In response, the Children and Families Commission of Orange County and First 5 LA have received a grant from the California Pay for Success Initiative, a partnership of Nonprofit Finance Fund (NFF) and the James Irvine Foundation, to apply a new opportunity in funding sustainability to vital health care and developmental services to young children. In a model known as “Pay for Success,” the Commission and First 5 LA will soon leverage positive outcomes to help sustain programs that reduce health care costs and benefit the community at large.
The guiding principle of Pay for Success is that early intervention and preventative services will, over time, substantially reduce the outlay of public funds. The $100,000 grant will assess the overall cost savings the Commission’s Bridges Maternal Child Health Network and First 5 LA’s Welcome Baby and Select Home Visitation programs provide through early intervention, and evaluate the feasibility of the Pay for Success model.
Since 2000, the Children and Families Commission of Orange County has partnered with hospitals, government agencies and community based organizations to positively impact birth outcomes and the health of children ages 0 to 5 by providing early outreach, intervention and support services to families through the Commission-funded Bridges Maternal Child Health Network. The network represents a strong infrastructure of 10 birthing hospitals, the County of Orange Health Care Agency, and four non-profit home visiting providers.
In LA, First 5 LA’s Welcome Baby and Select Home Visitation program will also participate in exploration of the Pay for Success model. Welcome Baby offers personalized prenatal, post-partum and hospital visits with a professionally trained "Parent Coach" from pregnancy for the first 9 months for families living within First 5 LA's Best Start Communities. Available at no cost to all maternity patients, the Welcome Baby continuum of care also includes breastfeeding support, referrals to community resources and an in-home visit from a registered nurse.
The Children and Families Commission of Orange County and First 5 LA were established following voter approval in 1998 of Proposition 10, which added a 50-cent sales tax on tobacco products sold in California. First 5 refers to the commissions’
“As the funds allocated by the Commission shrink, we’ve worked to identify alternative funding strategies to ensure that proven programs continue to help young children and their families have the best start,” said Maria Minon, M.D., Chair of the Children and Families Commission of Orange County. “The Pay for Success model is especially encouraging, because it creates new opportunities for public-private partnerships to fund programs that are making lasting positive impacts in the lives of California’s most vulnerable children.”
Kim Belshé, executive director of First 5 LA, said: ““We look forward to partnering with our Orange County colleagues on the implementation of an innovative financing model that offers the potential of leveraging program success to secure sustainable resources. Through the Pay for Success grant, the Orange County and Los Angeles Commissions can demonstrate that hospital-based screenings for home visitation can contribute to improved outcomes for young children and savings to state payers.”
“This investment in outcomes measurement will allow the Commission and First 5 LA to better quantify the considerable value their programs deliver to their communities, the healthcare system and county government,"
Specifically, the Commission and First 5 LA will use the grant to conduct a series of in-depth feasibility assessments;
Michael Ruane, chief of strategy and public affairs of CalOptima, said his organization supports the sustainability efforts of the Commission. CalOptima is a leading Orange County organized health system that administers health insurance programs for low-income families, children, seniors and persons with disabilities.
“Now is an opportune time to look at innovative programs that could be expanded to serve a broader population and contribute savings to the health care system,” he said. “The CalOptima Foundation is charged with supporting innovative programs that benefit our current CalOptima members and the Bridges for Newborns program has been a key program for many of our members.”
Mark Refowitz, director of the Orange County Health Care Agency, said the agency supports the potential application of the Pay for Success model for the Bridges Network.
“We hope this effort meets with great success and will serve as a model for reducing health care costs and inefficiencies throughout the county and the state,” he said.
Dr. Minon said the structure and goals of the Pay for Success program aligns perfectly with the Commission’s current focus. As funds from Prop.10 have fallen, the Commission’s attention has shifted from primarily funding programs to looking for new ways to help community programs become financially self-sufficient.
“We expect that the things we learn over the next several months during our feasibility effort, will help not only our existing programs, but our larger efforts to help community organizations become sustainable on their own,” Minon said. “Just as important, we’re hopeful that what we learn will be valuable for all Proposition 10 commissions throughout California. Like us, they’re facing the difficult challenge of ensuring the continued availability of programs that are improving children’s lives.
“It’s a challenge we must face head-on.”