HomeMy WebLinkAbout022712_ca07
ON~ Consent Agenda
i~~~~, JEFFERSON COUNTY PUBLIC HEALTH
\Ii;i,&~~' 615 Sheridan Street. Port Townsend' Washington' 98368
~""NO.~ www.Jeffel'8oncountypubDchealth.org
February 2, 2012
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE: Pebyu..ilLY'j ~I) d-.DI;;t
SUBJECT: Agenda Item - Contract Agreement with Port Gamble S'KIallam Tribe
for Nurse Family Partnership Supervisor Role; February 1, 2012 -
January 31, 2015; $28,329 annually, plus mileage
STATEMENT OF ISSUE:
Jefferson County Public Health, Community Health, requests Board approval of the Contract Agreement
with Port Gamble S'KIallam Tribe for Nurse Family Partnership Supervlsor Role; February I, 2012 -
January 31, 2015; $28,329 annually, plus mileage
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
This Agreement allows the Port Gamble S'KIallam Tribe to establish the evidenced-based program, Nurse
Family Partnership under the umbrella of JCPH. It Is a regional partnership that allows JCPH, which has
provided NFP services for 12 years, to provide Infrastructure support In the form of nursing supervision to
the Port Gamble S'KIallam Tribe. This regIonal approach helps provide needed services to smaller
communities that may not be able support evidenced-based programs on theIr own and gives JCPH an
opportunity to share Its experience and expertise by contract.
FISCAL IMPACT ICOST BENEFIT ANALYSIS:
Funding for this contract Is based on Yuko Umeda, PHN, providing supervlsory role servlces for 43 hours a
month, based on the current rate of compensation plus a proportionate share of benefits and covered
employee expenses Incurred by JCPH. This contract will also cover the cost of 10 hours of data clerk entry
per month at the rate of $23.23.
COMMUNITY HEALTII
DEVELOPMENTAL DISABILITIES
MAIN: (360) 385-9400
FAX: (360) 385-9401
PUBLIC HEALTH
IllWAYS WOllllilllll '1111 A SAfIIlIlllIl
HEALTHIER COMMUNITY
ENVIRONMENTAL HEALTII
WATER QUALITY
MAIN: (360) 385-9444
FAX: (360) 379-4487
Consent Agenda
RECOMMENDATION:
JCPH management request approval of the Contract Agreement with Port Gamble S'Klallam Tribe for Nurse
Family Partnership SUpervisor Role; February 1, 2012 - January 31, 2015; $28,329 annually, plus mileage
2---I/o~ L-
Date
CONTRACf AGREEMENT
By and Between
Port Gamble S'KJallam Tribe And Jefferson County Pnblie Health
For provision of one (1) PubUe Health Nurse for Nurse FamDy Partnership (NFl) Supervisor Role
Section 1: PURPOSE:
TInS AGREEMENT for Ptofessional Services is entered into between Port Gamble S'l(lanllm
Tribe, herein referred to as the "Tnee" and Jefferson County Public Health (JCPH), herein
u:fiou..d to as the "Contractor" to provide services as a Nurse Family Partnership Supervisor.
Section 2: TERMS:
This Agreement shaI1 commence on February I, 2012 and c:ontinue through January 31, 2015
uuIess termimltPil as provided herein. The agreement may be extP.nrlP.rl beyond January 31, 2015
upon mutual written consent of the Tribe and the Contractor.
Section 3: SCOPE OF AGREEMENT:
Contractor will provide Public Health Nurse services for Nurse Family Partnership Supervisor
Role.
A. Contract Representatives:
The Tnee and Contractor will each have a contract representative who will have responS1"bility to
I'dmlniRter the contract for that party. A party may change its J:ep1~ve upon providing
written notice to the other party. The parties' t'e{)J:esentatives are as follows:
;Port Gamble S'K1allam Tnee Contract Representative
Edward Fox, Health Serviees DIrector
32020 LIttle Boston Road NE
Kingston, W A 98346
(360) 297-9661
Contractor's Contract Representative
Jean Baldwin, Director
Jefferson County Public Health
615 Sheridan St.
Port Townsend, WA 98368
(360) 385-9400
Section4: COMPENSATION:
Port Gamble S'K1allam Tnee agrees to provide the following:
A. Pay Contractor the actual cost of Employee's services to Port Gamble S'J{lallllm Tribe
for Nurse Family Partnersbip supervisory role. This reimbursement tate will be based on
the Employee's current tate of compensation as a Jefferson County Public Health
employee at the time the service is provided plus a proportionate share of benefits, and
covered employee expenses incurred by Jefferson County Public Health.
Pan Gamble S'KIalJam Tn'be - Jeffilrson County PubUc Health
Tn1le will pay Contraetor $49.50 I hour to provide 43 hours monthly as NFP Supervisor
not to exceed $25,542 An1Inally without express written QTl)f\1ldTl1el1t signed by both
parties.
Tribe will pay 10 hows of data clerk entry per month at the rate of$23.23 not to exceed
$2,787 annually without express written amendment signed by both parties.
Additional hours worked above the agreed upon hours weekly, will be charged at
the same hourly rate.
B. In addition, provide for reimbursement of nursing statffor mileage incurred in connection
with provision of stated services at the rate of$O.5SS per mile or the current IRS Standard
Business Mileage Rate.
c. Contractor sba1l submit invoices of actual cost to Port Gamble monthly for payment of
work completed to date.
D. Contractor records and accounts pertaining to this agreement are to be kept available for
inspection by representatives of the Tn1le and state for a period of six (6) years after final
payments. Copies sha1l be made available upon request.
E. Any additional fees required by Nurse-Family Partnership or requested by the Tn1le for
training and approved program supplies for Tribe will be paid to NFP by Contractor and
reimbursement for such costs will be billed to Tribe. Costs incurred under this item sha1l
not affect the contractual amount of$28,329.oo for supervision and data clerk expenses.
Section S: INDEMNIFICATION:
The Contractor sha1l indemnify, defend and hold harmless the Tn1le, its officers, agents and
employees, from and against any and aU claims, lawsuits, demand.. for money dmnl\8flS,losses or
liability, or any portion thereo~ including attomey's fees and costs, arising from any i$u:y to
person or persons (mcluding the death or injury of the Contractor or dAmage to personal pluperty)
if said injury or dmnage was caused by the negligent acts or omissions of the Contractor or its
employees or representatives.
Section 6: INSURANCE:
The Contractor sball obtain and keep in force during the terms of this Agreement, or as otherwise
required.
A. Commercial Automobile Liability Insurance providing bodily it\iury and prolx'dy
damage liability coverage for aU owned and non owned vehicles assigned to
or used in the performance of the work. for a combined single limit of not less than
$300,000 each occummce.
B. Professional Liability Insurance providing $2,000,000 per incident; $4,000,000
aggregate.
Port Gamble S.KIaIIam TrIbe. JeIfersoD CoulIly Puhlll: Health
C. The County shall participate in the Worker's Compm...mon and Employer's Liability
Insurance Program as may be required by the State of Washington.
D. Its membership in the Wa!!mngton Counties Risk PooL
Section 7: CONFIDENTIALITY:
All parties to this Agreement and their employees or representatives and their subcontractors and
their employees will ma;ntA1n the confidentiality of all infmmation provided by JCPH or Port
Gamble S'l{lallam Tn"be or acquired in performance of this Agreement as required by HIP AA
and other privacy Jaws. This Contract. once executed by the parties, is and ren"l!n!! a Public
Record subject to the provision ofCh. 42.56 RCW, the Public Records Act
Section 8: OWNERSHIP AND USE OF DOCUMENTS
The Contractor acknowledges and agrees that any and all work product directly connected and/or
associated with the services rendered hereunder, including but not limited to all documents,
dmwings, reports. and the like which the Contractor in the perfonnance of the service hereunder,
either solelyand/or jointly with the Tn"be shall be the sole and exclusive property of the Tn"be.
Other materials produced by the Contractor in connection with the services rendered under this
agreement shall be the property of the Tribe whether the projects for which they are made are
executed or not. Each party may, with no further permission required from the other party,
publish to the web, disclose, distribute, reproduce, or otherwise copy or use, in whole or in part,
such items produ""" during the course of the Project to the extent disclosure is allowed by
HlPAA.
Section 9: INDEPENDENCE
Nothing in this agreement shall be considered to create the relationship of employer and
employee between the parties hereto. The Contractor shall not be entitled to any benefits
accorded Tn"be employees by virtue of the services provided under this agreement. The Tn"be
sha1l not be responsible for withholding or otherwise deducting federal income tax or social
security or for contn"buting to the state j1u!ustrial insurance program, otherwise 88l"11'nil1g the
duties of an employer with respect to employee.
Section 10: REPORTING
The Contnh.1or will provide a report to the Tn"be for payment for services rendered monthly.
The report shall contain a brief Sllmmmy of the work perfonned, relationship to the tasks
identified in Exhibit A and the tota11ines generated.
Section 11: DISPUTE RESOLUTION
The Parties agree to work C06,pelatively to accomplish all of the tenns of this Agreement,
however, acknowledge that there may be instances in which either the Tn"be or the Contractor
bas not complied with the conditions of this Agreement or that clarification is D"C""'Ill'Y to
Wtmplet provisions of this Agreement. In such an instance, the Tribe and the Contractor shall
attempt to resolve the matter through d;scusslons. If unsuccessful, the Tribe and the Coutl",,1or
agree to refer the matter to Don-binding 11lediation.
If the mediator cannot resolve the conflict or dispute then the issue shall be brought before a
Dispute Panel. The Dispute Panel shall review all issues, concerns and conflicts with a goal to
Pen Gamble S'KJaIIam Tribe - Jell'er.ion County PuhIlc HcaJtb
determine acceptable solutions for both Parties The decisions fthe Dispute Panel shall be final
and binding on both Pames.
DISPUTE PANEL: The Parties may voluntarily submit any COntIactual dispute to a dispute
paneI as follows: each party will appoint one member to the panel and those two members in turn
will appoint a third member. The dispute panel will review the facts. contract provisions and
applicable law. and then decide the matter. This provision does not affect the right of either party
to seek a legal recourse in a court of competent jurisdiction.
Section 12: TERMINATION
The Tn1le and the Contractor reserves the right to terminAf'fo! this contIact in whole or in part. with
30 days notice. In the event oftennination under this clause, the Tn1le shall be liable for only
payment for services rendered prior to the effective date of termination.
Section 13: INTEGRATED AGREEMENT
This Agreement together with attachments or addenda represents the entire and integrated
agreement between the Tn1le and the Contractor and supersedes all prior negotiations,
representations. or agreements written or om! between the parties. This agreement may be
amended or modified only by a written instrument signed by both Tn1le and ContIactor.
Section 14: PROGRAM MODEL ELEMENTS
The Tn1le and the ContIactor understand and agree that Program implem~on by Tn"be and
Contractor must be based on key parameters-Model Elements identified through research and
refined based upon the Program's experience since 1997 and attached to this agreement as
Exhibit B. Nurse-Family Partnership Model Elements.
Section 15: PROPRIETARY PROPERTY
The Tnoo and the ContIactor understand and agree that Nurse-Family Partnership grants to the
Tnoo and the Contractor a non-exclusive limited right and license to use the Proprietary P10pelty
for the purpose of carrying out the obligations of this contract Nurse-Family PlUtnetship
reserves the right to modify the Proprietary Property from time to time in accordance with the
data, research. and current modalities of deliveries Program. Nurse-Family Partnership shall
retain ownership and all the rights to any Proprietary Property. whether modified or not by the
Tn1le and/or the Contractor. In any event, ail software, Nurse-Family Partnership Community
and Efforts To Outcomes Website content, excluding the Tribes and Contractors data shall
remain the sole pulperty of Nurse-Family Partnership.
Port Gamble S'KlalJam Tribe - JelJ'erson CounIy Public Health
Approved this
day of
,2012,
, , Port Gamble S'Klallam Tribe
John Austin, Chair, Jefferson Board of County Commissioners
Approved as toe form Onlr:
&)..,J gyl3 '2
Jefferson Co. Prosecu Office
Port Gamble S'KlaIJam Tribe - Jefferson County Public Health S
ExhIbit A
Statement of Work
Nurse Family Partnership (NFP) Supervisor Role: Tune and Costs
Roms for adding 1 new nurse home visitor to the Jefferson County NFP team
ntbl ho
Mo IvS ms:
Team case 2 Halfin person, halfvia telephonelvideo
conferences
Team meetings 1 Half in person, halfvia telephondvideo
1:1 Supervision 4 Half in person, half via telephondvideo
Field supervision 8
Data 6
Conference calls 2
Consortium mtg 1
Annual Sup 3
. .
Prep for 1:1, 4
teammtll
Travel time 8 For supervision and community meetings
Advisory 4
boardffribal
board,
community
meetinllS
Data entry clerk 10
Port Gamble S'KlaIIam Tribe. JeffersoIl County Public Health
Exhibit B
o~ Nurse-~
-r-'Q\ Partnership
,J H<lpingFim-T_ P_StttatJ.
Nurse-Family Partnership
Model Bements
CUENTS
E1emeDt 1 Oient participates vo1untati1y in the Nume-PamiIy Partnership l>!usiam.
Nurse-Family PartneIShip servic:es are designed to be supportive and build self-efficacy.
VolUlltlUy enrollment promotes building trust between the client and her nume home
visitor. Choosing to participate empowers the client. InvolUlltlUy participation is
inconsistent with this goal It is understood that agencies may receive refenllls from the
legal system that could be experienced by the client as a requirement to participate. It is
essential that the decision to participate be between the client and her nurse without any
other pressure to enroll.
Element Z Oient is a first-time mother.
Fmt-time mother is a nulliparous woman. hllviog no live births. Nurse-Family
PartneIship is designed to take advanrage of the ecological ttansition. the window of
opportunity. in a fb:st-time mother's life. At this time of developmental change a woman
is feeling vulnemble and more open to support.
Element 3 Oient meets low-income cdteda at intake.
,
The E\mim study was open to women of all socioeconomic backgrounds. The
investigatots found that higher-income mothers had more n:soutCes available to them
outside of the propm. so they did not get as much benefit from the progmm. From a
cost-benefit and policy standpoint, it's better to focus the program on Iow-;n,""",,,
women.lmplem""ting agencies, with the support of the Nurse-Family Partnership
National Service Office, establish a threshold for low-income clients in the context of
their own community for their tatget population.
ro.....(!IIt 4 Oient is emolled in the program eady in her pregnancy and receives her first home
visit by no later than the end of the 2hweek of pregnancy.
A client is considered to be enrolled when she receives her fb:st visit and aIll.'~Ill''Y
forms have been signed. H the client is not enrolled during the initial home visit. the
m:mitment con"'.... should be recorded in the client file accorc:Iing to agency policy. It is
xecommended that only one pre-enrollment visit be provided. Early enrollment allows
time for the client and nurse home visitor to establish a relationship before the birth of
the child. and allows time to address prenatal health behaviors which affect birth
outcomes and the chikrs neurodevelopment. Additionally. program disllt>m;notion data
show that earlier entry into the progtlUl1 is related to longer stays during the infimcy
phase, increasing a client's exposure to the program and offering more opportunity for
behavior changes.
POll Gamble S'KIaIJam Tribe - Jetfersoo County Publlc Health
'N{Q~trnON CONTEXT
F.1.........t 5 Client is visited one-to-one: one JlU18e home mitor to one first-time mother/family.
Clients are visited one nurse home visitor to one flmt-time mother. The mother may
choose to have other supporting family membefS/ olgttifirqnt other{s) in ..ttend..n....
during scheduled visits. In particular. fitthers are Pnrrn~ to he part of visits when
possible and appropriate. The Oluse home visitor engages in a thempeutic nmse-client
telationsbip focused on promoting the client's philities and behavior change to protect
and promote her own health and the well-being of her clrild. It is important for nurse
home visitol:S to main1.llin professional hnt.,,,I~";es within the nurse-c:lient reIationsbip.
Some agencies have found it useful to have other 0l1tSeS on their team at times to
accompany the primary nurse home visitor for peer consultation. This helps the client to
understand that there is a team of nurse home visitors available and that this second
nUlSe home visitor could fill in if needed. This may reduce client attrition if the flmt
nUlSe is on leave or leaves the progaun. Other team members. such as a social wmker or
mental health specialist, may also accompany nurses on visits as part of the plan of care.
The addition of group activities to Pnh~n.... the progmm is allowed, but can not take the
place of the individual visits and can not he counted as visits. It is expected that clients
will have their own individual visits with their nurse. and not joint visits with other
clients.
Element 6 ClieDt is visited in her home.
The program is delivered in the client's home, which is Q{'fi'led as the place where she is
currently -'ding. Her home can be a shelter or a situation in which she is tempomrlly
living with fiunily or friends for the majority of the time (i.e., she sleeps there at least
four nights a week). It is understood that there may be times when the client's Iiving
situation or her work! school schedule make it dlffinut to see the client/child in their
home and the visit needs to take place in other settings. But whenever possible. visiting
the client and child in their home allows the nurse home visitor a better opportunity to
observe. assess and understand the client"s context and "M"PngeS.
Element 7 Client is visited throughout her pregnancy and the fhst two yeam oCher child's ore In
accordance with the current Nurse-Family Partnership Guid..lIfte&.
Prenatal visits occur once a week for the flmt four weeks, then every other week until the
baby is ham. Postpartum visits occur weekly for the flmt six weeks and then every other
week until the baby is 21 months. From 21-24 months visits are montllly. To meet the
needs of the individual fiunily, the nm:se home visitor may adjust the frequency of visits
and visit in the evening or on Wl'f'kPn"s. An expertati.,., that a home visitor is available
for regular contact with the family over a long period of time, even if homm.... do not use
the home visitor to the maximum level rec;ommPnr1e<\ can be a pol1leUul tool for
change.
@Copyrlght 2011 Nurse-FamlIy Partnership. AD rights reselVed.
Port Gamble S'KIalImn Tribe. Jefferson COIIIIly Public Health
peECTAnONS OF THE NURSES Ar:,ID.SUPERVlS08i
RI.....<:tat 8 Nurse home mtolll and nurse ....II'~.1.lors are tegistered professional nurses with a
...fmwnum of a Baccalaureate degree in ~.
When hiring, it is expected that nurse home visitor and nU!lle supervisor .."ndtrl~_ w.iII
be evaluated based on the individual nmses' background and levels ofknowledge. skills
and abilities taking into ~rl.....,,"1l the nurses' experience and PtI"<"l'tion. The BSN
degree is (;MdrlPretf to be the standard educational background for entry into public
health and provides background for this kind of work. For nurse supervisors, a Master's
degree in nmsing is preferred. It is understood that both education and ezr-iPnCl' are
important. Agencies may find it difficult to hire BSN-prepared nmses or may find well
prepared nurses that do not have a BSN. In _Iring this decision, agencies need to
consider each individual nurses' qualifications. and as needed, provide additional
professional development to meet the expectations of the role. Non-BSN nurses should
be encouraged and provided support to complete their BSN. Agencies and supervisors
can seek consultation on this issue from their nU!lle consultant.
Element 9 Nurse home v.lsitors and nurse supervisors complete core educational sessions
required by the Nurse-Family Partnership National Senrice Office and deliver the
intchCl1tlon with fidelity to the NFP Model.
It is the policy ofNU!lle-Family Partnership National Service Office (NFP NSO) that an
nurses employed to provide NFP services will attend and participate in an core NFP
education sessions in a timely IIIal111er, as is tlPfinM by NFP NSO policy and the NFP
NSO contract. NU!lle home visitom and nw:se supervisors w.iII deliver the progtml with
fidelity to the model. F1deIity is the extent to which impl........."11g agencies adhere to the
model elements when lmpl""""'''11g the progmm. Implementing these components
provides a high level of confidence that the outcomes acbieved by famili.... who enroll in
the progmm will be comparable to those achieved by families in the three mndomized,.
controlled triaJs.
~PP!.!CAnON OFjHE INTERVENTION
m;':"'ent 10 Nurse home Wdtors, using professional knowledge, judgment and skill, apply the
NUllIe-Family P..........hlp Visit-to-Visit Gnjdplln"".lndiv.Idm'~g them to the
strengths and "h..U....ges of each family and "i'J>u,.lnftUqJ time across defined
i'Iugtam dorn..I.....
The NFP VISit-to- VISit Guidelines are tools that guide nurse home visitom in the
delivery of progmm content. NU!lle home visitom use strength-based approaches to
working with famili.... and individualize the guidelines to meet the client's needs. The
domains include:
1) Pemonal Health (health maiol"Pn<lnce pmctices; nutrition and exercise; subslllnCe use;
mental health)
2) Environmental Health (home; work; school and neighborhood)
3) Life Course (fiunily p1~nni~ education and livelihood)
4) M~t'P1TI~1 Role (mothering role; physical care; behavioml and emotional care of child)
@Copyright2011 Nurse-FomDy Partnership. AD rights reserved.
Port Gamble S'K/aIIam Tribe - Jefti:n;on County Publle Hea\Ih
5) Friends and Family (personal ~twutk relationships; assistance with rhilrll"llre)
6) Health and Human Services (linking r..mi1i~ with needed refeaaIs and services)
Element 11 Nwse home visitors apply the theoretical framework that U11derpins the p~
emphAod'l.f"g Self,.Eflicacy, Human Ecology andJ\tta..hnl....t- theories. tbrough
....w;nt "'fni..... methods.
The underlyiug theories are the basis for the Nurse-Family Partnership Pr~ The
clinical methnrl. that are taught in the education sessions and promoted in the NFP
VISit-tO- VISit Gm(lpJ;..... are an expression of these thPnriPO, These theories provided the
fmmework that guided the development of the NFP VISit-to-VISit Guidelines. Nurse
Home VJSitor and Supervisor Competencies, and Nurse-Family Partnership Core
Education Sessions. They are a COIl$tant thread throughout the model and Nurse-Family
Partnership clinical nnnti..g practice.
Elemem 12 A full-time IlDtlle home visitor carries a c:aseJoad of DO more than 2S ac:dve clients.
Full time is considered a 4O-hour work week. Agencies may have a different rl..nnirinn
for full time, and should pro-mte the nurse's caseIoad accordingly. At least half-time
employment (2O-hour work week) is necessary in order for nurse home visitors to
become proficient in the delivery of the program model. Existing teams that already are
in place but do not meet these expectations should consult with their nurse N>n"\.1111nt.
Active clients are those who are receiving visits in accordance with the NFP VISit-to-
VISit G1.1k1PJ;""" and the plan established by the client and the nurse. In praclice, clients
are considered participating if they are having regular visits. Agencies can establish their
own poliri... regarding a tim..&Prne for di.....h~~"& mi","..g clients. It is expected that
supervisors will work with their nurse home visitors to monitor caseloads and utilize the
program to serve the number of r..",,1iPO they are funded to serve. The contmct between
the NFP National Service Office and the Implementing Agency states that the Agency
will:
1) Ensure enrollment of23 to 25 first-time mothers per full-time nurse home visitor
within nine months of~nni..g impt.....Pnfllt100; and
2) Ensure that each nurse home visitor carries a caseload of not more than 25 active
r..""Trpo; and
3) Maintain the appropriate visit schedule.
~ON AND CUNICAL SUPERVISION
Element :13 A full.time nurse lIapelvisor provides lIupervision to DO more than eight individual
IlDtlle home vildtors.
Full time is considered a 4O-hour work week. It is expected that a full-time nurse
supervisor can supervise up to eight individual nurse home visitors, given the
expectation for one-to-one supervision, prosmm development, referral management and
other administmtive tasks. It also is assumed that other administrative tasks may be
in..11'c1Prl in time dPc1iQlted to NFP, inr1ndi..g the supervision of some additional
@Copyright2011 Nurse-FamlIy Partnersh!p. AU rlghfs reselVed.
PGlt Gamble S'KIal1em Tribe. JefI'elsoD County Public Hea1th
administrative, cleric:a1 and interpreter staff Refer to the sample supervisor job
description found in the lmpIemmlisg Agenq Ol'imttdirm pfl&k8t The minimum time for a
nurse supervisor is 20 hours a week with a team of no more than four individual nurse
home visitors. Though NFP discourages """'11.... teams, even teams with less than four
nurse home visitors still requite at lesst a half-time supervisor. Existing teams that are
already in place but do not meet these expectations should consult with their nurse
consultant.
Element 14 Nume supetviso1s provide nume home vlsitom "llnfcalll11penision with retlec:tion,
dem......h..te iD~'''II(lD of the theories, and fAM1/tate professional development
essendal to the nume home visitor role through specific supervisory acthities
inclvdl'lg one-to-one clinical supervision, case ~Uri:e&, team meetiJJgs and
field supemsion.
To ensure that nurse home visitors are ..lini~lly competent and supported to implement
the Nurse-Family Partnership Program, nurse supervisonl provide clinical supervision
with reflection through specific supervisory activities. These activities include:
1) One-to-one clinical sqpervision: A meeting between a nurse and supervisor in one-to-
one weekly, one-hour sessions for the purpose of ref1ectiog on a nurse's work In..htd;.,g
management of her cascload and quality assmance. Supervisors use the principles of
reflection as outlined in NFP supervisor tmlning. Supervisors who carry a cascload will
make lIl:l:llIIgCDlets for cIinica1 supervision with <<,flection from a qualified person other
than the nurse home visitots he/she supervises.
2) (':0.,. conr.."""<:cs: Meetiogs with the team dedicated to joint review of cases, Efforts
to Outcomes (ETOTM) data reports and charts using reflection for the purposes of
solution Boding, problem solving and professional growth. Experts from other
disclpli'letl are Invited to participate whee such input would be helpful. Case confereoces
reinforce the reflective process. Case conferences are to be held twice a month for 1 %
to 2 hours per case ..nnfereno;:e.
3) Team meetlrtg!l: Meetings held for administmtive pmposes. to discuss progtam
implemeetation issues, and team building twice a month for at least an hour or as
needecl for team meetings. Team meetings and case conferences altemate weekly so
there is one meeting of the team every week.
4) Field sqpervision: Joint home visits with supervisor and nurse. Every four mnnths the
supervisor makes a visit with each nurse to at least one client aod additional visits on ao
as needed basis at the nurse's request or if the supervisor bas concems. At a minimum,
time spent should be 2 - 3 hours per nurse every four months. Some supervisonl prefer
to spend a full day with muses, enabling them to observe comprehensively the nurse's
typical day as well as her home visit, time and case management skills and charting. After
joint home visits with a supervisor and nurse, a Visit Tmp''''''","tation Scale is completed
aod discussed.
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Port Gamble S'KIa1Jam Tribe - Jefferson County Public HeaJtb
t.ROGI<<AM MONITORING AND USE OF DATA
Rt.....~ 15 Nwse home yWtors liIIld JlUl8e supetriaom c:oDect data as specified by the Nwse-
Family P~hip N'ltiOft,,1 Service Oflice liIIld use NFP ""'I>vtts to guide thelr
pmc:dce, assess liIIld guide program implementation. iDfoan "I/nl"". supervfsion.
enhance px~_ quality liIIld demonstrate program fidelity.
Data are coIlec:ted. entered into the ETO softwue and subsequently used to address
pmctice. Data are nt'1i...,.n to guide impIOVf'mPnt!l in progmm implementation and
demoosttate fidelity. The ETO r:epo1tll are tools with which nU1Se home visitots and
supervisots assess and manage areas where system, o~"i""tinoiJ, or operational
changes are needed in order to enhance the ovemll quality of program opemtions and
infonn reflective ll11perrision of each nw:se. It is expected that both supetVisol:s and
nurse home visitom will review and utilize their data.
AGENCY
Rt.....et>t 16 A Nwse-FamIly Partn..w.fp ImpIememiDg Agency is I~ In and operated by an
organization Imown In the community for being a encce&sful provider of
l>1"vcntion services to Iow-Inc:ome families.
An Implementing Agency is an organization <:Ommitted to providing intemal and
extemal advocacy and support for the NFP program. This agency also will provide
visible I....._hip and passion for the prognun in their commnnity and assure that NFP
staff members are provided with all tools necessary to assure program fidelity.
Rlt.matt 17 A Nutlle-FamIly Pattn.....hfp ImpJ.em....t11'lg Agency CGlm:ue& a Iong-tenn
Commwdty Advlsory Board that meets at least quarterly to promote a
commwdty SUI>}>v4t system for the Pro&"au.. and to promote ptogtam quality and
sustafnabllity.
A Community Advisoty Board is a group of <:Ommitted individuals/otganlzatinos who
share a passion for the NFP prognun and whose expertise can advise, support and
sustain the program over time. The agency builds and maintains community partne18bips
that support implementation and provide resources. If an agency can not create a group
specifically dedicated to the Nurse-Family Parttt"""hip program. and larger groups are in
place that have a similar mission and role dedicated to providing services to low-i"'""O"l"
mothets, chi1dren and fimu1i"8, it is acceptable to participate in these groups in place of a
NFP dedirntl"rl group. It is essential that issues important to the impl,.",,,,,,"'tinn and
sus",i".hffity of the NFP program are brought forward and addressed as ".wed
m.........t 18 Adequate support and structnre shall be In pisce to ....Pt>urt 11UtlIe home visitors and
nutse supetriaom to implement the program liIIld to assure that data are
a(;' ...n''''1 ente1ed Into the database in a timelymanncr.
Support includes the necessary infmsttucture to support and implement the program.
This includes the necessary physical space. desks. computers, cell phones, filing cabinets
and other infmsttucture to carry out the program. Further, this includes employiDg a
person primarily usponsible for key administtative support tasks for
@COpyrlght2011 Nurse-FamIly Partnershlp. AD rlghts reserved.
POll 0mnbIe S'KIaIIam Tribe. Jefferson County Public Health
NFP ~ as well as ....mnl1g data and maintaining A"""....c:y ofETO repotl:a. This
J:ellOUtCC is cdtica1 to """''"''B administrative Sl.lpp,nt and accuracy of data entry.
aIIowing muse home vioitua lime to focus on their pthw., mIe of providing semces to
clients. NFP bplP1nPf>ft~Agencies sbaIl employ at least one 0.5 F1'E geaeml .
admiaisuative SllIff nvom\)et- per 100 c:Iieots to suppun the muse home visitors and muse
supetrisonl and to accurately enter data into the NUDe-FamIly P~hip National
Sel:rice Office ETO nAtabaR on . timely basis.
R""'HPn....
I<"nm",."he>-.J..JC'_n,H..&OIds.D. (1998) Intetvention processes as p-*f"tntsof C".'!> (.,.og in.
pte9'eDtive home-visitation pmgmm. J011T716/ of': ..nib P~ 26, 49-64.
OIds. D. (2006) The muse.fiImi1y pattnetsh.lp: An evidenee-based pI('4....,tt.,c: itlte...,ulion. I/fftmI Mmrtm
HIIJII/J JfIHf1IIII. 27, 5-25-
OIds. D., HiD. p.. O'Brien, R., Racine, D.. &: Moritz, P. (2003) Taking ~.c:utl.c: intervention to scale:
The nw:se-fiunlly pattnetsbip. CogniJilII41lIIlW- ".~uJ PnzttiR, 10, 278-290.
OIds, D.. Racine, D.. GIazner,J.. &: IC1t7.mA,,\ H. (1998) J""....,,,.;~ the policy and pmgcun relevance of
results from m,.,nn.,..;......! trials of home visitation. J011T716/ ofOmmtJm;g Pg.lJoll1gy. 26, 85-100.
Port 0ambI0 S'KIaIIam Tribe - Jeft"ersoD County Public HeaIlIl