DATE: November 16, 2021
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director
SUBJECT: Retroactive Revenue Agreements with California Department of Public Health
RECOMMENDED ACTION(S):
TITLE
1. Approve California Department of Public Health’s letter constituting a binding agreement and retroactively accept award funding for the California Home Visiting Program, effective October 1, 2020 through September 30, 2023, total not to exceed $1,932,468.
2. Approve California Department of Public Health’s letter constituting a binding agreement and retroactively accept award funding for the California Home Visiting Program - State General Fund Expansion, effective July 1, 2020 through June 30, 2023, total not to exceed $3,305,760.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will provide the Department of Public Health with three years of California Department of Public Health (CDPH) funding for the California Home Visiting Program (CHVP). The funding will support salary and benefits, and operational costs to execute the required services which include providing outreach, home visitation, health education and linkage to community resources for County pregnant and parenting women and their families. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, the Department would not have sufficient funds to operate this critical program and will be unable to provide evidence-based home visitation services to County families.
RETROACTIVE AGREEMENT:
The first recommended agreement is retroactive to October 1, 2020 and was received from CDPH on October 9, 2020. The second recommended agreement is retroactive to June 1, 2020 and was received from CDPH on July 27, 2020. Both these items were delayed due to staff oversight, which has been addressed by the Department to ensure deadlines are met.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. CDPH approved non-competitive allocations of Maternal, Infant, and Early Childhood Home Visiting funds ($644,156 annually) and State General Funds ($1,101,920 annually) to the County for the CHVP for FY 2020-23. The funding will support salary and benefits, and operational costs to support the Nurse-Family Partnership (NFP) services provided by the Department’s CHVP. Sufficient appropriations and estimated revenues were included in the Department’s Org 5620 FY 2020-21 Adopted and FY 2021-22 Adopted Budgets and will be included in the FY 2022-23 Recommended Budget.
DISCUSSION:
The Department provides NFP services countywide through the County’s original NFP site in the City of Fresno and a CHVP site in the City of Selma. The program provides nurse home visitation services to low-income, first-time mothers and their families following the evidence based NFP model. From pregnancy through the child’s second birthday, Public Health Nurses with specialized training visit with mothers, fathers, and extended family members to monitor the health of the mother, child, and environment, as well as provide information on pregnancy, parenting skills, healthy relationships, disease prevention, and appropriate community services. The nurses encourage positive health choices, such as:
• avoiding smoking, drinking and using drugs;
• seeking prenatal care;
• eating nutritious foods; and,
• increasing intervals between births.
CDPH funding has supported the CHVP in Fresno County since 2012. On January 7, 2020, your Board approved an agreement with CDPH for an additional one-year funding of the existing CHVP program. On June 9, 2020, your Board accepted State General Funds (SGF) from CDPH to expand the CHVP, increasing services at both program sites. Approval of the recommended actions would provide the Department with three years of additional funding to support salary and benefits, and operational costs for NFP services provided by the Department’s CHVP.
In FY 2020-21, the County’s CHVP served 117 families with 89 infants and completed 240 in-person and 528 telehealth visits. The program had 18 graduates and 46 new enrollees. CHVP provided clients linkage to health care services and other resources including childcare, job training, housing, transportation, injury prevention, childbirth and lactation classes/services, charitable and legal services as well as early childhood intervention and dental services. Clients were also connected to crisis intervention services including intimate partner violence, mental health, and substance abuse cessation. The recommended agreements will provide funding for the CHVP program to continue working to:
• reduce infant mortality and emergency department visits;
• improve school readiness and family economic self-sufficiency; and,
• coordinate and refer to other community resources and supports.
REFERENCE MATERIAL:
BAI #29, June 9, 2020
BAI #34, January 7, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CA Department of Public Health CHVP
On file with Clerk - Agreement with CA Department of Public Health CHVP SGF Expansion
CAO ANALYST:
Ron Alexander