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Home My WebLink About930230.tiff RESOLUTION RE: APPROVE COLORADO CHILDREN'S TRUST FUND GRANT APPLICATION FOR HEALTH DEPARTMENT'S FIRST STEPS PROGRAM AND AUTHORIZE CHAIRMAN 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 Colorado Children's Trust Fund Grant Application for the Weld County Health Department's First Steps Program, commencing August 1, 1993, and ending September 30, 1993, with the 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 Colorado Children's Trust Fund Grant Application for the Weld County Health Department's First Steps Program be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chairman 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 10th day of March, A.D. , 1993. /�' // ,' / /// ”4,‘.- /0 ��„ BOARD OF COUNTY COMMISSIONERS ATTEST: iZZU� %� ��w �! WELD COUNTY, COLORADO Weld County Clerk to the Board EXCUSED DATE OF SIGNING (AYE) Constance L. arbert, Chairman BY: 44.,,--/14/< tg��'��`"t //\ � 9X /1 ��j /f) Deputy Clerk to the 1 W. H. bster, Pro-_):L9-11171-4 em ' 6` APPROVED AS ORM: L U ,� ( y< eorge Baxter EXCUSED County Attorney Daly K. Hall /2 /Barbara J. Kirkme r O 930230 14 / r i 6 C A''' MEmoRAnDuM Constance L. Harbert, Chairman 0 To Board of County Commissioners Date Marrhft, 1093 COLORADO From Jeannie K. Tacker, Business Manager. Weld cn„nry Maa1tb Dopt. Subject. Colorado Children's Trust Fund Grant ppply.3tagt �✓1 Enclosed for Board approval is a grant application to the Colorado Children's Trust Fund requesting approval of funding to continue the Health Department's First Steps Program. The Health Department is requesting approval of $20,000 for the period of August 1, 1993 through September 30, 1993. The funds will be used to continue First Step's efforts to help women obtain access to prenatal care obtain early well- child care for their children and obtain other needed community obtain other needed community resources. I would recommend your approval of the contract. If you have any question, please feel free to contact me. 53023C f{LOG/P PROGRAM DESCRIPTION Amount of money requested: $20,000 Community need and area of the state to be served: The First Steps program was initiated to help women access early prenatal care, early well-child care for their children, and other community resources. The clients were identified as a high risk population in need of parenting and nurturing skills. This segment of the population, not reached by any agency within Weld County, is the very young family, from pregnancy through the child's first year. First Steps' services begin in the first trimester of pregnancy, thus are in a unique position to identify families at risk for abusive behavior, possibly even before the child is born. Other agencies often do not see this particular client base until they are identified at a later date with developmental delays or abuse and neglect. With the realization that First Steps is able to reach these young families at a critical time, we consulted with Weld County School District #6, Weld County Inter- agency, and Greeley Success by Six, who all encouraged and supported our efforts at early identification of at risk families and children. As a result, case managers were trained and certified in the Parents As Teachers curriculum. The PAT program, developed by the Missouri Department of Education, serves as a preventive measure based on the assumption that all families benefit from support and education concerning child development. Utilizing the PAT curriculum, case managers dramatically decrease dysfunctional parenting beginning during pregnancy. Attachments contain articles and brochures that reflect on the positive achievements of the PAT program. 1992 child abuse statistics within Weld County cite 1334 reported cases of abuse and neglect. Cities reporting the highest incidence of abuse are: Greeley--699 cases, Ft. Lupton--92, Evans--78, Dacono--48, Erie--42 and Windsor--38 cases. First Steps case managers already work within these cities, as well as the remainder of the county, and agencies are well aware of the program's services. Child Advocacy and Resource Education (CARE) , in Greeley, states that clients who are isolated or lack social support, have low self-esteem, insufficient knowledge of normal child development and inadequate parenting skills are considered at risk for abusive behavior. First Steps is currently well utilized by county agencies as a referral source for these types of families who are in need of parenting education, nurturing and support. Teen parents are identified as being at risk as well. The 1990 live birth rate of 12-19 year old girls in Weld County is 55.7/1000, and the rate in the Johnstown and Milliken communities was 79.6/1000. During 1991, there were 324 births to Weld females age 10-19. 55% of First Steps clients are below the age of 19, and First Steps case managers currently provide educational services to teen parenting programs within the county schools. Other risking factors are parents with low educational levels, low socioeconomic status, and language barriers. Based on 1990 census, an estimated 131,821 people reside in Weld County. Approximately 10,030 persons over the age of 18 have less than a 9th 92O?3 grade education, 14% of the residents live in poverty, and 4% are considered linguistically isolated. Case manager address these concerns by working cooperatively with county schools and other agencies to encourage clients to remain in, or re-enter the educational system. Clients are referred for child care and financial assistance in order to facilitate this process. Three of the seven First Steps' employees are bilingual, therefore services are extended to linguistically isolated families. Type of program: Services provided by First Steps fall into both the primary and secondary prevention categories. Specific and targeted parenting education begins during pregnancy, so as to strengthen families and promote positive family functioning before abuse occurs. This service is available, during home visits, to any pregnant woman residing in Weld County. Home visitation services are valuable when focusing on the stresses and parenting issues within populations considered at risk. In addition, case managers provide life skills training, nurturing and support, and are able to network clients with each other to provide mutual group support and friendship. Program Rationale: The following components of the First Steps program address the primary and secondary prevention issues: The First Steps program matches the funding emphases and interest areas of the CCTV. The program provides home visitation services targeted to new parents, and provides parent education and support through a nurturing oriented program. It functions within the primary prevention level by working with educational programs in the county schools, providing prenatal and early parenting education, promoting positive family functioning through very early intervention, is voluntary and offered to all families within the county. It offers support services for new parents that are provided by a case manager who builds a relationship with the client throughout the entire pregnancy. Public education and awareness are achieved through the efforts of an Outreach Coordinator who is involved in door-to-door canvassing throughout the county, as well as at health fairs. Advertising, public and agency education and presentations to groups or individuals are accomplished by the Program Coordinator and Outreach Coordinator. First Steps offers secondary prevention services by identifying families considered at risk, and considers specific stresses or parenting issues with clients. Referrals, education and support are provided to families with special needs children through the relationship between case manager and their clients. The First Steps program presently has a well-developed referral system within the county. Approximately 700 clients have been referred to the program by individuals or 40 different agencies. Risk factors that contribute to parenting stress are pregnancy during the teen years, low socioeconomic status, temporary housing, low educational levels and single parents. Demographic information on First Steps clients indicates that 55% are 19 years of age or younger, 77% are unemployed and 50% earn less than $1,300 per 90230 year (this includes teen mothers living at home) , but 78% earn less than $10,000. Only 39% have completed high school, 35% have temporary housing and 70% are single, divorced or separated. A high percentage of First Steps clients have one or more of these factors, thus have a decreased tolerance to the stresses of parenting. Case managers were trained and certified as Parents As Teachers Educators in October 1992. The PAT program is utilized with the present clientele, beginning in the last trimester before birth. The PAT curriculum is preventive in nature, and families benefit from the support and education concerning child development. Also, the emotional support and parent education increase families' abilities to cope with parenting stresses, be independent, and enables parents to build confidence in their parenting abilities. The focus of the home visit is to teach parents about age appropriate growth and development and positive parenting skills. Case managers develop strong relationships with their clients. They are then able to provide nurturing and emotional support, increase the parent's self-esteem, and decrease the possibility of abusive behavior. First Steps works cooperatively with over 40 different agencies within Weld County. Some of these include the Department of Social Services, Weld County Health Department, Sunrise Community Health Center, Salud Family Clinic, Centennial Developmental Services, Inc. , private physicians, and other agencies that provide necessary resources such as food, clothing and housing. The cooperative effort has resulted in relief from the lack of basic necessities that cause high stress among new parents and prevent them from following through on prenatal care. The efforts of many agencies in Weld County enable First Steps assist a client population not served by any other agencies on a regular basis, and one considered at risk for abuse and neglect. By cooperating with other county agencies, First Steps clients achieve a 5% low birth weight for babies as opposed to 7.3% county-wide. Target groups: Although the services offered by First Steps are available to all pregnant families in Weld County, clients are primarily low-income single women. No financial eligibility is required. Services are voluntary and at no cost to the client. Goals and Objectives: Goal: Participants in the home visitation, parent education program will demonstrate increased self-esteem, increased knowledge of child development and improved positive parenting skills. Objective 1: 100% of all postpartum clients will participate in the PAT program. Objective 2: 90% of the adults participating in the PAT program will demonstrate increased knowledge of child development. 930130 Objective 3: 90% of the adults participating in the PAT program will perceive improved self-esteem and parenting abilities, self-responsibility, increased feelings of social support and a decreased sense of isolation. Strategies for Implementation and Timetable: First Steps services are well known and highly successful. No specific change in the delivery of services is necessary, as they are already in place and ongoing. Therefore no timetable is included. Home visitation and case management are used beginning in the first trimester of pregnancy. Case managers perform a detailed needs assessment including the client's physical and psychosocial history. They ascertain the need for prenatal medical care and basic necessities that put new parents at risk for abusive behavior, i.e. , lack of food, clothing, finances, etc. Assessment of necessary parenting skills begins in the first trimester as well. After making initial assessments, case managers refer clients to appropriate agencies within the county, and make monthly follow-up visits. These visits ascertain the client's progress with referrals and provide support, education and advocacy. The First Steps program schedules 6 home visits in the year following birth. If a case manager determines that a client is at risk, the service is expanded to allow for monthly visits for 1 year. At the present time, staffing is adequate (2 1/2 case managers) . Qualifications of Staff: The Program Coordinator is a Registered Nurse, and Case managers are Registered Nurses or Social Workers. All are certified PAT educators and have extensive experience working with expectant parents and new families. In addition, several of the case managers have extensive experience working with groups. Evaluation: Both formative and sunmative evaluations will be implemented incorporating the Parents as Teachers evaluation model. The formative evaluation, at 6 months postpartum, will focus on determining whether the process and procedures are working, project materials are effective and whether participants are satisfied with the services. The sunmative evaluation, conducted one year after the child's birth as services are completed, will measure whether the goals and objectives were met. Pre and post tests will be used to measure changes in knowledge base and parenting behaviors. Self- perception scales will be used to measure changes in attitudes and feelings. The First Steps program already has a computer system for tracking client demographics and data concerning services rendered. Only 2-3 items would need to be added to accommodate data requested by the CCTF. 920230 Budget Justification Since First Steps has shown we already serve a population identified by the CCTF as high risk and use methods recommended by the CCTF, we ask your support to continue this program. We are requesting funding from the Colorado Children's Trust Fund in order to continue the First Steps program from July 1, 1993 -- September 30, 1993. The First Steps program is presently funded with $50,0000 from Weld County. Both United Way and the North Colorado Medical Center Foundation have allocated $10,000 as matching funds for the CCTF grant funding. At present, we are putting together a cooperative long term funding effort from local sources. We are confident that we will be able to secure funding, but this is a time consuming process. Community support is evident among local foundations and businesses. State Farm Insurance contributed $500 toward funding efforts, The Assistance League of Greeley donated $500 to provide incentives to encourage women to make and keep appointments with physicians. Hewlett Packard contributed $150 towards the purchase of cloth diapers. The community residents and businesses donated infant clothing and equipment during the Christmas season for First Steps clients. Physicians, health clinics, schools, and many local agencies show their support by referring their clients to the First Steps program. Future Funding: The First Steps program is funded as stated above. Several requests for funding have been submitted, but have not been acted upon as of yet. We are in the process of securing additional, local, long term funding, and are confident that we will be able to secure it. 930230 Project Budget August 1, 1993 - September 30, 1993 1. Anticipated Revenue A. Children's Trust Fund Grant $20,000 B. Local Support 1,150 C. In - Kind 3,821 D. Other Sources -0- Total Income $24,971 II. Anticpated Expenditures Line Item Total Cost CCTF Local In-Kind Other Personnel $19,078 $18,438 $ $ 640 Supplies/Mat $ 200 $ 100 $ 100 Travel $ 250 $ 250 Postage $ 50 $ 50 Printing $ 200 $ 200 Publicity $ -0- Space Rental $ 2,280 $ 1,012 $1,268 Utilities, etc $ 1,763 $1,763 Emergency Fund $ 650 $ 650 Client incentives Staff Training $ 500 $ 500 Total Expenditures $24,971 $20,000 $1,150 $3,821 -0- 920230 Applicant Agency: Weld County Health Department for First Steps Program Title: First Steps Director: Randolph Gordon, M.D. , M.P.H. Director, Weld County Health Department 1517 16th Avenue Court Greeley, CO 80631 353-0586 Contact Person: Kris Howard, R.N. Program Coordinator, First Steps 1517 16th Avenue Court Greeley, CO 80631 353-4192 Amount of Grant Request: $20,000 WELD COUNTY BOARD OF COMMISSIONERS WELD COUNTY, COLORADO BY: Ch rman °`x/5/93 ATT d o the Board Deputy Clerk to the Board —` Approved as to form: WELD COUNTY HEALTH DEPARTMENT BY: ' "...4/�,fp'r Randolph`Gordo`n, M.D. , M.P.H. Director 920230 Hello