Damakant Jayshi
The Marathon County Health Department will serve about 50 families in 2023 through its Nurse Family Partnership program, saving the county a significant amount of money in the process, its top health official said on Wednesday.
The program, which has transitioned from Start Right, a similar program from the Health Dept., formally launched on Jan. 1.
“We have training for the nurses tentatively scheduled and we have a signed agreement to share nursing supervision costs with another county in the consortium, so work has begun,” the county’s Health Officer, Laura Scudiere, told Wausau Pilot & Review.
The NFP is already being implemented in 40 states. Marathon is latest county in Wisconsin to adopt the voluntary home visiting program which “supports low income, first-time mothers and their babies by assisting parents to increase their parenting and life skills,” Scudiere told Marathon County Health and Human Services Committee, citing NFP, while briefing the members on the program on Wednesday.
Under the program, she said, specially trained registered nurses will provide support, advice, and education on child and maternal health, development and care. But while Start Right services started during pregnancy and continued until age 5, the NFP will begin in early pregnancy and continue until age 2.
According to the figures shared by Scudiere the county paid $690,000 per year to its external partner, Children’s Service Society, now known as Children’s Wisconsin, to provide the services. By changing the model, the Health Dept. could serve 50 families and save $372,972 in 2023.
“Internal analysis indicates that 50 families is the demand in our county currently,” she said.
NFP has evidence to support return on investment if they factor in costs related to “criminal justice implications, medical care, child welfare, special education costs and quality of life,” Scudiere said. The estimated return on investment is $60,428 per family served.
Other benefits of the NFP program include mothers having more stable partner relationships, enhanced parenting skills, and decreased reliance on welfare. Participants are less likely to deliver their babies preterm and more likely to initiate and continue breastfeeding than non-visited mothers. Fewer risky behaviors, with less substance abuse during pregnancy, are among the other benefits. NFP also appears to reduce mortality in both mothers and children over the long term, the health officer added.
Scudiere also said the new program will have a gradual start, and results in the first year would be modest.
“I want to emphasize that this year is going to be a pilot year for us, which means we are learning a new program and implementing it from scratch,” she said. “So, we do not expect to be fully operational from Day 1.”
That is because nurses will need to be trained in the model, “but we will be able to double that in future years,” she said.
The value of the program should not be weighed by this first year, she said. The County Board “has already saved over half a million dollars in this first year alone” with this model change. “It’s estimated that we will save the county more next year as we will not have additional startup costs.” She then conducted an interactive session of three case studies with the supervisors on the HHS Committee, each highlighting the work of the NFP program and how it supports teenagers and women who need the program’s services.
The NFP has supported 2,650 families in Wisconsin since 2007. Scudiere said it is a proven, evidence-based program and has had 40 evaluation studies.
During the discussion, some HHS Committee members asked about the proposed savings while others asked about the NFP’s role if law enforcement were involved in cases of possible sex trafficking.
The NFP program was nearly derailed by some Marathon County Board of Supervisors during the budget discussion in November last year. Citing cost concerns, some wanted to explore the possibility of replacing the Start Right/NFP by Hope Life Center, an unaccredited faith-based pregnancy crisis center in Wausau headed by the chair of the Republican Party of Marathon County. A number of supervisors pushing for the change were endorsed by the party in the April 2022 election and some of them received cash donations from the GOP.
But other supervisors, county residents, advocacy groups and a certified and state-regulated healthcare agency vehemently opposed such a change. Top officials from the county, both elected and appointed, have said the county has no plans to formally partner with Hope Life Center.
The supervisors opposed to NFP proposed a drastic cut in its budget, from $841,507 to $220,000, but the move was defeated by a majority of the County Board. The 38-member board drastically reduced every cut proposed by some supervisors.
Some supervisors who support NFP expressed concerns that any budget cut, however small, would lead to a scaled-back NFP program, but county officials said they will press ahead with the original structure despite the cut.
The funding reduction is a challenge, Scudiere said, “but we had budgeted that funding to provide Children’s Wisconsin for transition in care between families receiving Start Right services care and NFP services.”
Previously, County Administrator Lance Leonhard also said the program would not be redesigned despite the cut in the budget.
“We will implement the NFP model as planned,” he told this newspaper last month.
