DATE: September 10, 2019
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Amendments with Children and Families Commission of Fresno County for Nurse-Family Partnership and Nurse Liaison
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Amendment II to Agreement No. 16-683 with Children and Families Commission of Fresno County for the Nurse-Family Partnership program extending the term by one year from July 1, 2019 to June 30, 2020 and increasing the maximum by $208,988 to a total of $835,952.
2. Approve and authorize the Chairman to execute a retroactive Amendment II to Agreement No. 16-684 with Children and Families Commission of Fresno County for the Nurse Liaison program extending the term by one year from July 1, 2019 to June 30, 2020 and increasing the maximum by $338,957 to a total of $1,388,930.
REPORT
Approval of the recommended actions will provide the Department of Public Health with an additional year, for a total term of four years, of funding from the Children and Families Commission of Fresno County (First 5) to support the existing Nurse-Family Partnership (NFP) and Nurse Liaison programs. In addition, the recommended amendments will allow the County to use the funds as the local match to draw down approximately $618,193 of Federal Financial Participation (FFP). The First 5 and FFP funding will support salary and benefits, operational and indirect costs, with no increase in Net County Cost. 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 be able to accept First 5 funds nor draw down FFP funding, which supports salary and benefits, operational, and indirect costs for both programs. Non-approval would also lead to a reduction in the Department’s NFP and Nurse Liaison staff and services that currently provide much needed assistance to children ages 0 to 5 and their families in the County.
RETROACTIVE AGREEMENT:
The recommended amendments are retroactive to July 1, 2019 as both were received from First 5 on June 7, 2019. The time required to prepare and review the recommended amendments 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. Each of the recommended amendments provide additional funding and extend the agreements for an additional year, for a total term of four years. The NFP amendment will provide an additional $208,988. The Nurse Liaison amendment will provide an additional $338,957. The First 5 funds will support salary and benefits, operational, and indirect costs for the programs. The recommended amendments plus the FFP drawdown into the agreement with California Department of Public Health for the Maternal, Child, and Adolescent Health program (NFP $184,673 and Nurse Liaison $433,520; total FFP $618,193) will provide a total of $1,166,138 of additional funding. Sufficient appropriations and estimated revenues are included in the Department Org 5620 FY 2019-20 Recommended Budget. The recommended amendments allow indirect cost recovery of 15% of total personnel costs; the Department’s indirect cost rate is 25.42%. The 10.42% ($33,899) difference will be covered by Health Realignment.
DISCUSSION:
On December 6, 2016, the Board approved agreements with First 5 to receive funding supporting the NFP and Nurse Liaison programs. Public Health Nurses (PHNs) in the NFP program provide evidence-based nurse home visitation services to low-income, pregnant, or parenting first-time mothers in the County. PHNs in the Nurse Liaison program work with Valley Children’s Hospital and Community Regional Medical Center as well as the medical community outside these facilities to ensure that referred high-risk infants and children under six years of age living in the County receive medical care, resources, and support as needed. The Board approved amendments on August 7, 2018 to extend the agreements for one year and accept additional funding.
First 5 funds two of the six PHNs in the NFP program. During FY 2018-19, the program:
• served 156 families;
• made 1,312 home visits and attempted an additional 169;
• ensured 90% of infants were up to date on immunizations at 12 months of age;
• provided 100% of infants with developmental assessments using the Ages & Stages Questionnaires®, Third Edition (ASQ®-3) at 4, 10 and 18 months of age; and
• helped 94.8% of clients initiate breastfeeding at birth.
In FY 2018-19, the Nurse Liaison program:
• provided case management services to 234 pregnant/parenting teens, high-risk children, and their families;
• administered 229 developmental screenings to at-risk children;
• made 218 referrals for developmental, mental health, and other community agencies; and
• kept the re-hospitalization rate of children who received Nurse Liaison services to under 1%.
Approval of the recommended amendments will accept an additional year of funding from First 5, providing the local match to leverage federal funding further supporting the programs, and allow the NFP and Nurse Liaison programs to continue improving pregnancy outcomes, child health and development, and linkage to resources as needed.
REFERENCE MATERIAL:
BAI #47, August 7, 2018
BAI #35, December 6, 2016
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment II to Agreement No. 16-683 with First 5 for NFP
On file with Clerk - Amendment II to Agreement No. 16-684 with First 5 for Nurse Liaison
CAO ANALYST:
Sonia M. De La Rosa