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Home My WebLink About20040585.tiff RESOLUTION RE: APPROVE 2004.2005 GRANT APPLICATION FOR EXPANSION OF 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 the 2004-2005 Grant Application for expansion of 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, commencing July 1, 2004, and ending June 30, 2005, 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 2004-2005 Grant Application for expansion of the Nurse Home Visitor Program between 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,and 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. The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 25th day of February, A.D., 2004. BOARD OF COUNTY COMMISSIONERS W D COUNTY, COLORADO ATTEST: i i 4è\ 5JSRobert D. Masden, Chair Weld County Clerk to th 14d: t 0 William H. J e, Pro-Tem BY: Deputy Clerk to the Board'— M. ile ( R VED AS TO • Davie E. Long 4A-Li Glenn Vaad ate of signature: S 2004-0585 H L0031 Attachment B r.s�. \Pt , Colorado Nurse Home Visitor Program l 2004-05 GRANT APPLICATION COVER SHEET 1. Name of Applicant Entity:Weld County Department of Public Heal th and Environment Address/City/Zip 1555 N. 17th Avenue. Greeley. CO Rn631 - 2. Name of person completing application: Nancy Weber,BSN,MPH Position/Title:Nurse-Family Partnership- Supervi sor — Telephone: (970) 304-6420 ext. 2341 FAX: (970) 304-6416 — E-Mail: nweber@co.weld.co.us 3. Name of Authorized Signer: Linda Henry,RN,MA Position/Title:Director of Nursing and Health Education — Telephone: (970) 304-6420 FAX: (970) 304-6416 E-Mail: Lhenry@co.weid.co.us Signature: X ('5 LteL9 rit — 4- Grant proposal is for(check one): o Category A: Nurse Home Visitor Program —Category B: Alternative Nurse Home Visitation Program x Category C: Nurse Home Visitor Program Expansion 5. Grant request for July 1, 2004 through June 30, 2005: $430.485 l\N\ Robert D. Masden, Chairman, Board of County Commissioners FEB 2 5 2004 ATTEST: mh`��, G!'' WELD COUNTY CLE:t T•/ •g ,: y < H:\W61 PDOCSWHVPUPVIicx 1CW ron\(AmcAB05APP�v,SM.doc BY: -. DEPUTY CLERK Attachment C �(,gz 11B ASSURANCE of INTENTION to MEET PROGRAM REQUIREMENTS: Applies to NEW NURSE HOME VISITOR PROGRAMS(Category A)and NURSE HOME VISITOR PROGRAM EXPANSIONS(Category C). Please assure that the applicant entity intends to meet the Program Requirements,as described in Section 1.6 and Section 1.7 of the Rules Concerning the Nurse Home Visitor Program(Attachment A),by initialing each of the outlined areas below and by signing this Assurance Page. X Training Requirements X Visit Protocols X Program Management Information Systems X Reporting and Evaluating System X Staffing Requirements Name of Applicant Entity:Weld County Department of Public TIP alth and Fnvironment Name of Authorized Signer: Linda Heen�ry,�RN,NA �Signature of Authorized Signer: X � Q _ ii/U Cl41A Date: L41 /a .Q, OO54 V/1 H:\WPDOCSWHVPNpplica[ion\(Af achC)0405A®vevoe.doc Nurse Family Partnership Expansion Proposal for 2004-05 Weld County Needs of the Population Served Weld County is located in northern Colorado, measuring over 4000 square miles, with a population of 194,000 people. In the year 2002, a birth rate of 17.4 was recorded being steady from that same birth rate of 17.4 in the year 2000. There were 3581 live births in Weld County in 2002: 511 babies were born to mothers age 10— 19 years 329 babies were born to Hispanic mothers age 10-19 133 of the above Hispanic mothers reported prenatal care starting by 3 months gestation. An estimated 18.9% of Weld County residents are uninsured, and 12.5% of Weld County residents live below poverty. These demographics demonstrate the need for support programs like the Nurse Home Visitor Program. The current participants in the Weld County Nurse Family Partnership (NFP) are 76%Hispanic, 17% Caucasian, 4% Multiracial, and 1%American Indian. The average age is 18.39 years, with an average education level of 9.67 years. 68 clients report a household income below $10,000 per year, 86% of the clients are not married, 69% have participated in the WIC program, and 80% have enrolled is some coverage of Medicaid, yet many of the clients only qualify for the short term benefits of Emergency Medicaid. They do not have ongoing coverage of Medicaid for health care. Referrals to the current Weld County NFP program come from a variety of agencies. We have 11 agencies that regularly send referrals, and many community agencies and divisions that occasionally send client referrals. Through our work with current clients, we have made connections with the Weld County Probation Office, Department of Social Services, area school districts, and many clinical providers. Prenatal Plus and First Steps are both prenatal support programs in our community. Due to funding constraints, each program is limited in their ability to offer home visitation to all clients. The expansion of the Weld County NFP program would be an avenue to offer home visitation to more eligible clients, and assist with decreasing the number of needy clients that do not receive any prenatal /parenting support services. Growth and the development of housing in southern Weld County is creating more demand on prenatal support and family assistance services. The expansion of the Weld County NFP will allow 2 additional visiting nurses to be assigned to serve clients in the southern portion of Weld County. The Weld County Southwest Services Complex building has office and clinic space for the Weld County Department of Public Health and Environment. This will serve as host to some of the NFP staff, program materials and activities. Implementation and Fidelity to the Nurse Home Visitor Model The Weld county NFP program began in January 2001. The master degree prepared supervisor was selected at that time. Bachelor degree RN's were hired in February and March of 2001. One replacement BSN was hired in 10-02. all of the NFP staff have attended and completed the required NCCFC training protocol. All nursing staff have completed the NCAST training and certification. The Weld County NFP program fully participates in the CIS system since initial training in July 2001. A variety of CIS reports are reviewed monthly with emphasis on monitoring client visits, nurse caseload, mileage, and program content of visits. As part of the Quality Improvement activity, we focused efforts on early gestational age enrollment. At this time 50% of our clients were enrolled into the program by 16 weeks gestation. A total of 72% of the clients have enrolled by 28 weeks gestation. Occasionally a client is enrolling outside of the 28 week guideline, due to individual circumstances, and community needs. Through the year 2003, the Weld County NFP program has attrition rates of 5.4% clients in the pregnancy phase, and 27.2% in the infancy phase. Each of these rates is lower than the average of all Colorado sites. In the program history, there have been 70 clients discharged from the program, the most common reason for discontinuing the program is due to the client moving out of the community(30 clients), followed by 20 clients that declined further participation, and 12 clients unable to locate. Attempts to retain clients that express the need for change in the programming include: a varied visit schedule, frequent mail contacts, and appropriate client incentives at times to motivate the client to continue participation, as they see the benefit for their child and themselves. Plans for Expansion of Infrastructure An expansion of the Weld County NFP program will be an opportunity for us to serve 100 more clients in the community. The Weld County Department of Public Health and Environment administration has determined that the additional personnel will be housed in the two Health Department office locations in Greeley, and the Southwest County Services Complex. Offices equipped for phone, computer, internet, and fax access are available for the 4 additional RN staff that will be added. This facilitates that RN visitors can serve the clients in southern Weld County that have limited health resources. The geographical area has increased in population recently and continues to experience a large number of housing developments. The entire Weld County government system is served by an Information Services contractor, who is responsible for facilitating additional computer equipment and program installation as directed by our administration. This process would be in effect to install all new computer needs. Managers of the Weld County Department of Public Health and Environment will be involved in discussions of storage and security of the necessary materials for the NFP program. This will include a redesign of current storage and the needs of additional space and access for the expanded phase of the program. Security is necessary to prevent the loss of materials purchased by program funding. Within the county structure, there are options for adequate storage with reasonable security and access to appropriate staff. The Weld County Department of Public Health and Environment Administration staff will continue to provide program support from the Department Director, and the Nursing Division Director. The WCDPHE business office will continue to provide the financial management and accounting for the entire NFP program. Recruitment and Retention of Nurses The Weld County Department of Public Health and Environment (WCDPHE) will utilize county personnel policies to recruit and hire Bachelor degree prepared RN's for the four NFP expansion positions. The RN positions will be posted and advertised with emphasis for bilingual skills. Visiting nurses with bilingual skills are an asset as we enroll 76%Hispanic clients. The Weld County NFP staff have been host to a number of University of Northern Colorado senior nursing students. There is a positive relationship with instructors and students that could enhance the applicant base. We will be seeking RNs with experience in Public Health, Maternal Child, Pediatric, and other visiting programs. The 0.5 FTE master prepared supervisor, and the 0.5 FTE Data Assistant, may be additional assignments for the individuals that are currently in the part time positions. Otherwise, the positions will be posted and hired by the county personnel procedure. The budget reflects our starting wage for a Community Health Nurse II, with annual increases, along with step increases earned with positive evaluation. Starting the new staff at a level II is a statement of expecting top applicants to be selected. Our current NFP RN staff have been very steady. Weld County has only needed to select and hire one replacement RN. We believe that a thorough selective interview process has attributed to our low staff turnover. Also, the program design assists that the nurses work in a team setting and experience support from the program supervisor, and site development staff. The new staff involved in the NFP expansion will belong to the Family Visit Team and participate in many WCDPHE agency activities. The NFP staff will also be assigned an office space in the agency with their individual phone extensions, e-mail, and computers. This is an asset to integrate the program staff with the Nursing Division of the agency. Success in Recruiting Clients Since the start of the Weld County NFP program in January 2001, 227 client referrals have been received and processed by the NFP staff. One hundred and fifty five clients have been enrolled into the NFP program. Referrals have come from at least 15 different agencies, with a majority of referrals from the Sunrise Community Health Center, the Medicaid Presumptive Eligibility process of the Health Department, area school districts, North Colorado Family Medicine, followed by a variety of other providers and community agencies. The program supervisor receives client referrals from all the sources, and meets daily with the nursing staff to coordinate assignments. Efforts are made to promote early gestational enrollment. The referral packet is marked with the gestational date information, and nurses are encouraged to assess the interest and eligibility of the client quickly. The referrals that come from the Presumptive Eligibility (PE clinic) of the Health Department are often very early in gestation, due to the fact that clients generally seek the PE clinic process immediately after their positive pregnancy test. At the PE appointment, the clients are offered the NFP program if appropriate, and can meet with the visiting RN with in a week, to establish their understanding of the program and enrollment. There have been two periods of time that the Weld County NFP program has needed to limit client referrals. In October 2002, all RN caseloads were full and time did not allow for processing new referrals, and in April, May and June of 2003, it was necessary to not expand client caseloads, as funding decreased for the current programming, and RNs were required to take on other assignments in the agency to remain in full time status. Beginning July 1, 2003, the Weld County NFP program has been freely accepting referrals from all area agencies. Community contacts were made to review and refresh information with community providers to encourage ongoing client referrals. Troubleshooting An expansion of the Weld County NFP program will create additional partnerships and cooperatives in the community. Enhanced utilization of the Southwest County Services Complex to host some of the new RN staff, is a good example of cooperation in the community. We will continue to work with the 2 Prenatal Plus type programs to make determinations about appropriate program opportunities for clients. The NFP program is targeted for clients that would benefit from the longer more intense interventions and home visits that are provided. The Weld County Department of Public Health and Environment expects to integrate new staff into the NFP program, as well as the entire agency. A mentor design will be instituted to partner new staff members with existing staff in orientation activities. This will assist new staff in becoming integrated into the NFP program, introduction to community partners, teamwork, and agency activities. Community publicity about the expansion plan will be promoted through the Advisory Committee, the Weld County government, Health Department Administration, and current staff. Upon news of approval of the expansion and funding awards, immediate work will begin to generate referrals from additional sites, community announcements will be issued to describe the additional service available, and hiring activities will be initiated. Broad Based Community Support In our Weld County community, we have experienced an increase in the understanding of the NFP program, and the value to clients and families. The funding for the NFP program is better understood, and appreciated as it serves a need in the community. The Promises For Children organization has started a Prenatal Referral Resource Line that takes calls from anyone needing information about pregnancy, prenatal health care, health coverage programs, and access to care in Weld County. NFP program staff have been involved in the design of the resource line, and will be receiving referrals of eligible clients. This is progress from our past history of competition for referrals, and an atmosphere of not sharing between agencies. This has been accomplished, as the NFP supervisor participates on the Promises For Children committee, the Bright Beginnings—Warm Welcome advisory committee, and staff taking advantage of other opportunities to share the success and intensions of the NFP program. The Weld County NFP staff can describe at least one very positive situation with each referral source that we work with. Overall, through successful experiences, we have been able to increase the definition and understanding of the NFP program for community, school, and agency personnel. The Weld County Department of Public Health and Environment is the host for the NFP program. We experience a great amount of support from the agency administration. Clinically, we receive client referrals from the Medicaid Presumptive Eligibility process, at early gestational ages. There is great cooperation and communication between the nurses and the prenatal health care provider, when a client selects the Health Department prenatal care clinic services. The NFP nurses are able to follow up treatment concerns and reinforce medical advice and care. The administration of the Health Department provides all personnel services, office operations, staff training, and supply storage for the NFP program. Staff salary step increases are supported by department administration, as earned by staff, according to the county personnel policy. The Health Department administrator expresses support for the expansion proposal of the Weld County NFP program. Geographical Placement Weld County is a geographically large county, measuring over 4000 sq. miles. There are numerous small communities in Weld County, especially along the Highway 85 corridor. Most of the communities have very few health services in their area, and depend to services provided in the Greeley area. There is not a public transportation system that serves outside of Greeley. This makes transportation a barrier for the low income population that may have limited access to private transportation. The NFP Nurse Home Visitor model provides a connection for clients to their necessary services. Even though the nurses do not transport clients to other destinations, their involvement can: 1) assist clients in making arrangements for attendance at appointments 2) facilitate that clients have necessary paperwork or preparation when applying for assistance, to avoid the need for multiple appointments 3) help clients have appropriate questions prepared for the provider, 4) assist clients when a phone contact is an adequate means to communicate with a provider or agency, and avoid unnecessary appointments. As described previously, a large amount of growth is occurring in the south west region of Weld County. Currently we have 20 active clients in this region. The NFP expansion would allow us to serve up to 30-40 additional clients in this area that is furthest from the center of services in the Greeley area. The Salud Family Health Center has constructed a new clinic near Frederick in south west Weld. This clinic offers full health and dental services. We already have a relationship established with the Salud health system, and the NFP program would receive many referrals from this clinic site. The Salud Clinic provides health care, Presumptive Eligibility, and WIC services. This would be complemented by the NFP program of prenatal and parenting support, home visits, and program curriculum. APPLICANT: WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT I PROJECT: NURSE HOME VISITOR - - -PROGRAM + PR --- -- it -- EXPANSION PROJECT 2004-2005 BUDGET FOR THE PERIOD: I Annual Number I Total Source of Funds 2004-2005 2005-2006 I 2006-2007 Salary _Months Amount *Applicant Requested Requested j. Requested I ' Rate 1 Budget Reguired I and Other from CDPHE I from CDPHE 1 from CDPHE PERSONAL --- . _.- --- ---- l_ 1 426051- --_ Visiting RN -CHN II 42,605 , 121 46,191' 48,099 Visiting RN-CHN II . - 42,605 121 42,605 46,191 I 48,099 Visiting RN-CHNIII I �I 42,605 12 42,605! 46,191 48,099 r Visiting RN-CHN II _ 42,605 _-- 12 42,605, 46,191': 48,099 Office Technician 111 12,618 - 12, _-I 12,6181 --13,699 14,234 Contractual/Fee for Service: ' 1 Supervising Personnel: 27,003 12. 27,003'. 286201 29514 .5 FTE --_ --_ Fringe Benefits_ Rate=31.97% I I 67,1501 01. 67,150 72,598 75,495 I Total Personal _--.- - -- - _ 299,681 311,639 _ 277,191 0 277,1911. _-.-_- OPERATING — (include only costs not part of - -- -- _-- - - indirect) Office Supplies 1,2001 1,2001! 1,200 Client Materials ' — 8,0001 3,500, 3,000 Copies--forms 2,000 1,250 1,250 Emergency fund 500 500 500 Postage 600 p 1,200' 1,200 Telephone L, --- -_ --. _— 1,200 Computer Network Fee 3601 3601, 360 Cellular Phones Usa a Fees 9 2,400 2,400 2,400 Medical Supplies - -- ! ' 900 300'. 300 00,P rats � _---i �_ L _-- I_ 1,500 Other Staff Development Total Operating 19,060 12,8001 12,310 NCCFC Training.___-_ __ -._- NCCFC Training _ 1, 13,000 0' 0 NCCFC Materials I 1,750, 0 0 NCCFC Clinical Info. System Support 1,000', _ 0. 0 NCCFC Purchase of System&TA 6,0001 6,000 I 6,000 NCCFC Indirect at 26% 5,655 1,5601 1,560 PIPE - . - ._ 968 ---- 200 200 - - SubTotalTraining - I - 28,3731 _-- 7,76O. --- 7,760 NCAST Training -_-- - 3,160 _ 0I 0 NCAST Materials { 1,003 50 50 - _ _ _ 50 - - Total NCAST �- _. _ 4,163 50 I Mileage(Visit) TRAVEL: 1 � --- 17,040 _ 17,210! 17,382 9 Travel to Trainin s_NCCFC ' _i 8,250, 1,535 _ _ 0 NCAST 6,8881 01 _ 0 ; Sub Total Travel _ _--- ', - 32,178 ---18,745'.. 17,382 I EQUIPMENT: Computers with MS software(3) , 1 6,000 0 0 Modems(2) ' Cellular Phones (4) 400 011 400 Sub Total Equipment , 6,400 0 400 Total Direct Costs 367,465 339,0461 349,541 Administrative/Indirect @ 17.15% ' - _ f - 63,020 58,146 59,946 I I _ TOTAL PROJECT j_ 397,193 9,488 430,485 40 Source of Funding for"Applicant , 1 -- - - - -- and Other.. I Pp Local/County** Medicaid Funding _ i I I Patient Fees 1CI Other Total Applicant and Other __ ' IL any other - -- j - se grant'?funds No X used to I I matchYes ' / I XI Signature of Director or Authorized Representative ' I Weld County NFP Expansion Project 2004-05 Budget Narrative Personal Services The salaries in this section are designated for four full time RNs, 0.5FTE Data Assistant and 0.5 FTE nursing supervisor position. RN's will have a full caseload of clients to follow and recruit, by the end of the first program year. Benefits are calculated per Weld County policy and schedule. Salary step increases are earned by personnel with successful completion of 6 month and 1 year intervals. Cost of living increases are anticipated annually. Operating Expense • Office supplies are utilized by the staff to provide client notebooks, charts, files, and general organization • Client support materials are calculated on the suggested schedule of$145.00 per family throughout program participation. In the first year of participation, $80 is spent per family on program incentives, educational materials, and developmental tools. The line items for year 2 and year 3 indicate the amount allocated for family education materials, parenting support information, and tools for developmental stimulation. • Printing expenses are derived from duplication of program forms, facilitators, educational materials, and printing program brochures and program promotion materials to use in the community. • Postage is for client and program contacts. • The phone line item includes office phone equipment and service for all program staff. • Computer network fees provide access to the internet system. • Cell phone usage is calculated at $40 per monthly service package, for 5 RNs for 12 months =$2400 • Health and program supplies will include scales, blood pressure equipment, batteries, and small items in the visiting bags (tape, gloves, sanitizer, demonstration items). • Professional development is available to provide team or individual training in program related fields. NCCFC Training • All nursing staff, including the supervisor will attend the entire sequence of NCCFC training during the program year. This involves 10 days of training. • Training materials for the NCCFC sequence cost $350 per nurse. Five nursing staff will participate • The CIS system will be required to track the program data and activity. • Technical support of the NCCFC is estimated to be $6000 per year. • NCCFC indirect costs are assessed at a program standard of 26%. • PIPE curriculum materials are provided to each visiting nurse. It is necessary to purchase a multiple of activity cards and parent handbooks, due to language differences, and two office sites. NCAST Training • Four RNs will attend the NCAST training sessions. • The current Weld County NFP site has a set of Keys to Caregiving videos. Four RNs will all need the entire NCAST training and assessment materials and tools, with the exception of the Keys to Caregiving video set. Travel • Visit Outreach mileage—During the first year of the program expansion, the new staff will build a full caseload. It is anticipated that two nurses will be assigned in less populated areas, and will have higher mileage. The formula for mileage is calculated: o 50 visits x 10 miles x 12 months x $.355 reimbursement x 2 RN=4,260 o 50 visits x 30 miles x 12 months x $.355 reimbursement x 2 RN= 12,780 • Travel to NCCFC trainings is figured for five nurses, involving 10 nights, 10 days of per diem costs, and driving mileage. • NCAST travel expenses will involve 10 nights of lodging, 10 days of per diem costs, and driving mileage. Equipment • Three computers are requested for the program expansion. Computer packages will be purchased to meet program criteria and agency standards. Installation will be included in the computer price as contracted by Weld County, with ACS. • Cell phone equipment will be issued to all visiting staff. Attachment G mat$ ,,i-, ASSURANCE of INTENTION to be an active MEDICAID PROVIDER: \ eLr≥ •-Y Applies to all NURSE HOME VISITOR PROGRAMS (Category A,B and C). The Center for Medicaid and Medicare Services(CMS)has approved Medicaid reimbursement for Targeted Case Management(TCM) services provided by Colorado Nurse Home Visitor Program sites. Targeted Case Management is a large part of the activities provided by Nurse Home Visitors. These 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." Specifically, the approved Colorado Medicaid State Plan further elaborates: "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; and, 4)routine monitoring and follow-up visits with the women in which the progress of obtaining the needed services is monitored." 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(MMIS)that allows for electronic billing of TCM services commencing July 1, 2004. All Nurse Home Visitor Program sites will be required to become an active Medicaid provider, if not already, and must be willing to bill Medicaid for TCM services. Please assure that the applicant entity is either an active Medicaid provider or will become on by July 1,2004. X Presently an active Medicaid Provider. Will become an active Medicaid Provider by July 1,2004. Name of Applicant Entity: Weld County Department of Public Health and Environment Name of Authorized Signer: Linda Henry.RN,MA Signature of Authorized Signer: X .2 ei jO4) yj,4 Date: C_ge�p /a, 020©!f ll/' H:\WPDOCSWHVP\ p a Wi05Ncw&ExMb'AnachG)0405Mediceiddoc - (itMemorandum ' TO: Rob Masden, Chair Board of County Commissioners FROM: Mark E. Wallace, MD, MPH, Director 1 • Department of Public Health and E iro COLORADO DATE: February 19, 2004�,U�a,� r �t� l�1, SUBJECT: Nurse Home Visitor Program Renewal and Expansion Proposals Enclosed for Board review and approval are two program funding proposals to the Colorado Department of Public Health and Environment(CDPHE) for the Weld County Nurse Home Visitor Program. If the renewal proposal is funded, WCDPHE will continue to provide county-wide nurse home visitor services to low-income, first-time mothers as provided for in the Nurse Home Visitor Program Act, section 25-31-101, et. Seq., C.R.S. as amended, and administered by the CDPHE. For these services, Weld County is requesting $400,716 for the term of July 1, 2004, through June 30, 2005. The proposal to expand the nurse home visitor program would increase our capacity to service eligible clients in Weld County. Additional program personnel, training, and operating costs would be covered by the requested amount of$430,485. This funding will be used to support health education and other resources for new young mothers during pregnancy and the first years of their infants' lives under program guidelines. WCDPHE will collaborate with multiple agencies in implementing this program. I recommend your approval of these grant proposals. Enclosure 2004-0585 (ici(iTc DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT j 1e 555 N. 17tO80631 Greeley, CO 80631 WEBSITE: www.co.weld.co.us ll ADMINISTRATION: (970) 304-6410 Wi FAX: (970) 304-6412 PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420 FAX: (970) 304-6416 O ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415 COLORADO, FAX: (970) 304-6411 Esperanza Y. Zachman Nurse Home Visitor Program Manager Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South—A4 Denver, CO 80246-1530 February 11, 2004 Dear Esperanza, Please accept our proposal and application for the expansion of our site, Weld County, Colorado, in the Nurse Home Visitation Program. Included is a proposal to expand the Nurse Home Visitation services by increasing our contract with CDPHE. In order to increase our capacity to serve eligible clients in Weld County, the anticipated budget award of$430,485 will cover additional program personnel, training, and operating costs. We have had great success in our community as clients and families experience growth, nurturing, and the ability to make positive choices for themselves. The Nurse Family Partnership staff in Weld County continues to work effectively with clients and community members to provide this model Nurse Home Visitor Program to as many eligible clients as possible. We ask for your consideration in the application process. Nancy Weber BSN, MPH Nursing Supervisor Hello