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Organization Background

The first five questions in this section were adopted from Charting Impact, developed by the Better Business Bureau Wise Giving Alliance, GuideStar USA, and Independent Sector. We chose to use these five questions because they have been thoroughly tested and encourage strategic thinking. Remember to answer all questions in this section at the organization level, NOT the project/program level. Be sure to cite all statistics and research in a separate attachment. Note: Character maximums include spaces. 2,000 characters with spaces is approximately equivalent to 325 words. 1. What is your organization striving to accomplish? Clearly and concisely state your organization's ultimate goal for intended impact. Identify the groups or communities you aim to assist, the needs your work is addressing, and your expected outcomes. Examine how your goals for the next three to five years (or an alternate timeframe specified in your answer) fit within your overall plan to contribute to lasting, meaningful change. When finished ask yourself, "If someone unfamiliar with our work were to read this, would they have a clear definition of what long-term success means for my organization?" (2,000 character max.) Annunciation Maternity Home (AMH) offers moms and babies in crisis the critical support and essential resources needed to change their lives and achieve long-term self-sufficiency. Battling barriers outside of their control -- poverty, neglect, homelessness, exposure to violence, mental health conditions, involvement in the child welfare system -- these young mothers have much to overcome. Their unstable past has led to low self-esteem, poor decision making, unhealthy relationships…and teen pregnancy. Without support to navigate towards a healthier lifestyle, this cycle of intergenerational poverty and familial dysfunction will continue, offering little hope for mom and baby to lead a healthy, fulfilling life (NASSEMBLY). In response, AMH offers a best-practice, two-generation program designed to support both mom and baby as a family unit. Laying a foundation with housing, basic needs, and medical care, we then empower each family with high school education, higher education, parenting instruction, quality childcare, life skills classes, job assistance, mental health services, and case management. Expected outcomes include: (1) healthy pregnancy and baby, (2) educational enrollment and completion, (3) improved parenting skills, (4) healthy living environments and relationships, (5) improved behavioral health and life domain functioning, (6) career employment, and (7) elimination of future unplanned/crisis pregnancies. AMH's 5-year strategic goals include: (1) strengthening governance structure, (2) securing an adequate and diverse base of funding and other resources, (3) ensuring a capacity to serve high demand, (4) attracting, developing, retaining highly skilled staff, (5) ensuring the safety, security, and confidentialty of residents and staff, and (6) maintaining best practices program and services. These strategic goals ensure that AMH continues to be an effective, comprehensive program that serves the needs of young families and our community. 2. What are your strategies for making this happen? Describe your organization's strategies for accomplishing the long-term goals you cited in your previous answer. Specify the broad approaches you employ and why your organization believes these methods will benefit your

target population or advance your issue. State near-term activities that serve as important building blocks for future success, explaining how these elements strengthen your organization's strategic approach. (2,000 character max.) AMH's six strategic goals developed by a committee of board members and staff focus on a need for expanded capacity based on demand while still providing the best possible services to each mother and baby who come to the Home. In (1) strengthening governance structure, AMH plans to attract and recruit engaged board members and strengthen existing committee structures and roles to increase our network and ability to accomplish strategic and organizational goals. This includes our strategic goal of (2) securing an adequate and diverse base of funding and other resources for current programs and future expansions. Annunciation will initiate an enhanced marketing strategy, expanded development plan, endowment fun, and build on existing relationships to strategically create a sustainable funding base that can grow with us. With a high demand for services (675 calls in 2015, 72 served), ensuring a (3) capacity to serve the demand is a priority. A Master Plan for our 23 acres of land was finalized in 2016, with Phase I including expanded adult housing and a new childcare facility. AMH is currently working closely with the City of Georgetown to meet infrastructure compliance for the Master Plan, with Phase I groundbreaking hoping to begin end of 2017. Through our expansions, Annunciation aims to (6) maintain a best-practices program by renewing our national accrediation, understanding clients needs, expand the day and walk-in programs (non-residential), and re-new our in-house counseling program. It will also be essential to (4) attract, develop, and retain highly skilled staff to meet program needs by offering good pay, opportunities for professional development, and a positive work environment. As AMH grows and increases capacity, it is essential to (5) ensure the safety, security, and confidentiality of our residents and staff in accordance with HIPAA guidelines through an ongoing review our our IT system and campus safety policies and procedures. 3. What are your organization's capabilities for doing this? Detail the resources, capacities, and connections that support your progress toward long-term goals. While describing your organization's core assets, identify both internal resources (including, but not limited to, staff, budget, and expertise) and external strengths (including partnerships, collaborations, networks, and influence) that have contributed to, or will contribute in the future to, the accomplishment of these goals. (2,000 character max.) AMH is the only nationally accredited, long-term residential facility in Texas licensed by the Texas Department of Family and Protective Services (TDFPS) to provide free services to teens and young women who are experiencing a crisis pregnancy. This niche service delivery encourages community connections, program support, and collaborations that maximize resources and strengthen program delivery. Internal resources include: (1) board member retention and knowledge, (2) continued passion and involvement of co-founders in program and growth objectives, (3) case manager retention, knowledge, and dedication, (4) wide volunteer base, (5) established reputation in community with proven track record of program success, and (6) vacant property for growth. External strengths include: (1) collaboration with the University of Texas Charter School for on-site high school education, (2) TANO member, (3) Health and Human Services Community Partner, (4) Providence Service Corporation

Partner, (5) Texas Alliance of Children & Family Service Member, (6) TDFPS Contractor, (7) Nurse Family Partnership Partner through Any Baby Can, (7) Texas Workforce Commission WIA Program Partner, (8) Blue Bonnet Trails MHMR Taylor Partner (psychiatric services), (8) Affiliated with the Roman Catholic Church, (9) AFP Member, and (10) Capital Area Food Bank partner. AMH received national accreditation as a family group home through the Council on Accreditation (COA) in New York in April 2014. Accreditation is an external validation of program delivery to all stakeholders, and signifies organizational infrastructure, program delivery, outcome measurements, and financial transparency at the level of national standards of best practice. AMH's Infant Development Center received state licensing in May 2014 and was named a 4-Star (top tier) Texas Rising Star certified program in February 2016. 4. How will your organization know if you are making progress? Explain how your organization assesses progress toward your intended impact. Identify milestones that signal progress and success. Describe your assessment and improvement process: the methods you use as you monitor key indicators and how your organization uses that information to refine your efforts. (2,000 character max.) AMH uses a Performance Quality Improvement (PQI) system to monitor organizational and client progress towards goals, intended impact, and accountability. A PQI committee consisting of all directors from each program area meet weekly to review client needs, employee needs, and key metrics. The PQI committee also meets quarterly to evaluate the last 90 days for service effectiveness and efficiency, quality and safety, identify areas where improvements to policies/procedures/services can be made, and implement any changes. The Board of Directors receives a report on key metrics monthly, and a final annual report to be reviewed and assessed for future changes/improvements. Program and financial data (including transitioning surveys) are collected throughout the year via an online database system and used in PQI reporting to generate reliable data signifying progress/outcomes. When collecting data, Annunciation has a set of 14 mission critical measures, 5 strategic measures, and 18 organizational measures there are reported at set intervals to track progress. Some of these measures will be compared to previous years, while others will be compared to intended outcomes and/or improvement over time. A few of these measures include occupancy percentage, number of client served annually, mental health assessments, parenting assessments, child development assessments, high school credits earned, baby birth weight, staff turnover, operating reserve, etc. While there are many areas where success is measured in our comprehensive program, key indicators of overall success include: (1) healthy pregnancy and baby birth weight, (2) enrollment in/completion of educational programs, (3) improved mental health in various domains, (4) on-track infant development, and (5) improved parenting skills. 5. What have and haven't you accomplished so far? Demonstrate recent progress toward your long-term goals by describing how your near-term objectives are propelling your organization toward your ultimate intended impact. Go beyond the outputs of your work to make clear how these outcomes are contributing to fulfilling long-term goals. In describing both outcomes achieved and those not yet realized, include what your organization has learned about what does and doesn't work, what risks and obstacles exist, and what adjustments to goals, strategies, or objectives have been made along the way. (2,000 character max.)

Aligning with the new strategic plan (2017-2022), a fluid Master Plan for our 23 acres of land is ready, outlining Phase I expansions with an immediate, low-cost response of adding six more bedrooms, increasing total daily capacity to 35, and a new infant development center with a capacity for 60 children (previously 23). Additionally, we have hired a full-time, in-house Clinical Services Director to address the mental health needs of our clients. A re-certification application has been completed to renew our National Accreditation (expiring 2018), and a new board prospect has been identified and approached. An annual plan coinciding with the strategic plan has been developed listing specific goals, time frames, and persons responsible to ensure progress toward strategic goals. Important building blocks from our previous strategic plan include national accreditation, childcare licensing, a new transitional living home for three mothers, and collaborations with local organizations to supplement our services. As a result, clients now receive Medicaid approval within two weeks, access a nurse regularly for one-on-one prenatal care, receive needed mental health services, receive funding for school and workforce opportunities, and have access to quality childcare after transitioning from our program. These successes elevated our program from quality to best-practices and achieved outcomes needed for long-term success. AMH organizational culture is to continously review, refine, improve. We have learned that consistent communication accross programs/services for each client is essential, family counseling requires flexibilty, and adult clients need extra staff support to meet their varying service plan goals, and we adjust accrordingly. As we enter into expansions, a big obstacle to overcome is meeting the City's infrastructure requirements and timeline when more help is needed now, and ensuring the development plan will sustain future growth.

Program Request Information

Note: If you have already provided appropriate responses to any of the questions below in the previous Organization Background section, simply type, “Answered in #___ of the Organization Background section.” This section focuses on the program(s) for which you are requesting funding. 1. Describe the program for which you are requesting funding, and the cause/issue it seeks to

address. Detail the strategies, resources, capacities, and connections that support your progress toward the program’s identified goals. Provide evidence to support the strategies you employ within the program that reinforce your organization’s long-term goals, and whether such strategies have been proven effective by research. (2,000 character max.)

The Counseling Program at AMH seeks to empower young mothers and their families in the midst of a crisis pregnancy using evidence-based practices in Cognitive Behavioral Therapy (CBT), Brief-Solution-Focused Counseling, Trauma-Informed Care, and Family Dynamics. We use goal-oriented, solution focused intervention to provide a practical approach to problem solving. CBT focuses on changing the thought patterns and behaviors behind the struggles experienced, in order to effectively change the way one feels. By incorporating family therapy grounded in the fundamentals of CBT, we can effectively change the perception and the relationship dynamics that may be causing negativity, scapegoating, and unhealthy communication patterns within the family. CBT is recognized by the American Counseling Association, American Mental Health Counselors Association, and Association for Creative Counseling as a form of intervention to treat symptoms of depression and anxiety, and has been found to be as effective as antidepressants in most cases, barring co-morbid psychological disorders. Each mother will receive a risk assessment upon intake, one weekly individual counseling session per week, and one group counseling session per week (teens) or month (adults). Family counseling will be completed as available and appropriate for each family. The Adult Needs and Strengths Assessment (ANSA) for clients 18+ and the Child and Adolescent Needs and Strengths Assessment (CANS) for clients under 18 will be used to support level of care and service planning, facilitate quality improvement initiatives, and allow for the monitoring of outcomes of services. The ANSA and CANS are currently used in a number of states and Canada in applications hospitals, emergency departments, and psychosocial rehabilitation programs to facilitate the linkage between the assessment process and the design of individualized service plans, including the application of evidence-based practices (PRAED). 2. Present data that substantiates the need for the services you wish to provide. Describe the need for

services and the tools you use to identify need. If you have wait lists for your services, describe the reasons or conditions that necessitate the wait lists, and how you prioritize them. (2,000 character max.) Mothers who come to Annunciation are caught in a cycle of poverty and family dysfunction. They

are often out of school, out of work, lack family support, have experienced multiple traumas, receive

little or no healthcare, and are unable to independently navigate through multiple community supports to find help and get back on track (NASSEMBLY). Now experiencing a crisis pregnancy, being a mom at this time in her life adds another layer of vulnerability and toxic stress. The American Association of Pediatrics states: "Adolescent parenthood is associated with a range of adverse outcomes for young mothers, including mental health problems such as depression, substance abuse, and posttraumatic stress disorder. These circumstances can adversely affect maternal mental health, parenting, and behavior outcomes for their children (AAP)." However, this population of young mothers in need of mental health services often face mutliple barriers to receiving treatment, including transportation, reliance on public or community-based healthcare and lack of insurance (AAP).

Multiple case studies show that a comprehensive, two-generation program helping both mom and

baby at the same time through mutliple levels of support to be a leading strategy in breaking the cycle of poverty in young famlies (NASSEMBLY). Mental health plays a pivotal role in helping mom overcome barriers and providing the stability needed for their child(ren) to receive nurturing care.

Currently, mental health prevention, early intervention, support and treatment for mental illness is

one of the 2016 top priorities for Williamson County (WCCHD). Annunciation aims to support this priority by providing life-changing mental health services to young mothers in crisis. This will eliminate our current reliance on Lone Star Circle of Care, allowing them the opportunity to serve others in their high-demand setting and providing a steady, on-site source of situational-specific counseling for young mothers.

3. Provide program service costs in the table below and describe how you arrived at your service

cost. If you quantify your service in units, please define what is meant by “unit.” Program Service Costs (Note: Table below will expand should you need to include additional comments/clarifications.)

Individuals/Units of Service Total Program Costs Individual/Unit Costs 75 mothers $61,022

(Budget Narrative) $813.62 Intake Risk Assessment, Weekly Individual Counseling, Group Counseling, ANSA / CANS Assessments

4. How will you make the program visible to those who would benefit from it? Specify whether the

program is new or existing. If the program is new, how do you plan to promote it? If the program already exists, how are you currently promoting it? (1,000 character max.) The in-house counseling program is available to any mother enrolled in our program. The AMH program is promoted through our website, social networks, 411, pregnancy resource sites, and targeted print marketing. Counseling services are available to any mother enrolled at AMH. The AMH program is promoted through our website, social networks, 411, pregnancy resource sites, and targeted print marketing. While the in-house counseling program previously existed, it was temporarily suspended during staff turnover to review, analyze, and improve. Currently, demand for AMH services exceeds capacity to fill.

5. How do you coordinate, cooperate, or collaborate with other agencies to achieve your program goals? Specifically highlight those organizations with which you have formalized agreements, such as Letters of Commitment or Memoranda of Understanding. (2,000 character max.)

Coordination. Harmonious functioning of parts for effective results. Helping each other but not changing the basic way of doing business.

Cooperation. Common effort and association for the purpose of common benefit. Helping each other in specific ways. Collaboration. To work jointly with others on a common goal that is beyond what any one group can accomplish alone.

(adapted from: Forest, C. Empowerment skills for family workers: A worker handbook. Cornell University, 2003.) While AMH coordinates, cooperates, and collaborates with many organizations across our spectrum of services, for the Counseling Program, specifically, we coordinate regularly with Lonestar Circle of Care and Blue Bonnet Trails MHMR Taylor for psychiatric services. 6. Briefly describe what sets you apart from other nonprofits in the area and why your organization is best situated to provide this service. (2,000 character max.) Annunciation Maternity Home is the only nationally accredited, long-term facility in Texas providing housing and support services for young women who are experiencing a crisis pregnancy, and their children. Referrals of pregnant/parenting young mothers from local schools, churches, non-profits, and community members speaks to the value and trust the communty places on the services we provide. Over the past sixteen years, Annunciation's program has grown from a small housing facility into a comprehensive program that includes housing for up to 29 mothers, on-site high school education, access to continuing education, counseling services, quality childcare, pregnant and parenting instruction, life skills classes, job assistance, and overall case management. Through these expansions, Annunciation has maintained the mission of helping young mothers achieve long-term independence through a two-generation model proven by reasearch to be the most effective method of breaking the cycle of poverty and family dysfunction (NAASSEMBLY).

Evaluation

Define the primary goal or goals (up to 3) you hope to achieve through this funding for your program. The goal identified below should be attainable within a 12-month period, and must relate to goals/outcomes articulated in the Program Request section of this proposal. GOAL: What will this funding help you accomplish? Example: Increase financial literacy for 200 low-income adults in Williamson County. Inputs: Resources – human, financial, organizational, community – that a program or organization commits to an effort. Example: One part-time coordinator, 4 trained volunteers, classroom space, materials (see Program Budget for more detail). Activities: What activities will support or accomplish your goals? Example: Deliver financial literacy classes. Outputs: What do you expect these activities to produce? Outputs are often quantitative measures such as # of participants, # of sessions held, # of encounters, so be sure to include anticipated benchmarks that will gauge your progress. Example: Present 24 financial literacy classes (2 per month) serving 200 adults. Regular attendance and number of participants (at least 20 per session) serve as key benchmarks in determining the success of the program. Outcomes: Specific, attainable, realistic result that shows the accomplishment of the strategy. What benefits, impact, or changes in behavior, knowledge, skills, and/or attitudes for participants do you anticipate will result from completion of the activities? Example: 85% of the 200 participants in the financial literacy program will exhibit increased financial literacy knowledge and skills as determined by pre- and post-testing. Performance Measures: How will you know when you have accomplished your goal? How will you measure and quantify results? Example: % of participants’ improvement from pre-test to post-test, regular attendance, and number of attendees. GOAL: Improve risk behaviors, behavioral health, and life domain functioning (including family functioning), for 75 at-risk pregnant or parenting young women ages 12 and up residing in Georgetown, TX Inputs Requesting $25,000 Seeds of Strength program support grant. One Program

Director (10% of full-time), one Licensed Counselor (100% of full time), health insurance, staff development and training. Purchase of certification program for Licensed Counselor to use ANSA/CANS assessments. Use of database (15% of monthly fee) to log counseling and assement data and track outcomes. Purchase supplies for individual and group sessions. (See Program Budget for more detail.)

Activities 1. Executive Director (ED) will serve as the program director providing grant oversight and ensure all financial and data collections requirements are met. 2. Licensed Counselor (LC) will provide an intake risk assessment for all incoming clients identifying risks for self-harm behaviors

3. LC will provide at least one one-hour counseling session per client per week based on cognitive behavioral therapy. 4. LC will provide one one-hour group counseling session for teen mothers per week using the Girls Circle Curriculum. 5. LC will provide one one-hour group counseling session for adult mothers per month using Girls Circle Curriculum. 6. LC will complete a Life Skills class log for all group sessions including name of each mother in attendance. 7. LC will receive training and become certified to perform ANSA (adult) and CANS (teen). 8. LC will complete an initial ANSA or CANS assessment per mother within one month of intake. 9. LC will complete subsequent ANSA or CANS assessments per mother monthly to track progress. 10. LC will meet with Executive Director and Program Services Directors (PSD) weekly or as often as needed to assist in building an effective individual service plan for each client. 11. LC will attend weekly Directors meetings and provide input on client needs and program improvements. 12. LC will attend weekly direct-care staff meetings and provide input and education on trauma-informed care to be implemented in the Housing Program. 13. LC will complete mental health sections of the Monthly Action Plan, (one per client per month) by the deadline and include most recent ANSA or CANS assessment data

Outputs (include quantitative projections, such as anticipated numbers served)

1. 75 mothers will receive a risk assessment upon intake 2. 75 mothers will receive group counseling sessions weekly (teens) or monthly (adults) 3. 75 mothers will receive weekly individual counseling sessions for the duration of their stay 4. 75 mothers will receive an intial ANSA or CANS assessment 5. 75 mothers will receive monthly ANSA or CANS assessments for the duration of their stay

Outcomes 1. 75 mothers served in the counseling program 2. 90% of mothers will receive weekly individual counseling sessions 3. 90% of mothers will receive group counseling sessions weekly/monthly 4. 90% of mothers subsequent ANSA / CANS scores will reflect a decrease in risk behavior. 5. 90% of mothers subsequent ANSA /CANS scores will reflect improvement in behavioral health 6. 90% of mothers subsequent ANSA / CANS scores will reflect improvement in life domain functioning

Performance Measures 1. Mothers initial and subsequent monthly ANSA / CANS assessments will reflect progress in multiple domains known to improve overall mental health and functioning. 2. Number of mothers who enroll in the AMH program long-term to track number served. Mothers enrolled in the program are required to attend individual and group counseling sessions as part of their program

requirements.

GOAL: Inputs Activities Outputs (include quantitative projections, such as anticipated numbers served)

Outcomes Performance Measures GOAL: Inputs Activities Outputs (include quantitative projections, such as anticipated numbers served)

Outcomes Performance Measures What are your plans to ensure that the work described above is continued and supported beyond this grant cycle? (1,000 character max.) Annunciation will continue to apply for grants and research additional funding opportunities for the counseling program by leveraging our best-practice nationally accredited program. Our strategic goal of securing an adequate and diverse base of funding and other resources means we are focused on enhanced marketing strategies and new funding sources to maintain program and funding stablity for this essential program.