Agenda Item AGENDA STAFF REPORT ASR Control 23-000970
MEETING DATE:	01/23/24
legal entity taking action:	Board of Supervisors
board of supervisors district(s):	All Districts
SUBMITTING Agency/Department:	Health Care Agency (Approved)
Department contact person(s):	Regina Chinsio-Kwong (714) 834-2729
	Debra Baetz (714) 834-2830

Subject: Approve Contract for Black Infant Health Services

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

3 Votes Board Majority

Budgeted: Yes

Current Year Cost: $522,797

Annual Cost: FY 2024-25 $650,000
FY 2025-26 $650,000

Staffing Impact:

# of Positions:

Sole Source: Yes

Current Fiscal Year Revenue: N/A

Funding Source: State: 100% (CDPH/MCAH/BIH)	County Audit in last 3 years: N/A
Levine Act Review Completed: Yes

Prior Board Action: N/A

RECOMMENDED ACTION(S):

Approve the selection of and Contract with Children and Families Commission of Orange County for the provision of Black Infant Health Services for the term February 23, 2024, through June 30, 2026, in an amount not to exceed $1,822,797.

Authorize the County Procurement Officer or Deputized designee to execute Contract with Children and Families Commission of Orange County as referenced in the Recommended Action above.

SUMMARY:

Approval of the selection of and Contract with Children and Families Commission of Orange County will allow for Orange County’s implementation of the Black Infant Health program administered by the California Department of Public Health Maternal Child and Adolescent Health.

BACKGROUND INFORMATION:

California Department of Public Health (CDPH) offers funding through Maternal Child and Adolescent Health Branch (MCAH) to counties throughout the state of California to improve services to pregnant and parenting women through various home visitation programs including Black Infant Health (BIH). The goal of the BIH program is to improve Black infant and maternal health as well as decrease health inequities in infant and maternal mortality rates. The Health Care Agency (HCA) plans to implement the evidence informed intervention that uses a group-based approach. The program consists of client centered life planning, goal setting, health, growth and developmental education, behavioral health screenings, group sessions, and referrals and linkages for services in the community.

Health disparities affecting Black women and babies are prevalent nationally, across the state, and in Orange County. Black women are four to six times more likely to die from pregnancy related causes than Asian/Pacific Islander, Hispanic/Latina and White women. Black babies are twice as likely to be born with a low birth weight which is more than infants of other racial or ethnic groups.

HCA has become eligible for funding to implement the BIH program in Orange County based on meeting the required number of eligible birthing moms and number of live births which meets CDPH/MCAH criteria for one service area. The Orange County Preference Policy is not applicable to this contract award.

Scope of Services

Children and Families Commission of Orange County (First 5) will work with established subcontractors to promote collaboration across non-profit sectors bringing organizational synergies to hire and scale staffing to be fully operational and effectively implement the BIH program at an enhanced rate for the County. First 5 will follow the curriculum set by CDPH to provide services to Black parenting women and their infants, 16 years or older, and pregnant through six months postpartum. The program has the capacity to provide services to 160 women and their infants per year.

The BIH program is based on current science that support an empowerment-focused, group-based intervention as a promising strategy for improving Black women’s birth outcomes. The model includes the following per fiscal year:

1. Prenatal classes (a minimum of nine prenatal group series serving at least 72 enrolled participants)

2. Post-partum classes (four group series serving at least 32 enrolled participants)

3. Each service area may serve up to 35 percent (56) of the total participants through one-on-one support without group

4. Serve 160 participants per year 72 prenatal, 32 postpartum and 56 one-on-one support sessions

Under this contract, First 5 subcontractors will at a minimum staff seven full-time equivalent positions: three Group Facilitators, one Mental Health Professional, one Outreach Liaison, one Data Entry and one Child Watch professional.

The BIH goals include reducing infant and maternal mortality rates improving birth outcomes in Black parenting women and their infants, increasing early prenatal care, connecting families to resources, parenting support, mental health and wellness services, breastfeeding education, empowering women, building resilience, reducing stress, increasing social support throughout the life course, promoting healthy behaviors to support health, wellness, and relationships and helping women become empowered to make healthy choices for themselves, their families and their communities.

Performance Outcomes

Performance and outcome measures are set by CDPH to demonstrate effectiveness of the program for Black parenting women and their infants. Through the partnership and services provided through BIH, mothers will be able to enroll and access prenatal care. During enrollment the pregnant mother will participate in prenatal classes that will include pregnancy topics, healthy habits, nutrition, child safety, screenings, referrals, and linkages to promote a full-term delivery and promote growth and development. Performance Measures will include:

Outcome Measure	FY 2023-2024 Outcomes
Prenatal Care	75 percent of mothers enrolled in BIH will enroll in prenatal care
Breastfeeding	75 percent of women enrolled in the program will exclusively breastfeed while in the hospital after birth
Safe Sleep	100 percent of women enrolled in the program will receive Safe Sleep education

The proposed Contract is a Sole Source Contract with First 5. First 5 is a reputable local government entity and regional provider for services related to children zero to five. First 5 is a trusted and strong partner and has operated in Orange County for over 25 years with an organizational track record of strengthening relationships and creating synergy to reduce barriers and improve services in the community. First 5 has multiple long-standing partnerships and agreements with several community partners offering services to children zero to five. Additionally, First 5 is part of the Bridges Maternal Child Health Network (Bridges) integrated system providing screening, at birthing hospitals, education and linkage to services including home visitation during the critical first years of life. Through Bridges Hospital screening, birthing hospitals will be able to complete referrals to home visiting services which is critical to help identify families that meet criteria for home visitation including BIH program. A direct referral at birth will help improve the ability for families to establish services and promotes program sustainability. First 5 can provide in-kind resources critical to support the successful implementation of this innovative initiative, which includes, a centralized office in Orange County, meals for meetings and educational sessions, client support materials and outreach and engagement through the First 5 platform and community relationships and forums.

This contract includes subcontractors or pass through to other providers, see Attachment B for Contract Summary Form.

The Contractors' performance has been confirmed as satisfactory. HCA staff has verified there are no concerns that must be addressed with respect to ownership/name, litigation status or conflicts with County interest.

HCA requests your Honorable Board of Supervisors approve the selection of and Contracts with Children and Families Commission of Orange County for provision of Black Infant Health Services, as referenced in the Recommended Actions.

FINANCIAL IMPACT:

Appropriations for this Contract are included in the Budget Control 042 FY 2023-24 Budget and will be included in the budgeting process for future years.

Should services need to be reduced or terminated due to lack of funding, this Contract contains language that allows HCA to give 30 days’ notice to either terminate or renegotiate the level of services provided. The notice will allow HCA adequate time to transition or terminate services to clients, if necessary.

STAFFING IMPACT:

N/A

ATTACHMENT(S):

Attachment A - Contract MA-042-24010626 for Black Infant Health Services with Children and families Commission of Orange County
Attachment B - Contract Summary Form