HomeMy WebLinkAboutWEBCO Initiative Funding AgrmtINITIATIVE FUNDING AGREEMENT
This Initiative Funding Agreement (this "Agreement") is entered into as of July 1, 2013
(the "Effective Date"), by and between Central Oregon Health Council ("COHC") and Central
Oregon Health Board (together with COHC, the "Parties").
RECITALS
A. COHC serves as the governance entity over Central Oregon's Coordinated Care
Organization (the "CCO").
B. COHC voted to fund the Initiative (defined below) as submitted by COHB.
C. COHB is an ORS Chapter 190 intergovernmental entity that has as one of its
primary objectives to arrange for and facilitate the provision and delivery of physical and
behavioral health services to persons enrolled in the CCO program and assigned to COHB or
who are covered by intergovernmental agreements with COHB.
D. COHC desires to fund the Initiative and COHB desires to carry out the Initiative
on the terms and conditions set forth in this Agreement.
AGREEMENT
COHC and COHB agree as follows:
1. The Initiative. COHB will undertake and complete the Maternal Child Health
Initiative as set forth in Exhibit A (the "Initiative"). COHB will coordinate the provision of the
services required to carry out the Initiative (the "Services").
2. Payment.
2.1. Subject to the terms and conditions of this Agreement, during the Initial
Term of this Agreement, COHC agrees to pay COHB actual costs incurred in connection with
the Initiative up to the budgeted amount of $180,212.00 (the "Initial Term Initiative Payment").
If this Agreement is renewed pursuant to Section 3.2 ("the "Renewal Term"), COHC and COHB
will mutual agree upon the budget for the Renewal Term (the "Renewal Term Initiative
Payment").
2.2. The Initial Term Initiative Payment will be paid quarterly in installments
(each an "Installment") on November 15, 2013, February 15, 2014, May 15, 2014, and August
15, 2014 (each a "Payment Date"). If the Agreement is renewed for an additional one-year term
pursuant to Section 3.2, the Parties will establish Payment Dates for payment of the Renewal
Term Initiative Payment in the written confirmation of the renewal.
2.3. The payment of each Installment is conditioned on:
2.3.1. COHB's timely submission of reports in the form set forth in
Exhibit B (each a "Monthly Report"). Monthly Reports must be submitted on or before the 5th
day of each month and must report on the Initiative activities of the previous month.
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CORDOCS:60021535.5
Attachment 1 — Page 1 of 17
2.3.2. COHB's submission of quarterly reports (each a "Quarterly
Report") addressing the Initiative activities of the immediately previous three months. Each
Quarterly Report must contain the information specified in Exhibit C and be submitted not less
than 15 days prior to a Payment Date.
2.3.3. COHB's submission of evidence of actual expenses incurred (each
an "Expense Report") for the three-month period immediately prior to the relevant Payment
Date. Each Expense Report must be submitted not less than 15 days prior to a Payment Date.
2.3.4. COHC's approval of the Monthly Reports, the Quarterly Report,
and the Expense Report for the three-month period preceding the relevant Payment Date, which
will not be unreasonably withheld or delayed.
3. Term.
3.1. Initial Term. The initial term of this Agreement will commence on the
Effective Date and continue until August 16, 2014 (the "Initial Term"). COHB will confirm the
launch of the Initiative in a written communication to the Executive Director of COHC.
3.2. Renewal. The Parties will meet to review this Agreement and the
Initiative on or before March 1, 2014. During the review, the Parties will determine if this
Agreement will be renewed for an additional one-year term. If the Parties mutually agree to
renew this Agreement, such renewal must be set forth in a writing signed by both Parties.
4. Termination.
4.1. Either Party may terminate this Agreement after giving thirty (30) days'
prior written notice to the other of intent to terminate without cause. The Parties shall deal with
each other in good faith during the thirty (30) day period after notice of intent to terminate
without cause has been given.
4.2. With reasonable cause, either Party may terminate this Agreement
effective immediately if the cause is not cured within thirty (30) days after written notice of such
cause. Reasonable cause shall include material violation of this Agreement or any act exposing
the other Party to liability to others for personal injury or property damage.
4.3. Notwithstanding any other provision of this Agreement, COHB shall not
be obligated under any provision of this Agreement during any fiscal year following the Renewal
Term unless and until COHB and COHC appropriate funds for this Agreement for such future
fiscal year. In the event that funds are not appropriated for this Agreement, then this Agreement
shall terminate automatically as of June 30 of the last fiscal year for which funds were
appropriated.
5. Joint Management Agreement. COHB has read and understands the Joint
Management Agreement (the "JMA") dated July 25, 2012 by and between PacificSource
Community Solutions, Inc. and COHB. COHB agrees: (i) to comply at all times with the JMA
in connection with its obligations under this Agreement, (ii) to perform its obligations under this
Agreement in such a manner as to further the goals of the JMA, and (iii) to alert COHC
immediately upon becoming aware of any violation of the JMA by either party thereto or COHB.
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CORDOCS:60021535.5
Attachment 1 — Page 2 of 17
6. Protected Health Information. COHB will not include any protected health
information ("PHI") in any report submitted to COHC. In addition, COHB will not release or
otherwise disclose PHI to COHC. If COHB obtains any PHI related to this Agreement, COHB
agrees to provide appropriate safeguards to protect the confidentiality of this information.
COHB shall provide appropriate safeguards by meeting or exceeding the requirements stated in
ORS §646A.622.
7. Compliance with Laws. In connection with this Agreement and the Services,
COHB and COHC will comply with Title VI of the Civil Rights Act of 1964, and all applicable
federal, state and local laws and regulations.
8. Indemnification.
8.1. COHB acknowledges that COHC has no control over the operations, acts,
or omissions of COHB. COHB will indemnify, defend, and hold harmless COHC and its
directors, officers, employees, and agents from and against any claim, liability, loss, damages,
fines, penalties, and expenses (including but not limited to reasonable legal fees and costs)
(collectively, "Losses") arising out of a third party claim to the extent related to (i) COHB 's
material breach of this Agreement or (ii) any act or omission of COHB, its officers, employees
and agents in connection with COHB's performance of, or failure to perform, the Services.
8.2. COHC will indemnify, defend, and hold harmless COHB and its directors,
officers, employees, and agents from and against Losses arising out of a third party claim to the
extent related to (i) COHC's material breach of this Agreement or (ii) any act or omission of
COHC, its officers, employees and agents in connection with this Agreement.
9. Miscellaneous.
9.1. Relationship of the Parties. The relationship of the parties is not that of
principal and agent, nor of joint venturers nor of partners, but is that of independent contractors.
Neither Party shall be deemed to be the legal representative of the other. It is expressly agreed
that this Agreement and the relationship between COHC and COHB hereby established does not
constitute a partnership, joint venture, agency or contract of employment between them.
9.2. Confidentiality. To the extent allowed under Oregon Public Records
Law, ORS 192.410. 192.505, neither COHC nor COHB shall use, publish, or otherwise disclose,
without specific written permission from the other Party, any information (in any form)
concerning the other Party, including its organization, personnel, business activities, or policies
as a result of or in connection with the performance of the Agreement; nor shall either Party use
said information in any way which might be injurious to the interests of the other Party or its
employees.
9.3. Severability. In case any one or more of the provisions or parts of a
provision contained in this Agreement shall, for any reason, be held to be invalid, illegal or
unenforceable in any respect in any jurisdiction, such invalidity, illegality or unenforceability
shall not affect any other provision or part of a provision of this Agreement or any other
jurisdiction, but this Agreement shall be reformed and construed in any such jurisdiction as if
such invalid or illegal or unenforceable provision or part of a provision had never been contained
3
CORDOCS:60021535.5
Attachment 1 — Page 3 of 17
herein and such provision or part shall be reformed so that it would be valid, legal and
enforceable to the maximum extent permitted in such jurisdiction.
9.4. Non -Assignment. This Agreement is personal to the Parties and cannot
be assigned by either Party without the prior written consent of the other Party. The foregoing
notwithstanding, this Agreement will be binding on, and will inure to the benefit of, the Parties
and their respective successors and permitted assigns. The Parties recognize that COHB is
entering into arrangements with certain partners to fulfill the objections of the Initiative and that
those arrangements do not constitute an assignment for purposes of this Section 9.4.
9.5. Entire Agreement. Except as otherwise provided in this Agreement, the
Parties agree that this Agreement, including the exhibits hereto, constitutes the entire agreement
and understanding between them and that any and all prior agreements are superseded by this
Agreement. The Parties further agree that this Agreement can only be amended or revised by a
written document signed by both Parties.
9.6. Waiver. The failure of either Party at any time or from time to time to
enforce any of the terms of this Agreement shall not be construed to be a waiver of such term or of
such Party's right to thereafter enforce each and every provision of the Agreement.
9.7. No Third -Party Beneficiaries. Nothing in this Agreement, express or
implied, is intended or will be construed to confer on any person, other than the Parties, any
right, remedy, or claim under or with respect to this Agreement.
9.8. Notices. All notices and other communications under this Agreement
must be in writing and will be deemed to have been given if delivered personally, sent by
facsimile (with confirmation), mailed by certified mail, or delivered by an overnight delivery
service (with confirmation). All notices to COHB must be addressed to the Executive Director
or the Board Chair at the address or facsimile number noted below the Parties' signatures (or at
such other address or facsimile number as COHB may designate by like notice to COHC). All
notices to COHC must be addressed to the Executive Director at the address or facsimile number
noted below the Parties' signatures (or at such other address or facsimile number as COHC may
designate by like notice to COHB). Any notice or other communication will be deemed to be
given (a) on the date of personal delivery, (b) at the expiration of the third (3rd) day after the date
of deposit in the United States mail, or (c) on the date of confirmed delivery by facsimile or
overnight delivery service.
9.9. Governing Law. This Agreement shall be governed by and construed and
enforced in accordance with the laws of the State of Oregon (regardless of that jurisdiction's or
any other jurisdiction's choice of law principles).
9.10. Counterparts. This Agreement may be executed in two or more
counterparts, each of which shall be deemed an original, but all of which together shall constitute
one and the same instrument.
[Remainder ofpage intentionally left blank.]
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CORDOCS:60021535.5
Attachment 1 — Page 4 of 17
IN WITNESS WHEREOF, the Parties enter into this Agreement as of the Effective Date.
CENTRAL OREGON HEALTH COUNCIL CENTRAL OREGON HEALTH BOARD
By: 1 „
Name: '1.1 : aney
Title: President
Address:
Fax:
By:
Name ch Pangare
Title. ' Secretary
B
Name: Damien Sands
Title: Executive Director
Address: 200 S.E. Combs Flat Road
Prineville, Oregon 97754
Fax:
Commissioner Mike Ahern, Jefferson
County
Commissioner Tammy B w y, Deschutes
County
Commissioner Ke ahlgren, Crook County
CORDOCS:60021535.5
-Attachment 1 — Page 5 of 17
CENTRAL OREGON HEALTH COUNCIL
Domain: Prevention and Population Health - Focused Primary Care/Public Health
Partnership
Strategic Initiative: Maternal Child Health (MCH)
Contact: maggi.machala(i)deschutes.org
PROBLEM STATEMENT: Research shows that prenatal and early childhood wellness
(physical, behavioral, social, emotional and cognitive) can positively impact life-long health and
learning. A key barrier to wellness in Central Oregon is inadequate coordination between primary
care, public health and other prevention services.
GOAL: Improve prenatal and early childhood wellness through a MCH care coordination
system that empowers low-income families and optimizes their use of primary care, oral health,
behavioral health, prevention, family support, early learning services and other CCO initiatives.
ACCOUNTABLE COORDINATORS: Central Oregon Health Board, PacificSource
PARTICIPATING PARTNERS: Central Oregon Pediatric Associates (COPA), East Cascades
Women's Group (ECWG), Advantage Dental, Pacific Source, St. Charles Health System, Mosaic
Medical, La Pine Community Health Center, Central Oregon Early Childhood Councils and
partners
WHAT:
Develop a regional MCH care coordination system incorporating:
1) Expansion of RN Care Coordinator/community health worker model for high utilizers into
ECWG.
2) Extension of care coordination into the home by expanding nurse home visiting programs (i.e.,
Cacoon, Maternity Case Management and Nurse Family Partnership programs).
To assure system continuity, connection with prevention services, and experienced home visitors,
RN care coordinators and community health workers will be hired by public health agencies.
• Deschutes County: Hire 2 RNs and 1 community health worker. RN 1 will support
ECWG and provide Maternity Case Management home visiting. She will also give
oversight to a bilingual community health worker who will be certified to provide WIC
and Oregon Mother's Care. RN 2 will develop primary care liaison role and provide
CaCoon home visiting services for special -needs children.
• Jefferson and Crook Counties: Hire .5 RN FTE each to provide similar care coordination
and home visiting services with primary care practices in their counties.
RN care coordinators: promote integration of prevention services and other CCO initiatives into
the practices and bring the primary care perspective back to public health.
EXHIBIT A
Attachment 1 — Page 6 of 17
WIC certifiers/nurse expanders: work in enhanced role to include assessment, screening and
referral to required services and outreach to primary care practices as well as family education
and advocacy.
Nurse Family Partnership (NFP): Deschutes County will expand the evidenced -based home
visiting program, NFP, by hiring 1 additional bilingual/bicultural RN to help serve the tri -
county's Hispanic CCO members and provide back-up for the other NFP nurses. (Currently, NFP
is only able to serve 50% of eligible referrals).
WHEN: July 1, 2013- June 30, 2014
**Based on program outcomes/resources, services may be expanded to other practices in the
region.
METRICS: see Exhibit C
CCO REQUIREMENTS ADDRESSED: low birth -weight, tobacco use, alcohol use, dental
visits, screening/referral for depression, developmental screening by 36 months, ED utilization,
and effective contraceptive use
REGIONAL HEALTH IMPROVEMENT PLAN GOALS ADDRESSED: 1) Health
Disparities, 2) Access to Resources and Quality Services 3) Early Childhood Wellness, 4) Safety
Crime and Violence 5) Preventive Care and Services, 6) Chronic Disease Prevention, 7) Alcohol,
Drug, Tobacco Use, 8) Behavioral Health and Suicide Prevention, 9) Oral Health, Improve dental
health of children/youth/adults, 9) Promote best practices in the community
HEALTH DISPARITIES AND INEQUITIES ADDRESSED: This initiative will address
disparities/inequities for our Hispanic population through use of bilingual/bicultural staff. It also
address disparities among the rural poor and those with limited transportation by serving clients
in their homes, connecting services in their primary care site, and through one-stop clinics in WIC
where they already participate—right care, right place, right time.
COST VS RETURN ON INVESTMENT (ROI): See Budget
ROI—Rand Corporation analysis found a net savings of $34,148 for every family served in
Nurse Family Partnership or $5.70 return for every dollar invested. (Secondary to program
outcomes including: 79% fewer preterm births, 69% reduction in tobacco use, 56% fewer child
ED visits.)
For every dollar spent on a pregnant woman in WIC, up to $4.21 is saved in Medicaid for her and
her infant because WIC decreases risk for preterm birth by 25% and low -birth -weight by 44%.
(It's estimated that the project will pay for itself by reducing the number of preterm births/year by
4 ($46,000 each). Short term cost reduction should also be realized through fewer avoidable ED
visits by the target population.
Prevention impact is difficult to measure, especially in the short term. Anecdotal or case studies
will help to demonstrate positive impact of the initiative on risk factors that lead to preterm birth
and other costly health outcomes.
EXHIBIT A
Attachment 1 — Page 7 of 17
EVIDENCE BASE FOR PRACTICE:
Early Childhood Experiences Affect Health Over the Life Course. (Rethinking MCH: The Life
Course Model as an Organizing Framework, US Dept. of Human Services, HRSA, Maternal
Child Bureau, November 2011
Karoly, LA et.al. Early Childhood Interventions: Proven Results, Future Promise, RAND
Corporation 2005
Kitzman, H, Olds DL et.al, Effect of Prenatal and Infancy Home Visitation by Nurses on
Pregnancy Outcomes, Childhood Injuries, and Repeated Childbearing, a Randomized
Controlled Trial JAMA 1997:278 (8)
Bitler M., Currie J. 2005. Does WIC Work? The Effects of WIC on Pregnancy and Birth
Outcomes, Journal of Policy Analysis and Management 24 (1): 73-91
EXHE
IC:
ETA
Attachment 1 — Page 8 of 17
Exhibit B
BUDGET AND COMPENSTATION
Wellness and Education Board of Central Oregon (WEBCO) will:
1. Pay Quarterly to each of the three counties a percentage of $45,053 not to total
more than for $180,212 for the length of the contract. The percentage
breakdown is as follows:
a. Jefferson 12%
b. Crook 12%
c. Deschutes 76%
2. Please see attached spreadsheet for full breakdown of total project cost — both
WEBCO (CCO) and other funding.
3. Payment will be reconciled based upon Crook check run dates on a bi-weekly
basis.
EXHIBIT B
Attachment 1 — Page 9 of 17
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EXHIBIT B
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Travel x 3 (PHN)
11.aptops x 3 (PHN)
Furniture/Office Space (2.5 NFP)
0.05 FTE Admin. Secretary
(Data Support)
Salary & Benefits
Cell Phones x 3 (NFP)
3.0 FTE PHN II Step 1
(ECWG, NFP, CaCoon)
Salary & Benefits
0.15 FTE Supv. For NFP nurses
Salary & Benefits
0.5 FTE Initiative Coord./PHN Supv.
Salary & Benefits
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Initiative Status Report
[Select]
Project Name: [Project Name]
'Select Darcj
Status Code Legend
• On Track: Project is on schedule • I ligh Risk: \t risk, with a high risk of going off track
• .1t Risk: Milestones missed but date intact • ( )ff Track: Date will be missed if action not taken
The project is [SELECT]
the month of [Select Start
Date] - [Select End Date],
due to the following:
Issues/ Problems:
Action items accomplished
the month of [Select Start
Date] - [Select End Date]:
Action items planned this
month, but not achieved:
Action items planned for
next month:
Areas/questions for
discussion:
Other.
Overall Status:
• [To add a bullet for any status, on the Home tab, in the Styles gallery, click the name of the status of you
need.]
Insert brief update in this box
• [Issue No. 1]
• [Issue No. 2]
• [Issue No. 3]
• (Action item 1)
• (Actions item 2)
• (Action item 3)
(Action item 1)
(Action item 2)
(Action item 3)
• (Action item 1)
• (Action item 2)
• (Action item 3)
Questions/discussion topics here.
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EXHIBIT B
CORDOCS:60021535.5
Attachment 1 — Page 12 of 17
Contact Information
(Workgroup Leader Info.)
Office: [Office Phone] Mobile:
[Cell Phone]
Email: [Email address]
Initiative Abstract
Summary of Initiative can be copy and pasted here.
B-3
EXHIBIT B
Attachment 1 — Page 13 of 17
Exhibit C
STATEMENT OF WORK AND COMPENSATION
Wellness and Education Board of Central Oregon (WEBCO) will:
4. Serve as fiscal agent for the MCH Initiative serving Central Oregon tri -
counties (Deschutes, Jefferson and Crook).
5. Summarize quarterly program data submitted by the counties into required
reports for PacificSource and Central Oregon Health Council.
6. Promote and advocate for Initiative success
7. Provide a point of contact for the MCH Initiative Coordinator and arrange
quarterly face to face meetings to assure communication and cooperation.
8. Look for funding opportunities to sustain the Initiative and expand it to
include Phase II
Deschutes County Health Services will:
1. Provide a .5 FTE ( 86.33 hr./month) Coordinator to serve as point of contact with
WEBCO for the MCH Initiative
2. Assure Coordinator attends quarterly Initiative meetings with WEB -co and other
meetings as required.
3. Assure Coordinator communicates at least monthly with Jefferson and Crook
County Initiative PHNs and Administrators as needed.
4. Assures Coordinator convenes quarterly meetings for the Initiative Workgroup.
5. Assure Coordinator provides required Initiative data quarterly to WEB -CO.
6. Hire, train and supervise a 1 FTE (172.67 hr./month) Spanish-speaking public
health nurse (PHN) to provide Nurse Family Partnership services for a maximum
caseload of 25 families in the tri -county area.
7. Hire, train and supervise a 1 FTE (172.67 hr./month) PHN to promote prevention
integration in East Cascades Women's Group and Maternal Case Management
services through a minimum of 2 home visits per day (average 500/yr.).
8. Hire, train and supervise a 1 FTE (172.67 hr./month) PHN to promote
prevention integration in Deschutes County primary care practices and provide
CaCoon services (for children with special health care needs) through at least 2
home visits/day (average 500/yr.)
9. Provide initiative staff office space, furniture, phone, IT equipment/support,
medical equipment and supplies, materials and promotion
10. Provide ownership -custody of medical records.
11. Promote and advocate for Initiative success
Jefferson County Public Health Department will:
1. Hire, train and supervise a .5 FTE e6.33 hr./month) PHN to promote prevention
integration in Jefferson County primary care practices and provide Maternal Case
EXHIBIT C
Attachment 1 — Page 14 of 17
Management and CaCoon services through at least 1 home visit/day (average
250/yr.)
2. Provide initiative staff office space, furniture, phone, IT equipment/support,
medical equipment and supplies, materials and promotion
3. Provide ownership -custody of medical records.
4. Promote and advocate for Initiative success
Crook County Public Health Department will:
1. Hire, train and supervise a .5 FTE (s 6.3 3hr./month) PHN to promote prevention
integration in Crook County primary care practices and provide Maternal Case
Management and CaCoon services through at least 1 home visit/day (average
250/yr.)
2. Provide Initiative staff office space, furniture, phone, IT equipment/support,
medical equipment and supplies, materials and promotion
3. Provide ownership -custody of medical records.
4. Promote and advocate for Initiative success
EXHIBIT C
Attachment 1 — Page 15 of 17
Deschutes County Health Services 6/5/2013
1) Expansion of RN Care Coordinator/CHW Model into East Cascade Women's Clinic
2) Expansion of CaCoon, MCM and NFP Home Visiting Models
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Baseline: = 160
Point in time measure 4/30/2013
NFP: DC 70, CC 8, JC 9 Total =87
CaCoon: DC 47, CC 11, JC 11 Total = 69
MCM: DC0,CC0,JC4 Total=4:
Target = 333
NFP: 87 (current) + 25 (new) = 112
CaCoon: 69 (current) + 74 new (50 DC, 12 CC,
12 JC) = 143
MCM: 4 (current) + 74 new (50 DC, 12 CC, 12
JC)=78
All programs: 333
Counties =DC -Deschutes, CC -Crook, JC -Jefferson
Baseline = 0
Target = 99 new NFP (25) + new MCM (74)
Baseline = 87 (current NFP)
Target = 186 (current NFP + new
NFP (25) + new MCM (74)
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Alcohol or other
substance misuse
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Screening for
clinical depression
and follow-up plan
(NQF 0418)
Outcome
Strengthen inter -organizational
relationships, interactions, and practice.
(Modifications in practice may include system level
changes in screening/referral or data tracking.
These will be captured quantitatively.)
Increase # served (pregnant women
receiving Maternity Case Management
and children receiving CaCoon HV) *
Increase # of pregnant women
screened/referred for substance abuse
(SBIRT) *
4 Increase # of pregnant and postpartum
women screened/referred for
depression/anxiety (Edinburgh Postnatal
Depression Scale) *
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Attachment 1 — Page 16 of 17
Deschutes County Health Services 6/5/2013
1) Expansion of RN Care Coordinator/CHW Model into East Cascade Women's Clinic
2) Expansion of CaCoon, MCM and NFP Home Visiting Models
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ECWG data
ORCHIDS/
MCM
ECWG data
ORCHIDS-
MCM
ORCHIDS-
CaCoon
Target and Baseline MCH initiative
Baseline = 85
NFP: DC 70, CC 8, JC 9 =87, screened = 46
CaCoon: DC 47, CC 11, JC 11 = 69. screened=37
MCM: DC 0, CC 0, JC 4 =4, screened = 2
*Used 53% as percent screened, based on DC MCM
& CaCoon data
Target =333
NFP: 87 (current enrollment) + 25 (new DC) = 112
CaCoon: 69 (current) + 74 new (50 DC, 12 CC,
12 JC) = 143
MCM: 4 (current) + 74 new (50 DC, 12 CC, 12 JC)
=78
Counties =DC -Deschutes, CC -Crook, JC -Jefferson
Baseline = 0
Target =360
(tot — 60/mos tot w/prenatal care — 50%
OHP)
Baseline = 0
Target =99
Baseline = Establish
Target = baseline + 99
74 new MCM (50 DC, 12 CC, 12 JC) and
25 new NFP (DC)
* Will be established Q1
Baseline = Establish
Target = baseline + 54
74 new CaCoon (50 DC, 12 CC, 12 JC)
* Will be established Q1
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Prenatal and
postpartum care:
Timeliness of
Prenatal Care
Outcome
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Increase # of families referred to a
medical home by NFP, CaCoon, and
MCM
Increase # of pregnant women coded for
first prenatal visit at ECWG
Increase # of postpartum OB/GYN check-
ups (21-56 days postpartum) *
Increase # of pregnant women receiving
oral health exam during pregnancy *
Increase # of children with a dental home
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EXHIBIT C
Attachment 1 — Page 17 of 17