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HomeMy WebLinkAbout010317_ca05615 Sheridan Street Port Townsend, WA 98368 Aff'f on www.JeffersonCountyPublicHealth.org Public HeConsent Agenda December 6, 2016 JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners Philip Morley, County Administrator FROM: Vicki Kirkpatrick, Director DATE: I I '3 ! ao)l SUBJECT: Agenda Item — Contract Agreement between Kitsap Public Health District and Jefferson County Public Health; January 1, 2017 — December 31, 2017; $49,537.12 STATEMENT OF ISSUE: Jefferson County Public Health, Community Health, requests Board approval of the Contract Agreement with Kitsap Public Health District and Jefferson County Public Health; January 1, 2017 — December 31, 2017; $49,537.12. ANALYSIS/ STRATEGIC GOALS/PRO'S and CON'S: This Agreement allows the Kitsap Public Health District to continue its participation in the evidence -based Nurse Family Partnership program under the umbrella of JCPH. This is the continuation of a 14 -year, regional partnership that allows JCPH to provide infrastructure support in the form of nursing supervision to the Kitsap Public Health District. This approach helps provide needed services to smaller communities not able to support evidence -based programs on their own. FISCAL IMPACT/COST BENEFIT ANALYSIS: The Contract Agreement is based on an annual fee for NFP nursing supervision for three NFP nurses. This Agreement also has provisions for travel and mileage at current GSA rates, and stipulations regarding extra services and or required purchases. RECOMMENDATION: JCPH management request approval of the Contract Agreement with Kitsap Public Health District and Jefferson County Public Health for NFP nurse supervision; January 1, 2017 — December 31, 2017; $49,537.12. �; :�r Nib12-19 tl�6 Community Health Environmental Health Developmental Disabilities Water Quality 360-385-9400 360-385-9444 360-385-9401 (t) Always working for a safer and healthier community (t) 360-379-4487 CONTRACT AGREEMENT By and Between Kitsap Public Health District and Jefferson County Public Health For provision of one (1) Public Health Nurse for Nurse Family Partnership (NFP) Supervisor Role Section l: PURPOSE: THIS AGREEMENT for Professional Services is entered into between the Kitsap Public Health District (KPHD), hereinafter referred to as "District" and Jefferson County Public Health (JCPH), hereinafter referred to as "Contractor" to provide services as a Nurse Family Partnership Supervisor. Section 2: TERMS: This Agreement shall commence on January 1, 2017 and continue through December 31, 2017, unless terminated as provided herein. The agreement may be extended beyond December 31, 2017, upon mutual written consent of the District and the Contractor. Section 3: SCOPE OF AGREEMENT: Contractor will provide Public Health Nurse services for NFP Supervisor Role and will meet obligations as contained in Exhibit A, Statement of Work. Section 4: CONTRACT REPRESENTATIVES: District and Contractor will each have a contract representative who will have responsibility to administer the contract for that party. A party may change its representative upon providing written notice to the other party. The parties' representatives are as follows: Kitsap Public Health District Contract Representative Suzanne Plemmons, Community Health Director 345 6th Street, Suite 300 Bremerton, WA 98337 (360) 337-5263 Contractor's Contract Representative Vicki Kirkpatrick, Director Jefferson County Public Health 615 Sheridan St. Port Townsend, WA 98368 (360) 385-9400 Section 5: COMPENSATION: District agrees to provide the following: A. Pay Contractor an annual fee for regular supervision of $49,537.12 for services to District for NFP supervisory role, which may be billed monthly at the rate of $4,128.09 or quarterly at the rate of $12,384.28, whichever is agreed upon by the District and the Contractor. B. In addition, District will provide reimbursement for travel and mileage incurred in connection with provision of stated services at the current year's GSA reimbursement rate. The District will be billed quarterly for travel and mileage. Kitsap Public Health District — Jefferson Country Public Health- KPHD Contract C. Any additional fees required by NFP for training will be split between the District, Port Gamble S'Klallam Tribe, and the Contractor. D. In the case approved program supplies required by NFP are unavailable for direct purchase, Contractor will purchase supplies and bill District for incurred cost. E. The District may request additional nursing supervisory hours at an hourly rate commensurate to Contractor's employee's hourly rate. In the case of emergency nursing supervisory needs, District will be charged and hourly rate. F. Contractor records and accounts pertaining to this agreement are to be kept available for inspection by representatives of the Health District and state for a period of six (6) years after final payments. Copies shall be made available upon request. Section 6: INDEMNIFICATION: Each party shall indemnify, defend and hold harmless the other party, its officers, agents, and employees, from and against any and all claims, lawsuits, demands for money damages, losses or liability, or any portion thereof, including attorney's fees and costs, arising from any injury to person or persons (including the death or injury or damage to property) caused by the negligent act or omission of the first party or its employees or representatives. In the event of damages, losses, or liability caused by or resulting from the concurrent negligence of the parties, their officers, agents and employees, each party's liability hereunder shall be only to the extent of that party's negligence. It is further specifically and expressly understood that the indemnification provide herein constitutes the each party's waiver of immunity under Industrial Insurance, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually negotiated by the parties. The provisions of this section shall survive the expiration or termination of this Agreement. Section 7: INSURANCE: Each party shall obtain and keep in force during the terms of this Agreement, or as otherwise required. A. Commercial Automobile Liability Insurance providing bodily injury and property damage liability coverage for all 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 occurrence. B. Professional Liability Insurance providing $2,000,000 per incident; $4,000,000 aggregate. C. Each party shall participate in the Worker's Compensation and Employer's Liability Insurance Program as may be required by the State of Washington. D. The Contractor will maintain its membership in the Washington Counties Risk Pool. Section 8: CONFIDENTIALITY: All parties to this Agreement and their employees or representatives and their subcontractors and their employees will maintain the confidentiality of all information provided by Contractor or Kitsap Public Health District — Jefferson Country Public Health- KPHD Contract District or acquired in performance of this Agreement as required by the HIPPA and other privacy laws. This Contract, once executed by the parties, is and remains a Public Record subject to the provision of Ch. 42.56 RCW, the Public Records Act. Section 9: OWNERSHIP AND USE OF DOCUMENTS The Contractor acknowledges and agrees that any and all work product directly connected to and/or associated with the services rendered hereunder, including but not limited to all documents, drawings, reports, and the like which the Contractor in the performance of the service hereunder, either solely and/or jointly with the District shall be the sole and exclusive property of the District. Other materials produced by the Contractor in connection with the services rendered under this agreement shall be the property of the District 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 produced during the course of the Project to the extent disclosure is allowed by HIPAA. Section 10: 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 District employees by virtue of the services provided under this agreement. The District shall not be responsible for withholding or otherwise deducting federal income tax or social security or for contributing to the state industrial insurance program, otherwise assuming the duties of an employer with respect to employee. Section 11: REPORTING The Contractor will provide a report to the District, whichever is agreed upon by the District and the Contractor, for payment for services rendered. The report shall contain a brief summary of the work performed, relationship to the tasks identified in Exhibit A, and the total lines generated. Section 12: DISPUTE RESOLUTION The Parties agree to work cooperatively to accomplish all of the terms of this Agreement, however, acknowledge that there may be instances in which either the District or the Contractor has not complied with the conditions of this Agreement or that clarification is necessary to interpret provisions of this Agreement. In such an instance, the District and the Contractor shall attempt to resolve the matter through discussion. If unsuccessful, the District and the Contractor agree to refer the matter to non-binding mediation. 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 determine acceptable solutions for both Parties. The decisions of the Dispute Panel shall be final and binding on both Parties. DISPUTE PANEL: The Parties may voluntarily submit any contractual dispute to a dispute panel 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 Kitsap Public Health District — Jefferson Country Public Health- KPHD Contract 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 13: TERMINATION The District and the Contractor reserve the right to terminate this contract in whole or in part with 30 days notice. In the event of termination under this clause, District shall be liable only for payment for services rendered prior to the effective date of termination. Section 14: INTEGRATED AGREEMENT This Agreement together with attachments or addenda represents the entire and integrated agreement between the District and the Contractor and supersedes all prior negotiations, representations, or agreements written or oral between the parties. This agreement may be amended or modified only by a written instrument signed by both District and Contractor. Section 15: PROGRAM MODEL ELEMENTS District and the Contractor understand and agree that Program implementation by District 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 16: PROPRIETARY PROPERTY The District and the Contractor understand and agree that NFP grants to the District and the Contractor a non-exclusive limited right and license to use the Proprietary Property for the purpose of carrying out the obligations of this contract. Further, the NFP reserves the right to modify the Proprietary Property from time to time in accordance with the data, research, and current modalities of deliveries program. NFP shall retain ownership and all the rights to any Proprietary Property, whether modified or not by the District and/or the Contractor. In any event, all software, Nurse -Family Partnership Community and Efforts to Outcomes Website content, excluding the District's and Contractor's data, shall remain the sole property of Nurse -Family Partnership. Approved this day of 32016. Keith Grellner, Administrator, Kitsap Public Health District Kathleen Kler, Chair, Jefferson Board of County Commissioners 6w , Kitsap Public Health District — Jefferson County Public Health- KPHD Contract Approved as to form Exhibit A Statement of Work Model Elements implemented through facilitation by Nurse Supervisor—applies to all sites (based on last contract, subject to change): Model element and JCPH 1KPHD PGST Nurse Home visitors # 2 3 1 Model Elements implemented through facilitation by Nurse Supervisor—applies to all sites (based on last contract, subject to change): Model element and JCPH KPHD PGST description #10, Work with NHVs to X X X increase knowledge, practice, and individualization of NFP visit to visit guidelines with families across all domains. #11, Work with NHVs to X X X review and reflect on theoretical bases of NFP as related to clinical practice. #12, Work with NHVs and X X X team to maintain required number of clients. Includes caseload management, outreach, referrals and maintaining community relationships. #13, Nurse supervisor X X X provides supervision to 6 NHVs at this time, appropriate for .875FTE Nurse supervisor #14, Nurse supervisor provides: 1. Weekly clinical X X X supervision 2. Case X X X conferences 3. Team meetings X X X 4. Field Supervision X X X #15 Data is collected and X X X used to guide practice, assess and guide program implementation, inform clinical supervision, enhance program quality, and demonstrate program fidelity. #17, Regional CAB X X X convened and will meet at least 3x year #18, Nurse supervisor will X X X help support and facilitate regional communication to Kitsap Public Health District – Jefferson County Public Health- KPHD Contract assure accurate data entry and implementation of nroaram Other related program implementation areas: Other areas related JCPH KPHD PGST to program implementation NFP Tribal Community of 0 0 Quarterly phone calls or Practice in-person meetings with NFP Tribal Nurse consultant, quarterly Tribal COP calls or in-person meetings. Additional communication with NFP Nurse consultant as needed. Washington State NFP X X X Consortium: 1. Monthly calls with WA State Nurse consultant 2. Monthly calls with WA State Nurse supervisors 3. Quarterly meetings with WA State nurse supervisors 4. On-site visits with WA state nurse consultant at least once/year. Coordination of team X X X meetings, case conferences, and reflective supervision times based on regional composition, including associated travel. Thrive by Five X X 0 Funding: application, Monthly and quarterly reports. NFP required Education X X X and training, such as DANCE education and annual NFP National Symposium Kitsap Public Health District — Jefferson County Public Health- KPHD Contract Exhibit B Nurse -Family Partnership Model Elements Ya-aj*y Partnershio Helping l=int -!'rote f1dreno Sitrcredrt• CLIENTS Element 1 Client participates voluntarily in the Nurse -Family Partnership program. Nurse -Family Partnership services are designed to be supportive and build self-efficacy. Voluntary enrollment promotes building trust between the client and her nurse home visitor. Choosing to participate empowers the client. Involuntary participation is inconsistent with this goal. It is understood that agencies may receive referrals 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 2 Client is a first-time mother. First-time mother is a nulliparous woman, having no live births. Nurse -Family Partnership is designed to take advantage of the ecological transition, the window of opportunity, in a first-time mother's life. At this time of developmental change a woman is feeling vulnerable and more open to support. Element 3 Client meets low-income criteria at intake. The Elmira study was open to women of all socioeconomic backgrounds. The investigators found that higher -income mothers had more resources available to them outside of the program, so they did not get as much benefit from the program. From a cost -benefit and policy standpoint, it's better to focus the program on low-income women. Implementing 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 target population. Element 4 Client is enrolled in the program early in her pregnancy and receives her first home visit by no later than the end of the 28th week of pregnancy. A client is considered to be enrolled when she receives her first visit and all necessary forms have been signed. If the client is not enrolled during the initial home visit, the recruitment contact should be recorded in the client file according to agency policy. It is recommended 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 child's neurodevelopment. Additionally, program dissemination data show that earlier entry into the program is related to longer stays during the infancy phase, increasing a client's exposure to the program and offering more opportunity for behavior changes. © Copyright 2011 Nurse -Family Partnership. All rights reserved. Kitsap Public Health District — Jefferson County Public Health- KPHD Contract 7 INTERVENTION CONTEXT Element 5 Client is visited one-to-one: one nurse home visitor to one first-time mother/family. Clients are visited one nurse home visitor to one first-time mother. The mother may choose to have other supporting family members/ significant other(s) in attendance during scheduled visits. In particular, fathers are encouraged to be part of visits when possible and appropriate. The nurse home visitor engages in a therapeutic nurse -client relationship focused on promoting the client's abilities and behavior change to protect and promote her own health and the well-being of her child. It is important for nurse home visitors to maintain professional boundaries within the nurse -client relationship. Some agencies have found it useful to have other nurses 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 nurse home visitor could fill in if needed. This may reduce client attrition if the first nurse is on leave or leaves the program. Other team members, such as a social worker or mental health specialist, may also accompany nurses on visits as part of the plan of care. The addition of group activities to enhance the program is allowed, but can not take the place of the individual visits and can not be 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 Client is visited in her home. The program is delivered in the client's home, which is defined as the place where she is currently residing. Her home can be a shelter or a situation in which she is temporarily living with family 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 living situation or her work/school schedule make it difficult 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 challenges. Element 7 Client is visited throughout her pregnancy and the first two years of her child's life in accordance with the current Nurse -Family Partnership Guidelines. Prenatal visits occur once a week for the first four weeks, then every other week until the baby is born. Postpartum visits occur weekly for the first six weeks and then every other week until the baby is 21 months. From 21-24 months visits are monthly. To meet the needs of the individual family, the nurse home visitor may adjust the frequency of visits and visit in the evening or on weekends. An expectation that a home visitor is available for regular contact with the family over a long period of time, even if families do not use the home visitor to the maximum level recommended, can be a powerful tool for change. © Copyright 2011 Nurse -Family Partnership. All rights reserved. Kitsap Public Health District — Jefferson County Public Health- KPHD Contract EXPECTATIONS OF THE NURSES AND SUPERVISORS Element 8 Nurse home visitors and nurse supervisors are registered professional nurses with a minimum of a Baccalaureate degree in nursing. When hiring, it is expected that nurse home visitor and nurse supervisor candidates will be evaluated based on the individual nurses' background and levels of knowledge, skills and abilities taking into consideration the nurses' experience and education. The BSN degree is considered 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 nursing is preferred. It is understood that both education and experience are important. Agencies may find it difficult to hire BSN -prepared nurses or may find well prepared nurses that do not have a BSN. In making 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 nurse consultant. Element 9 Nurse home visitors and nurse supervisors complete core educational sessions required by the Nurse -Family Partnership National Service Office and deliver the intervention with fidelity to the NFP Model. It is the policy of Nurse -Family Partnership National Service Office (NFP NSO) that all nurses employed to provide NFP services will attend and participate in all core NFP education sessions in a timely manner, as is defined by NFP NSO policy and the NFP NSO contract. Nurse home visitors and nurse supervisors will deliver the program with fidelity to the model. Fidelity is the extent to which implementing agencies adhere to the model elements when implementing the program. Implementing these components provides a high level of confidence that the outcomes achieved by families who enroll in the program will be comparable to those achieved by families in the three randomized, controlled trials. APPLICATION OF THE INTERVENTION Element 10 Nurse home visitors, using professional knowledge, judgment and skill, apply the Nurse -Family Partnership Visit -to -Visit Guidelines, individualizing them to the strengths and challenges of each family and apportioning time across defined program domains. The NFP Visit -to -Visit Guidelines are tools that guide nurse home visitors in the delivery of program content. Nurse home visitors use strength -based approaches to working with families and individualize the guidelines to meet the client's needs. The domains include: 1) Personal Health (health maintenance practices; nutrition and exercise; substance use; mental health) 2) Environmental Health (home; work; school and neighborhood) 3) Life Course (family planning, education and livelihood) 4) Maternal Role (mothering role; physical care; behavioral and emotional care of child) 5) Friends and Family (personal network relationships; assistance with childcare) 6) Health and Human Services (linking families with needed referrals and services) C Copyright 2011 Nurse -Family Partnership. All rights reserved. Kitsap Public Health District — Jefferson County Public Health- KPHD Contract Element 11 Nurse home visitors apply the theoretical framework that underpins the program, emphasizing Self -Efficacy, Human Ecology and Attachment theories, through current clinical methods. The underlying theories are the basis for the Nurse -Family Partnership Program. The clinical methods that are taught in the education sessions and promoted in the NFP Visit -to -Visit Guidelines are an expression of these theories. These theories provided the framework that guided the development of the NFP Visit -to -Visit Guidelines, Nurse Home Visitor and Supervisor Competencies, and Nurse -Family Partnership Core Education Sessions. They are a constant thread throughout the model and Nurse -Family Partnership clinical nursing practice. Element 12 A full-time nurse home visitor carries a caseload of no more than 25 active clients. Full time is considered a 40 -hour work week. Agencies may have a different definition for full time, and should pro -rate the nurse's caseload accordingly. At least half-time employment (20 -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 consultant. Active clients are those who are receiving visits in accordance with the NFP Visit -to - Visit Guidelines and the plan established by the client and the nurse. In practice, clients are considered participating if they are having regular visits. Agencies can establish their own policies regarding a timeframe for discharging missing 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 families they are funded to serve. The contract between the NFP National Service Office and the Implementing Agency states that the Agency will: 1) Ensure enrollment of 23 to 25 first-time mothers per full-time nurse home visitor within nine months of beginning implementation; and 2) Ensure that each nurse home visitor carries a caseload of not more than 25 active families; and 3) Maintain the appropriate visit schedule. REFLECTION AND CLINICAL SUPERVISION Element 13 A full-time nurse supervisor provides supervision to no more than eight individual nurse home visitors. Full time is considered a 40 -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, program development, referral management and other administrative tasks. It also is assumed that other administrative tasks may be included in time dedicated to NFP, including the supervision of some additional © Copyright 2011 Nurse -Family Partnership. All rights reserved. Kitsap Public Health District — Jefferson County Public Health- KPHD Contract 10 administrative, clerical and interpreter staff. Refer to the sample supervisor job description found in the Implementing_Agencg Orientation Packet. 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 smaller teams, even teams with less than four nurse home visitors still require at least 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 Nurse supervisors provide nurse home visitors clinical supervision with reflection, demonstrate integration of the theories, and facilitate professional development essential to the nurse home visitor role through specific supervisory activities including one-to-one clinical supervision, case conferences, team meetings and field supervision. To ensure that nurse home visitors are clinically competent and supported to implement the Nurse -Family Partnership Program, nurse supervisors provide clinical supervision with reflection through specific supervisory activities. These activities include: 1) One-to-one clinical supervision: A meeting between a nurse and supervisor in one-to- one weekly, one-hour sessions for the purpose of reflecting on a nurse's work including management of her caseload and quality assurance. Supervisors use the principles of reflection as outlined in NFP supervisor training. Supervisors who carry a caseload will make arrangements for clinical supervision with reflection from a qualified person other than the nurse home visitors he/she supervises. 2) Case conferences: Meetings with the team dedicated to joint review of cases, Efforts to Outcomes (ETOTm) data reports and charts using reflection for the purposes of solution finding, problem solving and professional growth. Experts from other disciplines are invited to participate when such input would be helpful. Case conferences reinforce the reflective process. Case conferences are to be held twice a month for 1 '/2 to 2 hours per case conference. 3) Team meetings: Meetings held for administrative purposes, to discuss program implementation issues, and team building twice a month for at least an hour or as needed for team meetings. Team meetings and case conferences alternate weekly so there is one meeting of the team every week. 4) Field supervision: Joint home visits with supervisor and nurse. Every four months the supervisor makes a visit with each nurse to at least one client and additional visits on an as needed basis at the nurse's request or if the supervisor has concerns. At a minimum, time spent should be 2 — 3 hours per nurse every four months. Some supervisors prefer to spend a full day with nurses, 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 Implementation Scale is completed and discussed. © Copyright 2011 Nurse -Family Partnership. All rights reserved. Kitsap Public Health District — Jefferson County Public Health- KPHD Contract 11 PROGRAM MONITORING AND USE OF DATA Element 15 Nurse home visitors and nurse supervisors collect data as specified by the Nurse - Family Partnership National Service Office and use NFP reports to guide their practice, assess and guide program implementation, inform clinical supervision, enhance program quality and demonstrate program fidelity. Data are collected, entered into the ETO software and subsequently used to address practice. Data are utilized to guide improvements in program implementation and demonstrate fidelity. The ETO reports are tools with which nurse home visitors and supervisors assess and manage areas where system, organizational, or operational changes are needed in order to enhance the overall quality of program operations and inform reflective supervision of each nurse. It is expected that both supervisors and nurse home visitors will review and utilize their data. AGENCY Element 16 A Nurse -Family Partnership Implementing Agency is located in and operated by an organization known in the community for being a successful provider of prevention services to low-income families. An Implementing Agency is an organization committed to providing internal and external advocacy and support for the NFP program. This agency also will provide visible leadership and passion for the program in their community and assure that NFP staff members are provided with all tools necessary to assure program fidelity. Element 17 A Nurse -Family Partnership Implementing Agency convenes a long-term Community Advisory Board that meets at least quarterly to promote a community support system for the program and to promote program quality and sustainability. A Community Advisory Board is a group of committed individuals/ organizations who share a passion for the NFP program and whose expertise can advise, support and sustain the program over time. The agency builds and maintains community partnerships that support implementation and provide resources. If an agency can not create a group specifically dedicated to the Nurse -Family Partnership program, and larger groups are in place that have a similar mission and role dedicated to providing services to low-income mothers, children and families, it is acceptable to participate in these groups in place of a NFP dedicated group. It is essential that issues important to the implementation and sustainability of the NFP program are brought forward and addressed as needed. Element 18 Adequate support and structure shall be in place to support nurse home visitors and nurse supervisors to implement the program and to assure that data are accurately entered into the database in a timely manner. Support includes the necessary infrastructure to support and implement the program. This includes the necessary physical space, desks, computers, cell phones, filing cabinets and other infrastructure to carry out the program. Further, this includes employing a person primarily responsible for key administrative support tasks for © Copyright 2011 Nurse -Family Partnership. All rights reserved. Kitsap Public Health District — Jefferson County Public Health- KPHD Contract 12 NFP staff, as well as entering data and maintaining accuracy of ETO reports. This resource is critical to ensuring administrative support and accuracy of data entry, allowing nurse home visitors time to focus on their primary role of providing services to clients. NFP Implementing Agencies shall employ at least one 0.5 FTE general administrative staff member per 100 clients to support the nurse home visitors and nurse supervisors and to accurately enter data into the Nurse -Family Partnership National Service Office ETO database on a timely basis. References Korfmacher, J., Kitzman, H., & Olds, D. (1998) Intervention processes as predictors of outcomes in a preventive home -visitation program. Journal of Community Pychology, 26, 49-64. Olds, D. (2006) The nurse -family partnership: An evidence -based preventive intervention. Infant Mental Health Journal, 27, 5-25. Olds, D., Hill, P., O'Brien, R., Racine, D., & Moritz, P. (2003) Taking preventive intervention to scale: The nurse -family partnership. Cognitive and Behavioral Practice, 10, 278-290. Olds, D., Racine, D., Glazner, J., & Kitzman, H. (1998) Increasing the policy and program relevance of results from randomized trials of home visitation. Journal of Community Pychology, 26, 85-100. Kitsap Public Health District — Jefferson County Public Health- KPHD Contract 13