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 the Agreement with the California Department of Public Health for the California Home Visiting Program
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with the California Department of Public Health for the California Home Visiting Program, decreasing the amount by $255,458 to an amount not to exceed $4,381,150.
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BACKGROUND:
Under the California Department of Public Health, the California Home Visiting Program (CHVP) was created as a result of the Patient Protection and Affordable Care Act of 2010. Family Health Services (FHS) has been receiving CHVP funding for its own Nurse-Family Partnership Program (NFP) for over seven years.
NFP is an evidence-based nurse home visiting program with over 40 years of research to support its efficacy in positively impacting the life trajectory of first-time mothers and their children. Using a client-centered, strengths-based approach, nurses work with families for up to 30 months with 64 planned home visits, providing an intensive level of support that has proven positive outcomes. Research data gathered at the state and national levels shows lasting positive impacts for NFP families more than 12 years after they exit the program. Outcomes have included: 48% reduction in child abuse and neglect; 59% reduction in child arrests at age 15; 72% fewer convictions of mothers; 56% reduction in emergency room visits for accidents and poisonings; and 67% reduction in behavioral and intellectual problems at age 6. NFP is found to reduce preventable causes of death among children and all causes of death among mothers.
NFP nurses serve teens and young women county-wide and focus on culturally diverse young mothers in at-risk urban areas: North County (communities of South San Francisco and Daly City), Central County (City of San Mateo) and South County (East Palo Alto and North Fair Oaks). NFP nurses provide comprehensive, coordinated in-home services to support positive parenting, school readiness and achievement, as well as to improve outcomes for families residing in identified at-risk communities.
DISCUSSION:
This amendment is due to Health Resources and Services Administration (HRSA) funding reductions that became effective for FY 2017-18 and FY 2018-19. Specifically, FY 2017-18 and FY 2018-19 are being reduced by $127,729 each. FHS positions that were to be supported by this CHVP funding have been adjusted, in order to be funded by other sources. This amendment also adds mandatory programmatic requirements for implementing CHVP as identified by HRSA.
As reported at the September 20, 2018 NFP Community Advisory Board, a total of 451 families have been served in the NFP since its launch in 2012, with 71 families successfully graduating from the program. All of the children born within the program received the Ages and Stages developmental screening by four months and the Ages and Stages socio-emotional screening by six months. In addition, 98% of the mothers initiated breastfeeding. FHS plans to continue carrying out such activities in the coming years.
The resolution contains the County’s standard provisions allowing amendment of The County’s fiscal obligations by a maximum of $25,000 (in aggregate). The agreement and resolution have been reviewed and approved by County Counsel as to form. The County’s Contract Compliance Committee has approved a waiver for a four-year agreement.
This agreement is late due to delays at the state level in distributing contracts to local agencies.
The approval of this agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing home visiting to at-risk young mothers and children. It is anticipated that 100 families will be enrolled within 15 months of program implementation and maintained throughout the duration of the program.
PERFORMANCE MEASURE:
|
Measure |
FY 2017-18 Actual |
FY 2018-19 Projected |
|
Families to be enrolled within 15 months of program implementation and maintained throughout the duration of the program* |
203 families 203% |
205 families 205% |
*Measure includes NFP families supported through multiple funding sources, including this CHVP grant, Measure K, and Maternal, Child and Adolescent Health.
FISCAL IMPACT:
The term of this agreement is July 1, 2015 to June 30, 2019. The amount of the agreement is being reduced by $255,458 to an amount not to exceed $4,381,150 for the four-year term. Funds in the amount of $998,923 are included in the FHS FY 2018-19 Recommended Budget. There is no Net County Cost associated with this revenue agreement.