Group Teen Triple P – Level 4

Start-Up Costs

Initial Training and Technical Assistance

The 2017 cost for an agency to train 20 practitioners (with the below inclusions) in Group Teen Triple P is USD $31,525, excluding any taxes. Taxes will be applied where appropriate. Costs are valid to 30 June 2018.

TRAINING INCLUSIONS:
Group Teen Triple P Provider Training (3 days) & Accreditation (2 days per group of 20 practitioners - each practitioner attends for a half-day accreditation session). The Accreditation follows 6-8 weeks after the initial Provider Training.
Participant Notes and Training & Accreditation Evaluation Booklets for Group Teen Triple P.
Facilitator's Kit for Group Triple P, including

• 1 x Facilitator's Manual for Group Teen Triple P
• 1 x Teen Triple P Group Workbook
• 1 x Group Teen Triple P Presentation Slides (CD)
• 1 x Every Parent's Guide to Teenagers (DVD).

A Pre-Accreditation Workshop (1 day) is required for this training course. The 2017 cost for 20 practitioners is USD $3,630, excluding any taxes.

The host organization will need to provide:

• An appropriate training venue to accommodate 20 people behind tables in a U-shape (minimum 20 x 26 feet, centrally air-conditioned/heated with a breakout space for small group activities).
• Catering for practitioners ensuring dietary requirements are met, if necessary.
• Data projector, screen, and speakers for a PowerPoint Presentation and screening of a DVD.
• Whiteboard or flip chart with markers.

Note: Generally, there is no cost in hiring a training venue as agencies typically provide a space within their organization's building or at another agency willing to provide space in their community.

There may be additional costs related to practitioner travel for training, accreditation and support days if the practitioner is traveling to the events from far away.

The time investment by practitioners to familiarize themselves with the program and prepare for accreditation (in addition to attending training, pre-accreditation workshop, and accreditation) is approximately 10 hours.

FOR SMALLER ORGANIZATIONS:
Open Enrollment (OE) Triple P Provider Training Courses are available in multiple locations annually and are recommended for organizations training fewer than 10 practitioners. OE trainings can be a more cost-effective option if the required practitioner numbers are low. However, they are organized on demand, which results in less flexibility in terms of the levels on offer and the available dates. Please contact your local office for a copy of the OE schedule and costs or visit the Open Enrollment page at www.triplep.net.

Curriculum and Materials

Curriculum: Included in Training Costs

Materials: Group Teen Triple P workbook - $28.50 exclusive of taxes, 1 per family (Additional copies for other family members are optional.)

Licensing

None.

Other Start-Up Costs

Triple P America (TPA) uses an implementation and sustainability framework to assist and support implementing organizations and communities (Triple P Implementation Framework; McWilliam, Brown, Sanders & Jones, 2016). Foundational support is provided by a Triple P Implementation Consultant free of charge. Additional consultation and/or tailored support can be determined by TPA and the implementing organization.

OPTIONAL:

A Triple P Briefing is often the first step in the early stages of the implementation process and is strongly recommended for organizations new to the Triple P system. Designed to outline the Triple P system (e.g. levels of intervention, training programs, service delivery options, implementation and sustainability factors), they help organizations inform managers, decision makers, supervisory staff, and practitioners about the Triple P system. The 2017 cost for a Triple P Briefing is USD $3,630, excluding any taxes. Taxes will be applied where appropriate. Costs are valid to 30 June 2018.

Intervention Implementation Costs

Ongoing Curriculum and Materials

Group Teen Triple P Workbook - 1 per family - $28.50 exclusive of taxes.

Staffing

Triple P is designed to train an existing workforce to deliver the program to parents.

In addition to the practitioner, other positions may include program manager, data entry clerk, quality assurance or program evaluation for larger roll-outs.

A suitably qualified and experienced person should be appointed as program coordinator within the organization.

Other Implementation Costs

Program delivery guidelines to consider, based on one practitioner delivering the group:

• Parent contact = 10 hours (2 hours per session for 5 weeks)
• Questionnaire scoring = 5 hours (30 minutes per family; 10 families on average per group)
• Telephone and in-person support = 15 hours (30 minutes per family each week for 3 weeks; 10 families on average per group)
• Preparation and post-session debrief/supervision = 5 hours
• Case notes and report writing = 5 hours (30 minutes per family; 10 families on average per group)

For a group of 10 families, total practitioner time required would be = 40 hours over 5 weeks (i.e., 4 hours per family).

PROVIDED AT NO ADDITIONAL COST:
Practitioners and organizations can use the web-based Triple P Automatic Scoring and Reporting Application (ASRA) on the Triple P Provider Network to electronically score the questionnaire data they collect when working with families. The Triple P ASRA has been developed to assist practitioners and organizations with entering and scoring data simply and efficiently, as well as with program evaluation and reporting.

Note: The use of ASRA can reduce the time spent on questionnaire scoring.

Agencies/organizations are encouraged to set up peer support groups for their Triple P providers. Individual providers are encouraged to attend peer support groups (in-person or via teleconference when necessary). These peer support groups provide practitioners an opportunity to discuss their current Triple P cases, as well as common process issues that may arise for the group as a whole. It is recommended that practitioners use the self-regulatory approach in discussion of cases and process issues.

OPTIONAL:
The Stay Positive communications strategy (including associated materials) is available to explain Triple P to parents in the community and to help destigmatize the notion of asking for parenting help. Stay Positive costs will vary depending on the organization's communications plan and needs. Costs can be estimated through conversations with TPA.

PROVIDED AT NO ADDITIONAL COST:
On completion of the Triple P Provider Training, practitioners gain access to the web-based Triple P Provider Network, which is one avenue of continued support following training. This password-accessed website supports trained Triple P practitioners working in the field. It provides helpful advice about the delivery of the program and access to a range of clinical resources.

Space requirements:
The program delivery venues should have a room large enough to comfortably seat 12 participants, movable chairs and a table for audio-visual equipment. There should be access to a large TV monitor, projector and screen, and a whiteboard, blackboard or easel with butcher's paper and pens. Practitioners typically deliverer the program in their organization's venue or a community agency such as a library, recreation center, faith-based organization, childcare center or school. These venues are typically easy for parents to access and are unlikely to have a cost for venue hire.

Other optional:
Some organizations provide parents with transport, tea and coffee, child care, or other supportive measures to help families attend the sessions.

Implementation Support and Fidelity Monitoring Costs

Ongoing Training and Technical Assistance

OPTIONAL:
Half-day professional development workshops are available in a range of topics.

Clinical Support Days are available to provide an opportunity for practitioners to meet with fellow practitioners to discuss cases, problem solve, plan for future delivery, and receive expert feedback for professional development. This is also available through telephone support.

Fidelity Monitoring and Evaluation

All Triple P programs are structured around robust resources that guide the practitioner to deliver programs in a consistent and coherent way. These include manuals for the practitioner with comprehensive session guides, video examples to be shown to parents at pre-determined times during each program, and parent workbooks and tip sheets that provide exercises and discussions designed to ensure parents receive the programs as they were designed and evaluated.

Session checklists are provided for each Triple P intervention and can be utilized by practitioners to monitor their own fidelity to the program, and agencies/organizations that are leading Triple P rollouts in communities may also collect these measures from practitioners as a measure of fidelity to the program. Practitioners and organizations are encouraged to use the checklists to assist in their self-regulation and continuous quality improvement.

Agencies are also encouraged to identify local sources of expertise in conducting independent evaluations of program outcomes on a larger scale. Triple P America does not typically undertake such evaluations but can assist in identifying suitable research groups if requested.

Ongoing License Fees

No information is available

Other Implementation Support and Fidelity Monitoring Costs

No information is available

Other Cost Considerations

The potential reach of the program is largely dependent upon the capacity for practitioners to deliver the program. Practitioner productivity standards and organizational staff attrition rates contribute to the overall long-term costs considerations. One of the easiest ways for organizations to maximize their investment is to retain their highly-trained staff and set productivity standards.

Year One Cost Example

This example is for a larger organization; smaller organizations with fewer than 10 practitioners will need to contact Triple P directly for expense estimates.

In this example, an agency uses 20 practitioners to deliver Group Teen Triple P - Level 4 to families in the community. Each practitioner delivers the program 3 times during the year to groups of 10 families each. Thus, each practitioners serves 30 families and the agency collectively serves 600 families in the first year. The agency uses it own facilities and equipment for program delivery.

The costs provided below exclude taxes which will be applied where appropriate. Costs are valid through June 30, 2018.

In the Year 1, the agency serves 600 families at a cost of $87.09 per family. In subsequent years, the program cost would be substantially reduced if the agency maintains its trained staff.

Funding Overview

No information is available

Allocating State or Local General Funds

State and local funding has been used to support many components of Triple P. Vehicle license fees, tobacco taxes, and other state laws have been instrumental in funding evidence-based programs such as Triple P. Local school districts may also have discretionary funds available to advance student success and student health services. Schools are an ideal setting for Triple P services to be delivered and as educational institutions become trauma-informed, additional support may be found there. State Innovation Model funding may also be accessed by knowledgeable hospitals and primary care clinics, which are able to link public health approaches such as Triple P with the goals of population health and the Triple Aim. Existing funding mechanisms for community clinics and federally qualified health centers also provide a route for state reimbursement of the most intensive Triple P services. It is important to approach Triple P funding with a willingness to explore options broadly.

Maximizing Federal Funds

Formula Funds: Title I grants to school systems have been used to train teachers and counselors in Triple P. TANF and Title IV-B social services funding can be used for training and interventions through parenting programs.

Discretionary Grants: Discretionary grants from the federal government can be sought from a wide array of federal agencies, including the Departments of Education, the Centers for Disease Control, National Institutes of Health, Centers for Medicare and Medicaid Services and the WIC Program. A wide-ranging review of federal grant opportunities will be important for sites considering Triple P. It is important for agencies to monitor government FOAs across HHS because many agencies may have categorical programs that can be applied to Triple P programming. This is especially true for divisions with ancillary public health missions.

Entitlements: Triple P has been funded with Medicaid, Title IV-E, and Title V dollars. Medicaid is used to fund Triple P when offered as a health, mental health, or case management service. Direct Title IV-E dollars as well as waivers to states and counties have supported direct practitioner training costs for child welfare workers and indirect administrative costs related to coordinating training. Triple P America has developed a Title IV-E toolkit to assist jurisdictions in navigating the IV-E reimbursement process. Title I, II, IV of the ESSA (re-authorizing ESEA), present opportunities for jurisdictions to fund Triple P services through a variety of school-based initiatives.

Foundation Grants and Public-Private Partnerships

Many foundations and United Ways support Triple P. With the many different targets of the Triple P intervention, interest can be garnered from a variety of foundations, especially those with priorities including child abuse, health and mental health care, violence prevention and parenting education. Triple P seeks to link its network of direct service providers with educational institutions and public agencies which have the capacity to develop research and service provision proposals. Because members of the Triple P community have expertise in basic research, clinical research, and public sector administration, public-private partnerships are seen as desirable and key in building a sustainable system within jurisdictions.

Debt Financing

Debt financing is a source of funding for initial implementation of Triple P. This is particularly effective when the program targets a population at risk of an expensive remedial intervention in the absence of Triple P.

Generating New Revenue

New revenue can be useful for both start-up costs and sustaining Triple P, particularly when the intervention desired does not have an already existing funding source. A range of approaches can be considered, from fund raising efforts to excise taxes to tax form check-offs and children's trust funds. An openness to exploring new options for realizing new revenue should be brought to the effort. In this regard, healthcare reform initiatives present opportunities for jurisdictions to pilot programs that increase cost efficiencies and quality of care.