visit was some concrete recommendations of ways to improve,
as you all know, that come out of this three day on-site visit, and we had a great opportunity
to talk about the way that we were looking at cost per child that was a recommendation
that our fiscal expert gave us of looking at how do we do that and doing some comparison
to the way that we were currently doing it to see if it was a better way for us. And we had some follow up meetings to talk
about that. Did the suggested recommended methods
change the way we were doing business and improve our interactions? So we then took that to say, we should meet
more regularly. I think that there will be many other success
stories shared as you listen to the awardees who will be sharing their stories with us
today. But as you think about where you have found
success, please consider how you can share that with your colleagues as well. What we do know is for successful grant management,
we need to establish a process for the intentional collaboration between fiscal management and
program management. We need to make sure that the people who are
supportive and help us get money out the door are talking to the people who are bringing
the money in the door and making sure that throughout the process we have various check
points so that we’re able to manage the funds, know what we’re contributing to, and know
how we’re spending it every step of the way. It’s important for us to identify times to
meet together to discuss views and use of the funding to get a deeper understanding
of the unique views we bring. As you meet together, discussing things such
as what are the key times in the funding cycle to share our views of successes and challenges. That’s a great way to identify times that
meetings may be most helpful and can really prepare you for the funding cycle as it begins
or ends. It’s also really important to think about
how you’re communicating regularly during the cycle, and what do you communicate? I know that that’s also very difficult to
manage information in such a large complex system, and so thinking about what are the
key points that need to be communicated? Is there a regular touchpoint for seeing how
much money has been drawn down from HRSA to the state or Territory is there a touchpoint
for talking about how local implementing agencies are spending, and at what point do you identify
if you will have funding available that may have been unspent for various reasons that
now need to be Reconsidered Who do you bring into those conversations? Encouraging discussion among your team members
about these issues as well as the terms that they use and ask each other clarifying questions
as with any language sharing brings a deeper understanding of the language we use sometimes
we use terms that we don’t really think about. And so thinking together helped me understand
how does this term apply to your work, how do we understand this work together– are
very important discussion points so that each of us as a program person or fiscal person
really are intentional to gain a deeper understanding and think about the goals that we have for
the MIECHV program. We can’t understand everything. As much as I love to try to really learn what’s
available in the super circular, I have to rely on other people to be able to have that
expertise and knowledge. On my team, I had different people that monitored
the local implementing agency spending, and I had different people who looked at our spending
as a state. And that’s very important to make sure that
they come together to look to see if the way that the money is being spent is addressing
both the state needs as well as the local implementing agency needs. As you proceed throughout this conversation
today, I’d like to encourage you to make use of the handouts, really thinking through the
different aspects of who is the members of your team, how do we communicate, what are
the opportunities that we have together? A useful resource was in the Fiscal Year 18
NOFO Appendix D. There’s just a sampling here of some selected terms, but we encourage you
to make sure that you bring those out when you’re
together in meetings and talk about the different selected terms that fiscal uses and programmatic
uses, again, for the purposes of continuing to increase your effectiveness in managing
this nuance grant. We look forward today to hearing from US Virgin
Islands, South Carolina, and Louisiana about different processes that they have put in
place to work toward these effective oversight of the MIECHV grant. We’ll look forward to receiving any questions
in the chat or any additional ideas that you have and hope that we can continue this conversation
in other various ways after this webinar. So with that, I’d like to be able to turn
it over to Charmaine. And Charmaine, I’m going to put your first
slide up there for you. Welcome, Charmaine. And thank you for talking about how US Virgin
Islands made significant progress in improving the financial spending to lift draw-down restrictions. Good afternoon, everyone. As stated, my name is Charmaine Myers. I am the Assistant Director of the Maternal
Child Health Program at the United States Department of Health. Today, the United States Virgin Islands Department
of Health. Today, my presentation is on how the USVI
made significant progress in improving financial spending to lift draw-down restrictions. A few years ago, the Virgin Islands Department
of Health Maternal Child Health Program MIECHV was placed on draw-down restriction. No one wants to be on restriction, especially
draw-down restriction. So in 2016 when Dr. Peterson became the Program
Director, she wanted us to do whatever was necessary to ensure that the draw-down restriction
was lifted. We had to do what we had to do in order to
get the job done. One of the first things that was very, very
important that we realized was the communication processes. We had to develop a well-established communication
plan among all of our key personnel. It is crucial to communicate effectively to
ensure that our goals and objectives were achieved. Here at the USVI MCH, we developed a well-established
communication plan among our keeper of mail, which included our federal MIECHV project
officers and grant management officers partners, Tia, Jamie, and Marilyn. Our VA Federal Grants Office, our Commissioner’s
Office, the Office of Management and Budget, the Department of Finance, and the Department
of Property and Procurement. Although we had many other personnel included
in our processes, the list of names that I mentioned was the most critical in order for
us to meet our goals and objectives of the MIECHV program as well as to help us lift
the restriction off the grant. Next, we had to develop standard operating
procedures in order to guide our spending. As everyone knows, standard operation procedure
is an effective tool that every organization should have in place. Standard operation procedures gives us a better
understanding of how processes can help us decide how to move forward. Without these operating procedures, it made
it difficult for us to spend our money and to spend it timely. Our standard operation procedures ensure that
all of our employees were performing the processes in the same way. So this was very, very pertinent. This assisted us, it was one of the other
key points that assisted us in lifting our restrictions. Next up, we had to meet all deadlines. In order for us to draw funds, it was required
for us to submit budget narrative, an SF424, backup documentation to reflect payroll, fringe,
all our services in charge and expenditures, and we had
to do this by the 20th of each month. We had to consistently meet these deadlines,
because as we know deadlines is a cornerstone to any successful organization. Both the program and our federal grants partners
needed to maintain a structure of the organization in order for us to meet our obligations, the
company’s goals, and of course deliver our services. So this was another key point in meeting deadlines. In order for us to process any item that we
needed to fulfill, we had to ensure that our deadlines were met. If and if we saw a report off the [INAUDIBLE]
or something that was done and we knew that we couldn’t do it within that time frame,
we would request an extension before the deadline passes, of course, so that we don’t get backtracked. Because once you don’t meet deadlines, it
actually pushes back your work and you have so much more to do, because you have your
future work, your current work that you have to do, and you also have to go back and meet
this deadline that you didn’t meet previously. OK, so next up, we had to establish a fiscal
team that met by meeting. Our MCH financial team consisted of the [INAUDIBLE]
director, Dr. Peterson, myself the Assistant Director, our Financial Management Officer,
Ms. [INAUDIBLE], our Office Manager, Ms. Marlene [INAUDIBLE], and of course our Financial Management
Program Manager, Ms. Yvonne [INAUDIBLE]. A monthly meeting was held to ensure that
all of our payments were processed timely and to also ensure timely draw out. Every other week, we held weekly joint meetings
between our fiscal and our programmatic personnel. This was very, very important in order for
us to go forward. For some reason, it’s very difficult for a
lot of organizations– I’m quite sure Illinois, North Carolina, you guys can relate. At certain points, it’s like, fiscal people
don’t speak program and program personnel does not speak fiscal. This was one of our challenges we had within
the Department of Health itself. The fiscal folks were operating on a fiscal
measure, and be programmatic personnel was just speaking program. In order for us to bridge that gap, we had
to bring everybody together. So we did this and we had our joint meeting
bi-weekly, and that worked out very well because we were able to know where each other were
and at what point and what needed to be done in order for us to go forward jointly. Charmaine, we might have lost your audio for
a moment. Are you still there? Can you guys hear me? I hear you now. Yeah, OK. Go ahead. OK, great. OK so meetings were held regularly so that
each player knew where we were in the spending process. The programmatic personnel were responsible
for spending the funds, and the fiscal personnel were responsible for processing the payment
of the funds. So that was very important. So the programmatic persons, they were responsible
for going out, making sure that the funds were in convert so that we can liquidate the
funds, and the fiscal persons made sure that all those encumbrances were liquidated. So those two aspects were very necessary and
had to get together in order for us to get where we needed so that we could spend money
timely and so that the funds could be drawn timely. So we had to establish timelines and ensure
that those timelines were adhered to. Bi-weekly, we met with our federal partners. This was very important, because at this meeting
we were able to give updates as to where we were in our spending, and if there were any
changes that were necessary, it would be addressed at this time. This those meetings were very, very critical
in us getting off of our restriction. We also communicated regularly with our Federal
Grants Management Office. The Federal Grants Management Office was the
office that was solely responsible for the beginning of the processing of any federal
grants. In our federal grants office in the Virgin
Islands, there are many processes that we had to adhere to. The Federal Grants Office is the office that
does our financial federal report. That report, of course, is very, very important
because if it’s not done and done timely, it created a lot of problems for the program. This is where when I stated before that the
program and fiscal needed to meet in order for us to collaborate, this was one of our
[INAUDIBLE]. We were having many, many challenges submitting
our SFRs timely, and one of those reasons for that is because fiscal was not speaking
to program the way we should have. So after we bridged that gap and we got it
together, we were able to work together so that we can ensure that our SFRs were submitted
timely. Communication– we communicated regularly
with our federal Grants Management Office. OK, so as we continued to communicate with
our Federal Grant Management Office, the Office of Management and Budget, Property and Procurement,
Finance, we still had to ensure that we continue to monitor and build on our internal control. So what we did is we ensured that the MIECHV
program had internal controls and those internal controls were adhered to. Not only did we do them for the MIECHV program,
but we did it for all of the MCH programs. Any program on the Virgin Islands, the United
States Virgin Islands MCH Programs, we ensured that all of the internal controls were developed
and they were being followed. Because our programs, our block grant our
SSDI program, our Newborn Heritage Screening Program, all of those programs contribute
to our MIECHV program. We all work together in order for us to meet
the goals and objectives of each program. And we all play a part, and an important part,
in order for us to be successful. OK, so some of our ongoing activities, of
course, were to ensure that collaboration and input of all stakeholders were present. And just like I mentioned, we have our MIECHV
program which consists of our Nurse Family Partnership and our Healthy Families Virgin
Islands Program. And in all of these, collaboration was necessary. So these partners were included in all of
our processes, from our financial meeting or programmatic meeting, all of us collaborated
to ensure that we were able to meet the goals and objectives of MIECHV, and these programs
also assisted us in getting off of our restriction. Next up, we designed and implemented a spending
plan to meet program goals. So a spending plan was done just about sometimes
we had to do it like every week, we could have done it every two weeks. It depended on exactly what was happening
in the program at the time. Because we have so much challenges and not
within the MCH program but within our government financial structure, there were many times
where we had to redo, revise our spending plan. Our HR office,
we worked diligently with them every day to ensure that our positions are filled. If those positions aren’t filled, then we
would have to, of course, revise our budget to reflect or to redirect the monies to another
area so that we could ensure that all the monies were spent under the MIECHV program. And also we had to ensure that we revised
the budget and stuff like that so that we could meet those different scenarios that
came up unexpectedly. Next up, we had to obtain buy in and support
of our executive staff. Our executive staff is very, very important,
because they could either make or break us. If they were not involved in our processes
and they didn’t understand exactly what we were about, we would definitely not be where
we are today. The executive staff, the commissioner, for
instance, the commissioner was very, very important in our processes. She was the one that was responsible for signing
off on all of our budgets and any documentation that we had. We needed to ensure that those budgets were
fine in order so that we could start spending our money in a timely manner. The commissioner’s office also signed off
on our [INAUDIBLE]. So any position that we filled, we needed
to ensure that the commissioner signed off on that [INAUDIBLE] so that we could proceed
and get those people on board. Our program, MIECHV program, is 99% fully
staffed. And this came as a result of the hard work
of, of course, the MCH staff, the MIECHV staff, and of course all of our supporting partners
like the Commissioner’s office, the Office of Management and Budget, and the Department
of Finance that is responsible for financial aspects in the Virgin Islands government. As I mentioned before, we have to work closely
with our Human Resources office so that we can recruit and fill vacancies. Because of our HR office, because of our ability
to recruit and fill those vacancies like I stated before, the MIECHV program is 99% fully
staffed. We just have one position, and we’re in the
process of filling that position as we speak. So it is very important for all of our partners
to be intimately involved in our process. We know how important MIECHV is to us, and
it’s our responsibility to ensure everyone else around us knows it’s important so that
we can all move forward, because we cannot do what we do without the support of all of
our stakeholders, which includes our federal partners and the Virgin Islands government
as well as the Department of Health. I would like to just leave you with this. In anything that we do, we have to follow
up, follow up, and follow up. If we don’t follow up, we will definitely
fall short. If the Department of Health MIECHV MCH program
did not follow up, follow up, follow up, we would not have been off of restriction today. We had to follow up with everyone in order
for us to be successful. We had to follow up on the commissioner’s
office to make sure our budgets were fine, we had to follow up with the Office of Management
and Budget to make sure our [INAUDIBLE] were processed. We had to follow up with the Department of
Finance to make sure our checks were cut. I mean, it was a follow up, follow up, follow
up process. We thank our federal partners, Tia, Jamie,
and Marilyn, because they did an exceptional job in assisting us in order for us to be
where we are today, and we are off of this restriction, and we plan to be off restriction
forever. At that precedes the end of my presentation. I will now turn it over to our North Carolina
partners. Excellent. Thank you. We’re going to hear from South Carolina in
just a minute. We have two questions coming in. Kathy Pillow-Price has asked a question, Charmaine. Did you find that over time you were able
to reduce the frequency of your meetings? She had a similar experience where they met
very frequently at first and then they reduced it to about a monthly meeting instead of weekly
as they got more experience. Yes, yes. We actually were able to do that. The bi-weekly meetings, what we called– at
first we wanted to ensure that everything was moving, so we met in order to know where
every everyone were, if they needed assistance, what assistance would be needed, what plan
would we come up with in order for us to fix whatever issues we have. So those meetings started off bi-weekly, and
then of course, we could have made it monthly meetings. And of course, we are very thankful to federal
partners, because they guided a lot of what we accomplished based on their bi-weekly meetings
that we had to do, that we had to take part in every week. Great. Thank you, Charmaine. Maria has an excellent question. Maria, I’m going to save your question for
our portion at the end. I think that’s something that all of our presenters
will be able to reflect a little bit, and we’ll be able to get back to that great question. So I’m going to now turn it over to our team
from South Carolina. Good afternoon, everyone. My name is Cathy Ramage. I’m one of the Home Visiting Coordinators
for the Children’s Trust of South Carolina. And here with me is McKenzie Hudson, she is
Grant’s Accountant for the Children’s Trust of South Carolina. Hi, everyone. We’re excited to be here today to talk a little
bit about what we’ve done and what we do in South Carolina to improve collaboration across
fiscal and programmatic lines. So McKenzie and I will be tag teaming this
presentation, so you’ll hear us switch back and forth a couple of times. So to get us started, to give you an idea
of our structure, we are a quasi-state agency but operate as a 501(c)(3) non-profit, which
makes us a little unique in the MIECHV world of state leads. We award funding to some recipients across
the state, a total of 17. Across these 17 sites or sub recipients, we
fund the implementation of three models– Parents of Teachers, Healthy Families America,
and Nurse Family Partnership to serve a capacity of just over about 1,000 families statewide. One unique thing about our network of LIAs
is the number of who are in located in medical homes. This was something we targeted through expansion
in 2014 and brought on seven new sites to implement the Healthy Steps Program model,
but those sites of course since transitioned to other home visiting models. But it still leaves us with quite a few medical
home grantees that include SQHCs, pediatric offices, clinics, hospital systems, and so
forth. And the majority of our LIAs operate in some
of these kinds of settings. So I’m the primary fiscal contact for the
MIECHV grant. I work in our finance department, but I would
say a good 75%, sometimes 100% of my time is on MIECHV. But I work very closely with our two home
visiting coordinators, one of them being Cathy, and the other is [? Aver ?] [? Shrinkle. ?] And they divide their tasks by home visiting
model, their program monitoring tasks. So for instance, Cathy monitors the Nurse
Family Partnership and the Healthy Families America
sites. This is helpful for me when I have a question
about a specific sub recipient or training, I can contact whoever monitors that model. I believe this eases with our communication. OK, and now I believe we have a polling question. We want to get your input on this question,
so we came up with this. When implementing program and fiscal collaboration,
what do you feel is your biggest obstacle? We have listed some different answers here
that we personally feel like are large obstacles like budgeting, determining allowable expenses,
grants management skills slash technical assistance needs, communication, sub recipient monitoring,
receiving reports which can be from either side, or other, which you can fill in and
put your own answer. Some answers coming in. In a moment, Cathy is going to read the answers. All right. Watching the responses come in. It looks like determining allowable expenses
has gotten a number of votes, as well as grant management skills slash technical assistance. Let’s scroll down. Oh, sub recipient monitoring is big with eight
votes. So right now, that’s our leading one, sub-recipient
monitoring. OK, so we’ll try and keep that in mind as
we go through the rest of our presentation and highlighting some of the things we’ve
done in that realm. Let me double check and make sure we have
grant management, allowable expenses, OK, general budgeting. OK, pretty much all over the place. But we’ll try and touch on a couple of these. OK, so we’ll switch back to the slides now. And moving forward. For our next slide, we wanted to highlight
our collaboration as a recipient of the MIECHV grant. So for the pre-award stage, we all communicate
when a notice of funding opportunity is released. We have multiple meetings together to determine
what we need to budget for. For example, our program staff usually lets
us know what kind of trainings and travel they’ll have, and we will put amounts for
salary, fringe, indirect, et cetera in the budget. Approval must be given on both sides before
we submit our application. Also annually before contracts are issued,
we ask our sub recipients to submit budgets for the upcoming grant year. Our home visiting coordinators and I review
these budgets, and we work through the approval process together. It is a joint decision on whether approved
a budget is approved or not. We also collaborate on the contracts process
by making sure the appropriate program and fiscal language is correct and that risk assessments
and procurement has been completed. And moving on to the post award period– each
program year, the MIECHV team holds a program year meeting to plan upcoming trainings, events,
and other needs. So the financial staff is invited to attend
the meeting and provide input on ideas for the coming year as well as share thoughts
on the grant funding. Additionally, the MIECHV program team will
say it holds monthly meetings in which the finance team is invited to attend when it
is appropriate. We’ve put this up here as quarterly meetings,
because they often just end up being quarterly, is the frequency that’s comfortable for us. This can be decided by the finance team or
the MIECHV team whether or not we need to meet or discuss something. Regularly set meeting calendar invitations
are shared with the finance team to keep them aware of these ongoing meetings and let them
know when there’s an opportunity that we’re available in case they need to meet with us. Budget to actual reports are written every
month and saved where everyone that works on the grant can access them. In addition, as Cathy mentioned, we usually
have quarterly in-person meetings to look at budget to actual spending during the regular
meetings. Together, we’ll review expenditures, and we’ll
estimate future projects so that everyone is on the same page and spend down is looking
good for the rest of the year. We also internally have trainings on coding
and try to provide as much financial technical assistance as possible to make it less of
a burden and so everyone understands and is on the same page. And for close outs. We communicate when final reports are received
and when deliverables are met before we issue any payments. So now we wanted to highlight our collaboration
on the sub recipient level. For technical assistance, we have some annual
events that we use to align our programmatic and fiscal mandates for sub recipients. For instance, Children’s Trust hosts an annual
finance training where both finance and program staff are encouraged to attend. We really want the fiscal and program staff
to also collaborate on the sub recipient level so they can be in tune with their spending
and budgets. This is usually an issue with some of the
larger medical homes that our sites are housed in, but we continue to encourage them to communicate
with each other on a regular basis. At the training, we discuss federal and grant
requirements, and we usually spend time on topics they find more difficult such as allowable
costs. Additionally, we host an annual workforce
development event for all South Carolina MIECHV funded staff called the All Sites Assembly. This event is required of key programmatic
and site lead staff, and the goal of this event is to not only provide necessary training,
technical assistance, and bring in specialized presenters but the other main target is to
help build a team culture across the state of LIAs and to offer an opportunity for them
to share innovations and best practices directly with each other and to build those friendships,
those relationships across the state. At the All Sites assembly that we hosted this
past June, sights participated in a number of roundtable sessions, was the format that
we chose to do this work. Within these small round tables, the fiscal
staff provided a quick review of allowable expenditures for program staff through an
interactive medium of bingo. This part of the assembly received really
great reviews, and the sub recipient staff learned that finance folks can be a lot of
fun. And I think that was a direct quote from the
evaluation, just disclaimer there. So in that sense, we’ve begun approaching
fiscal technical assistance in the way that we approach programmatic technical assistance,
drawing upon what’s working well within other LIAs and connecting sites around their innovations
and strengths. And so this kind of goes back to the poll
responses that you entered for votes for budgeting and determining allowable expenses. I think we’ve really started, and the assembly
was a really good example of, why not connect sites that are really great at budgeting with
each other in some kind of format or way that’s appropriate and flows naturally and doesn’t
sort of hold up anyone’s expertise over anyone else’s? And so we really feel like the round tables
have been a great addition to that event in particular and moving forward hopefully more
of that can happen in lots of different ways. All right, on our regular communication with
sites, both home visiting coordinators have scheduled calls with each sub recipient that
we monitor. These occur either monthly or bi monthly. The financial staff members receive this calendar
invite, so they are aware when the calls are going to take place. The bulk of the call agenda is programmatic,
but financial topics are often discussed and the finance team is brought
on the calls when issues arise or questions need to be answered. So at least quarterly, we include sub recipient
finance staff on a portion of those calls as well as the program lead staff to discuss
the status of their spending, budget to actual, and any questions or issues that have arisen. And of course, we bring in McKenzie on those
calls as well. So within the realm of monitoring, again,
we conduct annual programmatic as well as financial site visits with each of our sub
recipients. When able, we coordinate with our fiscal team
to see if it would be beneficial to combine or complete a joint site visit. This helps not only keep everyone in the know
and gives finance a clear understanding of the LIAs program, which can help in processing
things like requests for payments but also can facilitate better connections between
the fiscal and programmatic staff at the sub recipient level, especially when these key
roles are separate and located in different offices as we sometimes find with some of
our medical home sites, especially hospital systems. So we try to be strategic in how we approach
each LIA’s structure and what’s going to work best for their staff as well. We of course share back any relevant findings
with each other when joint site visits aren’t possible or appropriate. We also keep regular focused communication
throughout the year and between calls. Our home visiting coordinators regularly review
reimbursement submissions and let me know or our finance staff know when sub recipient
staffing if anything changes. So in conclusion, part of our success is based
on systems and processes that help us stay in contact and make sure we keep each other
aware of what is happening on the fiscal and programmatic sides, but we also like each
other and work gracefully with each other to help develop our understanding and provide
the best support to our sites that is possible. Excellent. Thank you so much. We did have two questions that came in. Casey is asking if you are able to share your
bingo game that engaged the LIAs. Of course, we would love to share that. OK, great. So we’ll get that out to folks on this call. And then we also have a question from Tina. She says she’s interested in learning more
about the pre award and post award process of your site. She said, would you be able to share a little
bit more about that process? I think for the pre award, it’s determined
based on our schedules and when we can get together and when our deadline is, especially
for the applications. For the sub recipient budget reviews, we try
to have deadlines for our sub recipients when they should have those in. Those usually are about a month prior to the
contract start dates, and we try to get those approved before we issue contracts. So I hope if you have any more specific questions
on pre-awards, just let me know, but I’ll go ahead and go to post award. For quarterly meetings, our program staff
have their own meetings and finance just kind of joins in. Well, they have them monthly and we join in
quarterly. We have a SharePoint site where I’ll update
and add reports for our budget to actual, so they can go out there anytime and see where
they’re at. I’ll also do a specific one for our sub recipients,
so they can see exactly where they’re at percentage wise on their spend down. So if we need to ask
our sub recipients to submit a budget revision or if we need to have some kind of talks–
because a lot of the time if they’re not spending, it’s also programmatically. There’s something on the programmatic side
as well. Great. Yeah. Thank you. That’s very helpful. I want to move us ahead so we have time for
our Louisiana presenters, and then we can come back at the end with additional questions. So thank you both very much, and we’re going
to move it ahead to our final set of presenters. Hi, this is Gina Easterly with Louisiana,
and good afternoon to everyone. Thanks for allowing us to share our collaboration
between program and fiscal here at our state. I’m the Supportive Services team lead for
the Bureau of Family Health, which sits in the Office of Public Health at Louisiana Department
of Health. And I oversee MIECHV and other early childhood
initiatives within the Bureau. We’re extremely lucky in that we have fiscal
and program staff housed within the same organization, within the Bureau of Family Health. We’ve had evidence based home visiting here
in our state for almost 20 years, and the business unit has been an integral part to
our success. At present, we have 19 home visiting teams,
14 of which implement Nurse Family Partnership and five that implement Parents as Teachers. All receive support, also, from an Infant
Mental Health Consultant and an Outreach Specialist. So again, all of our program and fiscal staff
work via contract or are directly hired through the state within the Bureau. And I’m going to turn it over to Tracy to
introduce herself and talk a little bit more about fiscal. Good afternoon. This is Tracy Hebert Hubbert, and I am the
Business Unit Team Lead with the Bureau of Family Health, housed here at the Office of
Public Health Louisiana Department of Health. Our business unit team is responsible for
fiscal oversight and monitoring of all of our Bureau of Family Health Grant and program
initiatives. And that includes the Louisiana MIECHV program. We are responsible for developing our Bureau
of annual operating budget and closely monitoring our budget and making the necessary budget
adjustments. We are housed within the program office, so
our business unit is housed within the Bureau of Family Health, and we are the direct liaison
between the MIECHV program of the Bureau of Family Health programs and our OPH budget
and fiscal office. Our business unit is responsible for all of
our fiscal grant management out of the bureau developing our service recipient contract
agreements, all fiscal and sub recipient monitoring, and purchasing and procurement for our department. I want to acknowledge our assistant business
manager, whom I know I could not work the vision that I have for this unit without him. He’s not presenting today, but that’s our
Assistant Business Manager Shane Bates. He’s responsible for assuring robust contract
processes, developing our sub recipient protocol and procedure manuals, and overseeing all
of our fiscal sub recipient monitoring for the Bureau, which includes the MIECHV program. Thanks, Tracy. So whether it be generating new ideas for
new grants, sharing findings from site visits or monitoring, looking over fiscal reports
or invoices, we do everything together in Louisiana. Every week, we have standing time, protected
time to discuss all things fiscal and program. So collectively, we develop agendas for these
meetings and address each agenda item and then we determine what if any action items
need to be completed prior to our next weekly meeting. For example, when developing and submitting
grant applications, I will create the conceptual framework to determine what current or future
activities need to be funded through the grant, write the project narrative, develop the logic
models, tables, any other supporting documentation. And then fiscal–
We are responsible for recommending the appropriate procurement method, whether that’s in-house
or via contract or reviewing cost effectiveness of the budget. Our business unit is responsible for developing
the budget narrative for the MIECHV grant as well as submitting the grant application. I think the big opportunity that Louisiana
has is that the program and the fiscal office work together not only to assure that we have
a smooth application submission process but that the implementation plans have been thoroughly
thought out and that we jointly respond to terms and conditions that are within the notice
of grant award for the MIECHV grant. Once funding is approved, the business unit
works closely with our Office of Public Health fiscal office to ensure adequate accounting
structures set up to be able to track our grant activity expenditures and our revenue. The business unit ensures that activities
of the MIECHV grant are included in the Bureau of Family Health annual operating budget request. We also make sure that if need be, we negotiate
adequate budget authority to be able to implement all of the activities that are within the
MIECHV grant as well as our other Bureau of Family Health Grant Activities. In relation to monitoring on the program side,
we implement sub recipient monitoring via monthly site visits with every single team. The business unit provides oversight for all
of the staff that are responsible for the fiscal sub recipient monitoring. All of the day to day communication with all
of our implementing agencies, with business staff, with their fiscal staff, troubleshooting,
problem solving, we provide cost allocation, training to our staff or to our implementing
agencies as needed. And by program and fiscal working together,
it certainly creates a much larger awareness and understanding of the monitoring process
across program and fiscal, and we can certainly address any challenges that may arise from
the sites because we’re monitoring activities together and immediately. And we’re able to maintain frequent communication
with our contractors and teams. In relation to tracking funding expenditures
and reporting, so I review invoices quarterly, and at least once a month I review detailed
fiscal reports that are prepared by the business unit. The fiscal office prepared an overall MIECHV
program financial status report for our program. That report tracks our grant spending on our
state fiscal year, on the grant’s fiscal year, and also grant spending from inception to
date. That financial report also includes the overall
budgetary comparison and a projection of expenditures for the MIECHV program. Business unit staff utilize an ad hoc reporting
tool where we can extract any charge by source document, transaction
number, vendor, end date of the transaction. The business unit and program staff, Gina
and I and our Assistant Business Manager, we together review that overall financial
report as well as those ad hoc report for allowability. Business unit staff conduct rigorous monthly
reviews of our source documents in support of the invoices that are submitted to us for
payment. Business unit staff work closely with the
fiscal office. We have worked with our fiscal office to develop
an Infrastructure expenditure report so that the MIECHV program can track its spending
against its 25% infrastructure cap. And we review that spending quarterly. The business unit staff, we pre-approve all
of our implementing agencies purchasing and procurement request, particularly looking
for allowability, looking to ensure that there is budget to support the purchase. We also monitor and track our implementing
agencies budget, their projected expenditures, and their comparisons. And we look at those monthly. And this business unit is also responsible
for processing and approving our implementing agency contract budget revisions when they
are requested. Program and business unit staff review our
procurement preapproval forms also in our payroll reports quarterly. Particularly, we’re looking for allowability. I think the great benefit that we have to
our business unit being housed in the program along with the MIECHV program is that we have
a greater understanding of how to track and project our spending for the program. Our meetings are held often enough because
they’re weekly that we can problem solve, that we can request corrections in a timely
fashion. And I think that that’s the biggest benefit
that we have to being able to work together and being in the same program. I think that we inform the work that our fiscal
office does, particularly. Couldn’t agree with you more. This is a huge asset to me personally, being
able to work with Tracy and Shane so closely in so many different ways, but particularly
in relation to tracking and reporting. So in reporting the program side, I develop
along with help from my team, and submit all of the performance and annual grant reports
with input from the business unit. The business unit, we provide information
and feedback on performance for the annual reporting. We also meet with our fiscal office to give
them an update on outstanding obligations, the processing of those for payment, particularly
when we’re in close out. That’s one of the ways that we assure that
our FFR is reported accurately. So we’d also like to take a couple of minutes
to talk about our work with HRSA. We have quarterly calls with HRSA, and then
of course the multi-day HRSA site visits that our colleagues have talked a bit about today
as well. So we participate in quarterly calls, and
we develop and implement the agenda, we have a call document that all our team, including
our fiscal, the business unit, contribute to in preparation for that call. And then for site visits, we certainly co-create
the agenda and just the plan for the overall site visit with input from the program side,
from our fiscal colleagues, any of our home visiting staff on the ground, our state and
community partners, family members and any other stakeholders. And for the program side of the site visit,
myself and my other statewide support team help lead that part of the site visit. The business unit, we participate in those
quarterly calls with HRSA. We significantly contribute to our planning
and implementing for our visit, and of course we lead the fiscal portion of the
site visit. We develop all of the tools, the policy procedure
manual that leads our fiscal sub recipient monitoring. And by working together so closely and especially
in preparation for our quarterly calls, it makes for efficient, robust calls with HRSA. And then in relation to the site visits because
we work so closely together, it was really, really successful. We’ve only had one in my tenure here, and
it was a great learning experience and because we planned it together, everybody knew what
everyone else was doing, and then there was a joint review of findings from the program
on the fiscal side, and we were able to develop support plans for our internal staff as well
as some of our sub recipients and come up with innovative and creative solutions to
the challenges that we had. And then in relation to professional development,
I just wanted to briefly talk about we’re planning some training for all BFH staff including
MIECHV related to contracts and grants. So that’ll be developed in consort with me
and the program folks, as well as Tracy and Shane and some of our other fantastic fiscal
business unit staff within MIECHV. And I will just mention that we have an annual
education event each year that everybody in MIECHV takes part in, so that’s the program
and the fiscal staff, and we have [INAUDIBLE] and breakout sessions available for all staff. Thank you so much, Tracy and Gina. This was such excellent information. And thank you for those of you that could
stay on for the last few minutes. We did have an excellent question come in
early. I want us to have a chance to address it. It came in from Maria. Do you think it would be helpful to have some
fiscal team members embedded in the programmatic area for financial oversight opposed to having
all full fiscal partners within the finance department? I know Loraine is going to take a stab at
that. She’s already actually answered that over
in the chat pod. After 17 years in state government with five
governors and at least as many organizational structures, I would agree with Charmaine that
it’s very helpful to have a fiscal team member housed within the programmatic staff. So hopefully that’s a strategy that a lot
of your programs can adopt. If there are any additional questions, please
do go to the chat pod and feel free to ask them. I do have two quick polling questions, and
then we’ll just do our wrap up slide as our last slide next. So folks that are still on, if you could just
take a moment and please say, will you take an action step based on this webinar? Your answer yes or no, and then if you do
plan to take an action step, could you please briefly describe what it might be? And if you do not plan to take an action step,
what would have been more helpful in this webinar to help you be able to do so? So I’m just going to leave this open for about
another minute and give folks a chance to react to the question, and then we’ll do our
final slide. All right, so thank you again to those of
you who’ve had a chance to participate in this polling. I’m going to close up the polling now and
move on to our final slide, which gives you a little bit of information about how to access
our next webinar and also our evaluation. We do have some resources that might be useful
if you’ve not had a chance to download them. They’re all on HRSA’s web site. There’s a sub recipient monitoring manual,
which is an excellent tool. There’s also some communications guidance
around the different stakeholders that you work with. And
finally, our opioid and neonatal abstinence syndrome brief has just been released as well. So you can find those and other very useful
resources on the HRSA website at this link. Our next webinar will be on February 19th
on the topic of Pay for Outcomes, Pay for Success. And finally, at the end of this webinar, you’ll
have an evaluation survey that pops up automatically. We’d love your feedback, so please take a
few minutes to complete that.

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