HomeMy WebLinkAbout20120380.tiff RESOLUTION
RE: APPROVE GRANT CONTINUATION APPLICATION FOR FISCAL YEARS 2012 AND
2013, INCLUDING 2011 PROGRESS REPORT, FOR NURSE HOME VISITOR PROGRAM
AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS,the Board has been presented with a Grant Continuation Application for Fiscal
Years 2012 and 2013,for the Nurse Home Visitor Program, including the 2011 Progress Report,for
the period commencing July 1, 2012, through June 30, 2013, from the County of Weld, State of
Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the
Weld County Department of Public Health and Environment,to the Colorado Department of Public
Health and Environment, with further terms and conditions being as stated in said application, and
WHEREAS, after review, the Board deems it advisable to approve said application, a copy of
which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Grant Continuation Application for Fiscal Years 2012 and 2013, including
the 2011 Progress Report, for the Nurse Home Visitor Program from the County of Weld, State of
Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the
Weld County Department of Public Health and Environment, to the Colorado Department of Public
Health and Environment be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said application
o noy I al LT, CC • /L
-9- la a. •a5- 13 2012-0380
HL0039
GRANT CONTINUATION APPLICATION FOR FISCAL YEARS 2012 AND 2013, INCLUDING 2011
PROGRESS REPORT, FOR NURSE HOME VISITOR PROGRAM
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 8th day of February, A.D., 2012.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
- .
ATTEST: 2�cw..:��'��
Sean P. Co way, Chair
Weld County Clerk to the Board e-//
/- C
� F. Garcia, Pro-T>
BY: _r` ��. �.��\ti_ L
Deputy i4 erk to the Board ! ,� �i A a a .
:r ra Kirkmeyer�tirrov
y5���
Tl"Y -� �'-vi. E. Long
ty Attorney
ugla ademac -r
Date of signature: a
2012-0380
HL0039
Memorandum
AN 1861
i TO: Sean P. Conway, Chair
IBoard of County Commissioners
stlirsOrLit.1 J\
FROM: Mark E. Wallace, MD, MPH, Director
Ili C 0 U N T'' Department of Public Health and
Environment
4�J ('/(')
DATE: February 1, 2012
SUBJECT: Nurse Home Visitor Grant Proposal
Enclosed for Board review and approval is the Grant Proposal between the Colorado Department
of Public Health and Environment and Weld County Board of Commissioners for the Weld
County Department of Public Health and Environment's Nurse Home Visitor program
(WCDPHE).
Funding for this program will be provided by Colorado State Tobacco Settlement Funds and
Medicaid payments for targeted case management services. Weld County Department of Public
Health and Environment is applying for funding in the amount of$678,480. The contract is
funded by the Colorado State Tobacco Settlement Funds and Medicaid reimbursements.
The grant will fund 8 FTE including 1 FTE OT, 6 FTE Public Health Nurse II and.75 FTE Public
Health Nurse III, supervisor. At no cost to the client, specially trained registered nurses provide
bi-monthly home visits to low-income, first time mothers residing in Weld County. These home
visits begin in pregnancy and continue until the client's child reaches the age of two years.
Clients are educated and encouraged to develop positive maternal/child health practices, and
understanding of infant/toddler developmental needs, effective parenting, and maternal economic
self-sufficiency.
These funds are for activities performed during the time period of July 1, 2012 through June 30,
2013. I recommend your approval of this request for funding.
Enclosure
2012-0380
Attachment A
FY2012-13Colorado Nurse Home Visitor Program
CONTINUATION APPLICATION (2011 Progress Report) January 2012
CHECKLIST
Materials must be submitted in the order listed below.
Name of Agency: Weld County Department of Public Health and Environment
lip Attachment A: Application Checklist
Continuation Application(2011Progress Report)Cover Sheet. This page must be typed and signed.
I� Continuation Application (2011 Progress Report), not including the proposed budget page (Attachment Cl),
Expenditures-to-date Report (AttachmentC2) and other attachments, is limited to no more than eight (8) single-
spaced, 81/x 11 numbered pages.Use Courier font, 10 pt.
O Part A: 2011 Progress Report
O Part B: Grantee Response to FY2011-12 NHVP Award Summary
FI Attachment Cl: FY2012-13 Proposed Continuation Budget for the period of July 1,2012 through June 30,2013.
/® FY2012-13 Proposed Continuation Budget Narrative Form
❑ Attachment C2: FY2011-12 Expenditures-to-Date Report for the period of July 1,2011 through December 31,2011.
❑ Electronic Excel copy of Attachments Cl and C2 emailed to Julie Becker by 4:00 pm on February 13,2012 at:
julie.becker@state.co.us.
IF Attachment D: Assurance of Intention to Meet Program Requirements
11 Attachment E: Assurance of Intention to be an Active Medicaid Provider
Cr Attachment F: Assurance of Intention to Follow Caseload Guidelines
❑ Assembly and Submission:
• Binding: All materials must be binder clipped ONLY. Rubber bands,staples and paperclips are not allowed.
• Signatures: Cover Sheet must be signed by both the agency authorized signer and the NFP Supervisor.
• Copies: One(1)original and four(4)copies. Five complete sets of all required materials,including attachments.
• Complete: All items listed in the Application Checklist (Attachment A) are included in each copy. Excel copies of
attachments Cl and C2 are emailed to Julie Becker.
• Due Date: Received by CDPHE on or before Monday,February 13,2011 by 4:00 p.m.
• Mailed or delivered to:
Flora Kulwa Martinez,Home Visiting Programs Coordinator
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South,PSD-A4
Denver,CO 80246-1530
18
(.71J/.,2 —0330
FY2012-13Colorado Nurse Home Visitor Program
CONTINUATION APPLICATION (2011 Progress Report) January 2012
COVER SHEET
1. Name of Agency: Weld County Department of Public Health& Environment
Address/City/Zip: 1555 N 17'h Ave Greeley CO 80631
2. For the period of July 1,2012 through June 30,2013,please indicate:
Total funding request: $ $678,480 (TOTAL amount required whether covered by NHVP funds,Medicaid or other dollars)
County(ies)to be served: Weld
Total number of families to be served/caseload: 150
Total FTE to be funded: 7 .75
Total number of nurse home visitors to be funded: 6
3. Name of person completing Progress Report: Barbara Francisco, RN
Position/Title: NFP Supervisor
Telephone: 970-304-2460 x2186 FAX: 970-304-6416
E-Mail: bfrancisco@co.weld.co.us
Name of Authorized Signer: Sean P. Conway,Chair
(Must be an individual with authority to sign a grant application
Position/Title: BOARD OF COUNTY COMMISSIONERS, WELD COUNTY
Telephone :_970-336-7204 FAX: 970-352-0242
E-mail: sconway@co.weld.co.us
Signature(Authorized Signer):X /I,r�
Signature: (NFP Supervisor): X '1i&%I kizal / et
**Signatures indicate review and approval of application as submitted.**
�
61.44eil
to
5. Name of Agency Contract Administrator for FY2012-13 contract:
Name: Mark Wallace,MD
(Must be the individual authorized to receive a state contract.)
Email Address: _ mwallace@co.weld.co.us Phone:_ 970-304-6410 x2104
9
,70/2-D.580
e
FY2012-13Colorado Nurse Home Visitor Program
CONTINUATION APPLICATION (2011 Progress Report) January 2012
Part A. 2011 Progress Report.
1.Provide the 2011-12 NHVP funded
caseload for your agency 150
2.Note your agency's NFP caseload on
Feb.12012 and include your source of 144
information(it may be from your own
records)
3.Indicate the number of clients served June 30,2011: 125
for the last 3 quarters(those that had a September 30,2011: 126
least one home visit) December 31,2011: 14 0
Please use data from the Quarterly
Summary Tables reports for the
quarters ending in June and September.
You may use data from your own
records for quarter ending in December
4.If your caseload size did not meet July 13, 2011 was the last working day for a NHV who had
NHVPcontractrequirementsduring been working 20 hours/week. The newest NHV who was hired
any of the reporting periods above 11/16/10 as a 20 /week NHV moved into the vacancy and
(Quarters ending June 30,2011, became a full time NHV effective 8/16/11, after the
September 30,2011 and December 31, County went through a Sunset Review process. In the past
6 months this NHV completed required trainings and has
2011)explain why and describe how
been building her caseload. She reached a census of 25
and when your team will achieve
clients at the end of December, 2011.
funded caseload size.
From 4/1/11 to 12/30/11 our team lost 80 clients. The
NHVs were unable to locate 19 clients, 12 clients moved
out of Weld County, 9 clients returned to work and were
unavailable between the hours of SAM - 5PM, Mon. - Fri.
which are our work hours per Weld County policy. Twenty-
one clients graduated, 2 miscarried, 1 refused a new NHV,
1 client lost custody of her child, 4 clients were
discharged due to excessive missed appointments/attempted
visits, 5 clients felt they had received what they
needed, one was dissatisfied with the program and two
dropped the program after getting pressure from their
families.
The team works diligently to pursue AWOL clients, and to
enroll new clients. Caseload requirements will be
reviewed again in a January team meeting and reasons that
enrolling new clients may be challenging will be
addressed with problem solving solutions. The
expectation is that the team will be at funded caseload
by 03/01/2012 .
Outcome Chosen by site on which to focus Intensive Quality Improvement
5.Outcome to focus on Date Participants
Infancy Attrition/Client Supervisor
Retention in Infancy 09/01/11 NHVs
Office Technician
6.Rationale:The NFP Objective is 20% or less. Infancy is a vulnerable time for a new
mother. Support through this phase is important for establishing a strong
10
relationship between the mother and child and to solidify a strong foundation for
positive parental involvement with the child in the future.
7.CurrentStatus:The Weld County cumulative attrition rate during the Infancy phase of the
NFP curriculum was approximately 34% as of 12/31/10
B.Outcometoachieve:Decrease client attrition in the Infancy phase by 1% by 6/30/12
9.Strategy Responsible person How measured
1. Develop a list of Supervisor 1. Complete by 10/4/11
reasons clients drop out of NHVs
program in Infancy phase.
2 . Establish a baseline
2. Assess clients' need NHVs of clients currently
for creative visit Supervisor on flexible
schedule, i.e. phone schedules. Track
visits, fewer or more number of clients who
visits per month as daily choose a flexible
schedule's change & every 3 schedule between
months. Adjust schedule to 10/1/11 and 6/30/11.
meet clients' needs. Offer
fewer/more visits and phone
visits
3 . Review client
3 . Assess client NHVs assessments &
interest/participation Supervisor satisfaction with
in curriculum every 3 curriculum with
months & PRN. Offer individual NHVs
curriculum & supplemental monthly during
material that supports Reflective
clients' interests & needs. supervision.
4. Preview Infancy NHVs 4. 10% of clients
curriculum in last setting one or more
trimester of pregnancy, goals for the newborn
emphasizing areas of period of the infancy
interest to client. Assist phase will have met
client in setting a long their goals during
term goal for the newborn the infancy phase.
period of the Infancy
phase.
5. Offer to do a video NHVs 5. Track how many
album through Infancy & clients accept this
Toddler phases to be given offer and how many
to the client at program of them graduate by
graduation 6/30/12
10.Ongoing Evaluation:
List of reasons clients drop from program during Infancy phase was completed 10/4/11.
Nineteen clients are currently on flexible schedules. The NHVs are finding that by
offering flexible schedules they have retained these clients who most likely would
have dropped out of the program had they not been offered a flexible schedule. Some
clients have fewer monthly visits, some have increased monthly visits when they are
available. Beginning to discuss infancy phase topics and developing a long term goal
11
for infancy during pregnancy has created continuity for some clients, though not all.
Several NHVs are videoing clients and their children two to three times during each
phase. This is very appreciated by our clients and does seem to increase their
investment in their NHV who can then use the increased rapport to develop improved
communication and interest in the program. Our cumulative attrition rate during
Infancy between 6/1/11 and 9/30/11 was 32 .7%
Intervention Chosen by site on which to focus Intensive Quality Improvement
11.Intervention to focus on Date Participants
Motivational Interviewing 09/1/11 Supervisor
NHVs
Office Technician
12.Rationale: Use of Motivational Interviewing techniques increases and improves
assessment and collection of information. Improved skills increase focus on client
needs, desires, and goals, strengthening the client-NHV relationship and the
satisfaction of both participants as they work together.
13.CurrentStatus: Team supervisor is experienced in using and teaching communication
skills. 5 NHVs have adequate skills* when using Motivational Interviewing techniques.
One NHV is a novice in using MI and has fair skills.
14.IdealStatus:All team members will increase MI proficiency by one level, i.e. Adequate
to Above Average and Fair to Average.
*Ratings based on rating skill levels used in Motivational Interviewing Assessment:Supervisory Tools
Enhancing Proficiency
15.Strategy Responsible person How measured
1. Team members will Supervisor 1. Self rated proficiency
complete a self rating NHVS will increase one
10/2011 and again 06/2012 competency level.
at team meetings.
Supervisor will provide
rating forms and file
ratings for later
comparison. Supervisor 2 . 100% participation in
NHVs 80% of discussions and
2. Once monthly the team exercises.
will participate in
discussions and exercises
using Building Motivational
Interviewing Skills
workbook.
Supervisor 3 . NHVs will be asked to
3 . Team will use MI NHVs self report changes in
techniques when clients are confidence and ease of
presented in case use of MI at monthly MI
conferences. discussions & exercises.
3 . Supervisor will monitor
team's use of MI
techniques during client
case conferences using
12
MI Assessment: Tools for
Enhancing Proficiency at
11/11/11 case conference
and at 6/26/12 case
conference & compare
results.
4. NHVs will use MI Supervisor 4. Supervisor will observe
techniques during NHVs & hear NHVs using MI
supervisory home visits techniques with clients
and will discuss with
+NHV.
16.Ongoing Evaluation:
The self rating form ranged from a 1 (used the identified strategy not at all) to a 7
(Used the identified strategy almost all the time) . The average rating for the NHV
team was a 4, with individual scores ranging from 2 .9 to 5.4. This indicates the
opportunity for growth in all 6 NHVs. All NHVs have read Building Motivational
Interviewing Skills and express appreciation for reviewing MI techniques with the
opportunity to practice skills with each other. Use of MI techniques has been
discussed with each NHV after supervisory visits and all are reminded to use MI when a
NHV presents a client during a case conference. Ratings from 11/11/11 case conference
averaged 4. Subjective feedback is that all NHVs are feeling more comfortable with
using MI with clients. Observation by the supervisor during client visits indicates
NHVs are using MI techniques in a more fluid and conversational manner indicating
increase proficiency and ease with the technique.
Implementation Indicator Chosen by site on which to focus Intensive Quality Improvement
17.Implementation Indicator to focus Date Participants
on
Case Conference 10/1/2011 Supervisor, NHVs, Office
Technician
18.Rationale: NFP guidelines require twice monthly case conferences. Discussions of
individual clients, working on MI techniques, and having expert guests provide
opportunities for team members to support each other, fosters team building and
individual growth, and reinforces strength-based focus and solution based approaches.
19.CurrentStatus: Case conference and team meeting formats are unclear
20.Ideal Status:Formats will be clearly defined with case conferences dedicated to
presentation of clients for the purpose of problem solving client issues with
individual NHVs, professional growth, and program implementation and evaluation
21.Strategy Responsible person How measured
1. Review NFP definition of Supervisor 1. Review completed by
case conference NHVs 11/11/11.
Office Technician
2. Create a rotation Supervisor 2 . Completed and posted by
schedule for presentation NHVs the second week of each
13
of client issues, guest Office Technician quarter.
presenters, and Track number of Case
professional growth for Conferences from 10/11/11
each quarter until 6/30/12 . to 6/30/12
Implement Case Conference
schedule
3 . Review Client Review Supervisor 3 . Review completed by
Case Conference form NHVs 10/11/11
and format with team.
4. Once a quarter during Supervisor 4. NHVs will share how they
team meetings & in NHVs feel re using the structure
supervision sessions seek at 12/6/11, 3/6/12, &
feedback regarding getting 6/5/12 team meetings.
effective support utilizing
case conference structure.
22.OngoingEvaluation: Review of case conference and team meeting definitions has decreased
confusion about formats and purpose, and increased use of the structure. Rotation
schedule will be created this month. Previous months have been filled with
instructional discussions new forms and assessments as well as piloting new staff
assessment forms so a rotation schedule was not completed. The Client Review Case
Conference form will be reviewed this month also. Feedback regarding effective support
for utilizing the case conference structure was not done 12/6/11 for the same reason.
Part B. Grantee Response to FY11-12 NHVP Award Summary.
1. Referrals have been steady through the first 6 months of this fiscal year. The team
supervisor has done presentations at two Greeley High Schools since the current school
year began, is a member of the Young Child Wellness, has continued to be active in
other community councils and committees. The team celebrated the 10th anniversary of
the Weld County NFP program and invited all stakeholders to our party. The team also
did a presentation to health department staff about our staff and program.
2. Program Outcome Indicator - Infancy Attrition. As noted previously the team has
chosen to continue working on this indicator and have more specific measurements in
place.
3 . Client Intervention Indicator - Motivational Interviewing. As indicated previously
the team will continue to work on this intervention. The team supervisor sees
increased levels of proficiency and comfort in using the techniques evidenced by
improved completeness of information shared in individual supervision sessions, by
increased use of MI techniques during supervisory visits, and by communication used by
the team in team meetings and case conferences.
4. Program Implementation Indicator - increase program exposure in the community.
Division Manager attended NFP education session last fall. The Advisory Board
Assessment tool was disseminated to board members with a very limited number returned.
An email to all board members asking for feedback regarding desire to continue on our
board resulted in purging 7 previous members who are no longer able or willing to
participate. We attempt to be considerate of those members who are unable to attend
on a regular basis but wish to stay involved by receiving copies of meeting minutes.
NHVs visit local schools several times during the school year and maintain
communication with community providers who are working with current clients, keeping
provider aware of the county program.
14
NHVP Attachment Cl
FY2012-13 Proposed Budget for the pond of July 1,2012 through Juno 30,2013
COUNTY. WELD COUNTY OEPARTNEM OF PUBLIC H
Prefect Nat NUM NONE VISITING PAIITME11L11P
TOTAL COME TOTAL AOBICY
FY 11103 91 000111 AN I. mansFft7fOTAL S O C
411 S Ass SA MS CONTRACT SvlR7a[7(ANN:)
10DOeT(a•C1
Atawl No.d
Salary mer•. A.Oter SLOOPS
Sawa sit Sae N•9•d
01444 Or4R.4 FTS Pawl y
ran .I., --' MO
1 --
4
T ss•.� ■. ...a . _ S_ .. _. 1u•814
Pte. _Nrdlt fen•r:Dea gram — ±!—Mr- — -.' ._ •_.¢5L
PUAEa rse Nair r.Keee.n •.i,. •=.r�-e t1. :Th..7. ... .. ..1
INAc Hie NtFMl-vrssU a: -�Mit��.$.t'' - .=7 —a4
PttA&Heel*Woo 4-Too Wro �••'e'�1-i'XI 7...1 .. . puss 3s
ewe N.rt,Nano-Ow '.D Noon s_ f742PS SUSS 11T,11
N1 s
12
g
12
gi
tg
19
la
19
t
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51ar•.eo Per.pelw ��■ D°Lrl
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Nue Nero,NAM Amgen Coo.onrrr-Sort Friona" • r• •
IE 1At !4 31 114a
■.- 1Q
N 19
Far.fow•Tor Rw 3e.13% 114,14E Ste4.10'6 1T/AOOj
IQ se
I TOTAL PER40NAL SERVICES .. Mri>.4 swag NS4N4
OIEMT1p 1p.4.1A ' • T
Ma OPmene Ewwww P• w ool99 on •tl ta-R& M>XR 31.094
flora Stow*4%A Elr.wl.r ,'••■lir $6 I14 13.!90 b PI
Pniwrq 4 PtpYeraw $6 I lh E4.� SS
700
Poor A snooty saw.. 1 1 _ 11a0o
owww ceror.(brg Nara eat rd nwva+News i 141971 $4100 14 507
sh0¢e s.4or.. ITN 1107 NMI
'Oa&!runs 19 110
TQ 10
10 1Q
S 10
1~0
L TOTALOPERATNO . • . IMfl 01114 Sn'161
EWIANENTlp4Y . • T -
C,$if$#4.n. 141 1690 '
ca a Faros IN Sio
1Q tQ
11 N
I TOTAL Nurser a is IS NM ISO
TRAVIS.tDwrl Eonw.1 1 .y r
%WI Owecn WINO, �.. Pita Slat .1Q
IeP Trrw.B Twos*
O a*mien.Tod 13 Oslo in Mew O.•nr,or Gird AracM 12 11
Annr1 Uwe irsw012-3Ownn°r'-oitt20!!:'1t.La 4 wasp SQ IQ
Amgen Moors eve.. .wawa mlw.l SQ 12
o4r Trail 22
NI t
4 rata ITSaS . . 111111 1141.4 114!•4
or MSS&USNMUSTANGS 10.441 Ems* 1 OUOCET
Room,Oa. fadN1122S]01 Tom art*014.91 1 IN 18
saw wens ar410416.1441Woirt Ron.140 ya MEMe'ormat OtIBN Nr e.441Asa0 _ Al
liq
Amor Sisal Fee S7DU sicasonten TIM 1721 Se VI S1Y14 Val
MnM cans MAO Wig 4aNrawl a 147 122ra S it 12.1411
Now CwaYaa$tSlwwick Send wwww .) • 19
oast Nino EAN1N(SIDS ow O 9 rri ncNinl. w.¢1VP warrior era 9. 4014 AT9 WI vin 14944
we II'?lel POP Soros as*(S417 or*flaws•row M1VP Nawwmn NR IV 1) LM 15% All.
ire Saber EAaann CPU for War mar MOM Nor'w.Ain 1Q al
4apa[aWS 1 Fobs. n'r�F o -mint wOe__ 1S 12
Orr T.wW.Urp(t 1r.P t•.NZr3OrathetTw ert.N91 _ EO
Orr Trrr1114II.I r.T.r Vw. e'o 11T3 o nAI mwrNrNtetr•Iwkn 1TJ _u 10
Elvt.4an mews 121
Adams Oe•.4!Pnen Dr or 371111/4 14 704 14 Al
14 1n
3.TOTAL TRANdq 4 TECH ABYSTAIICE IS STS tItUS 1114.114 SI41M
NM I's jpl.at WAIT TM.I.B 4 NTOrlrf I RAW -- -
NCAST Rowsw..w 10 14
*CAST MrNWrl�.Ct*eern•rwM'SIE NCAS1 PaMEQBE a-a..,Fa aWn+d1 1n 10
PPE Trewal wash Se N
12 ffi
4 TOTAL CAP COATI a a 0, N a
9MilSAILIVAC!_flid in, 1 I 1110417
III V
141 SQ
>44, 'V
la /Q
T. TOTAL OTNCA COSTS td ! , M N
TOTAL OEPECT►ROcass Co3T 3 lA00 1,44.44 ossene 1.1 et MH RICO MGM 11111271
,•ONNITRATIVE COSTS Poo Ar.r!rb3!_I+s COON - WPC(1.
n o%FY12 COPE raw5seo n4•.a'.a VS SIB V
194 1Q
,heed Br.11O lOD 4 KSS1 4131 444 am wit 1112,
' ass la T2 Ka tag it
r- Ni se? I 11421a R19
narided Siena, al 204 1711 Li8Q4 A n00
r1slTldSo „1 7s 220 1142, uer
)1dsdOtseseB AS% 443? 4044! $ttNQ 114.1100
n 99
10 10
1w 30
111 so
TOTAL ADMMSTRATNE COSTS N $11N , POW SiMS IP.55
TOTAL PROJECT COSTS Maroc Progrn•AOr,WYetrt Cools} M _MST WAS MAN? Van?
S. .*b-ore SOURCES'PAW w MSG?" N.alas A.dart
S
S
$
Tot OOar Saacwe $0.00
!aide.d A•s..TN Ncrwww i.. nor us
L:gnMvnet COME PwwwooOfed.r Ems rv.
ISp..IW.el COPSE CHAS 011cr. 0r• _ no.
Bud•et Justification — Weld Count De•artment of Public Health & Environment
Personnel Services
Contributing Description Annual FTE Position Cost
Individual &Role Salary
Position&Name Current COLA for 07/01/12-12/31/12 29s
(if known) Anticipate another COLA of 2% 01/01/13-
06/01/13
Lorena Provides support services to supervisor and $ 35,559 1.0 $ 1,431
Pasillas NHVs. Creates visit packets, files & COLA &
Office replenishes program materials, addresses performance step
Technician, envelopes & mails program letters, orders increase
III supplies, equipment and support materials,
answers program phone & responds to callers
needs, inputs NHV visit data into ETO
database, completes purchase orders & does
local shopping for the program.
Dana Garvey Performs duties as outlined by the NSO $ 54,864 1.0 $ 3,233
Public Does targeted case management with clients COLA &
Health Nurse Attends mandatory health department performance step
II, Nurse meetings and trainings increase
Home Visitor Charts in Electronic Medical Records
Kathleen Performs duties as outlined by the NSO $ 56,560 1.0 $2,011
Hagihara Does targeted case management with clients COLA
Public Attends mandatory health department
Health Nurse meetings and trainings
II, Nurse Charts in Electronic Medical Records
Home Visitor
Vesta Unruh Performs duties as outlined by the NSO $ 58,249 1.0 $ 1,140
Public Does targeted case management with clients COLA
Health Attends mandatory health department
Nurse II, meetings and trainings
Nurse Home Charts in Electronic Medical Records
Visitor
Jodi Performs duties as outlined by the NSO $ 53,338 1.0 $28,274
Woodward Does targeted case management with clients From 0.5 to 1.0
Public Attends mandatory health department FTE 08/16/11 &
Health Nurse meetings and trainings COLA
II, Nurse Charts in Electronic Medical Records
Home Visitor
Geraldine Performs duties as outlined by the NSO $ 61,534 1.0 $ 2,479
Holton Does targeted case management with clients COLA
Public Attends mandatory health department
Health Nurse meetings and trainings
II, Nurse Charts in Electronic Medical Records
Home Visitor
Arians Rowe- Performs duties as outlined by the NSO $ 61,534 1.0 $ 2,479
Denning, Does targeted case management with clients COLA
Public Attends mandatory health department
Health Nurse meetings and trainings
II, Nurse Charts in Electronic Medical Records
Home Visitor
Barbara Performs duties as outlined by the NSO $ 46,316 0.75 $ 3,233
Francisco, Attends mandatory health department COLA &
Public meetings and trainings performance step
Health Nurse Does public outreach and marketing, sits on increase
III, NFP
Supervisor
Fringe @ 38.83% $166,602
Benefits
Subtotal Personnel Services: $594,596
Operating Expenses
Item Description Item Cost
Office Operating Batteries, ink cartridges for printer, 3 $4,000 No increase
Expense ring binders, pens, pencils, storage totes, From reduced
pocket folders, manila folders and labels, FY11-12 budget
and other assorted office supplies
Client Support Parenting books, educational toys, tooth $5,500 No increase
brushes, swaddling blankets, calendars, bus from reduced
passes, educational brochures and FY11-12 budget
pamphlets, digital thermometers, and
educational DVDs. Received a $750 grant
from United Way Promises for Children to
purchase educational toys and digital
thermometers. Received a $1000 grant from
WalMart and purchased educational DVDs from
Injoy Videos.
Printing & Required to use the county print shop for $5,700 $1,500 increase
Publications all printing needs. Cost per month averages from reduced
$350.00 for reproduction of program FY11-12 budget
facilitators and forms. Prices have
increased. $3,700 of the budgeted $4,200
spent from 7/11 through 12/11.
Postal & First class letters are sent to all $1,300 $100 increase
Shipping referrals, AWOL clients, & attending from reduced
physicians. Postcards are sent to clients FY11-12 budget
the client does not respond to phone
messages. 1/22/12 postage rates increased
1G for first class and 3G for postcard
rates. $650 of the budgeted $1,250 has been
spent from 7/11 throughl2/11.
Communications 7 cell phone plans that include 300 text $4,500 $548 increase
messages per month per phone. With texting From reduced
on the plans the NHVs are having increased FY11-12 budget
success reaching clients to confirm
appointments, decreasing the number of
attempted visits and no show appointments.
Long distance calls have increased with
increased referral sources in the south
county area. $2, 070 of budgeted $3, 652 has
been spent 7/11 through 12/11.
MedicalSupplies Clorox wipes and paper towels Lysol spray & $ 800 $400 reduction
alcohol preps are used to clean equipment. From reduced
May need to replace one portable DVD player FY11-12 budget
& a rolling case.
Outside Services 0
Subtotal Operating: $21,ao0
Computers with Amount is for maintenance as needed such as $500 $500 increase
Software a hard drive crash and/or software From reduced
installation. Y11-12 budget.
Cellular Phones Phones are provided at no charge by the $ 50 $50 increase
county. There is a charge for replacement From reduced
batteries, chargers, & belt clips. New FY11-12 budget.
phones require new accessories.
Subtotal Equipment: $550
Travel
Item Description Item Cost
Visitoutreach Visits in the outlying areas can be $34,000 $11,500 increase
mileage widespread. NHVs make every attempt to from reduced
cluster visits. Mileage reimbursement FY11-12 budget.
increased 7/1/11 from $.49 to $. 535 & the
county began covering mileage from the last
visit to home. $15,700 of budgeted $22, 500
has been spent from 7/11 through 12/11.
NCCFC/UCHSC
Training Travel
Travel for Dyadic
assessment tool
PIPE Travel
Program
meetings
(nurses,
supervisors,
other)
Other travel
Subtotal Travel: $34,000
NFP Training &Tech Assistance Expenses
Item Description Item Cost
Program
Development
Administrator
Orientation
Program Support Fee Set by the National Service Office $7,046
Nurse Consultation Set by the National Service Office $2,534
Nurse Consultation
(2)
Initial Nurse one NHV will retire 07/16/12 $4,069
Education
Initial NFP See above. $ 517
Education
Materials
Initial Supervisor
Education
Supervisor
Expansion
Data
Transmission
Setup Fee
Data Transmittal
Fee
Educational
Materials
Professional The budget reduction eliminated $3500 from $4,200
Development this category for FY11/12. The remainder
was spent on new manager training provided
by the NSO and sending our newest NHV to
important trainings to prepare her for
working with our clients. Several free
trainings were attended by various team
members. I would like to give those NHVs
who did not attend major trainings or
conferences this year the opportunity to do
so during the next fiscal year.
Subtotal NFP Training&Tech Assistance: $18.366
NCAST Costs
Item Description
Item Cost
NCAST Registration
NCAST Materials
PIPE Training Materials
Subtotal Equipment: 0
Other Costs
Item Description Item Cost
Subtotal Other: I o
Administrative Costs
Item Description Item Cost
Salaries Business Manager, Program Biller $ 4, 725
Supplies
$ 725
Data Processing Services $34,210
Purchased Services $ 2, 000
Insurance $ 245
Overhead Utilities, Phones,etc. $45, 100
Subtotal Administrative Costs: $87,oos
Part C. Fiscal Management
1. Related to FY2010-11(July 1,2010 through June 30,2011):
A B C (=B/A)
CDPHE NHVP funding Final Budget Final Expenditures billed %of budget expended
(do not include Medicaid or (after mid-year budget to CDPHE($) (%)*
in-kind) revision) ($)
CDPHE NHVP funding $610,704 $610,673.83 99%
( do not include Medicaid or
in-kind)
*If the percentage of your budget expended is less than 97.0%, please provide a detailed explanation of why your
organization under-spent the budget.
A B C (=B/A)
Medicaid Total Medicaid Final Medicaid %of reimbursements
Reimbursements for Expenditures for the expended (%)**
Claims with dates of period 7/1/2010-
payments between 6/30/2011($)
7/1/2010-6/30/2011
($)
Medicaid $48,525 $49,487.03 1.02%
Note: This figure should This figure should be in
match reports from the your accounting system
Office of Health Care AND should match the
Policy and Financing. total cumulative you
Flora Martinez will showed on your cost
email you this figure. reimbursement
statements for the period
7/1/2010- 6/30/2011
**If the percentage of your reimbursements expended is less than 97.0%, please provide a detailed explanation of why
your organization under-spent the budget.
2. Related to FY2011-12(July 1,2011 through June 30,2012):
A B C (=B/A)
CDPHE NHVP Funding Budget for FY 2011-12 Expenditures July 1,2011- %***
Dec. 30, 2011
CDPHE NHVP Funding $620,954 $308,910*ESTIMATE 50%
(Do NOT include in-kind or *DEC11 BILL IN PROCESS
Medicaid)
15
Medicaid Medicaid Estimate for Total Medicaid %***
FY 2011-12 Reimbursements for
Claims with dates of
payments between
7/1/2010-6/30/2011($)
Medicaid
***so% of the contract period has elapsed. If % of reimbursements is less than 40% of your Medicaid estimate, please
explain.
3. Please complete Attachment C2: FY2011-12 Expenditures-to-date Report and provide a brief description of your
method for completing Attachment C2 based on the instructions provided on pages 6, 7 and 8.The report must cover
the time period of July 1,2011 through December 31,2011.
4. Please submit an electronic Excel copy of Attachment C2 to Julie Becker at:julie.becker@state.co.us.
16
Attachment D
/v°°t\
*at FY2012-13 Colorado Nurse Home Visitor Program (NHVP)
ASSURANCE of INTENTION to MEET PROGRAM REQUIREMENTS
NHVP applicants seeking funding must assure that they intend to meet the Program Requirements, as described in
Sections 1.6, 1.7 and 1.8 of the Rules Concerning the Nurse Home Visitor Program(Attachment H),by initialing each of
the outlined areas below and by signing this assurance page.
�"V\ Annual Plan
WEt ) Training Requirements
h\Cik.) Visit Protocols
yLa Program Management Information Systems
l tiv Reporting and Evaluation System
3\J Staffing Requirements including to hire nurses as stated in Definitions (11) and (13)of the Rules
Concerning the Colorado Nurse Home Visitor Program and to obtain and retain documentation
demonstrating all nurses have a current license.
Eligibility of Clients including securing and maintaining proof of income for each mother
participating in the program.
Name of Agency: weld_County Department of Public Health and Environment_
Name of Authorized Signer: Mark Wallace, MD, Executive Director, WCDPHE
\nkeuv U W pit C,D
Signature of Authorized Signer: X y1
Date: a J t
I a
28
Attachment E
FY2011-12 Colorado Nurse Home Visitor Program (NHVP)
ASSURANCE of INTENTION to be an ACTIVE MEDICAID PROVIDER
The Center for Medicaid and Medicare Services (CMS) has approved Medicaid reimbursement for Targeted Case
Management (TCM) services provided by NHVP sites. Targeted Case Management services are defined by CMS as
"services which will assist individuals eligible under the Colorado State Plan in gaining access to needed medical, social,
educational, and other services." Nurse home visitors provide targeted case management through 1) assessment of the
needs for health, mental health, social service, educational, housing, child care and related services to women and
children;2) development of care plans to obtain the needed services; 3) referral to resources to obtain the needed services,
including medical providers who provide care to a first-time pregnant woman and her first child; and, 4) routine
monitoring and follow-up visits with the women where progress in obtaining the needed services is monitored, problem-
solving assistance is provided and the care plans are revised to reflect the woman's and child's current needs."
The Colorado Department of Public Health and Environment and the Colorado Department of Health Care Policy and
Financing have created a Medicaid Management Information System that allows for electronic billing of TCM services
under the NHVP. All NHVP sites are required to be active Medicaid providers, if not already, and must bill Medicaid for
TCM services as allowed. A portion of the annual funding for each NHVP site is derived from Medicaid reimbursements.
NHVP applicants seeking funding must assure that they intend to meet the Medicaid requirements by initialing each of
the outlined areas below and by signing this assurance page. The entity will:
TI1ELJ Be an active Medicaid Provider on or before July 1, 2012 through June 30, 2013.
rh4ElO Enroll all NHVP nurses in Medicaid as providers.
lyt£ Have a Medicaid consulting physician.
'MVO Submit TCM claims as established by Medicaid billing rules and requirements,
including timely filing of claims.
Ensure that all Medicaid-eligible participants are identified and receive assistance with
enrollment and referrals to other programs, including the Early and Periodic Screening,
Diagnosis and Treatment(EPSDT).
Name of Agency: Weld_County Department of Public Health and Environment
Name of Authorized Signer: Mark Wallace, MD, Executive Director, WCDPHE
V Y
Signature of Authorized Signer: X Wv ��E
��
eD la 1 ' a,
Date:
29
Attachment F
FY2011-12 Colorado Nurse Home Visitor Program (NHVP)
ASSURANCE of INTENTION to Follow CASELOAD GUIDELINES
The 2006 NHVP audit conducted by the Office of the State Auditor included a recommendation to the CDPHE to work with the State
Board of Health and the NHVP management partners to address program costs through caseload standards and attrition rates. More
specifically, the Department should:
(a) Determine why local sites are not achieving and maintaining caseload standards and develop strategies to help increase
participation.
(b) Establish guidelines for reducing caseloads and funding when sites do not meet caseload standards.
(c) Provide attrition analyses to the local sites and develop specific strategies to reduce the level of addressable attrition at each local
site.
It is understood that sites will not always reach 100%of their funded caseload due to factors such as (1)nurse turnover, (2)new nurses
learning the NFP model, (3) caseload build-up over 7-9 months, and (4) sites developing adequate referral networks. Instead, a
statewide baseline of an 85%active caseload of the total number of participants funded to be served within a given fiscal year has been
set. Active clients are defined in the NFP Efforts to Outcomes (ETOTM) software as those that have not been discharged from the NFP
program and have had a completed nurse visit within 90 days. The CDPHE and the NHVP management partners will review site-
specific active caseload trends covering a three-year period (current year and two years prior) to assess for legitimate caseload size
variances and to arrive at site-specific funding recommendations based on a reasonable expected active caseload size. Please
acknowledge review of this material by signing below.
Sites are expected to track their active caseload numbers using ETO reports and will be expected to report any caseload variations.
Sites will be alerted to any issues they need to address to ensure they are meeting active caseload expectations.
The NHVP mid-year budget adjustment process will be enhanced to consider year-to-date expenditures based on active caseload size.
If a site has cost savings as a result of a lower active caseload, those dollars may be redistributed to another grantee site.
For sites indicating an active caseload deficiency (consistently below baseline over the three-year trend period), a Performance
Improvement Plan will be required,including specific strategies and timelines for meeting active caseload expectations.
If a site does not meet the Performance Improvement Plan active caseload size expectation, a recommendation may be made to the
State Board of Health to reduce the active caseload number and funding in the site's contract to be commensurate with the site's
consistent performance.
The CDPHE contract will include active caseload size expectations as well as this plan as a means to formalize these requirements and
to hold all parties accountable for maximum caseload and funding efficiency.
The CDPHE and NHVP management team will develop a detailed caseload maintenance process and timeline to guide and assist the
sites in effectively managing caseload size, including implementation of proven strategies to retain clients or to recruit new participants
to the program.
Name of Agency: Weld_County Department of Public Health and Environment
Name of Authorized Signer:Mark Wa
llace, MD, Executive Director, WCDPHE
Signature of Authorized Signer: X ' ' `� Y2 ��� � �
Date: a I a ) 1a,
30
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