TANF and Child Support Moving Forward: Further Incorporating Family Input

Instrument 1.

Expression of interest form

OMB NUMBER: 0970-0531

EXPIRATION: DATE 09/30/2025

TANF and Child Support Moving Forward: Further Incorporating Family Input

Expression of interest form

Introduction

Thank you for your interest in pilot testing the resources developed by the TANF and Child Support Moving Forward: Further Incorporating Family Input study! This study is sponsored by the Office of Planning, Research, and Evaluation (OPRE) in the Administration for Children and Families at the U.S. Department of Health and Human Services (HHS). This is not part of any HHS monitoring or auditing activities.

This form will take about 10 minutes to complete. Expressing interest is not a commitment to participate or a guarantee that you will be selected to participate.

Completing this questionnaire is voluntary. Please feel free to skip any question or stop the questionnaire at any time. You can skip a question by scrolling past it without selecting an answer. You can submit your questionnaire early by using the next arrow to skip sections and hitting “submit.”

Please click ‘next’ if you consent to complete your expression of interest.

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About pilot testing

By submitting this form, you are expressing your program’s interest in pilot testing the study’s toolkit of resources, “Elevating Family Input in TANF and Child Support Programs: Resources for Program Staff, Leaders, and Families.”

Piloting testing includes:

• Program staff committing to leading an improvement effort that includes input from families over a 12-month period (starting between [month] – [month 6 months later] 2023). Improvements can be to policy, service delivery, service offerings, operations, systems, and more.

• Referencing and using the study team’s toolkit of resources to support your improvement effort.

• Meeting with study team coaches at least monthly over the 12-month pilot testing period.

• Sharing the progress, successes, and challenges of your program improvement effort with study team coaches.

• Providing feedback to the study team about the toolkit of resources, through a monthly survey, interviews at the 6- and 12-month points of pilot testing, and a focus group a few months after the pilot testing period ends.

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Selection

The study team will review all expressions of interest and may follow up with you to learn more about your program and interest in participating and to share more details about the pilot.

The study team will select eight programs to participate, ensuring a diversity of program types, locations, experience engaging families for their feedback, and areas for improvement. The study aims to include four TANF/Tribal TANF programs and four child support/Tribal child support programs. The study will also identify two TANF/Tribal TANF programs and two child support/Tribal child support programs to serve as alternate pilot sites, which may be invited to participate if a selected site becomes unable to continue the pilot. The study team will contact all programs that express interest to invite them to participate in the study, to invite them to serve as an alternate, or to notify them that they have not been selected.

We appreciate your interest in the Family Input Study!

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Expression of Interest form

Contact information

1. What is your name and title?

   1. [Open text field]

2. What is your email address?

   1. [Open text field]

Program information

3. Agency and program name

   1. [Open text field]

4. Please select your program type. [Select one only]

   1. Child support

   2. Tribal child support

   3. TANF

   4. Tribal TANF

5. What local areas (e.g., county, city), state, territory, or Tribal organization does your program serve?

   1. [Open text field]

6. About how many families does your program currently serve per year?

   1. [Open text field]

Program interest and background

7. Briefly describe why you’re interested in participating in this pilot. Suggested response length: 2-4 sentences.

   1. [Open text field]

8. To what extent do you and others in your agency or program know what aspect of your program you want to improve? [Select one only]

   1. We know exactly what we want to improve.

   2. We have several areas that we want to improve but no clear priority.

   3. We have a few general ideas about what might need to be improved.

   4. We do not have a clear idea about what to improve right now.  SKIP TO Q10

9. Briefly describe what you plan to improve or what you are considering improving. Suggested response length: 2-4 sentences.

   1. [Open text field]

10. How ready do you feel your agency or program is to engage with families for program improvement? [Select one only]

    1. We already do this regularly.

    2. We have done this a few times recently.

    3. We haven’t done this much, but leadership and staff are interested in engaging families for their feedback.  SKIP TO Q12

    4. We haven’t done this much and we will have to do some work to get leadership or staff to see the value in engaging families for their feedback.  SKIP TO Q12

11. Briefly describe how you have engaged with families to improve your program. Suggested response length: 2-4 sentences.

    1. [Open text field]

12. Please list any federally-funded evaluations (sponsored by HHS or other federal departments), demonstration grants, or ongoing technical assistance your agency or program has participated in over the past three years.

    1. [Open text field]

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Next Steps

Thank you! The study team will review your expression of interest. They may contact you to schedule a brief call to learn more about your program and interest in participating and to share more details about the pilot. The team expects to contact programs that have expressed interest in [month] 2023.

Please contact the study team if you have any questions or if you decide that this opportunity is not right for your program and you want to withdraw your expression of interest. You can email the Mathematica study team at [email protected].

We appreciate your interest in the Family Input Study!

[Submit]

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