HomeMy WebLinkAboutph lettrState of California-Health and Human Services Agency
~~ ~ - California Department of Public Health ~ti~ ~:.. ~
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MARK B NORTON, hIIO, NE5PH ARNOLO 5CHWARZENEGGER
Director Govemar
December 31, 2010
Ann Dickman, RN, PHN f~OARDOFSt1~RVISORS
MCAH Director
Butte County Public Health Department ~+aN ~ ~~ ~Q~~
695 Oleander Avenue OROVII.I_!=, CALI~ORI~fR
Chico, CA 95926
Dear Ms. Dickman:
APPROVAL OF AGREEMENT FUNDING APPLICATION (AFA} FOR AGREEMENT #
2010-04 -Fiscal Year 2010-11.
The Maternal, Child and Adolescent Health (MCAH) Division of the California
Department of Public Health {CDPH) approves your Agency's 2010-11 AFA, including
the attached Scope(s) of Work (SOW) and Budget(s) for administration of MCAH
related programs.
To carry out the program{s) outlined in the enclosed SOW(S). and Budget(s), during the
period of July 1, 2010, through June 30, 2011, the MCAH Division will reimburse
expenditures up to the following amounts:
Maternal, Child and Adolescent Heal#h $ 113,978
The availability of Title V funds is based upon funds appropriated in the FY 2010-11
Budget Act. Reimbursement of invoices is subject to compliance with all federal and
state requirements pertaining to CDPH MCAH related programs and adherence to all
applicable regulations, policies and procedures. Your Agency agrees to invoice actual
and documented expenditures and to follow all the conditions of compliance stated in
the 2010-11 Program and Fiscal Policy and Procedures manuals, which includes the
ability to substantiate all funds claimed. CDPH MCAH policies and procedures can be
accessed at httr~alcdph.ca.QOVlMCAHfiscal.
Maternal, Child and Adolescent Health Division, Center for Family Health
1615 Capitol Avenue, MS 8300, P.O. Box 997420 Sacramento, CA 95899-7420
(916) 650-0300
Internet Address: www.rdph.ca.gov
Ann Dickman, RN, PHN
Page 2
For agencies claiming Title XIX funds, you also agree to maintain secondary
documentation that clearly substantiates time study activities as being non-program
related, non-matchable, matchable or enhancable. You also agree to use either:
1. the web-posted CDPH MCAH andlor BIH Base Medi-Cal Factor (MCF),
2. the CDPH MCAH prior approved alternate MCF (MCAH Program only),
3. a Variable Base MCF for specific staff who serve- a unique client population, and
who verify and document '100% of their Medi-Cal enrolled and non-Medi-Cal
enrolled clients during each time study period {MCAH Program only), andlor
4. the Lodestar generated MCF.(AFLP Program only).
Please ensure that all necessary Individuals within your Agency are notified of this
approval and that the enclosed documents are carefully reviewed. This approval letter
constitutes a binding agreement. If any of the information contained in the enclosed
SOW(s) and Budgets} is incorrect or different from that negotiated, please contact your
Contract Manager, Toni Ballenger, at (916} 650-0351 or by a-mail at
toni.ballengerCu7cdph.ca.gov within 14 calendar days from the date of this letter. Non-
response constitutes acceptance of the enclosed documents.
Sincerely,
~~
Shabbir Ahmad, DV , MS, PhD, Acting Chief
Maternal, Child and Adolescent Health Division
Enclosure(s)
cc: Mr. Bill Connelly
Chair Board of Supervisors
25 County Center Drive
Orville, CA 95926
Katee Schaffer, RN, MSN
Program Consultant
Maternal, Child and Adolescent Health Division
Toni Ballenger
Contract Manager
Maternal, Child and Adolescent Health Division
Central File
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Agency: Butte County Public Health Department Fiscal Year: 2010-2011
Agreement Number: 2010-04
MATERNAL, CHILD AND ADOLESCENT HEALTH {MCAH) PROGRAM
SCOPE OF WORK (SOWS
The Local Health Jurisdiction {LHJ) must work toward achieving the following goals and
objectives by performing the specified activities, evaluating the results and focusing on process
andlor outcomes.
Goal 1: Ensure that all children are born with op#imal health outcomes to healthy
mothers
Goal 2: No health status disparities among raciaclethnic, gender, economic and
regional groups.
Goal 3: A safe and healthy environment for women, children and their families.
Goal 4: Equal access for all women, children and their families to appropriate and
needed care within an integrated and seamless system.
Tcmelines: All of the implementation activities identified in this SOW are to be conducted
within the term of this Agreement's fiscal year.
Objective 1
MCAH Program in the LHJ operates under the direction of an approved MCAH Director in
accordance with the State MCAH Program Policies and Procedures Manual.
Implementation Activities
1.1 The LHJ must have an MCAH Director who meets the professional qualifications and
time allocation as specified in the current State MCAH Program Policies and Procedures
Manual. (See State MCAH Program Policies and Procedures Manual.)
Evacuation Process or Outcomes
1.1.1 The local MCAH Director must submit a copy of an approval letter or a waiver
with the annual Agreement Funding Application (AFA).
1.2 The MCAH Director, as the manager of the local MCAH program, is responsible for directing
local MCAH Programs and ensuring the performance of the core public health functions of
assessment, policy development, and assurance.
Evaluation Process or Outcomes
1.2.1 List all local MCAH Programs funded by the State MCAH Division in the Annual
Report.
1.2.2 Identify the State MCAH Division and Title V (Federal) priority areas with the
corresponding local MCAH Program in the Annual Report.
1.3 The local MCAH Director's responsibilities include the following:
• Develop policies and procedures, standards, and protocols
• Develop LHJ andlor community infrastructure that promote community partnerships
and provide family-centered, culturally-competent services
• Ensure implementation, coordination and evaluation of local MCAH Programs
• Conduct a Title V Needs Assessment within the local community every five years
• Ensure hiring and orientation of key personnel, adhering to the State MCAH Program
policy regarding personnel requirements
MCAH SOW {Rey 06/203 0) Page 1 of 6
Agency: Butte County Public Health Department Fiscal Year: 2D1D-2019
Agreement Number: 2010-04
* Develop activities and evaluation methods to measure results that relate to meeting
MCAH priorities and the LHJ multi-year plan
• Use core public health functions to assure that progress is made toward the State
MCAH Division and Title V (Federal} goals, objectives and priorities
Evaluation Process or Outcomes
1.3.1 Submit a duty statement that includes the local MCAH Director's responsibilities,
identified in the State MCAH Program Policies and Procedures, with the annual
AFA. When the MCAH Director position changes or the duties change for the
MCAH Director, submit the revised duty statement at the time of the change.
1.3.2 Complete and submit Form 4, MCAH Related collaboratives, to document the
MCAH Director's participation in MCAH-related collaboratives with the Annual
Report.
Objective 2
The local MCAH Program wiq conduct activities, such as outreach, case finding, referrals
and community education that assist the MCAH population to apply for and access
health care services, including Medi-Cal and other publicly subsidized health care
Implementation Activities
2.1 The local MCAH Program provides information on health care resources, services and
referrals to the MCAH population through:
• Activities that facilitate early and continuous access to medical care and services,
such as, outreach, case finding, referrals and community education
• Activities that provide referrals to Healthy Families, Medi-Cal, Access for Infants and
Mothers (AIM} and other low costlna cast health insurance programs for health care
coverage
• Identification of local high risk populations and prioritization of these populations for
outreach and referral services for medical care
Evaluation Process or Outcomes
2.1.1 Complete a Form 5, Outreach~Activities, for each Outreach Activity and keep on
file for audit purposes. Submit three examples for the Annual Report.
2.1.2 Describe the tracking system for referrals in the Annual Report.
2.1.3 Report the number of referrals to Healthy Families, Medi-Cal, AIM and report the
number and name of other low cost or no cost health insurance programs in the
Annual Report.
2.1.4 Identify the local targeted high risk populations
2.2 The LHJ promotes community wide collaboration in the development and
implementation of outreach programs and works to assure that services are provided in
a culturally sensitive manner with no duplication of services.
Evaluation Process or Outcomes
2.2.1 Complete and submit Form 4; MCAH Related collaboratives, with the Annual
Report to document participation of MCAH staff in MCAH-related collaboratives.
A
MCAH SOW (Rev 06/2094) Page 2 of 6
Agency: Butte County Public Health Department Fiscal Year: 2010-2011
Agreement Number: 2010-04
2.3 The LHJ provides a toll free or "no cost to the calling party" telephone information
service (Title V requirement) that meets the fallowing minimum standards:
• The service must provide current culturally and linguistically appropriate information
and referral to community health and human resources for the general public
regarding access to prenatal care antl health care providers
• The telephone number must be disseminated widely throughout the LHJ by means of
pamphlets, publications and media publicity
• At minimum, the toll free line must be operational during normal business hours and
must linguistically reflect the LHJ's population mix
• Personnel staffing the toll free line must have cultural sensitivity training
* After hours messages must be answered by end of the next business day
Evaluation Process or Outcomes
2.3.1 Complete and submit Form 6, Toll Free Telephone Report, with the Annual
Report.
Objective 3
Ensure that ail pregnant women will have access to early, adequate and high quality
prenatal care with a special emphasis on low-income and Medi-Cal eligible women.
implementation Activities
3.1 The MCAH Director will be responsible far ensuring the duties of the Perinatal Services
Coordinator {PSC) position are performed in accordance with the MCAH Policies and
Procedures. The Full Time Equivalent {FTE} for the PSC position is strongly
recommended but not required.
3.2 The MCAH Director, PSC or designated representative will implement and ensure that
CPSP is preformed in accordance with MCAH Policies and Procedures, CPSP Provider
Handbook and Steps to Take Guidelines.
Evaluation Process or Outcomes
3.1.1 Report specific information as requested in the Annual Report.
Objective 4
Reduce preventable infant deaths that are classified as Sudden Infant Death Syndrome
(SIDS}
Implementation Activities
4.1 Contact all parentslcaregivers who experience a presumed SIDS death to provide grief
and bereavement support services.
4.2 At least one public health pro#essional to attend the State SIDS Annual Conference
andlor other SIDS training(s}.
MCAH 50W {Rev 0612410) Page 3 of 6
Agency: Butte County Public Health Department Fiscal Year: 2010-2411
Agreement Number: 2010-04
4.3 It is also strongly recommended that a local SIDS objective 4.3 be developed to
address the following activities:
• Monitor SIDSISIeep related deaths to infants via CDRT attendance.
• Promote SIDS risk reduction activities by providing risk reduction education and
materials to the community.
• Provide technical assistance to TCMIPHN program for "Babies Sleep Safe" Crib
grant program provided by the Butte County Child Abuse Prevention Council.
+ Producelreproduce SIDS educational materials
• Provide trainings and materials to professionallcommunity agencies as requested:
• Attend 1-2 local health fairs to provide SIDS prevention and risk reduction materials
Evaluation Process or Outcomes
4.1.1 Report the number of infant deaths due to SIDS in the LHJ.
Report the number of parentslcaregivers contacted.
4.2.1 Provide staff member name and date of attendance at the SIDS Annual
Conference andlor training(s}
4.3.9 Describe the results of the specific LHJ defined activities that address the
promotion of SIDS risk reduction and education materials to the community
The LHJ can use the following directions and guidelines to develop and write specific
local objectives and activifies for their agency.
Objective 5 (Insert local objectives, implementation activities and evaluation
processesloutcomes here)
Each Fiscal Year the local MCAH Program is required to address one or more local
priority objectives(s} identified in its Five Year Needs Assessment
5.1 The LHJ must complete the following process to address one or more local priority
needs objective(s) by:
5.2 Improve perinatal birth outcomes by strengthening collaboration within the perinatal
community utilizing the vehicle of the perinatal Council:
• Work with the Dental Collaborative and the Dental Education Workgroup to
improve access to prenatal dental care:
o Create education outreach program regarding the availability and
importance of prenatal dental care for pregnant WIC and Medi-Cal eligible
women.
o Implement outreach program through four WIC sites, FQHC clinics and
through CPSP programs.
• Work with the perinatal Council's perinatal Substance Abuse Workgroup to
increase access to drug and alcohol treatment services #or perinatal women:
o Implement Substance Use Self Assessment form through local CPSP, OB
and WIC settings.
o Distribute perinatal Recovery Resource Guide to appropriate agencies
including OB providers, CPSP providers, WiC and home visitation
programs.
o Work with focal birthing hospitals and Methadone Maintenance Treatment
program staff to conduct training for OB practitioners on Care and
Treatment of Pregnant Women on Methadone Maintenance.
MCAH SOW (Rev 0612010} Page 4 of 6
Agency: Butte County Public Health Department Fiscal Year: 2010-2011
Agreement Number: 2010-04
5.3 Decrease the incidence of unintentional injuries for children birth to 14 years of age:
o Facilitate bi-annual Safe Kids Butte County Meetings.
o Write Kids' Plates grant with focus on Safe Routes To School -Pedestrian
Bike Safety. Grant designed to increase Butte County Public Health
Department's capacity to address this vital issue.
oRecruit 2-3 schools to participate in "Walk to School Day" activities. Provide
Technical assistance as needed for these schools.
o Work with California Department of Public Health's Injury Policy Committee
to shape policy related to childhood injury.
o Participate in Safe Kids California Executive Committee as Chapter
representative.
5.4 Work to increase childhood activity levels to help decrease incidence of childhood
overweight:
oCollaborate with Sierra Cascade Nutrition and Activity Consortium, City of
Chico, Butte Bicycle Coalition, Chico VELA Cycling Club and others to
promote safe and walkable routes to school.
o Work with Nursing Supervisor, WIC and CHDP Deputy Director to assess
internal capacity to address childhood obesity issues and create a
collaborative action plan which will decrease duplication of effort.
Evaluation Process or Outcomes
5.1.1 Identify the activities and implementation strategies that address each objective
5.1.2 Report specific evaluation processes, outcomes, or measures that were
completed during the fiscal year for each local objective
5.1.3 Maintain documentation of activities on file
5.2.1 Evaluation:
• Dental:
o Agendas and minutes from Dental Copaborative will be on file.
o Summary of work to promote access to prenatal dental care and
denta! education will be included in annual report.
o Educationalloutreach materials will be included in final report
•Perinatal Substance Abuse:
o Summary of self assessment form's implementation activities and
evacuation of effectiveness will be included in final report.
o List of agencies and providers to receive the Perinatal Recovery
Resource Guide will be provided with final report.
o Summary of training details including educational materials,
attendees and evaluations will be included in final report.
5.3.1 Evaluation:
• Agenda's and minutes for Safe Kids Butte County meetings will be on file.
KEds' Plates grant proposal and data establishing the need for funding will be
included in final report.
• Summary of Walk a Child to School activities will be included in final report.
MCAM SOW (Rev 0612010) Page 5 of 6
Agency: Butte County Public Health Department Fiscak Year: 2014-2411
Agreement Number: 2410-04
• Final recommendations for the CDPH Injury Policy Committee will be included
in final report.
• Agenda's and minutes for Safe Kids California Executive Board meetings will
be on file. Major decisionslaccomplishments will be included in final report.
5.5.'I Evaluation:
• Summary of Safe Routes tv School activities will be included in final report.
• Summary of internal collaboration and capacity building efforts will be included
in final report.
• Collaborative action plan will be included in report.
MCAH SOW (Rev 0612010) Page 6 of S