Tribal Maternal, Infant, and Early Childhood Home Visiting Program Guidance for Submitting Annual Reports

Tribal Maternal, Infant, and Early Childhood Home Visiting Program: Guidance for Submitting an Annual Report to the Secretary

Tribal Maternal, Infant, and Early Childhood Home Visiting Program Guidance for Submitting Annual Reports

OMB: 0970-0409

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U.S. Department of Health and Human Services

Administration for Children and Families

Office of Early Childhood Development




Tribal Maternal, Infant, and Early Childhood

Home Visiting Program


Guidance for Submitting

Shape1 Annual Reports






U.S. Department of Health and Human Services

Administration for Children and Families

Office of Early Childhood Development

330 C Street SW

Washington, DC 20201





Tribal Maternal, Infant, and Early Childhood Home Visiting Program

Background Information:

Guidance for Submitting Annual Reports


511(e)(8)(A) of the Social Security Act Section requires that grant recipients under the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program for states and jurisdictions submit an annual report to the Secretary of Health and Human Services regarding the program and activities carried out under the program, including such data and information as the Secretary shall require. Section 511 (h)(2)(A) further states that the requirements for the MIECHV grants to tribes, tribal organizations, and urban Indian organizations are to be consistent, to the greatest extent practicable, with the requirements for recipients under the MIECHV program for states and jurisdictions. Tribal MIECHV grant recipients have been notified by the Administration for Children and Families (ACF) that in each year of their grant, except the first year, they must comply with the requirement for submitting an Annual Report that should describe activities carried out under the program during the past reporting period.


This document provides guidance to grant recipients when submitting their Annual Report. Reports shall be submitted via GrantSolutions.gov per instructions given to each recipient by ACF as part of their cooperative agreement.




Any questions and comments regarding this guidance may be addressed to:


Jesse LaSarte

Tribal Program Analyst

Tribal Home Visiting Program

Administration for Children and Families, HHS

Mary E. Switzer Building

330 C Street, SW

Washington, DC 20201

[email protected]





PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: Through this information collection, ACF is gathering information to report activities associated with grants to the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program. The purpose of this information collection is to submit an annual report to the Secretary of HHS. Public reporting burden for this collection of information is estimated to average 25 hours per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection of information through section 511(e)(8)(A) of the Social Security Act. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0409 and the expiration date is XX/XX/202X.



  1. Guidance for Submitting Annual Reports


Each year following the first year of the grant, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grant recipients must provide a written report regarding the program and activities carried out under their cooperative agreement during the previous reporting period. The audience for the Annual Report is the Department of Health and Human Services (HHS), ACF, and other leadership.


The goal of the Annual Report is to tell the story of your program, your community, and the families you serve. Given the importance of storytelling in Indigenous communities, consider including imagery, testimonials, quotes, and stories (which could include digital stories) from your program staff, community partners, and families. Doing so provides an opportunity to amplify the voices on the ground and in the field of the families you serve and the workforce that supports them. The report also offers valuable information to HHS regarding your assessment of the challenges, successes, and lessons learned over the past year. This is also an opportunity for you to reflect on your progress and to help inform your future programmatic decisions. The report can be used for multiple purposes, including sharing with leadership, community members, partners, potential participants, etc. The report can be presented and formatted however you prefer.


Other reports grant recipients submit include the Demographic and Service Utilization Data Report (DSUR), Performance Measurement Data Report (PMR), and Quarterly Performance Data Report (QPR). While these reports are essential, the objectives for the Annual Report differ but are equally important. The objectives for the Annual Report are to:

  • Provide rich, contextual information that cannot be found in other types of Tribal MIECHV reporting.

  • Use information provided by grant recipients to help inform individual support for each grant recipient, overall technical assistance, and future policy decisions.

Section 1: Update on the Implementation of the Home Visiting Program in Targeted Community(ies)

Please discuss how you are meeting the goals and objectives you set out to accomplish when you developed your Implementation Plan. Your goals and objectives are at the heart of all the activities you will be reporting on.

      1. List each program goal and objective identified in your Implementation Plan and provide an update on your progress in meeting your goals and objectives.


In your approved Implementation Plan, you lay out the design and blueprint of your home visiting program. In the sections below, please discuss how the design and blueprint came to life. Note successes, barriers/challenges, and any lessons learned.


      1. Please describe your efforts to recruit, retain, and provide support and professional development to staff. Describe activities implemented over the past year and outcomes related to:

    • Staff recruitment and hiring

    • Professional development and support for staff well-being

    • Staff retention

    • Training to ensure well-trained, competent staff are trained, beyond model developer-provided activities

    • High-quality reflective, clinical, and administrative supervision

    • Infant and early childhood mental health consultation

      1. Please describe your activities related to providing high-quality home visiting program services, including:

    • Developing and documenting program operations, policies, and procedures to support implementation fidelity and program quality

      1. Please describe your efforts to recruit, engage, and retain program participants. In responding to each item below, consider what is working well and where there are opportunities for improvement.

    • Recruitment of families, including referral partners and what has been your most successful recruitment strategy

    • Engagement of families

    • Retention of families

    • Participant completion of the program

      1. Please describe the progress you may have made toward the development of a coordinated early childhood system.

      2. Please describe your progress in engaging with the broader community(ies) (e.g., partner agencies, local advisory committee, interested parties within your community, tribal leadership, leadership within your organization, the families you serve around your home visiting program).


Section 2: Update on the Collection, Reporting and Use of Data

Reflecting on completing the DSUR, PMR, and QPR reports this past year, please address each item listed below:

        1. Describe the top two successes your team has experienced in the collection, analysis, data reporting, and use of data during the reporting period.

        2. Describe the top two challenges your team has experienced with data collection and reporting during the reporting period. How have you addressed these challenges?


Section 3: Progress toward Fidelity Monitoring, Program Management, and Improvement

In your approved Implementation Plan, you lay out your plan for quality assurance and ensuring your program elements are implemented as planned. Below, address the following:

          1. How are you using the data that your program collects to monitor and assess the quality of program implementation and service delivery?
          2. Describe your progress of engaging staff in quality assurance.
          3. List out the QA targets you set out and whether you met those targets.
          4. Describe any additional successes and challenges monitoring program fidelity and service delivery overall.


Section 4: Update on Contribution to MIECHV Learning Agenda through Participation in Research & Evaluation Projects

Thinking about research and evaluation activities opportunities during the past year, please address the following:

            1. Please describe the research and evaluation activities you engaged in to contribute to the MIECHV Learning Agenda.
            2. Please describe any successes and challenges to your participation.
            3. Please include any recommendations for meaningful and feasible grant recipient involvement with home visiting research and evaluation activities.


Section 5: Dissemination

              1. Please describe the past year's dissemination efforts, and include examples of products, where appropriate. Relevant dissemination materials and products could include:

  • Pamphlets, brochures, or fact sheets

  • Newsletters (electronic or print)

  • Web- and social media-based products (blogs, podcasts, video clips, etc.)

  • Digital stories or videos

  • Presentations and posters


Section 6: Technical Assistance Supports

                1. Technical Assistance (TA) support can be provided through the ACF federal team, contracted TA providers, as well as other resources and networks within the home visiting field.

  • What are the TA resources or tools that you found helpful? Did not find helpful?

  • Were your technical assistance and training needs met?

  • Do you have any recommendations on improving TA support?





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File TitleAffordable Care Act Tribal Maternal, Infant, and Early Childhood Home Visiting Program Guidance for Submitting an Annual Report
AuthorMoushumi Beltangady;[email protected]
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File Created2024-11-04

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