Title
CONSIDERATION OF A GRANT APPLICATION IN THE AMOUNT OF $783,868 TO THE HEALTH RESOURCES & SERVICE ADMINISTRATION (HRSA) FOR HEALTHY START INITIATIVE FUNDING TO PROVIDE HEALTHY BABIES PROGRAM SERVICES AT THE HEALTH DIVISION.
Presented by: Adrienne Byrne, Health Division Director.
RECOMMENDED ACTION: Approve the electronic submission of the application for the grant; and if awarded, authorize the Chairman to accept the award, authorize the establishment of budget authority as provided in the financial considerations section of this request, and implementation of the Staffing Table changes identified in the Personnel Considerations section of this request.
Additionally, the Health Division is requesting approval to have the Community Engagement Institute of Wichita State University conduct the required evaluation of program services and community impact for the five years of this grant cycle.
Body
Grant Renewal: Yes
Never Applied: No
Applied; not awarded: No
Grant Summary and Timeline: Healthy Babies is an educational program for prenatal and parenting families. Registered Nurses and Community Liaisons provide education and family support through home and office visits. The education provided is designed to improve birth outcomes (prematurity, low birth weight, and infant mortality) among at-risk families. Services are available to all Sedgwick County residents regardless of income or insurance coverage, prenatally through the child's second birthday. In addition, the Healthy Babies provider ensures the client is connected to other community resources based on individual need.
The first Healthy Start grant was received in 1997 to provide wraparound services in three northeast Wichita zip codes (67208, 67214, and 67219).
Eligibility for this grant requires an Infant Mortality Rate (IMR) of 8.8 or higher for the three year period 2013-2015, and the following zip codes collectively meet the criteria: 67205, 67207, 67208, 67210, 67211, 67213, 67214, 67217, 67218, and 67219.
Healthy Babies will partner with community health clinics, residency programs and private providers to wrap services around moms via the evidence-based Healthy Steps for Young Children intervention model.
The Healthy Steps model bridges the gap between the client and the medical team and research shows that this model:
• Improves client satisfaction with medical care, resulting in follow-through for prenatal care and well-child visits.
• Helps the clients understand the importance of having a medical home and improves trust with the medical team.
• Increases immunization rates.
• Improves safe sleep practices, decreasing related infant deaths, one of the top three causes of infant death in Sedgwick County.
• Improves physician satisfaction with care because the home visitor helps keep the clients involved in their own medical care, as well as the care for their family.
This patient-centered care approach is the foundation for the life course perspective, which focuses on understanding how early-life experiences can shape health across an entire lifetime; and potentially across generations. (www.healthysteps.org)
With regard to the grant-mandated evaluation, the Community Engagement Institute at Wichita State University has been providing evaluation support for the last year and has built relationships with staff and understands program workflows, internal software, performance measures, and reporting requirements and enabling them to continue to evaluate our program would provide continuity of services. This institute provides professional evaluation services and coordinates with the Kansas Department of Health and Environment (KDHE) and other local health departments on a regular basis.
Financial Considerations:
Grant period starts: April 1, 2019
Grant period ends: March 31, 2024
Source of funding
Grant: $783,868.00
Required Match: $0.00
Required Cash Match: $0.00
Required In-Kind Match: $0.00
Other funding: $0.00
TOTAL SOURCES: $783,868.00
Uses of funding
Operational costs: $783,868.00
Personnel: $573,153.00
Contractual services: $134,000.00
Operational supplies: $24,000.00
Equipment: $0.00
Indirect administrative costs: $52,715.00
Capital projects cost: $0.00
TOTAL USES: $783,868.00
Source of matching funds: N/A.
Source of other funding: N/A.
Budget Authority Adjustment:
No additional budget authority is needed for 2019 and all future budget authority issues can be resolved within the annual budget process. This is a five-year grant in the amount of $3,919,340, with annual grant award amounts of $783,868. The initial grant year is April 1, 2019, through March 31, 2020; with each additional grant year to follow, based on availability of funds and program performance, as reported via annual continuation reports. Funds to be managed through Fund Center 38031-274.
Personnel considerations:
This grant provides funding for eight positions, including: one nurse provider, four community liaison providers, one Fetal Infant Mortality Review (FIMR) Coordinator, one project manager and one program director. One new full-time equivalent position, a Community Outreach Coordinator, is being requested for this grant. (See Attachment 3 - Budget Impact Statement).
Expected measurable outcomes:
The HRSA grant has 19 benchmark goals for 2024. Select goals are reported below. The Division of Health will complete the following by 3/31/2024:
1. Increase the proportion of women, infants, and children participating in Healthy Babies that have a primary medical provider (medical home) to at least 80% (SCDOH CY2017 = 97%; CY2016=93%).
2. Decrease low birth weight births to Healthy Babies prenatal program participants by ensuring the following:
a) Increase abstinence from cigarette smoking among Healthy Babies participants to at least 90% (SCDOH CY2017 = 92%; CY2016=88%)
b) Increase the proportion of HS women participants who have a documented reproductive life plan to at least 90% (SCDOH CY2017 = 88%; CY2016=82%)
c) Reduce the proportion of HS women participants who conceive within 18 months of a previous birth to 30% (SCDOH CY2017 = 3%; CY2016=2%)
3. Increase proportion of HS women participants who engage in safe sleep practices* to at least 80%. *As assessed during monthly home visits (SCDOH CY2017 = 97%; CY2016=90%)
Requirements from Sedgwick County: (reporting requirements or other actions required of the organization should the grant be awarded)
Sedgwick County is required to submit budget reports to Health Resources and Services Administration (HRSA) annually starting June 2020. Quarterly financial reports are submitted to the HHS Payment Management System at which time Cash Requests are completed. No further action is required from Sedgwick County for this grant.
Alternatives:
To not apply for the funding and seek financial support to sustain the program from other sources or to allow the program to downsize through attrition of grant funding sources. Note: This is the end of our five-year Healthy Start grant. If we do not apply for this funding, we will need to request local monies to pay for personnel costs for the eight staff currently funded via this grant or drastically reduce the moms and babies that receive services in the program.
Policy considerations: N/A
Legal considerations: N/A