To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan, 707-565-4774; Amelyn Olson, 707-565-2696; Jan Cobaleda-Kegler, 707-565-5157
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Department of Health Service Agreements
End
Recommended Action:
Recommended action
The Department of Health Services (DHS) is seeking Board of Supervisors approval to execute the following agreements which include nonstandard indemnification language:
A) Revenue agreement with St. Joseph Health Northern California, LLC d.b.a. Providence Santa Rosa Memorial Hospital for laboratory services for a period of three years
B) Agreement with Nurse-Family Partnership to continue implementation of the Nurse-Family Partnership Program from August 1, 2024, through July 31, 2027, for a not to exceed amount of $105,418.
C) Agreement with California Mental Health Services Authority, for the Quality Measures and Performance Improvement Program through December 31, 2025.
D) Modifications to the agreements in this Board Item which do not significantly change the scopes of service in order to address increased service needs, subject to available funding as well as review and approval by County Counsel.
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Executive Summary:
The Department of Health Services (DHS) is seeking Board of Supervisors approval to execute agreements which include nonstandard indemnification language. Such language can expose the County to increased legal and financial risks that deviate from established policies. This approval ensures that any exceptions are carefully reviewed and justified in the public’s best interest. This oversight maintains accountability and protects County resources. The first is a revenue agreement with St. Joseph Health Northern California, LLC d.b.a. Providence Santa Rosa Memorial Hospital for laboratory services will have a three-year term that starts the date of agreement execution. Second is an agreement with Nurse Family Partnership to implement the Nurse-Family Partnership Program from August 1, 2024 through July 31, 2027, for a not to exceed amount of $105 ,418. And finally the department is entering a Participation Agreement with California Mental Health Services Authority for the Quality Measures and Performance Improvement Program through December 31, 2025.
Discussion:
Providence Santa Rosa Memorial Hospital - Laboratory Services
DHS seeks authorization to execute a revenue agreement with St. Joseph Health Northern California, LLC d.b.a. Providence Santa Rosa Memorial Hospital for laboratory services for a period of three years after the execution date of agreement. St. Joseph Health Northern California, LLC d.b.a. Providence Santa Rosa Memorial Hospital is seeking indemnification from the County, an action which requiring approval from the Board. The agreement has been reviewed by Counsel and Counsel concurs with recommending the Board approve authorizing the DHS Director to enter and execute the agreement.
This contract was initiated by Providence Memorial Hospital. It is their policy to have a contract in place with every reference laboratory they may utilize.
There is no cost to Sonoma County related to this agreement. The contract does not include a specific number or type of lab tests that Providence Memorial Hospital will send to the Sonoma County Public Health Laboratory (SCPHL); therefore, there is no set amount of revenue expected from this agreement. Providence Memorial Hospital only occasionally sends samples to SCPHL for testing, on an ad hoc basis. Published SCPHL rates for testing apply, using the fees approved by the Board (Located on the SCPHL website at <https://sonomacounty.ca.gov/health-and-human-services/health-services/divisions/public-health/public-health-regional-laboratory%20>.
Department of Health Services Home Visiting Program to continue implementation of the Nurse-Family Partnership Program
DHS seeks authorization to execute an agreement with the Nurse Family Partnership National Services Office to continue implementation of the Nurse-Family Partnership Program. Nurse-Family Partnership (NFP) is seeking indemnification from the County, an action which requires approval from the Board. The agreement has been reviewed by Counsel and Counsel concurs with recommending the Board approve authorizing the DHS Director to enter into and execute the agreement.
Program Information
DHS’ Home Visiting program has been implementing NFP since 2010. NFP is an evidence-based nurse home visiting model that works with first-time, low-income pregnant people. Clients enroll prior to 28 weeks of pregnancy and work with their nurse home visitor up until their child’s second birthday. NFP nurses provide families with education about pregnancy, childbirth, breastfeeding, child development and nutrition; and connect families to community resources the support their health, education, and economic self-sufficiency. NFP has been shown to improve birth outcomes, reduce child abuse/neglect, increase immunization and breastfeeding rates for infants, and increase child developmental screenings and referrals. Evidence also shows that the protective factors from enrollment in the program last well beyond childhood with higher rates of educational attainment and lower incidence of risk factors such as illicit drug use and obesity.
Since implementing NFP in Sonoma County, DHS has served over 1100 families, with 850 babies born through the program. Nearly two-thirds (63%) of all clients ever served in NFP identify as Hispanic or Latino/a, 8.5% identify as American Indian, and 3.5% identify as Black or African American.
Contract Details
This contract outlines how NFP will support DHS as an “NFP network partner,” and lays out expectations to ensure DHS implements NFP to fidelity. Under the agreement, DHS will utilize NFP’s proprietary materials, collaborate with the NFP National Service Office, provide data for evaluation and reporting, and participate in NFP training activities.
Under the three-year term, DHS will pay NFP a total of $105,417.76 ($34,750 in FY 2024-2025, $34,778 in FY 2025-2026, $35,890 in FY 2026-2027) for staff training, training materials, and network fees to implement the model. Network fees cover the technical assistance, proprietary NFP program tools and materials, and data and evaluation services.
Funding
Costs are covered by Public Health Realignment.
California Mental Health Services Authority (CalMHSA) - Quality Measures and Performance Improvement Program
CalMHSA is a Joint Powers of Authority (JPA) formed in 2009 by counties throughout the state to work on collaborative, multi-county projects that improve behavioral health care for all Californians. Recognizing that counties may need assistance responding to new state-level requirements for certain quality measures, CalMHSA began an initiative to calculate those measures on counties’ behalf - preserving their time and resources to dedicate toward providing care.
This item requests approval to enter into a participation agreement, and any amendments or documents related thereto, with CalMHSA for the Quality Measures and Performance Improvement Program from January 1 through December 31, 2025, subject to review and approval as to form by County Counsel.
This participation agreement requests mutual indemnification, which requires authorization from the Board of Supervisors. Each party would defend and indemnify the other party against any claims arising out of the other party’s negligence in the performance under the agreement.
The agreement has been reviewed by Counsel who concurs with recommending that the Board approve authorizing the DHS Director to enter into and execute the participation agreement and any amendments or documents related thereto within delegated authority levels as outlined in Sonoma County’s procurement policy.
This participation agreement does not have a fiscal impact.
Strategic Plan:
Not Applicable
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
None
Fiscal Summary
|
Expenditures |
FY24-25 Adopted |
FY25-26 Projected |
FY26-27 Projected |
|
Budgeted Expenses |
$34,750 |
$34,778 |
$35,890 |
|
Additional Appropriation Requested |
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Total Expenditures |
$34,750 |
$34,778 |
$35,890 |
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Funding Sources |
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General Fund/WA GF |
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State/Federal |
$34,750 |
$34,778 |
$35,890 |
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Fees/Other |
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Use of Fund Balance |
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General Fund Contingencies |
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Total Sources |
$34,750 |
$34,778 |
$35,890 |
Narrative Explanation of Fiscal Impacts:
There is no fiscal impact for FY 2024/2025. As for the future budget years, they will be included in the supplemental budget processes.
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Staffing Impacts: |
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Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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Narrative Explanation of Staffing Impacts (If Required):
Not Applicable
Attachments:
Attachment 1 - St. Joseph Health Northern California, LLC d.b.a. Providence Santa Rosa Memorial Hospital Agreement
Attachment 2 - Nurse-Family Partnership Agreement
Attachment 3 - California Mental Health Services Authority Agreement
Related Items “On File” with the Clerk of the Board:
None