DATE: March 5, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Retroactive Agreement with Nurse-Family Partnership
RECOMMENDED ACTION(S):
TITLE
1. Under Administrative Policy No. 34 for competitive bids or requests for proposals (AP 34), determine that an exception to the competitive bidding requirement under AP 34 is satisfied and a suspension of competition is warranted due to unusual or extraordinary circumstances, and that the best interests of the County would be served by entering into an agreement with Nurse-Family Partnership as it is the only early childhood program that meets the Coalition for Evidence-Based Policies; and,
2. Approve and authorize the Chairman to execute a retroactive Agreement with Nurse-Family Partnership for a nurse home visitation program, effective July 1, 2023, not to exceed four consecutive years, which includes a three-year base contract and one optional twelve-month extension, total not to exceed $227,712.
REPORT
Approval of the recommended actions will allow the Department of Public Health (Department) to continue to use Nurse-Family Partnership (NFP) services that include access to the NFP “Electronic Visit-to-Visit Guidelines,” technical support, and specific materials required for implementing the evidence-based NFP program which provides nurse home visitation to low-income, first-time mothers and their children in the County. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, the Department’s NFP services which provide much needed services to first-time mothers to improve their birth outcomes and health of their families would be delayed or cease operations.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
It is requested that the County find under AP No. 34 that an exception to the competitive bidding requirement is satisfied, and a suspension of competition is warranted due to unusual or extraordinary circumstances, as NFP is the best evidence-based model currently available on the market and has the best fidelity in multiple studies across the country. NFP is the only early childhood program that meets the Coalition for Evidence-Based Policy’s as the program that produces significant economic return on investment. In addition, important data from all home visits is continuously collected for NFP sites through the NFP National Service Office’s data collection system. This data is analyzed and returned to the local NFP site to provide information on progress towards meeting NFP benchmarks in improving maternal and child health. The Internal Services Department - Purchasing concurs with the Department’s assessment that this satisfies the exception to the competitive bidding process required by AP 34.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to July 1, 2023 and was received from NFP on December 13, 2023. Lengthy contract negotiations were required in order to meet County standard contract terms, including updated insurance and liability requirements. The time required to prepare and review the recommended agreement did not allow presentation to your Board at an earlier date.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum compensation in FY 2023-24 is $56,928; $227,712 for the term. The annual compensation cover fees related to training, use of NFP tools, and implementation support to carry out home visitation program services under the NFP service model. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2023-24 Adopted Budget and will be included in subsequent budgets.
DISCUSSION:
From pregnancy through a child’s second birthday, specially trained NFP nurses visit regularly with mothers, fathers, and extended family members, offering advice on everything from child development to finding a job. During the visits, the nurses answer questions, monitor the health of both mother and infant/child, and provide information on pregnancy, parenting skills, and appropriate community services. The nurses encourage positive health choices, such as avoiding smoking, drinking, or the use of drugs; seeking prenatal care; and eating nutritious foods.
In FY 2022-23, the County’s original NFP program was able to achieve outcomes including:
• Nine babies out of the 106 born during the fiscal year were less than 37 weeks or preterm compared to fiscal year 2021-22, which was at 13 babies.
• The breastfeeding initiation rate was 94%, of which 37% continued to breastfeed at 6 months.
• 100% of enrolled children were screened for developmental and emotional delays using the Ages and Stages Questionnaires at the prescribed intervals.
Approval of the recommended actions will allow continuation of the County’s NFP program for an additional three years, with an option to extend for an additional 12-months. The Department has provided nurse home visitation services with the evidence-based NFP program since 1997. To use the NFP name, logo, technical support, ongoing nurse education, and related materials, the Department is required to enter into an agreement with NFP.
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition Acquisition Request
On file with Clerk - Agreement with NFP
CAO ANALYST:
Ron Alexander