Cascade County health staff seek to start universal home‑visiting pilot despite state contract delays

Cascade County Public Health told the Board of Health on March 5 that it has been awarded a $350,764 Universal Home Visiting (UOHV) pilot grant but the county has not yet executed the state contract.

The health department’s maternal‑child health supervisor, who presented the update, said state contract language introduced a requirement for heightened cyber‑security coverage and initial weekly payroll terms that county counsel and state contract staff have since revised. “I just received a couple of weeks ago a new draft contract where they also removed to the insurance requirements or changed them,” the supervisor said. She said county legal staff continue to negotiate remaining terms and that the state has offered assistance to pay for cyber coverage in at least one other county.

The supervisor said the award is intended to pilot universal nurse home visiting available to all new parents through a child’s first birthday and to collect outcome data through the McVie data system used by SafeCare and Parents as Teachers. “This the announcement was for $350,764. This the purpose was to, pilot universal home visiting,” she said. She added the state is open to a no‑cost one‑year extension but long‑term funding is undecided.

Because the contract start date is listed as July 1, 2024 and runs through Dec. 30, 2025, department leaders told the board they have already incurred roughly $40,000 in preparatory expenses and are asking the commission to approve contract execution so staff can begin the pilot. The supervisor said the department would not immediately hire new staff for a short pilot; instead, existing nurses would deliver services and the grant budget had requested two nurses and a care coordinator for full implementation.

Public health nurses described the program as broader than the county’s current Maternal and Child Health (MCH) home‑visiting work because UOHV would provide universal screening and follow‑up rather than only serving people the department classifies as high risk. “With this grant funding, I technically only have the ability to go in and see these families, a couple of times or more based off solely of the pediatrician or the medical provider’s discretion. However, with this grant, we would have the opportunity to provide home visiting services to all moms,” said Megan, a public health nurse.

Board members and staff discussed practical barriers to executing the contract, including the county’s limited cyber‑insurance capacity and the short remaining contract period. Department leaders said they had raised these issues with state officials, who encouraged negotiation of contract terms and in at least one case offered to pay for cyber coverage for a county partner.

The department asked the board to support rapid contract approval and to authorize staff to begin pilot activities if the county signs the state contract. No formal commission action on the contract was recorded during the meeting.

Ending: Department staff said they will continue negotiating contract language with state legal and contract teams, seek commission approval as needed, and return to the board with updates on contract execution and pilot roll‑out if the county proceeds.