MARICOPACOUNTYDPH_ NFP_INCENTIVEFUNDSUSTAINABILITYAWARDLTR_DRAFT.PDF

Maricopa County — Formal (2023-08-09)

View PDF Item 42 Meeting page

Extracted text (via pymupdf) 16100 characters
July 17, 2023  
 
Bonnie Drenth 
Maricopa County Department of Public Health 
4041 N Central Ave Suite 700 
Phoenix, AZ 85012 
 
Dear Ms. Drenth: 
 
Nurse-Family Partnership, a Colorado nonprofit corporation (“NFP”), is pleased to make an investment 
not to exceed $273,569 from the Nurse-Family Partnership Incentive Fund in Maricopa County 
Department of Public Health (“Agency” or “you”) to support sustainability of the Nurse-Family 
Partnership® Program (the “Program”). The NFP Incentive Fund offers short-term sustainability 
funding to existing NFP organizations looking to continue to serve families. 
 
We are investing in you so vulnerable moms will continue to receive the care and support they need to 
have healthy pregnancies and achieve better lives for themselves and their families.  After careful 
consideration, we have approved your request for Sustainability Incentive Funds to MCDPH NFP 
families within the current service area over the next 12 months while longer-term sustainable funding 
is secured. 
 
NFP is prepared to support you during the term of this investment with a restricted grant (the 
“Investment”) as described below and by providing other services and support as described in the 
[Implementation Support Services Agreement, dated November 1, 2018 as amended] (the 
“Implementation Agreement”).   
 
This letter of agreement, including all exhibits, which are attached and incorporated by this reference 
(the “Agreement”), is effective as of July 1, 2023, through December 31, 2023, and sets forth the terms 
and conditions of the Investment.    
 
The parties agree that the Investment is expressly contingent on Agency satisfying the 
terms of this Agreement, including meeting the milestones set forth in Exhibit A (the 
“Milestones”). NFP has the right to adjust or withhold payments as it deems appropriate 
based on vacancy savings resulting from Agency hiring later than dates projected in the 
Milestones. 
 
The parties further agree that the Investment is intended to support Agency’s efforts to 
implement the Program while Agency secures and gains access to sustainable Program 
funding. Agency agrees to notify NFP as soon as Program funding is secured from 
another source.  
 
What NFP Will Do: 
 
1. Invest in Agency. NFP will invest up to $273,569  in Agency.   
 
NFP will make payments in accordance with monthly invoices from the Agency as outlined in 
the payment schedule and Milestones reporting.

2 
 
 
 
 
 
2. Collaborative Success Plan.  To support Agency’s ongoing successful implementation, NFP 
will periodically assess the extent to which Agency is implementing the Program with Fidelity 
to the Model.  NFP’s Nurse Consultant and Agency will co-create a Collaborative Success Plan 
(the “CSP”) to identity goals and specific action steps, including due dates for completing 
action steps.  The CSP will be in place as long as Agency is implementing the Program.  The 
CSP is assessed and updated as circumstances require to identify opportunities for growth and 
provide a framework for action.  
 
3. Supervisor and Nurse Home Visitor Hiring Support. Should Agency experience challenges 
after 30 days of posting position, such as not finding enough candidates, not being able to 
source candidates expediently, not being able to meet market salary, or not being able to find 
bilingual or nurses who can work flexible hours, Agency shall notify NFP and NFP will work 
directly with Agency to explore and execute solutions to hiring.   
 
4. Sustainability Resources. NFP will provide tools and support Agency in its efforts to 
become sustainable, including providing a Sustainability Planning Template and advising 
Agency on how to complete it. 
 
5. Tools and Support for Outreach, Referral Generation, Referral Conversion to 
Enrollment and Client Retention. NFP will consult on generating, converting and retaining 
referrals, including specialized training, marketing, developing and executing an outreach 
plan at the request of the Agency, should Agency need it to meet their milestones.  
 
6. Notify Agency If Payments Will Not Be Made.  NFP will notify Agency in writing, at least 
15 days before the scheduled payment date, if any payment from NFP will not be made as 
scheduled because Agency has not fulfilled its obligations or met the Milestones.  The 
notification will detail where Agency is not making satisfactory progress.  NFP will meet with 
Agency to attempt to resolve the issues detailed in the notification. 
 
7. Manage Information and Expectations.  NFP will work with Agency on its preparation of 
its bi-annual progress reports and provide quarterly data reports to Agency.  
 
The payment amounts and reporting schedules may be changed by NFP under certain 
circumstances, such as identification of risks that need additional attention or material changes 
in circumstances that may affect the successful completion of Milestones.  To minimize the 
impact on Agency, any such modifications will be discussed in advance with Agency.  If 
Agency believes that its performance will be materially affected by any such material changes, 
events or issues, Agency shall promptly provide a written report to NFP.  Such a report must 
describe the relevant events or situation and Agency’s proposed action plan.  Any material 
change in Agency’s plans must be approved by NFP. 
 
8. Retain Right to Revise Terms or Declare Investment Terminated.  If there is a material 
change in the administration of Agency or the other funding supporting Program delivery or if 
NFP believes Agency is incapable of satisfactorily completing the work of the investment or 
meeting the Milestones, or if Agency has breached any material term, representation or 
warranty set forth in this Agreement, or if circumstances regarding NFP’s available funding 
significantly change, or if any other reason in NFP’s discretion warrants it, NFP may, at its 
sole discretion, declare the investment terminated, or unilaterally revise the terms and

3 
 
conditions of, the investment.  NFP will meet with Agency to attempt to resolve the issues 
before making such a declaration.   
 
 
What Agency Will Do: 
 
1. Implement the Program with Fidelity to the Model.  Agency shall implement the Program 
in accordance with the terms of the Implementation Agreement, as amended from time to time, 
adhering to the Model Elements, including, but not limited to, Model Element 12, which states 
that a “full time Nurse Home Visitor carries a caseload of 25 or more active Clients.”  Agency 
shall provide NFP with at least three (3) months’ advance written notice of any circumstances 
that suggest Agency may not meet the fidelity standards. 
 
2. Sustain your NFP Program as Proposed in your Incentive Fund Application. Agency shall 
carryout sustainability of NFP services as described in its Incentive Fund application, which 
was submitted to and approved by NFP. Agency shall submit a written request to NFP for 
approval if they would like to change anything that was specified in the Incentive Fund 
application, such as geographic service area or staffing.  
 
3. Sustainable Funding; Use of Investment. Agency shall report ongoing efforts to secure 
sustainable funding from other sources. Agency shall notify NFP immediately upon securing 
sustainable funding and shall access the Investment funds last when other funds are available. 
Agency shall discontinue invoicing NFP once sustainable new funds are received. 
 
4. Milestones. Agency will meet the Milestones outlined in Exhibit A. Agency shall notify NFP 
as soon as possible after becoming aware that Agency may not meet the Milestones. 
 
5. Collaborative Success Plan.  Agency will fully cooperate with the CSP process and use it to 
drive program improvement, program fidelity and goals. 
 
6. Supervisor and Nurse Home Visitor Hiring Support. Agency shall post all open NHV and 
Supervisor positions on NFP’s national careers website within two (2) weeks of opening the 
job requisition.  Agency shall make best efforts to find bilingual nurses, as appropriate for the 
population served. 
 
7. Tools and Support for Outreach, Referral Generation, Referral Conversion to 
Enrollment and Client Retention. If Agency has Outreach FTEs, the FTEs must be trained, 
by NFP, in NFP outreach and sales strategies to increase referrals. Agency shall ensure NFP 
has access to its referral information, by either providing NFP with an electronic file at least 
quarterly or by using an NFP-hosted system for entering, tracking and reporting referral 
information.   
 
8. Notify NFP of Key Personnel Changes.  Agency will notify NFP immediately of any changes 
in key personnel in the leadership team or in Nurses hired as part of this expansion.  
 
9. Comply with Reporting and Meeting Requirements.  Agency will comply with the reporting 
requirements detailed in Exhibit B. 
 
On a regular basis, NSO may meet with Agency to review progress against both the end of 
investment results and the Milestones specified Exhibit A.

4 
 
10. Representations and Warranties.  Agency represents and warrants to NFP that: (1) it is 
qualified to receive charitable contributions and has the full power and authority to make and 
enter into this Agreement; and (2) Agency’s entering into and performing its obligations under 
this Agreement do not violate any applicable law or any agreement with or right of any person. 
 
11. Responding to Clients; Enrolling the Highest-Risk Clients. Agency shall respond within 
two (2) business days of receiving referrals.  Agency shall make best efforts to enroll the 
highest risk clients.   
 
 
High-risk clients exhibit at least one of the following characteristics:   
• 
Serious mental health issues 
• 
Substance abuse issues 
• 
Intimate partners violence  
• 
Developmental/intellectual disability  
• 
Pregnancy complications/chronic illness 
• 
<19 and not in school 
• 
Excessive economic hardship 
• 
Homeless/residential instability 
• 
>19 and <12th grade education 
 
Agency shall demonstrate best efforts to enroll high risk clients by conducting outreach 
directed at any of the following:  
• 
Substance abuse treatment centers, 
• 
Teen-serving organizations 
• 
Incarceration or juvenile detention centers 
• 
Homeless and teen pregnancy centers 
• 
Schools 
• 
Social services offices 
• 
Entitlement services offices 
• 
Women’s shelters 
• 
Foster care systems 
• 
Women outside of the traditional social services network. 
 
12. Ensure That All External Communications About the Investment Meet NFP’s 
Guidelines.  All internal and external communication about the investment will be identified 
as “with support from the Nurse-Family Partnership Incentive Fund”.  Agency shall be open 
and available to do presentations, information calls and other types of communication (in 
person or online) to inform stakeholders, funders, peer agencies and others about NFP’s 
Incentive Fund.  Agency will use NFP brand guidelines (logo, the right naming conventions, 
etc.) in all NFP business. 
  
13. Use of Funds.  Agency shall use the investment for the purposes and in the manner provided 
in this Agreement.  No portion of the investment may be expended for any purpose other than 
as provided in this Agreement without the prior written approval of NFP.  No portion of the 
investment may be used to carry on propaganda or otherwise attempt to influence legislation 
within the meaning of Section 4945(d)(1) of the Internal Revenue Code of 1986, as amended, 
and the Treasury regulations thereunder (the “Code”), or to influence the outcome of any public 
election or to carry on a voter registration drive within the meaning of Section 4945(d)(2) of 
the Code.

5 
 
14. Future Funding.  Agency acknowledges that NFP and its representatives have made no actual 
or implied promise of funding except for the amount specified by this Agreement.  If the 
investment is terminated or if any of the grant funds are returned, Agency acknowledges that 
NFP will have no further obligation to Agency relating to this investment upon such return or 
termination. 
 
Payment and Milestones.   
 
NFP will make payments not to exceed $273,569 over the term of the Investment and in alignment 
with the budget in Exhibit C, provided Agency has satisfied all conditions in the Agreement and does 
not have other available funds for Program implementation: 
 
These payments will be made following receipt of an invoice and brief report each month and/or until 
all funds are expended:  
Report and Invoice Date – Sent to NSO – No 
Later Than: 
Invoice Payment Date – Sent to MCDPH NFP 
– No Later Than 
08/31/23 for July Expenses 
9/29/2023 
09/29/23 for August Expenses 
10/31/2023 
10/31/23 for September Expenses 
11/30/2023 
11/30/23 for October Expenses 
12/29/2023 
12/29/23 for November Expenses 
1/31/2024 
1/31/24 for December Expenses 
2/29/2024 
 
Nurse-Family Partnership looks forward to working with you to reach more families and improve the 
lives of more moms and babies.  Thank you for the opportunity to work with you. 
 
Sincerely, 
 
 
 
 
 
 
 
Date:   
 
 
 
Chief Executive Officer  
 
Accepted:  
Agency 
 
Taxpayer I.D. #  
 
 
 
 
 
By: 
________________________________ 
Date: ______________________________ 
 
Name, Title 
FOR AND ON BEHALF OF MARICOPA COUNTY  
 
By:____________________________________________ 
Chairman, Board of Supervisors  
Date 
 
ATTEST 
______________________________________________ 
Clerk of the Board 
 
 
Date 
 
APPROVED AS TO FORM 
______________________________________________ 
Attorney for Maricopa County 
 
Date

6 
 
 
EXHIBIT A – MCDPH, AZ NFP Sustainability MILESTONES  
 
1. Service Capacity and Families Served 
 
A. Staffing.  Agency shall maintain the 2 FTE NHVs, 0.5 Supervisor, 0.5 Outreach, and 0.25 
administrative assistant being funded throughout the duration of this award.  
 
B. Capacity / Caseload.  MCDPH NFP shall reach through ramp-up and maintain enrollment of 
50 families.  Agency’s NHVs from all teams shall make best efforts through ramp-up to 
reach and maintain full caseloads of 25 families. Measured monthly. 
 
Projected 
Caseload 
07/31/2023 
08/31/2023 
09/30/2023 
10/31/2023 
11/30/2023 
12/31/2023 
MCDPH NFP  
50+ 
50+ 
50+ 
50+ 
50+ 
50+ 
 
C. Referrals.  Agency shall maintain an average response time of no more than two business 
days, from receiving a referral to following-up with the referral by engaging with the 
potential client directly or documenting attempts to do so.   
 
3. Sustainability 
A. Convene at least four CAB meetings per grant year; 
B. Provide update monthly on progress towards sustainability progress and long-term 
sustainability of current budget. 
C. Complete the long-term sustainability planning tool by October 2, 2023 of the Investment. 
 
4. Continuous Quality Improvement and Innovations 
A. Agency shall have in place a robust CQI process and a team that will continuously assess 
potential barriers to quality implementation.  The Collaborative Success Plan (CSP) is a tool 
to support these efforts. 
1. During the investment period, Agency shall work on a minimum of one (1) formal QI 
project on client recruitment, nurse recruitment, client retention, or nurse retention in 
alignment with CSP; note: if other funders require a QI project you can use that QI 
project for this milestone as well. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EXHIBIT B – REPORTING AND MONITORING

7 
 
 
Reporting.  During the Investment Term, Agency shall report to NFP the following Milestones 
(template will be emailed to Agency): 
 
▪ 
Service Capacity and Families Served 
o Staffing 
o Caseload 
o Referral process 
▪ 
Sustainability 
▪ 
Continuous Quality Improvement work. 
 
 
Timing of Reports.  Agency shall report on their progress against Milestones monthly, alongside 
the monthly invoice, using a template to be provided prior to first invoice (from Exhibit A). 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EXHIBIT C – Sustainability Budget – MCDPH NFP

8

9