REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 8, 2023
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Agreement Funding Application for the California Home Visiting Program
End
RECOMMENDATION(S)
Recommendation
1. Approve and authorize the submission of the agreement funding application with the California Department of Public Health for the California Home Visiting Program, in the amount of $2,279,944, for the period of July 1, 2023 through June 30, 2024.
2. Designate the Chair of the Board of Supervisors, Chief Executive Officer, or Director of the Department of Public Health to execute and submit any subsequent non-substantive amendments and documents to the funding application for the California Home Visiting Program, on behalf of the County, subject to review by County Counsel.
3. Direct the Director of the Department of Public Health to transmit all non-substantive amendments in relation to the funding application for the California Home Visiting Program to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General funding (Net County Cost). The agreement funding application from the California Department of Public Health (CDPH) for the California Home Visiting Program (CHVP), in the amount of $2,279,944, does not require a local match. If awarded, a portion of these funds will be used to fund Department of Public Health (DPH) administration of this program, as well as funding the contract of the contractor currently providing these CHVP services. Adequate appropriation and revenue have been included in the Department of Public Health’s (DPH) 2023-24 budget.
BACKGROUND INFORMATION
CDPH CHVP will allocate $54,700,000 for early childhood home visiting across the state to the 57 Local Health Jurisdictions (LHJs), including San Bernardino County, participating in the program. Each LHJ receives an annual allocation with a base amount of $400,000 per year plus an additional amount based on each LHJ’s proportion of Medi-Cal births statewide. Funding is intended to increase the number of families participating in CHVP services. On December 15, 2020 (Item No. 53), the Board of Supervisors (Board) accepted grant award (County Contract No. 20-1207) (State Agreement CHV SGF EXP 20-36) from CDPH for the State General Fund Expansion to implement the CHVP, in the amount of $4,292,646 ($1,430,882 annually), for the period of July 1, 2020 through June 30, 2023.
The Maternal, Child and Adolescent Health (MCAH) Division of CDPH allocates resources to CHVP with the goals of promoting maternal health and well-being, improving infant and child health and development, strengthening family functioning, and cultivating strong communities. The program is designed to assist families who are at risk for adverse childhood experiences, which include child maltreatment, domestic violence, substance abuse, and mental illness. LHJs funded by CHVP may provide services to families using evidence-based home visiting models, including Healthy Families America (HFA).
Services are provided to pregnant and newly parenting families who have one or more of the following risk factors: domestic violence, inadequate income, unstable housing, less than 12 years of education, substance abuse, depression, and/or mental illness. Program services identify families at risk through assessment, screening, and family-based intervention processes. The HFA model is utilized by El Sol Neighborhood Educational Center (El Sol), a community-based agency that provides program services countywide. As the result of a formal procurement, El Sol was awarded a contract, approved by the Board on January 11, 2022 (Item No. 25), and amended February 28, 2023 (Item No. 46), to provide family-centered home visiting services under CHVP throughout the county, in the total amount of $2,612,000 for the two-year period of January 11, 2022 through January 10, 2024. Upon award of the requested CHVP grant funds, DPH will initiate the process to amend the current contract in order to be prepared to continue service delivery.
The primary method of service delivery employed by El Sol is individual family home visitation. Guided by the CDPH-selected Partners for a Healthy Baby curriculum, home visitor staff regularly engage, assist, and mentor a caseload of 172 families throughout the county at an average annual cost of $ 7,593per family. The frequency of home visitation is based on the acuity and needs of each family and is measured through periodic assessment of parent-child interactions, child development, and maternal depression by the home visitor staff. Home visitors also assist with facilitation of parent support groups, fatherhood involvement programs, and referrals for additional supportive services for families. Interaction with home visitor staff gives parents the tools to independently raise their children through preventive interventions focused on promoting and reinforcing positive, nurturing parenting and child development.
El Sol leads a CDPH-required community advisory board as part of the HFA model that invites families, community stakeholders, community-based organizations, and health care providers to share experiences and provide input and guidance for improving outreach, recruitment, and enrollment into HFA services. Further, El Sol participates in all meetings and training sessions conducted by CDPH and DPH, including program updates, technical assistance, and data quality assurance interactions.
On June 8, 2023, CDPH announced the funding opportunity for CHVP, in the amount of $2,279,944, for the period of July 1, 2023 through June 30, 2024, subject to approval and appropriation in the annual governor’s budget and/or approval of federal grant funds. DPH is required to submit a grant application to CDPH for each year to be awarded.
DPH is recommending delegated authority to accept and approve any non-substantive amendments and documents in relation to CHVP funding allocation. DPH will return to the Board to present any substantive amendments or future grants received.
This item is being presented to the Board at this time, as this is the first date available for presentation following the required operational, fiscal, and legal reviews. Approval by the Board will have no impact on DPH’s CHVP services and activities.
PROCUREMENT
El Sol was selected through a formal procurement and the resultant contract was approved by the Board on January 11, 2022 (Item No. 25), to provide family-centered home visiting services under CHVP in the amount of $2,380,000 for the two-year period of January 11, 2022 through January 10, 2024.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on July 20, 2023; Finance (Paul Garcia, Administrative Analyst, 386-8392) on July 17, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on July 24, 2023.