Title
a. Approve and authorize the Director of Health or Assistant Director of Health to execute an Agreement with Nurse-Family Partnership (“NFP”) for NFP in the amount of $150,000 to provide evidence-based programming to Monterey County first-time mothers and their babies for the period June 1, 2018 through June 30, 2021; and
b. Approve nonstandard insurance provision in Agreement as recommended by the Director of Health.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health or Assistant Director of Health to execute an Agreement with Nurse-Family Partnership (“NFP”) for NFP in the amount of $150,000 to provide evidence-based programming to Monterey County first-time mothers and their babies for the period June 1, 2018 through June 30, 2021; and
b. Approve nonstandard insurance provision in Agreement as recommended by the Director of Health.
SUMMARY/DISCUSSION:
The Health Department (Department) will implement the Nurse-Family Partnership program throughout Monterey County in this current fiscal year. NFP is an evidence-based health program that transforms the lives of vulnerable first-time mothers and their babies. NFP will enroll Medi-Cal eligible women early in their pregnancy and conduct the first home visit by no later than the end of week 28 of pregnancy. The Department will pair these women with an NFP nurse that will visit the home and work with the family until the child’s second birthday.
Each nurse will address health topics in the domains of personal health, environmental health, life course, maternal role, friends and family, and health and human services.
Nurse-Family Partnership has been shown to improve health outcomes among participants, such as decreased prenatal cigarette smoking, reduced hypertensive disorders of pregnancy, decreased childhood injuries, reduced subsequent pregnancies, and increased intervals between births. By achieving similar outcomes among first-time mothers in Monterey County, the Department through implementation of NFP will support efforts to provide higher quality care and reduce health care costs.
NFP has provided Commercial General Liability with a general aggregate limit of $3 million (County requires unlimited general aggregate) and automobile liability coverage of hired and non-hired autos only (County requires coverage for all vehicles). The Director of Health recommends Board approval of these non-standard risk terms. The start date of the Agreement is retroactive to June 1, 2018 due to the length of time it took to negotiate with the vendor the changes associated with this Agreement.
This action will support the Monterey County Health Department’s 2011-2015 Strategic Plan Initiatives: 1. Empower the community to improve health through programs, policies, and activities; 2. Enhance community health and safety by emphasizing prevention; and 3. Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. This work also supports three of the ten essential public health services: Inform, educate, and empower people about health issues; link people to needed personal health services and assure the provision of health care when otherwise unavailable; and assure competent public and personal health care workforce.
OTHER AGENCY INVOLVEMENT:
County Counsel-Risk Management and the Auditor-Controller have reviewed the Agreement as to legal form, liability provisions, and fiscal provisions respectively. Risk Management recommended seeking Board of Supervisors approval due to non-standard insurance language.
FINANCING:
Estimated NFP expenditures in FY 2017-18 are $50K. Costs will increase over the next year as nurses and support staff are hired.
When the program is fully implemented, annual expenditures are $1.1M. Funding is anticipated to be provided by $800K in 1991 Health Realignment and 1991 Social Services Realignment, and $300K in Medi-Cal and grant monies.
There are sufficient appropriations included in the Health Department’s (HEA003-8124) Adopted Budget for FY 2017-18, and Requested Budget for FY 2018-19.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Patricia McFadden, Management Analyst II, ext. 4726
Approved by: Elsa M. Jimenez, Director of Health
Attachments:
Agreement is on file with the Clerk of the Board