HomeMy WebLinkAboutAgenda - 09-01-1998 - 8kORANGE COUNTY
BOARD OP COMMI$$IONERS
ACTION AGENDA REM ABSTRACT
Meetwg Date:S<pmmber 1, 1998
Anion Agenda
[temp B-I[
SubjM: to-Home Bremd'eeding Support Program Grant Application
Depanmevt: Ccapemdve Fattmion Service Poblic Hmrivg: _Ym _X_ No
Hodge[ Ameodmeu[ RegnRW: _Yn _X_ No
ARachmmQa): Breas6'cedivg Program Appgmticv Nformvsiou Covmn:
Alice Penitt, ]J2-8181, ex[. 2054
TeRphone NumBen:
FBlleborough ]32-8181
Dmhw 688-]331
Mebeve 22]-2031
Cbepel Hill 9b]-9251
purpose: To reque8 pemuasiw w submit a g,uu eppBmaw w the Kme B. Reynolds Clurimble Tma to
requen firndivg for w In-HOnm Breaetfading Support Progrmn.
Badsgmubd: The Ls-Home BreasVttdivg Support program will be ajoim partonsbip between COOpmmive
A:dmaov Service, evd the Omnge Coumy Hdt6 Depmbnrnt, Piedmom Health Services, Inc.,
ant IINC Hospitals. 'Ibis BrouP ~ bcev:veeti°$ to drefl Bm B~ aPPIi<etiov. The pmgrem
w81 be modeled e8m adeting programs admisdemed BY the Cvaperative 6nmeiw Service m
,,:.,. wuvtim.
Breertfeedivg provide vuvy heekh bevefits wrthe mother avd hen child. BreWfed bebiw
have fawn mr ivfxaom, kse wmYPe4on avd dimrhu, etrovgn eM sbughter tmh, sM a
Nghm lQ [Ben fosmnla fed babies. Bsmmfadivg women me mom Bketywrnurv to they pro-
pregvmscy weight evd have a reduced vk ofoverian wd prenunopauml bremt cancer. In
eddidmr, h promata a close evd loving reLtivnaMP Between smtlmr and baby end is
ewwmi<a8y the bent source ofmrWSiw for ivfws.
T1m god ofthe pro8mm ie w Provide We support vended to as®at WIC and WIC eBgible
womev iu thw eewmto vitiate end cominue breestfeedivg. BY mvebve vmwenwWeu
efforts to breastfeed, the heats ofivfwm and women m Orange Cowry w81 be'unprovW.
The grmrc eppecation request dmdin$ for thrre yeah Bom [Cate B. Aeyvolda Tmrt to hue two
brmstfeeding Drogmm maimems ant one edndmatmvve assisuvt to work wiN WIC wd WIC
eligible rvmhms to educate them on bsmsReedivg, make hospiW virus aRm delivery, wd make
horse vieua ro mochas widw 72 horns ofhoapiW discharge to mppart tbev breestfeedmg
<BOtl9.
Recommevdetiov: The Matuger recommends that the Board eppmve the submittil oFlhe gent
apphmtioq and authorize the chair to sign the apphcation.
Io-Home BreasHeediag Support Pregrem
Grant Proposal
Gran[ [o be submitted to Kate B. Reynolds Charimble Trust m Winston Salem
by September I5, 1998
-- Application requires signature of County Extension Direttor and Chairman of
the Board of County Commissioners, a well as a listing of Board of
Commissioners members
-- In-Home Breastfeeding Support Program will be modeled after existing
programs administered by the Cooperative Exknsioo Service in rdne couvtia.
-- Grant proposal is for 3 year funding tomlling 53'19,508.00.
-- In-Home Breaslfeeding Support Program is join[ paMership betwern:
--Cooperative Exfmsiou Service
--Orange County HeaIN Department
--Piedmont Health Service, Inc.
-I1NC Hospitals
-- Objectives:
--Increau breatfeeding'utitiation rotes from 48% m 60%by the year 2002
--Increase brastfeeding duration mks at 6 weeks postparmrtr 6om 26% to 35%
by year 2002
--Increase breasHeeding duration rata at 6 months postpartum from l6% m 25%
by the Yeaz 2002
--Fifty percent of W[C and WIC-eligible pregnanVpostpartum women will enroll
in the to-Home Breaslfceding Support Program by rnd of year 2
-- Stall
-Two Brcatfeedivg Program Assistants (PA's)
--One support staff-administrative assismvt
--Staff will be supervised by Cooperative Exteaion Service
--Staff proposed to be hued March 1999 from grant funds
--In-kind Cunds would come liom smte Cooperative Extension Service budge[
(Expanded Foods and Nutriliop Program) and cowry Cooperative EMwsion
Service regulm budget
KATE B. REYNOLDS
CHARITABLE TRWT
Health Care Division Grant Application
Part 1: The Organization
Name of Oroe~}oi on Coopernfive Es¢nsion Service, Orange County Cenmr
S~reec AddressrP.O. Bos: l06 E Revere Rd. P.O. Box 8181
S:itY: Hillsborough, NC 2]2]8
C°wev, Orange
$Ig{r/jjy NC 2]28]
Comxt Per=on: Carolyn Rudd, Nutrition Pragrnms Supervisor
Addr .°. 4001-E Carya Dr.
Raleigh, NC 2]610
Tslea6ans: 919-250-1114
FAX: 919-250-109]
Summarize the organization's background, goals and current programs.
The Mission of the Cooperative Exwnsion Service (CES), authorized by an Act of
Congress in 1914, is to provide rtsearth-based information and informal
educational opportunities w communities, families and individuals designed to
enhance the quality of their lives. One eomportent of this broad range o/services
includes progwms which strengthen the economic and social structure of
families, and, hence, the nation. Recognizing the link between poverty and
malnutrition and realizing that many Americans wen not being reached by
available educationa! programs and resources, the Fedem! Government started
the Expanded Food arcd Nuhirion Educarian Progrnm (EFNEP) in the /960's.
EFNEP teaches Gmired income families with children to use [heir available
resouttes and develop the necessary skills to provide nutritionally sound meals.
Current programs ofCES include family and consumer education, (which includes
[he nutrition education programs), agriculture, 4-H and youth programs, and
community and rural development.
The proposed In-Home Breastfeeding Support Program will be ajoint
paztnership belwren CES and [he Orange County Health Department, Piedmont
Health Services, Inc., (W[C provider) and UNC Hospitals.
Describe how the project/program being proposed will assist the Trust in
accomplishing its goal. Clearly'denti[y and nuanCfy the
individuals who w'll benefit.
"/t (i.e, the Trusl) has done much to improve the [fives of mothers and infarcts,
workirsg ro give babies a better chance ofsurviva! and children a healthy start in
l je. " -from [he Foreword, A ! evacv of Car'no
The proposed In-Home Breastfeeding Support Program will assist the Tmst in
accomplishing its goal by encouraging mothers [o breas[feed [heir infants while
providing comprehensive support and follow-up. By assisting mothers in [heir
efforts [o breastfeed, we will improve the health of infants and women in Orange
County.
Breastfeeding provides many health benefits for the mother and her child.
Breastfed babies have fewer ear infections, less constipation and diavhea, svonger
and straighter teeth, and a higher IQ than formula fed babies. Breastfeeding women
are more likely to return to their pre-pregnancy weight and have a reduced risk of
ovarian and premenopausal breast cancm. In addition, it promotes a close and
loving relazionship between mother and baby and is economically the best source of
nuvition for infants.
Breastfeeding rates are an the rise; however, many women discontinue shortly after
delivery, often due to a lack of support. The goal of this project is to provide the
support needed to assist women in their efforts to initiate and continue
breas[feeding even during [he diffrcul[ times. Post-discharge education and follaw-
upsupport are especially critical, as most mothers are discharged within?4 hours of
delivery, before lactation is established. This proposal reinforces "Healthy People
2000", (the sponsor of this concept) goals: Increase to a[ leas[ seventy-five percent
the number of mothers who breas[feed their babies in the early post-panum period
and to at least fifty percent, the number who continue breas[feeding until the infant
is at leas[ six months old. Currently, [he breas[feeding initiation rate among our
target population is 48% and at six months postpartum decreases to 16%. These
figures indicate that i[ will be a challenge [o reach the goals of"Healthy People
2000". However, Ute In-Home Breastfeeding Support Program will lead us closer
to meeting these goals.
WIC and WIC-eligible women of Orange County will be targeted for this program.
According to the 1996 Pregnancy Nutrition Surveillance Report for Orange County,
344 pregnant women participazed in the WIC Program. Based on June 1998 data,
thirty-two percent of women participating in the WIC Program are of Hispanic
origin, a population more diffiwlno reach due [o language and cultural differences.
a
One of [he goals ofth is project is to provide a bi-lingual (Spanish-English)
program assistant to support this population.
Part II. The Projeet/Progrem: Please quanKfy information to the extent
possible. Describe the problems/need [hat the program will
address.
WIC and WIC-eligible pregnant /postpartum women of Orange County have
inadequate breastfeeding support urvices. Such services are essential w the
initiation and maintenance of lactation. Unfortunately, programs [ha[ provide
adequate support and on-going encourngement are currently not available [o women
with limited resources. The In-Home Breastfeeding Support Program will help
meet this need.
A survey of participants in the Wake County In-Home Breastfeeding Support
Program was conducted in 1996. Sixty-two percent of respondents reported that the
In-Home Breastfeeding Support Program helped them solve breastfeeding
problems and that the support was very important. After one year of intervention
(1990 -1991), Wake County experienced an increase in breastfeeding duration at
two (2) weeks postpartum fiom 75%to 84% and a[ eight (8) weeks postpartum
from l7°/a to 46%.
Outcome Objeci ver
1. WIC and WIC-eligible women ofOrange County will:
a. Increase breastfeeding initiation rates from 68°o m 60% by the year
2002.
b. Increase breastfeeding duration rates a[ 6 weeks postpartum from
26% to 35 % by the year 2002.
c. Increase breastfeeding duration rates at 6 months postpartum from
16% to 25 % by [he year 2002.
2. Fifty percent of WIC and WIC<ligiblepragnant/postpartum women will
enroll in [he In-Home Breastfeeding Support Program by [he end of year 2
3. Seventy-five percent of enrolled participants will be pleased with the support
received from the program as indicated by a Participant Satisfaction Survey
by the end of year three.
The In-Home Breastfeeding Support Program will be modeled after existing
programs administered by the Cooperative Extension Service. This program will
use trained para-professionals paired with WIC and WIC-eligible women to provide
this needed breastfeeding support The para-professionals will be mothers who
have had positive breastfeeding experiences and will be of the same socio-economic
status.
As peers, [here women will be able to provide culturally sensitive social support, in
addition to accurate and essential breastfeeding information in anon-threatening
environment The pare-professionals will be titled Breastfeeding Program
Assistants (PAs) and will function under the supervision of an Extension agent who
has experience managing community nutrition education programs. Piedmont
Health Services, Inc., Orange County Health Depattment and l1NC Hospitals wit l
provide lactation expettise and facilitate referral for medical complications.
Nutrition education for the PAS will be provided by Extension staff and
breastfeeding training by an [ntemetional Board Certified Lctation Consultant.
t. Hire two PAs (one to work wiN the Hispanic population) and one suppott
tt
stab person by March 1, 1999.
tz
1. Nutrition Programs Supervisor will provide in-depth [raining for [he PAS by
MaY 1, 1999.
2. The partners (Cooperative Extension Service, Piedmont Health Services,
Inc., the Orange County Health Department and IfNC Hospitals) will orient
PAs to their respective organiration as it relates to the In-Home
Breasifeeding Support Program by May 31, 1999.
3. By June 1, 1999, trained PAS will begin meeting with WIC mothers
prenatally and will perform the following:
a. Teach Breastfeeding classes.
b. Contact WIC participants who have already decided m breasffeed.
c. Make hospital visits [o enroll participants into the program.
d. Make home visits to enrollees within 72 hours of hospital discharge to
support their breastfeeding efforts.
e. Provide additional support as needed.
£ Track progress and duration at specified intervals.
g. Provide support for weaning.
h. Complete reports and utilim evaluation tools.
5. Throughout the Cording period, the partners will:
9
I. Provide continuing edu<a[ion opportunities for PAS.
?. Identify alternative sources of funding.
3. Publicize [he In-Home Breastfeeding Support Program throughour the
county.
6. Purchase appropriate educational resources.
5. Mee[ on a regular basis: Once per month during year one; and bi-
monthly thereafter.
m
The evaluation of [he program will be completed by [he Extension Agent, Nutrition
Programs Supervisor. A comprehensive computerized reporting system has been in
use by EFNEP for years. Breas[feeding reporting forms currently in use
(Attachment I) will be adapted to meet program evaluation needs. Demographic
data and measurements of breastfeeding initiation and duration rates among
population groups will be collected. Information will be available at any point, but
wil I be formally assessed quarterly [o monitor [he progress of [he program. A[ [he
end of each year, a Participant Satisfaction Survey will be used to make program
improvements.
Provide reasonable eviden a shoat fnhre funding if the plpjsM~g_'S to
nnFnae aRer the grant nerind eznire~
Based on the success of similar projects, [he In-Home Breastfeeding Support
Program will produce data [o support its continuation as an investment for the
health and well-being ofthe citizens of Orange County. Based on past experience,
we are optimistic about future funding to ensure the continuation of the program.
The project will explore funding opportunities Gom Smart Start, civic
organizations, March of Dimes, local businesses and foundations. Smart Start has
funded the In-Home Breastfeeding Support Program in Pasquorank, Wilson, Martin
and several other counties.
O nge C~nnd Io-Hnme Bren+Heeding Srrlryyrt Proerem Parmen:
Teresa Blue, Ambulatory Care Center, OB-GYN Clinic: [11VC Hospitals
Cynthia Garrett, Women's Health Clinical Nurse Specialist UNC Hospitals
Wanda Oakley, Nurse Education Clinician: UIVC Hospitals
Alice Pettitt, Family and Consumer Education Agent: CES - Orange County
Mesina Reddish, WIC Nutrition Director: Piedmont Health Services, [nc.
Carolyn Davis Rudd, Nutrition Programs Supervisor: CES -Wake County
Karen Seifert, Nutritionist: Orange County Health Depanmen[
Robin Stanley, WIC Nutritionist: Piedmont Health Services, Inc.
Bgd{et Agglye's
Celgaly Sauce of Ym Qe: Yw Two Year three Told EVpmea
1'"'A1ve CESM1YIC KB0.
PA SeIay+BNe61e
2 Fv0 Time Egdvebaa K. B.RryroBs 58,516.00 61,d52.00 61,515.00 IBI,SOT00
Admie.Aae. Sdery+
Bme6a
1 Fu0iime Equivdad K. B.Rrymka JS,10.t 00 Jt,I5i 00 39,000.00 111,5)500
Supssvie0r'e Sealy CES In-Kid 6.00000 6,000.00 b,00D.0D 18.000.00
Prof 'ond Savior
(1<nerim CowKan) K. B.0.eYnolde 1.50000 1.30000 1.60000 1.60000
Tmnmg (gait) CPS m-KUd 0,500.00 0.30000 4.800.00 11.800.00
Training Malaida K. B. geyail6e 1.000.00 300.00 500.00 3.000.00
CmunimB EA~ueivn CES IVXmd 4,000.00 4.000.00 0.000.00 1;000.00
Aniad COnSmmm K. B. ReynoWe Tp00 9110.00 100.00 1.100.00
Canuminiuavn-Pages K. B.Rryndde 1.200.00 IjW.00 1.150.00 1,150.00
Comnadwion-Cdl Pbnne K. B. Reyedde 3,00000 ;000.00 ;00000 6.000.00
Conmadcuim-Ogke
Phone K. B. 0.eYnnlde I,000.OD 1,000.00 I,OOD.00 3,OOOOD
Bnaa PUmpek SuppBn WIC
K B. Reynolds ;000.00
1.000.00 1.00000
),000.00 2,000.00
).000.00 6,000.00 9.000.00
Eduuiod Supplies WIC N-Kind
K B. ReY^9Be SOO.OO
1,000.00 300.00
1000.00 50000
1.50000 1,50000 1,500.00
Tnrvel-PA K. B. Reymld t,p0.00 t.80o.00 1,92000 31,510.00
Tnvd-Supervisor CES IV-1(®d 1,3W.00 '/00.00 '1110.00 1.600.00
PrandiaW Sylp0es K. B. Reynolds 4,000.00 I,000.OO O,000.OO 12,OOO.OD
Category Savce of Yelr One Yev T.w Y®r Three Totelfi pmvo
I~nw
CESIWIC
KBR
ORce tpex-Reml CES IaKiid ;500.00 ;500.00 ;SOO.Op ],50600
Compere Fquipmem&
SoBwue K. B.Rrymlde 1.000.00 SOD.OD 50000 5.000.00
(86a Suppliu K. B. Relmdde 2,500.00 ;500.00 ;500.Op ],SOO.OD
Imaoeil SUppBe CES ImRied 200.00 200.00 200.00 600.00
P9e9ge K. B. Kefau~0e SOO.OD 500.00 500.00 1,500.00
Table 5115,009.00 5115,201.00 5151,295.00 562,00000 5319,508.00