Example Logic Model Worksheets by HHS


									                                         Sample Project Logic Model
                                Worksheet #1: ULTIMATE PROJECT GOALS

Program Goal for Grantee X: Refine in-hospital paternity affidavit program in four areas of state to use
non-RN staff and have notary presence at all hours; referrals to free genetic testing and mediation;
referrals to marriage education

                Funding, Legislative Goals         Grantee and Collaborating             Project Goals
                                                     Organizations’ Goals

              OCSE 1115 Grant Priority                                              Strengthen delivery
                                                  Goal of the state                 of state paternity
              Area 1: Reducing use of             child support agency
              adversarial or formal                                                 affidavit program
                                                  is to promote the
              proceedings while                   financial well-being of
              increasing the financial                                              Expand the scope of
                                                  children of non-married           services associated
              security for children               parents by establishing
              born out of wedlock.                                                  with paternity
                                                  paternity, establishing           affidavit program
                                                  and modifying orders,
              NOTE: While this set of             enforcing orders, and
              Logic Model worksheets              processing and
              maps a project which                distributing child
              responded to a Federal              support payments.
              grant opportunity, the
              worksheets and the
              Guidelines may be used
              to design and monitor
              any project to improve
              program operations.
                           Worksheet #2: UNDERLYING ASSUMPTIONS

Program: GRANTEE X

                                                     Client Characteristics
          Problem Being Addressed
                                                   (Source of this Knowledge)
         (Source of this Knowledge)

      Paternity affidavit results have         •Unmarried parents
      improved statewide but lag in            •Lots of demands on their time
      certain areas; establishing
      paternity through courts is              •Fathers open to signing
      expensive and time consuming             affidavit if services available at
                                               hospital or open to exploring
      (Source: State administrative            genetic testing
      data)                                    (Source: Child support staff)

                                              Why Proposed Approach Will Work
                Client Needs
                                                 (Source of this Knowledge)
         (Source of this Knowledge)
                                              •Past in-hospital program works so
     •Ability to speak to someone at
                                              should improve if expanded
     the hospital regarding paternity
                                              •It focuses on increasing number
     •Some need genetic testing
                                              and type of staff involved in
     •Parents need to know benefits to        program. More staff can reach
     child of paternity establishment         more fathers
     •Parents need to understand              •It will extend notary services so
     options available to help obtain         available at all hours, thus could
     parenting plan or consider               serve more fathers.
     marriage                                 (Source: Previous program
     (Source: Child support staff)            experience; staff feedback)
                                Worksheet #3: PROJECT CONTEXT

 Program: GRANTEE X

    Characteristics of the             Other Related Interventions                Other Organizational
       Environment                 Informal understandings with local                Relationships
                                   dispute resolution centers in some areas,
Intervention will operate in       not all; state’s genetic testing partner
four areas with different
                                                                               •Prosecuting attorney’s
                                   agreed to participate
client bases (income,                                                          staff *
ethnicity, non-marital birth
                                                                               •TANF offices*
                                      Characteristics of Project Site          •Pre- and post-natal
Areas also differ in terms of
                                    Hospitals differ by patient loads,         pediatric clinics^
prosecutor agreement with
                                    staffing, presence of notaries; short
establishing paternity via          hospital stays limit time fathers on
affidavit                           site; varying availability of other
                                                                               •County vital records
                                    services, such as marriage education       offices*
Hospitals have flexibility in
how they operate affidavit                                                     •Native American tribe
program                                                                        liaisons*
                                          Grantee Characteristics
Non-RN staff have more
time to devote to paternity          State child support office operates
establishment                        regional offices that have discretion
                                     in program operations; different
                                                                               *Denotes existing
Existing marriage education          regions will manage project               relationship
programs in some
communities                                                                    ^Denotes new
                                                                               partnership needs to
Genetic testing labs
                                                                               be established
available in target                     Other Targeted Resources
                                      Grantee has healthy marriage
Mediators in all target               initiative in one of the areas
communities                           operating the program
                                     Worksheet #4: INPUTS TO INTERVENTIONS

Program: GRANTEE X

                   Inputs from Partners                                   Interventions (For Whom?)

                                                               Building Capacity
 Hospital staff (medical records, birth clerks, social         •Enlist hospital administration support
                                                               •Enlist non-RN staff
 Dispute resolution center mediators
                                                               •Train additional hospital notaries
 Notaries public
                                                               •Enhance child support materials
 Genetic testing labs
                                                               •Establish contract with dispute resolution centers
 Marriage education courses from community providers
                                                               •Establish Memorandum of Understanding with genetic
                                                               testing labs
                                                               •Identify marriage education providers
                                                               •Create referral system for other services (e.g.,
                                                               mediation, marriage education)
                     Grantee Inputs
                                                               •Develop system to capture participant data
                                                               •Develop reimbursement system to pay partners
  Child support staff (project manager and
  budget/contractors at central office, field office staff)
                                                               Provide Services for Unmarried Parents
  Written and visual materials
                                                               •Talk with fathers about paternity
  Toll-free phone line
                                                               •Offer genetic testing
  Staff to train hospital staff
                                                               •Offer mediation/parenting plan
  Staff to enlist support from other organizations,
  partners (including marriage ed)                             •Offer referrals to marriage education
                         Worksheet #5: INTERVENTIONS TO EXPECTED OUTPUTS

Program: GRANTEE X

             Interventions (For Whom?)                    Expected Outputs (For Whom? By When?)

                                                       Building Capacity
Building Capacity
                                                       •Hospitals develop model to use non-RN staff by 3/1/06
•Enlist hospital administration support                and implement by 4/15/06
•Enlist non-RN staff                                   •All hospitals have at least one notary available 24
                                                       hours per day, 7 days per week by 4/15/06
•Train additional hospital notaries
                                                       •Child support develops new booklet and enhances
•Enhance child support materials
                                                       current video by 3/1/06
•Establish contract with dispute resolution centers
                                                       •Child support obtains signed contracts from DRCs by
                                                       2/1/06; DRCs begin providing services by 4/15/06
•Establish Memorandum of Understanding with genetic
                                                       •All hospitals agree to participate by 2/1/06
testing labs
                                                       •Genetic testing lab MOU in place by 2/1/06
•Create referral system for other services (e.g.,
mediation, marriage education)                         •Marriage ed providers identified by 2/1/06
•Develop system to capture participant data            •Referral system in place by 2/1/06
•Develop reimbursement system to pay partners          •Data system in place by 2/1/06
Provide and Expand Services for Unmarried Parents      •Reimbursement system in place by 2/1/06
•More convenient in-hospital paternity process         Provide and Expand Services for Unmarried Parents
•Materials on free genetic testing available           Beginning mid-April and monthly thereafter:
                                                       •Increase contacts with fathers in hospitals by non-RN
•Materials on mediation/parenting plans                staff
•Materials on marriage education                       •Increase in presumptive fathers requesting genetic
                                                       •Increase in couples requesting mediation
                                                       •Increase in couples requesting marriage education

Program: GRANTEE X

             Expected Outputs                                                  Expected Subsequent Outcomes
                                             Expected Immediate Outcomes
          (For Whom? By When?)                                                    (For Whom? By When?)
                                               (For Whom? By When?)

        •Implement model by 4/15/06                                             Within 9 months:
        •Notary available 24/7 by 4/15/06     Within 3 months of starting       •10 percentage point
        •New booklet and enhanced video       services                          increase in orders established
        by 3/1/06                                                               in four parts of the state
                                              •Number of signed affidavits
                                                                                where initiative operating
        •Contracts with DRCs by 2/1/06        increases 10 percentage
                                              points                            By end of 2 year grant:
        •Genetic testing lab MOU by
        2/1/06                                •20 fathers have genetic test;    •Number of signed paternity
                                              75% voluntarily sign paternity    affidavits increases 20
        •Referral system by 2/1/06            affidavit                         percentage points
        •Data system by 2/1/06                •20 parent couples obtain         •100 fathers have genetic
        •Reimbursement system by 2/1/06       mediation services; 75% agree     tests; 75% voluntarily sign
                                              to parenting plan                 paternity affidavit
                                              •10 couples enroll in             •90 couples obtain
        •Increase contacts with fathers in    marriage education class; 80%     medication services; 75%
        hospitals by non-RN staff             complete                          agree to parenting plan
        •Increase in presumptive fathers                                        •64 couples enroll in
        requesting genetic testing                                              marriage education class; 80%
        •Increase in couples requesting                                         complete
        mediation                                                               •20 percentage point
        •Increase in couples requesting                                         increase in orders established
        marriage education                                                      in four parts of state where
                                                                                initiative operates
                                    Worksheet #7: MEASURING OUTCOMES

Program: GRANTEE X

            Outcomes                               Indicator/Measure                      Evidence of Change
      Immediate and Subsequent                                                        (How Do You Assess Success?)
Increase in in-hospital paternity        Number of signed affidavits              Compare the number of signed
establishment affidavits signed          increases 10 pct points in 3 months,     affidavits to same period previous
                                         20 pct points over entire project        year
Increase in voluntarily signed           75% of participating fathers sign        Compare the number of signed
paternity affidavits following genetic   affidavit voluntarily (of an est. 20     affidavits to same period previous
testing                                  fathers participate in first 3 months    year
                                         and 100 over course of project)

Increase in couples receiving            75% of participating parents sign        Compare number of signed parenting
mediation services                       parenting plan (of an est. 20 in first   plans to same period previous year
                                         3 months, 90 over entire project)
Increase in couples enrolling in         80% complete (of an est. 10 in first 3   No baseline available; instead, over
marriage education classes               months and 64 over entire project)       course of project, are targets met?
                                         based on provider attendance
Increase child support orders            10 pct point increase in orders after    Compare number of orders
established                              9 months; 20 pct point increase over     established to same period previous
                                         entire project                           year
                             Worksheet #8: BARRIERS TO IMPLEMENTATION

Program: GRANTEE X

                  Potential Barriers                                Possible Solutions
    To Recruiting Clients
    Parents not interested in services
                                                      Re. Recruiting Clients
                                                      Re-evaluate program materials, discuss with hospitals
    Parents cannot afford to file parenting plan      reasons for barriers, try phone calling of parents,
    Services not in convenient area to parents        revise materials if necessary

                                                      Re-evaluate and consider paying costs; would
                                                      serve fewer parents but would help ensure plan
                                                      is legal and effectual

                                                      Explore offering transportation assistance (e.g.,
                                                      gas vouchers)

    To Service Delivery
                                                      Re. Service Delivery
    Hospitals will not add notaries                   Enlist intervention of state Department of Health;
                                                      face-to-face discussions with administrators;
    Hospitals insist on using RN staff                stress benefits of program to children and minimal
    Hospital administrator will not participate       time commitment
    Genetic testing company may not serve all         Show best practices results from other hospitals that
    sites                                             use non-RN staff; offer training and follow-up

                                                      Start services in counties in which company can
                                                      provider testing; work to add new sites in yrs 2&3

Program: GRANTEE X

                                                                               Actual Outputs (Indicator? Time Frame?)
    Expected Outputs (Indicator? Time Frame?)                             Intervention # 1: Build Capacity
 Intervention #1: Build Capacity                                          1. Notary available 6 days/week
 1. Notary available 24/7                                                 2. Combination of RN and non-RN staff provide
 2. Non-RN staff trained                                                  services
 3. Child support materials revised                                       3. Materials revised on schedule
 Intervention #2: Provide and Expand Services                             Intervention # 2: Provide and Expand Services
    Available to Unmarried Parents                                        Available to Unmarried Parents
 1. Provide materials on genetic testing to fathers                       1. Provided information to small number of fathers
 2. Provide mediation information to couples                              2. Provided information to many couples
 3. Provide marriage education materials to couples                       3. Provided limited information to couples

                                                 Refinement of Intervention?

                                     •Option #1: Work with hospital administrator to
                                     identify additional notaries and non-RN staff
                                     •Option #2: Revise recruitment presentation to non-RN
                                     staff to stress benefits to clients
                                     •Option #3: Meet with non-RN staff to discuss what
                                     works/doesn’t work in approaching fathers/parents
                                     about genetic testing, mediation, marriage education

Program: GRANTEE X

    Expected Outcomes (Indicator? Time Frame?)                                           Actual Outcomes (Indicator? Time Frame?)
  Intervention #1: Build Service Capacity                                         Intervention #1: Build Service Capacity
  1. Signed paternity affidavits increase by 10                                   1. Signed paternity affidavits increased by 5
     percentage points within three months                                        percentage points
  2. Child support order establishment in offices with                            2. No change in order establishment rates
     paternity initiative increases 10 percentage                                 Intervention #2: Provide and Expand Services to
     points within 9 months                                                       Unmarried Parents
  Intervention #2: Provide and Expand Services to                                 1. 30 fathers have test; 50% voluntarily sign
     Unmarried Parents                                                            affidavit
  1. 20 fathers have genetic test; 75% voluntarily                                2. 20 couples attain mediation; 80% sign parenting
     sign paternity affidavit                                                     plan
  2. 20 couples obtain mediation; 75% agree to                                    3. No couples enroll in marriage education
     parenting plan
  3. 10 couples enroll in marriage education class;
     80% complete

                                                           Refinement of Intervention?

                                          •Option #1: Meet with staff who interface with
                                          fathers/parents—is there a better way to approach fathers
                                          regarding paternity or couples regarding marriage? Develop
                                          reader friendly brochures?
                                          •Option #2: Talk to genetic testers—why are fathers not
                                          signing affidavits? Misinformation? Provide talking points to
                                          staff who work with fathers at hospital/lab?
                                             Logic Model for Grantee X

                                      Project Logic Model

                                                                                 IMMEDIATE             SUBSEQUENT            ULTIMATE
            INPUTS                ACTIVITIES              OUTPUTS                OUTCOMES               OUTCOMES              GOAL(S)
                                                                                                      As of 1/07: 10 pct
                             Enlist hospital         3/06 Hosp Agree         Outcomes                                       Increased
      Child support staff                                                                             pt increase in CS
                             admin support           4/06 Hosp model          through 7/06                                  Pat. Est
A     CS materials                                                                                    orders
                             Enlist non-RNs          4/06 24/7 notaries      10 pct. pt. inc in                             at lower
S     Toll-free #                                                                                     As of 3/08: 20 pct
                             Train hospital staff    3/06 new booklet &      signed affidavits                              Cost
S     Hospital staff                                                                                  pt increase in
                             Train add. notaries     video                   20 fathers have
U     Mediators (DRC)                                                                                 affidavits signed
                             Enhance CS mats.        2/06 DRC contract       genetic test; 75%                              Expanded
M     Notaries                                                                                        100 fathers
P                            Contract w/ DRCs        2/06 lab MOUs           sign affidavit                                 Scope of
      Labs                                                                                            tested; 75% sign
T                            MOU with labs           2/06 link to marr.      20 couples see                                 Delivery
      Marriage ed            Create referral syst     ed. providers          mediator; 75% sign       90 couples get        Results in
I                                                                                                     mediation; 75%
O                            Develop MIS             2/06 referral sys       parenting plan                                 Improved
                                                                                                      sign plan
N                            Identify mar. ed         developed              10 couples enroll in                           Child
                                                                                                      64 couples enroll
S                            providers               2/06 MIS                marriage ed; 80%                               Support
                                                                                                      in marriage ed;
                             Provide testing,        2/06 reimb. syst.       complete                                       Outcomes
                                                                                                      80% complete
                             mediation, marriage     4/06 refer to labs,
                                                                                                      20 pct pt increase
                             education               mediators, ed.
                                                                                                      in orders estab.
    Intervention operates in four diverse areas (e.g., clients, demographics, economics); hospitals have flexibility in how they
    operate affidavit program; marriage education available in some target communities; mediators and genetic testing labs
    available in all communities

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