COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

February 12, 2004

BOARD MEETING DATE:

March 2, 2004

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

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

2. Approve an Appropriation Transfer Request (ATR) recognizing the appropriation of $129,224 in unanticipated revenue for FY 2003-04.

Background

The harmful effects of tobacco exposure on developing fetuses, infants, and toddlers have been well established. Tobacco use during pregnancy has been found to cause miscarriages, premature labor and delivery, low birth weight, and death from perinatal disorders. Children exposed to secondhand smoke are more likely to develop respiratory tract illnesses, ear infections, and other adverse effects on physical and mental development. There are an estimated 1,100 to 1,300 women who smoke throughout their pregnancy in San Mateo County and, although many women quit due to pregnancy, there is a 50% to 70% relapse rate six months postpartum. Furthermore, it is estimated that 20% to 25% of children in San Mateo County are exposed to secondhand smoke.

On January 23, 2001, your Board approved an agreement with the First 5 San Mateo County Commission (formerly known as the Children and Families First Commission) for the Smoke Free Start for Families (SFSF) Program to provide tobacco cessation services to residents of San Mateo County. The term of the agreement was January 1, 2001 through December 31, 2003.

SFSF will meet or exceed its project objectives. The current project quit rate for pregnant smokers is 38%, which is significantly higher than the national average of 10-15%. The relapse prevention rate (keeping women from smoking again) for pregnant clients is 89%, which significantly exceeds the goal of 70-80%.

Discussion

This grant Agreement will provide $759,661 to the Smoke Free Start for Families (SFSF) Program for the term of January 1, 2004 through December 31, 2006. These funds will be used to provide education to 10,000 service providers and community members about the hazards of tobacco; to positively impact the lives of 975-1,200 children in San Mateo County through behavior changes of their parents, caregivers, and other household members; and to positively impact the lives of 175-195 children of pregnant smokers.

Performance Indicators

Actual 2003

Estimated 2004

Projected 2005

Projected 2006

Program referrals for pregnant and postpartum women and household members*

839

440

440

645

Self-reported quit rates among pregnant smokers referred to the program (quit for at least 30 days)**

38%

30%

30%

30%

* The number of referrals is reduced in this agreement due to a change in focus of the program from number of clients served to number of children affected by the program.

** The reported quit rates for this agreement (2004- 2006) have been reduced due to a revised definition of "quit rates" as being "quit for at least 30 days."

Vision Alignment

The amendment to the grant agreement with the First 5 San Mateo County 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 grant agreement contributes to this commitment and goal by working with families to protect children 0-5 from the hazards of tobacco.

Fiscal Impact

The term of this grant is January 1, 2004 through December 31, 2006. The total amount of the grant is $759,661; $129,224 in revenues and expenditures for FY 2003-04 is included in the attached ATR. In kind costs, which include administrative staff support, computer system support, custodial and facilities expenses have been included in the Public Health's adopted budget for FY 2003-04. There is no net County cost associated with this grant.