Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Lizelle Lirio de Luna, Director, Family Health Services
Subject: Amendment to Agreement with Nurse-Family Partnership
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the Agreement with Nurse-Family Partnership to increase the funding for model implementation support, training and education services for the term of July 1, 2022 through June 30, 2026 increasing the amount by $300,000 to an amount not to exceed $500,000.
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BACKGROUND:
The Nurse-Family Partnership Program (NFP) is an evidence-based program developed on the basis of randomized controlled trial research to yield certain benefits for low-income, first-time mothers and their children. NFP helps low-income, first-time mothers develop behaviors that enable them to have healthier pregnancies, be better parents, have emotionally and physically healthier children, and attain greater economic self-sufficiency. NFP charges an annual fee for NFP Network Partner Program Support based on the number of funded Nurse Home Visitors and a fee for educational services provided to new Home Visitors, Supervisors, and Program Administrators.
On June 2, 2022, Family Health Services (FHS) signed an agreement with NFP to provide for evidence-based home visiting services for the term of July 1, 2022, through June 30, 2026, in an amount not to exceed $200,000.
DISCUSSION:
This amendment with NFP is adding $300,000 from FHS to fund a continuation of NFP Network Partner Program Support and educational services for our expanded NFP teams. Over the last few years, FHS has expanded the NFP program to 3 nurse supervisors and 16 public health nurses. These expansions are associated with increased required fees from the NFP National Service Office.
This Board is being asked to authorize the Chief of San Mateo County Health or designee to execute subsequent amendments which do not exceed an aggregate of $25,000.
This agreement is going to this Board late due to prolonged discussions with NFP.
The amendment and resolution have been reviewed and approved by the County Attorney as to form.
We expect to increase our active caseload in this evidence-based home visiting program with the growth in our NFP team and as each public health nurse reaches full capacity, which is identified by NFP as a range of 21 to 25 clients per FTE. New nurses can take up to 18 months to reach full caseload. By June 2025, we expect our 15.5 FTEs of public health nurse to reach a cumulative active caseload of 320 clients, and by June 2026 a cumulative active caseload of 330 clients.
PERFORMANCE MEASURE:
|
Performance Measure |
FY 24-25 Estimated |
FY 25-26 Projected |
|
Active Caseload of NFP clients in month of June |
320 |
330 |
EQUITY IMPACT:
This agreement will support NFP goals to improve the health, well-being, and life course trajectory of first-time pregnant people and young children in San Mateo County with limited financial resources. The vast majority of NFP clients are on Medi-Cal (99.4%). Of clients in NFP since 2012, 16.5% have been pregnant or parenting teens aged 12-17 years. NFP clients are mostly of Latinx/Hispanic ethnicity (74.7%). By race, NFP serves populations who identify as Hispanic/Latino (58.3%), White (14.7%), Asian (4.7%), Native American/Alaskan Native (2.9%), Black/African American (2.3%), Hawaiian/Pacific Islander (1.3%), with others identifying as multiracial, other race, or unreported. Expanding this program and the national support for implementation allows San Mateo County to expand this “gold standard” evidence-based home visiting program to more county residents, with long-term improved health, well-being, child welfare, education, and economic outcomes among participants.
FISCAL IMPACT:
The term of the amended agreement is July 1, 2022 through June 30, 2026. The amount of the agreement is not to exceed $500,000. This amendment increases the contract amount by $300,000. Funds in the amount of $95,998 are included in the FHS FY 2024-25 Adopted Budget. Similar arrangements will be made in future years. This contract is fully funded by the California Home Visiting Program Expansion Grant. There is no Net County Cost.