To: Board of County Commissioners
Through: Jennifer Ludwig, Public Health Director, Public Health Department
Prepared By:
prepared
Ann Stager, Nurse Manager of Nurse-Family Partnership, Public Health; Melissa Spencer, Director of Community Health Nursing, Public Health
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presenter
Presenter: Jennifer Ludwig, Public Health Director, Public Health
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Subject:
title
1:00 PM *Nurse-Family Partnership Elbert County Expansion
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Purpose and Request:
recommended action
The purpose of this discussion is to inform the Board of County Commissioners about a proposed expansion of Nurse-Family Partnership program services in Elbert County, effective January 1, 2025.
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Background and Discussion: Nurse-Family Partnership® (NFP) is an evidence-based, community health program with 45 years of research showing significant improvements in the health and lives of first-time families and their children affected by social and economic inequality. Since the inception of services in 2000, Colorado’s statewide implementation of NFP has been delivered through a variety of implementing agencies, ensuring the program is available to eligible families in all 64 counties. All nurses delivering NFP are trained on the model by the NFP National Service Office (NFPNSO) and receive nursing consultation and continuing education from Invest in Kids (IIK). IIK, the NFPNSO, and the University of Colorado monitor the data to ensure the program is being implemented with fidelity to the model as tested in the original randomized controlled trials. Per statute, Colorado Department of Early Childhood (CDEC) is responsible for fiscal oversight and contract management of the program. At Arapahoe County, we have an NFP team of 22 nurse home visitors, including supervisors and a manager, and three business supports, and are currently funded to serve 370 families in Arapahoe and Douglas Counties. The program is fully funded through the Colorado Department of Early Childhood. Kit Carson County NFP is currently funded to serve 36 clients in Lincoln, Cheyenne, Elbert, and Kit Carson counties. The birth rates in these counties have declined in recent years, specifically first-time parents utilizing Medicaid. Kit Carson and Invest in Kids (IIK) have determined it is not feasible to continue to fund an individual site with a caseload of 36 clients, therefore their program will be closing by December 31, 2024. Based on their assessment and discussions, the NFPNSO and IIK have requested assistance from three surrounding NFP sites to meet the needs of these communities and ensure long term success of the NFP program in Colorado. While Kit Carson, Lincoln, and Cheyenne Counties will be served by other agencies, Arapahoe County has been asked to assume client services in Elbert County, primarily in the town of Elizabeth. The estimated caseload per year is expected to range from five to ten clients.
Fiscal Impact: As planning continues, budgetary needs will be evaluated and addressed, via a contract amendment with Colorado Department of Early Childhood. Due to the small number of projected clients, no increase in nurse home visitor FTE is expected at this time.
Alternatives: Arapahoe County has the option to decline this expansion request.
Staff Recommendation: Based on initial discussions with Invest in Kids and assessment of ACPH NFP’s current programmatic capacity in Arapahoe and Douglas Counties, we are amenable to this proposed expansion in Elbert County.