DATE: May 14, 2019
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Agreement with Nurse-Family Partnership
RECOMMENDED ACTION(S):
TITLE
1. Make a finding that it is in the best interest of the County to suspend the competitive bidding process consistent with Administrative Policy No. 34 for unusual or extraordinary circumstances as Nurse-Family Partnership has an established nurse home visitation program; 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, 2018 through June 30, 2021 ($106,085).
REPORT
Approval of the recommended actions will allow the Department of Public Health to use Nurse-Family Partnership (NFP) services that include “Guidelines for Home Visits,” use of the Efforts to Outcome (ETO) system, 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.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
The Department’s request to suspend the competitive bidding process is consistent with Administrative Policy No. 34 from the fact that NFP provided nurse home visitation services based upon the evidence-based NFP program model. To use the name, logo, technical support, ongoing nurse education and related materials, NFP sites are required to enter into an agreement. Health Resources and Services Administration’s Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program funding mandates a proven successful family strengthening and home visitation program. The California Home Visiting Program (CHVP), which funds the County’s NFP expansion site in the City of Selma, offered grantees two home visiting models to choose from, NFP and Healthy Families America (HFA). NFP was selected as the more cost efficient model for the County and the model’s use of Public Health Nurses (PHNs) aligned with positions that the Department had in place. NFP consistently documents a research-based success rate with a consistent level of reliability, fidelity, and positive birth outcomes. The Internal Services Department - Purchasing Division concurs with the Department’s request to suspend the competitive bidding process.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to July 1, 2018 and was received from NFP on February 21, 2019. 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 2018-19 is $34,057; $106,085 for the term. The funds cover costs 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 2018-19 Adopted Budget and will be included in subsequent budgets for the term’s duration.
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 2017-18, the County’s original NFP program was able to achieve outcomes including:
• increased percentage of clients that initiated breastfeeding after birth from 88.6% to 94.3%;
• 37.7% of clients continued breastfeeding at 6 months after birth and 34.6% continued breastfeeding at 12 months after birth;
• 151 clients served and 1,187 home visits completed; and
• total premature birth rate among clients decreased from 12.1% to 11.4%.
The outcomes from the NFP program expansion to the City of Selma site for FY 2017-18 included:
• increased clients initiating breastfeeding at birth from 96.8% to 100%;
• 35% of clients continued breastfeeding at 6 months after birth and 14.8% continued breastfeeding at 12 months after birth;
• 128 clients served and 1,073 home visits completed; and
• total premature births decreased from 12.5% to 11.8% among clients.
Approval of the recommended actions will allow continuation of the County’s NFP program for an additional three years. The Department has provided nurse home visitation services with the evidence-based NFP program model since 1997. To use the NFP name, logo, technical support, ongoing nurse education and related materials, NFP sites are required to enter into an agreement.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Suspension of Competition Acquisition Request
On file with Clerk - Nurse-Family Partnership Agreement
CAO ANALYST:
Sonia M. De La Rosa