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HomeMy WebLinkAboutAgenda - 02-03-2004-9eORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: February 3, 2004 Action Age a Item No. - e_ SUBJECT: Breastfeeding Education and Support Program/Expanded Food & Nutrition Education Program DEPARTMENT: N. C. Cooperative Extension PUBLIC HEARING: (Y/N) No ATTACHMENT(S): INFORMATION CONTACT: Dr. Fletcher Barber, Jr., 245-2050 Alice Pettitt, 245-2054 TELEPHONE NUMBERS: Hillsborough 732-8181 Chapel Hill 968-4501 Durham 688-7331 Mebane 336-227-2031 PURPOSE: To provide a follow-up report on progress being made to secure sufficient funds to sustain the Breastfeeding Support Program/Expanded Food & Nutrition Education Program (EFNEP), and to request continuation funding from the County through the remainder of the fiscal year (until June 30, 2004). BACKGROUND Histo : In 1999, Cooperative Extension met with representatives from UNC Hospitals, Orange County Health Department and Piedmont Health to develop a breastfeeding support program. The group decided to adopt the In-Home Breastfeeding Support Program (IHBSP) and to house the program in Cooperative Extension since the model had been developed through the leadership of Cooperative Extension in Raleigh, and had been successful since its inception in 1991. The program has achieved national recognition. Cooperative Extension organized the Orange County In-Home Breastfeeding Coalition, which meets on a regular basis to help coordinate the program among all the agencies, and is made up of individuals from each agency, Orange County Cooperative Extension received funding as part of a statewide proposal from Food and Nutrition Services in September 2000. Program Description: The In-Home Breastfeeding Support Program pairs women who want to breastfeed their newborns with well-trained, nutrition educators who have breastfed their own children, The program places Breastfeeding Program Assistants in Cooperative Extension Centers (there are two in the Orange County Center) under the supervision of a multi-county Extension Agent who has experience managing community nutrition education programs. A second nutrition education paraprofessional who is also trained in breastfeeding education as well as the Expanded Food & Nutrition Education Program (EFNEP), serves as the Back-up Breastfeeding Education PA (there are two in the Orange County Center), The Back-up's job is to handle case overload and to ensure continuity of service to participants. When not serving in the breastfeeding capacity, the Back-up recruits, enrolls and provides basic nutrition education information from the EFNEP curriculum to limited resources families with young children. The Expanded Food and Nutrition Education Program (EFNEP) targets families with young children and pregnant teens to insure that healthy meals are being prepared. EFNEP employees work with these families for a minimum of six (6) teaching visits in their homes or in a small group setting. Interagency cooperation is a vital part of the success of the program. Cooperative Extension provides supervision for the program and coordinates the coalition. UNC Hospitals works with the program assistants who visit the hospital to recruit new mothers for the breastfeeding program. Mary Rose Tully, Director of Lactation Services at UNC Hospitals, who helped develop the statewide IHBSP program, works with her staff to provide continuous training for program assistants. UNC Hospitals provide the lactation consultant who is readily accessible to the program assistants for complex breastfeeding situations, and can help new moms have quick access to the health care system when medical complications arise. (UNC Hospitals credit one of the program assistants with recognizing a problem with an infant, coordinating with the hospital to get immediate care, and therefore saving the life of the infant). The Orange County Health Department and Piedmont Health Services, through the WIC (Women, Infant and Children) program, provide referrals to the program, and help coordinate educational sessions. The Breastfeeding program services, as well as the EFNEP program, are unique and do not duplicate those provided by any other program. This program reaches under-served populations in their communities and in their homes. BOCC Took Action in December: When Cooperative Extension learned in early December that the four Nutrition Program Assistants positions responsible for program implementation would be terminated on December 31, 2003 due the withdrawal of Federal funding, a request was made and approved by the BOCC to provide $27,000 to extend the EFNEP personnel and activities for two months from January 1, 2004 through February 29, 2004. This time extension allowed County staff time to continue and evaluate program options and better identify funding alternatives for the BOCC to consider for the longer term. Because of the design of the program and the need to serve both English and Spanish-speaking clients, Cooperative Extension determined that all four (4) positions are critical (two of the program assistants are bilingual and over half of the clients served speak Spanish.) Since December, the Cooperative Extension staff has contacted Cooperative Extension's Family and Consumer Science Department at the State level to keep up-to-date on the negotiations concerning the resubmission of the grant proposal to the regional office of Food Stamp Nutrition (FSN) in Atlanta, GA for the Breastfeeding Support Program. The State has informed the County that the program is not dead, but there is no definitive decision at this time. Due to the complexity of the process, the State also cannot give the County a time frame for that final decision. Contact has been made with Piedmont Health Services to determine if State WIC funds could be used to support part of the program. Staff is still exploring that option. Cooperative Extension has also met with UNC Hospitals staff and they have pledged their continued support of staff that will provide professional lactation support services, as well as providing regular training for program assistants both here in Orange County, as well as those across the state. UNC Hospitals is still exploring possibilities for monetary support of the program. Cooperative Extension also made contact with Orange County Partnership for Young Children to determine if it has any funds available that could be used to support the program, but staff is still awaiting a response. State Offers 50% Funding for Nutrition Education: In addition to Breastfeeding, the other component of the program here in Orange County is the Expanded Foods and Nutrition Program (EFNEP). This program offers nutrition education to limited resource families with small children, There are two program assistants whose positions were previously funded with 50% EFNEP funds. The State has committed to permanent funding for these two positions, but a match from the County would have to be provided. The State funding would be effective July 1, 2004, provided the BOCC decides to fund the County's 50% match in the upcoming budget process. Current Request from Cooperative Extension: Cooperative Extension (Orange County) asks that the BOCC provide funding at this time to continue both the two Breastfeeding Program Assistants positions and the two Nutrition Program Assistants from March 1, 2004 through June 30, 2004 at a full County expense of $35,000. Cooperative Extension will continue and pursue grant fund possibilities above and beyond the State offer of assistance for two positions to be available next fiscal year. County staff will provide the BOCC with a more complete evaluation of EFNEP outcomes and funding options for considering program extension beyond June 30, 2004 as part of the normal, new position analysis during the upcoming annual budget process. FINANCIAL IMPACT: The combined cost to continue funding for the four (4) Breastfeeding and EFNEP/Back-up Breastfeeding Program Assistants for a period of four months (through June 30, 2004) would be $35,000. Funds are available within the Human Services Safety Net to cover this additional expense and would leave a balance of $169,760 In the Human Services Safety Net account after the $35,000 is allocated. RECOMMENDATION (S): The Manager recommends that the BOCC approve continued funding of the four positions attached to EFNEP within Cooperative Extension through June 30, 2004, at a total cost of $35,000, with funds to be transferred from the Human Services Safety Net.