DATE: June 9, 2020
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Revenue Agreement with California Department of Public Health
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive revenue Agreement with California Department of Public Health, for the California Home Visiting Program - State General Fund Expansion, effective July 1, 2019 through June 30, 2020, total not to exceed $1,101,920.
REPORT
Approval of the recommended action will provide the Department of Public Health with California Department of Public Health (CDPH) funding for the California Home Visiting Program (CHVP) - State General Fund (SGF) Expansion. The funding will support salary and benefits, and operational costs to expand the Nurse-Family Partnership (NFP) program services provided by the Department. The program provides outreach, home visitation, health education and linkage to community resources to County pregnant and parenting women and their families, 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 action, the Department would not accept the funds to expand the program.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to July 1, 2019. It was received from CDPH on March 13, 2020 and the time required to prepare 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 action. CDPH approved a non-competitive allocation ($1,101,920) to the County for the CHVP SGF Expansion for FY 2019-20. The funding will support salary and benefits, and operational costs to expand the NFP services provided by the Department. Costs totaling approximately $15,721 have been incurred from March, 2020 pertaining to this recommended revenue agreement and are pending payment by CDPH to the County. Sufficient appropriations and revenues for estimated current year costs are included in the Department Org 5620 FY 2019-20 Adopted Budget.
DISCUSSION:
Currently, 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. On January 7, 2020, your Board approved an agreement with CDPH for an additional one-year funding of the existing CHVP program. Approval of the recommended action would provide the Department with CDPH, CHVP SGF Expansion funding to support salary and benefits, and operational costs to expand the NFP services provided by the Department. This will allow the program to fund additional staff and expand services to provide more families with concentrated case management.
The NFP program provides nurse home visitation services to low-income, first-time mothers and their families following an evidence-based model. From pregnancy through the child’s second birthday, Public Health Nurses with specialized training visit regularly with mothers, fathers, and extended family members to monitor the health of mother, child, and environment and 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.
In FY 2018-19, the County’s existing NFP program located in the city of Fresno served 156 families and completed 1,312 home visits. During that time, Fresno NFP helped 94.8% of clients initiate breastfeeding at birth and ensured 90.0% of infants were up to date on immunizations at 12 months of age. The program provided 100% of infants with developmental assessments using the ASQ3 at 4, 10, 18 and 24 months of age and ASQ-Social Emotional at 6, 12, 18 and 24 months of age.
In FY 2018-19, Fresno CHVP, which primarily serves the rural areas surrounding Selma, received 55 referrals and enrolled 47 families into program services. During that time, the program served 121 families and completed 1,001 visits; 851 in person and 150 telehealth. The program’s retention rate was 96.75% and is among the best in California. There were 33 infants born to mothers participating in the program and 100% initiated breastfeeding. Over 2,700 referrals were made for government assistance, crisis intervention, mental health, substance use, health care services, education programs and other services including transportation, housing and job training, among others.
The recommended agreement will provide funding for the NFP programs 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 #34, January 7, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CA Department of Public Health for CHVP SGF Expansion
CAO ANALYST:
Raul Guerra