COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

May 23, 2003

BOARD MEETING DATE:

June 10, 2003

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

Brian Zamora, Director of Public Health and Environmental Protection

SUBJECT:

Grant Agreement with First 5 San Mateo County

Recommendation

Adopt a Resolution authorizing the President of the Board to execute a grant agreement with First 5 San Mateo County.

Background

The explosion of knowledge about how infants and toddlers develop has led to a new appreciation of ways in which a baby's earliest experiences set the stage for later emotional competence and achievement. With the support of the Board of Supervisors and funders like First 5 San Mateo County (First 5), the Prenatal to Three Initiative (Pre-3) has grown into a nationally recognized early intervention program.

First 5 San Mateo County has committed $2 million per year to a decade-long Strategic Initiative on Early Brain Development. On April 28, 2003, the First 5 Commission made a commitment to give half of the annual Strategic Initiative funds, or $1 million, to Pre-3. Then, the First 5 Commission approved an initial three year contract with Pre-3 for a total of $3 million.

First 5 already awarded Pre-3 a three-year grant, the term of which is January 2001 through December 2003. That grant will be terminated six months early, on June 30, 2003, to be replaced by the larger Strategic Initiative grant.

Discussion

With this funding from First 5, Pre-3 will provide multi-disciplinary home visiting and group services to families on Medi-Cal, primarily to those with children up to age three but in very high risk cases, up to age five. Vulnerable children in families that face very high risk situations, such as mental illness or substance abuse, will be offered more intensive and longer-term services than families who face challenges that are amenable to short-term intervention by home visiting staff. Pre-3 will also use the funding to offer psychiatric assessment and treatment, drop-in parent support groups, called "Touchpoints" groups, parenting education classes and early literacy activities, like the "Raising a Reader" program. This First 5 funding also supports the case management and group support offered through the Prenatal Advantage/Black Infant Health program.

With this funding, Pre-3 will improve service delivery to achieve the goals of increasing early identification of children's health and developmental problems, and building parental knowledge and capacity to support early brain development of their children.

Performance Measures

FY 2002-03 Projected

FY 2003-04 Estimated

FY 2004-05 Estimated

Number of SMC families with children 0-3 assessed by a Public Health Nurse

1400

1500

1500

Percentage of Pre-3 parents followed through home visiting who place baby on back to sleep (prevention of Sudden Infant Death Syndrome)

82%

85%

85%

Percentage of Pre-3 children followed through home visiting who are screened for developmental delay

70%

80%

90%

Staffing for this work already exists in Health Services and through contracts with Family and Community Enrichment Services and the Child Care Coordinating Council.

Vision Alignment

The grant from First 5 keeps the commitment of Ensuring basic health and safety for all and goal number 6: "Children grow up healthy in safe and supportive homes and neighborhoods." The First 5 grant contributes to this commitment and goal by providing Pre-3 with funds to improve service delivery to achieve the goals of increasing early identification of children's health and developmental problems, and building parental knowledge and capacity to support early brain development of their children.

Fiscal Impact

The grant of $3,000,000 is to be used during the period of July 1, 2003 through June 30, 2006. The FY 2003-04 recommended budget will include $1,000,000 in revenue from the First 5 Commission. The rest of the grant will be included as revenue of $1,000,000 per year in the FY 2004-05 and FY 2005-06 budgets.

The majority of the work supported by this funding will be the local match for Medi-Cal funding in both Public Health and Mental Health. The extent of the match is anticipated to be approximately $600,000 per year. First 5 funding may not be used to supplant County or State funding, therefore, no impact on Net County Cost is anticipated.