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Certified Sustainable Sustainability Plan Template

COMMUNITY LACTATION ASSISTANCE SUSTAINABILITY PLAN

Community Resource Project, Inc.

Sustained breastfeeding support is a critical indicator of implementing system change to attain health communities

Certified Sustainable Community Resource Project Inc.

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Community Resource Project, Inc.

Certified Sustainable Plan

Table of Contents I. Narrative

A. Agency Overview…………………………………………………………….. B. Sustainability Plan Narrative…………………………………………………. Page 3 C. Existing Funding Sources…………………………………………………….. Page 5 D. Needed Funding Sources…………………………………………………….. Page 7 E. External Factors for Future Planning…………………………………………. Page 9 F. Internal Culture related to Fund Development……………………………….. Page 10 G. Priority Domains for Action………………………………………………….. Page 11 H. Strategies for Priority Domains……………………………………………….

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II. Budget A. Five-year Budget……………………………………………………………...

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III. Implementation Plan A. Training and Capacity Building Plan………………………………………… Page 15 B. Action Plan to Achieve Needed Efforts……………………………………..

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A. Agency Overview

Community Resource Project, Inc. (CRP) is a federally approved 501c (3) non-profit entity based in Sacramento. Founded in 1972 to provide much-needed poverty intervention services to low-income communities throughout the Northern California region, for 46 years CRP has provided on-the-ground administration of numerous federal, state and locally funded programs. Thus, our mission is to improve opportunities for people in need through energy efficiency, health, and education. Our dedicated staff provides services in more than ten languages to more than 60,000 clients annually through both our Health and Energy divisions. Through the efforts of our 2 Divisions, we envision healthy and economically stable communities, where everyone can realize a high quality of life. CRP is a trusted member of the Sacramento community as a result of decades of interaction, involvement, language competence, and program delivery that directly intervenes in distressed neighborhoods. CRP focuses on public health, health care education and utilization to improve the health of families and children during critical times of growth and development. In doing so, CRP demonstrates our leadership role to build stronger, healthier and more vibrant communities throughout our region. Our on-the-ground presence in disadvantaged areas throughout Sacramento County solidifies our on-going relationship with the First 5 target population. CRP’s Health Division services include:

Women, Infants and Children (WIC) Supplemental Nutrition Program: Our WIC program funding through the United States Department of Agriculture (USDA) allows us to provide nutritious foods, nutrition education, breastfeeding support, and referrals to health care and other social services, to low-income pregnant, postpartum and breastfeeding women, as well as to infants, and children 0-5 years old, within Sacramento County. CRP WIC serves approximately 22,700 mothers and children every month, within 8 service centers strategically placed in high need areas. Over 60 % of all children in California are eligible for WIC services. Thus WIC functions as an effective gateway to connect with other health related services. It behooves First 5 to continue to collaborate with WIC to ensure improved health outcomes for families whom both entities serve.

Community Lactation Assistance Project: Since 2007 CRP has successfully implemented the Lactation Consultant Assistance Project (CLA) in conjunction with DHHS Sacramento County WIC. This collaborative Project promotes and assists breastfeeding mothers and infants through specialized consultations and phone support with Internationally Board Certified Lactation Consultants (IBCLC’s). These consultants develop comprehensive care and follow-up plans for high risk breastfeeding mothers and their infants. Through our First 5 activities, WIC programs fill an important gap by educating parents and caregivers about the critical role breast milk plays in the healthy development of children during their first five years of life. Our Program has shown clear results in our ability to increase 6 month exclusive breastfeeding rates compared to clients who did not receive First 5 services during the same time frame.

Breastfeeding Peer Counselor Program (BFPC): Through special USDA funding, this program works within the WIC setting to target first time prenatal women. Enrolled clients are paired with a Peer Counselor (PC) who provides anticipatory guidance and one-on-one basic breastfeeding education throughout pregnancy, to prepare for successful breastfeeding initiation. PC’s provide services up until 6 months post-partum to impact breastfeeding duration. PC’s refer their clients to


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IBCLC staff when breastfeeding situations are beyond their scope of practice. This grant supports the efforts of First 5 funded IBCLC’s by ensuring that mothers who need additional support receive this, and thus better ensure compliance with the IBCLC’s care plan provided.

Regional Breastfeeding Liaison Program (RBL): This program works with the medical community and other community stakeholders to increase awareness of WIC’s breastfeeding resources in Sacramento County. As such, the Program facilitates strategies to make breastfeeding the norm for infant feeding in our county. Thus RBL staff educates and provides technical assistance to local hospitals in efforts to implement more breastfeeding-friendly policies including acquiring and maintaining certification through the Baby Friendly Hospital Initiative (BFHI); increasing breastfeeding competency in outpatient healthcare settings; and serving as a change agent to better ensure lactation accommodations in both the work and school setting. Most recently, our RBL’s are intently working to build partnerships with potential third party health providers and staying abreast of other State efforts to pursue reimbursement options for Lactation Consultant services in our region.

Cal Learn: This statewide program helps expectant and parenting teens receiving CALWORKS public assistance to complete high school, become independent, and form healthy families. Our case management and referral services help clients become self-sufficient adults and responsible parents, learn how to form healthy relationships, and achieve safe and secure futures.

Energy Division: The goal of our Energy Division is to improve energy efficiency and reduce the impact of energy costs on a family's household budget. Creating a livable and environmentally-friendly green community is our key driving force. We achieve this through home installation of energy-saving appliances, utility bill payment assistance, energy conservation education, and our lead-based paint abatement control program. These various services are provided throughout Sacramento, Sutter, and Yuba Counties.

Together, these core activities allow CRP to further the state and federal public health mission by providing access to an important array of services to ensure families have healthy outcomes. Our services, clearly demonstrate CRP’s important role in the public health continuum by providing the on-the-ground capacity for First 5 Sacramento’s strategies to continue to achieve narrow and deep impact.

B. Sustainability Plan Narrative

Our First 5 sustainability plan is integrated with our larger CRP agency strategic plan that has been actively pursued for the past 3 years. Historically, CRP’s has successfully leveraged funding through program process monitoring and management review. Through the leveraging of our WIC and First 5 grants in the Health Division, or as many as six (6) grants simultaneously in our Energy Division, these ongoing efforts are evidenced through our designation by the California Community Services and Development Department as a High Performing Agency.

Under the leadership of CRP’s management staff that include our Fund Development Specialist, Dr. Jesus Hernandez, who specializes in community development, Maureen Clark, Health Division Director and Controller Elizabeth Bianchi-Rossi they share responsibility for the organization’s leveraging of funds and sustainability. Maureen possesses a wealth of experience successfully leading our Health Division for nineteen (19) years. Alternatively, Elizabeth has been with CRP for eleven years serving as our Controller for the past three (3) years. During her first 8


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years serving as the Assistant Director of the Energy Division, she directly supervised or developed our leveraging program. Collectively, each of the responsible individuals will devote approximately 10-15 percent of their time to address financial review and program sustainability efforts. Additionally our Breastfeeding Promotion Coordinator, Jeannette Newman-Velez oversees our First 5 Grant as well as additional grants to maintain a full spectrum of breastfeeding support interventions to program participants. Jeannette has been with CRP for over 20 years.

Our strategic plan diversifies current and identifies new revenue streams to leverage other programs and services. CRP has established two (2) critical positions to ensure organizational sustainability. Both our Development Specialist and Social Media Marketer are integral to this task. Three (3) primary strategies serve to ensure we reach our goals:

1. Fund Development – Given that our current grant revenue is almost completely derived from government grants, CRP will pursue more foundation and other non-government grants and contracts to enhance and diversify our current revenue streams. For First 5 related sustainability opportunities, please refer to “Anticipated Funding Source Table” on page 7.

2. Social Media – This new operational improvement includes the recent enhancement of our website that encompasses an email marketing program to improve our outreach and branding messages. Our new social media marketer has responsibility for expanding our brand and implementing donations strategies, and shared service efforts with companies such as Amazon. We continue to expand our reach as a second year participant in the local Big Day of Giving Campaign this May.

3. Social Entrepreneurial Ventures- CRP is exceptional in our delivery of programs and services. Within our Energy Division we maintain contractor licensing and certification in specialized areas of solar installation, energy-efficiency retrofits, HVAC repair and installation, Lead Paint Abatement, window replacement and much more. These licensing and skill sets allows CRP to seek private venture contract opportunities that will provide unrestricted revenues to support our general program offerings in our communities. We have already demonstrated initial success with this pilot endeavor. As we execute our long-term implementation and fund development plan, we expect our unrestricted revenues to increase.


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C. Existing Funding Sources for 2018/19-2020/21

Source Amount Duration Funded Services First 5 Sacramento Contract $1,095,202 July 1,

2018-June 30, 2021

Direct lactation services to breastfeeding moms and infants; helpline coverage and home visits; supplies for breastfeeding moms and infants

Women, Infants and Children (WIC) Supplemental Nutrition Program

$1,865,534 July 1, 2018-June 30, 2021

Support staff services to breastfeeding moms and infants participating on WIC Program by WIC Dietitians/clinic managers, WIC Nutrition Assistants, Regional Breastfeeding Liaisons and Peer Counselors; training and supplies for First 5 staff not covered in First 5 contract

Big Day of Giving $5,000 May-June 2018

Unrestricted funds for agency needs

CRP/Agency fundraising efforts $4,000 - $18,000

Current through 2021

Incentives and/or unrestricted funding to support program and for staff, including gift cards and years of service awards.

Agency In-Kind Support Our USDA WIC Grant serves as the primary source of our agency’s In-Kind/discretionary

funding towards overall First 5 Program costs. This consists of both personnel and operating expenses. Such in-kind support averages out to be $564,886 annually, as indicated in our current 3 year contract. The WIC Program supports general breastfeeding education and support services for WIC mothers and infants in addition to staff training on breastfeeding promotion and support activities. Our WIC-Regional Breastfeeding Liaison Program funding supports First 5 milestones and collaborations in the community and with hospitals through the initial expansion of the Early Notification of Delivery System (ENS) process; our WIC-Peer Counseling Program funding supports First 5 milestones by linking new WIC breastfeeding moms to our First 5 Lactation Consultants for direct client services. Overall WIC funding supports administration and management of the First 5 Program; as we pursue other funding streams, these existing programs will continue to support our efforts to ensure quality Lactation Consultant services are provided to our target community within budgetary constraints.

Proposed Efficiency Measures In 2018, our agency adopted new financial management and accounting systems that include an

updated electronically-based system to track employee time and funding codes. These result in improved work systems, resulting in additional efficiencies to manage our various grants.

During 2019, the California Women, Infants and Children (WIC) State Program will transition to an electronic benefits system and a newly updated cloud-based Management Information System


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that is named, WIC Wise. Our agency will implement this system on September 23, 2019. Together these will improve all processes from service delivery to the efficient distribution of benefits. Both our WIC and First 5 Programs utilize an automated communication system that allows us to remind clients of their upcoming appointments for both WIC and First 5 Lactation consultation services. It also contacts who have missed their appointment, to ensure we do not lose their participation in both programs. In this upcoming fiscal year (2019-2020), those costs will be absorbed by our State WIC agency, thus freeing up some administrative costs. We anticipate the savings from these efficiencies will result in an annual savings of $20,000 a year.

Cost Saving Collaborative Efforts CRP is involved with multiple collaborative efforts that could ultimately result in cost savings.

As part of our WIC Program, our RBL grant allows our staff to work to improve communication and service linkage with the health care providers and hospitals in both Sacramento and Placer counties to ensure sustainability of breastfeeding support and services. The structure of our RBL program is a cost saving collaborative measure in itself, in that these services not only benefit our agency, but also our partner WIC agencies in the Sacramento and Placer County region. Sharing the expertise of these staff provide avoids duplication of effort and unnecessary administrative costs. The primary goals of the RBL program as they relate to our First 5 and delivery of services include the following:

Goal 1: conduct health care provider outreach and training on breastfeeding topics and referral to WIC lactation services; assist in the implementation of the 9 steps for breastfeeding friendly clinics at the Sacramento County clinic and continue to coordinate the Early Notification System (ENS) referrals with local hospitals.

Goal 2: strengthen discharge referrals for lactation support at WIC clinics and other community based outlets to ensure continuity of care post-discharge.

Most recently, our RBL’s are representing for both WIC programs in their discussions with River City Medical Group (RCMG) provider to implement a pilot reimbursement project. This endeavor hopes to provide a means for reimbursement of Lactation services provided to WIC Clients that are also RCMG health members. Ultimately these efforts help to bring about systems change that we hope will drive our health care partners to integrate breastfeeding into their core services and concurrently initiate billing mechanisms that allow such best practice endeavors to be absorbed by their system, similar to the internal system Kaiser Permanente utilizes.

Inter-WIC Agency Collaboration

WIC clinics are similar to Family Resource Centers (FRC’s) in that they provide similar services but in varying targeted geographic communities. Historically, our strong collaboration with our service counterpart, Sacramento County DHHS, ensures that low-income families who live within the corresponding service area can fulfill their service needs closest to home. With both our WIC and First 5 funded services, we continually cross refer mothers based on their need to ensure they do not lack prompt nutrition and breastfeeding support after discharge. This endeavor helps sustainability efforts for both CRP and Sacramento County WIC programs, through improved client retention.


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Collaboration with Local Hospitals and Regional WIC Programs Our ENS referral system embodies further collaboration where we work with local birthing

hospitals and other local WIC agencies to notify them when current clients or income eligible mothers deliver their baby. We currently receive an average of 375 referrals per month through this endeavor. Of these, 175 ENS referrals per month are referred to Sacramento County WIC; 33 ENS referrals per month to WIC in other counties and 167 referrals of mothers currently on our WIC program. Precious time is saved by avoiding clinic issues that can effectively be resolved through early intervention upon prompt referral.

Volunteer Support Our new partnership with UC Davis Human Lactation Program provides master level lactation

consultant interns to shadow Lactation Consultants and assist with tasks during one-on-one consultation sessions with First 5 moms and attend home visits. The value of volunteer hours is estimated to be $2500 - $5000 annually, depending on the length of interns’ rotation with us.

Upon achieving the above, cost savings and efficiencies, would result in consistent breastfeeding messaging in the community. This would further assist with referrals to our program and allow for continuity of care, and increased efficiency to achieve First 5 milestones.

D. Needed Funding Sources To sustain our current level of services, we will require approximately $934,628. This estimate is

subject to possible increases due to adjustments to salaries, benefits and future incentive pay.

Anticipated Funding Source Table

Source Amount Duration Services funded Confidence level (1-low to 3-High)

Arden Arcade Community Center/Black Child Legacy Campaign mini-grant

$650 2019 (1 year)

Community Baby Shower for African American families

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Annual Breastfeeding Celebration

$3,000 2019 Annual outreach event and non-restricted breastfeeding support items

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River City Medical Group Pilot Project -

$20,000 July 2020-2021

2

Big Day of Giving $5,000-9,000

2020/21 2021/22

Unrestricted funds for agency needs

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Dignity Heath Foundation Community Grant

$50,000-100,000

1 year LCA support services for LC direct services including Early Notification of Birth Service

2

March of Dimes California Community Grant Program

$10,000-50,000

6 months Community outreach support towards African American women

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Potential Sources for Additional Funding

March of Dimes California Community Grant Program: The purpose of this funding is to prevent birth defects, premature birth, and infant mortality in at-risk areas. The grants awarded can be from $10,000 to $50,000 for a 6-month period, to fund research for seeking causes of premature birth, identify barriers, and to implement interventions. In addition, the fund also supports educating health care providers and women about strategies to prevent health risks. The program advocates for health care coverage expansion and to improve maternal and infant health outcomes by providing emotional support and information to families. This offers the opportunity to further our endeavors to advocate, educate, and inform families about preventing health risks and infant mortality, as well as conducting outreaches to towards at-risk women in the area to help reduce premature birth and infant mortality.

Dignity Health Foundation (DHF) Community Grant: This funding serves to develop strategic partnerships between community-based organizations that link services directly to Dignity Health hospitals, leverage resources that address priority health issues and utilize creative strategies that have a direct, positive and lasting impact on the health of disadvantaged individuals and families in the local community. We will reapply for the 2020 funding Cycle to provide alternative funding for our Early Notification of Birth Service (ENS) activities and other collaborative activities that support the continuum of care for perinatal women, currently funded through our First 5 Grant. DHF Grants are awarded for 1 year for up to $50,000. Subcontracting through Federally Qualified Health Clinics and CPSP Programs According to the “Breastfeeding FAQs Medi-Cal Guidelines” (January 2004), breastfeeding (BF) benefits are reimbursable under OB/(FQHC) that coordinate with Comprehensive Perinatal Support Programs (CPSP) for billing of Lactation Consultant Services Program (CPSP). BF education is included in the nutritional, psychosocial, and health education support services (BF2-6).

Expanded Partnership/funding with Black Child Legacy (BLC) Grantees The BCL Campaign has strategically located 7 Community Incubator Lead (CIL) agencies in zip code areas that have exhibited disproportionately higher than expected infant mortality rates of African American children. These CIL’s are often located near our CRP WIC offices. It behooves us both to develop a partnership whereby Lactation Consultants could provide lactation services that specifically target African American clients to address the CIL perinatal condition areas of focus targeted.

Implementation Steps to Secure New Funding Please refer to our ‘Implementation Plan’ on pages 17-19 for specific steps for each funding source.

Alternative Options for Sustainability

While we would still provide Lactation support services to our clients, should we not be able to find alternative funding for our services, activities would be tailored down to the highest needed services. Specifically, these would focus on our face-to-face Lactation Consultant services. Our current


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WIC grant could potentially cover 1.5 Full-time equivalents (FTE) of the current 3.0 FTE IBCLC’s positions currently provided under our First 5 grant. With this drop in personnel, we would maximize our staffing by reducing geographic coverage for services and providing limited services to only our clinics with the highest birth rates (North Highlands, Citrus Heights, Arden area, Elk Grove/South Sacramento clinics). WIC funding would absorb some costs to provide breastfeeding aids and program supplies, however the quantity provided, would be decreased.

To help mitigate this gap in services, we will continue collaboration with local hospitals and out-patient health care providers to bolster their own aftercare programs and thus ensure some level of lactation support is provided to low-income women after hospital discharge.

We would continue to collaborate with our service partner, DHHS Sacramento County WIC, to ensure that WIC mothers requesting lactation services could access these as best as possible, through service coordination.

E. External factors Impacting Sustainability

IBCLC Third Party Provider Reimbursement Opportunities Currently, IBCLC’s cannot bill as independent providers, because they are not licensed in

California. However, there is a potential that IBCLC’s may be able to be licensed similar to other health care professionals in our State. This prospect would open the door to direct billing to Medi-cal and other third party insurers. Nevertheless, there are still many political and bureaucratic hurdles to address for this to come to fruition.

More third party health plans recognize the need to incorporate lactation services into their core direct services (such as Kaiser). This may provide opportunities for us to partner with those insurers for reimbursement of our Medi-cal clients that are also their members.

Political Factors: The political environment also impacts the availability of additional funding and opportunities for our Agency. With renewed focus on health and prevention, the community grants (i.e. Dignity Health grants) mentioned above may have an opportunity to release additional funding that would work to our benefit. Additionally, the new Governor of California has signaled increased support of programs related to social service and children’s health delivery. This will not only help ensure more Californians to have their health needs addressed, but also for children to have the support they need to thrive no matter what their economic status is. Perinatal support services fall into this category, having the potential to save tax payer dollars through preventative interventions.

While we receive grant applications from similar entities annually, it is uncertain if their scope and funding level will align with the scope of our current Lactation Consultant services. Studies show that for every tax dollar invested in WIC, 3 dollars are saved through prevention of illness and hospitalization of WIC participants. While WIC has historically received bipartisan support based on this consistent success, nevertheless, as a non-WIC is considered an entitlement program, we must advocate for continued funding. Federal contracts through the United States Department of Food and Agriculture (USDA) may in turn impact our ability to provide in-kind support from these programs in the future.


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WIC’s impact on the Nation’s Health Status Numerous studies have confirmed WIC’s impact in avoiding health care costs. Specifically, a 1997 study reconfirmed the original 1988 research in North Carolina, documenting WIC’s effectiveness in avoiding the health care costs to the Medicaid program by reducing the number of premature and high-risk births. Also, a 2002 analysis of longitudinal data concluded that there exists a significant positive association between WIC participation in pregnancy and normal birth weight in newborns. Infant-feeding practices play a major role in the development of childhood obesity. In an effort to address this issue, the California WIC Program partnered with the UC Davis Human Lactation Center to develop classes to help WIC parents have more realistic expectations about their infants’ behavior and to recognize and respond appropriately to infant “cues”. The project, WIC Baby Behavior Study, was highly successful in helping caregivers understand and accept normal infant behaviors, such as sleeping and crying. Caregivers were more likely to continue exclusive breastfeeding and less likely to use excessive amounts of formula. After attending Baby Behavior classes, this education resulted in better compliance with infant-feeding recommendations among WIC participants and fewer infants whose body weight was above 95% of normal infants. Currently WIC staff statewide have received this training.

F. Internal Culture to Support Fund Development and Sustainability

Internally, our Agency has taken multiple steps over the past 2 years to create a culture of innovation and service expansion. Additionally, much effort has been underway to further educate and engage our Board members, Executive team, and senior staff in addition to supervisors with the constant fine tuning and implementation of our agency’s current strategic plan. Our strategic plan’s focus areas target agency branding; funding diversification, Program sustainability and expansion. All of these efforts simultaneously catalyze the steps and discussion we pursue for our First 5 Certified Sustainable endeavors.

To further support our Agency’s ability to successfully secure additional funding and meet our needs, we have diversified and thus fortified our Administrative staff to include a Business Development Manager and a Project Coordinator. These staff work closely with both our Energy and Health divisions, and upper management to help identify opportunities to enhance, expand, and create programs. This endeavor not only supports existing services, but identifies and helps secure additional sources of both restricted and unrestricted revenue. Processes have already been identified to assist with the vetting of current opportunities to ensure they represent a good fit for our Agency to pursue. Additionally, our Project Coordinator is charged to help all programs better track, highlight, and communicate their program’s success and impact using visual demographics and storytelling. Our Agency has also subcontracted with a marketing specialist who has both increased our Agency’s presence in the social media world via Facebook and Twitter, and also helped to disseminate information about Agency activities via public service announcements and press releases to media outlets and elected officials. Collectively, these factors communicate key messages on our success in the community and develop a foundation for and culture of sustainability for the entire Agency.


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Internal Limiting Factors to Funding As indicated earlier we intend to pursue opportunities to collaborate with Federally Qualified

Health Centers (FQHC) to potentially bill for Lactation Services through a partnership with a Comprehensive Perinatal Support Program (CPSP). However, we recognize the barrier that our Agency does not currently have a billing system established to accept Medi-cal fee-for-service-type activity. This will most likely require additional staffing, training and/or funding to support if we were to be direct recipients of the billing relationship. To address this obstacle as we proceed, we will collaborate with entities that already have such a system in place.

Dedicating staff, time, and energy to pursue additional funding opportunities and complete grant documents may also be a minor limiting factor. Nevertheless, our Agency overall has a very successful track record in securing additional funds. It will be critical for us to continuously assess our capacity for growth and adjust hiring and training accordingly.

As our Agency is forward-thinking and has already initiated discussions with both staff and Board members on these topics, we will continue to create opportunities amongst the teams as we proceed. We anticipate the processes already in progress to secure additional funding will continue to improve as well as our strategies to seek out additional funders and supporters for all programs under the CRP umbrella. We possess a strong foundation to intensify our collaborative journey with strategic community partners while identifying and implementing innovative strategies, services, and funding.

G. Prioritized Domains for Action

Priority Rank a. Operational Framework 1 b. Measuring Impact and Accountability 2 c. Culture, Decision-Making and Change Management 3 d. The Nonprofit Brand 4 e. Revenue Structure 5 f. Engagement of Partners, Board and Volunteers 6

1. Operational Framework (Domain #2)

We prioritized the Operational Framework domain, towards our sustainability efforts because it conveniently coincides and aligns with our Agency-wide strategic plan and priorities to better stabilize financial processes and procedures. Integral to this process, we are strategically assessing our capacity for program implementation and growth.

With concerted efforts in this domain, CRP aspires to enhance and expand our other revenue generating services; diversify funding to thereby sustain our Lactation Consultant services by the end of year 3 of the First 5 Program contract as well as other CRP programs. Together these endeavors function to define our continued success. This concurrent effort allows us to catalyze our energy and resources to attain tangible objectives and thus provide quality services in a sustainable structure.


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2. Measurement Impact and Accountability (Domain #5) Once again, quantitatively measuring our current impact further enhances our ability to share our story both with service recipients and stakeholders who share our vision. Our focused efforts in this domain clearly aligns with CRP’s Strategic plan regarding increased community presence and subsequently augments our ability to capture success stories and communicate Program impact to Agency staff, the local community, and our stakeholders.

H. Strategies for Priority Domains

A. Operational Framework and Determinants for Success CRP will implement the following principle strategies to succeed in this domain:

1. Identify markers of financial health 2. Explore and identify collaborative opportunities/strategic partnerships that optimize

the connection between physical environment (i.e. Healthy homes and communities) and how this relates to the overall health of families

3. Identify strategies to communicate health disparities and environment and/or identify markers of health as it pertains to the physical environment, internally and externally with partners and funders.

To determine our level of success we will analyze our funding level stability and accumulation, including our amount of unrestricted funding. We will also increase partnerships and opportunities that will result in expanding services or service locations within our community.

B. Measurement Impact and Accountability Determinants for Success CRP will implement the following principle strategies to succeed in this domain:

1. Identify data available to utilize; create centralized processes for data sharing 2. Create framework within Agency to share success stories and highlight program

impact internally and externally that builds on service delivery, relationships with clients, stakeholders and funders

3. Strengthen internal and external strategies to communicate our value within our agency and to our local community. We have begun this process by initialing a quarterly newsletter to showcase our programs and their success. Our annual report provides a similar portrait for current and potential donors and stakeholders

To determine our level of success we will publish our Annual report, conduct regular sharing, and highlight program impact and success stories. This includes increasing our social media presence targeted towards agency staff, public officials, community partners, and clients receiving services. We helps to build additional funding opportunities as result of utilizing/packaging data to visually show successes/impact with funders, community partners, and stakeholders.


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II. Budget A. Five-year Budget

Community Resource Project, Inc. Five Year Financial Plan

1 How much First 5 funding is budgeted for your agency in Fiscal Year (FY) 2020/21 $363,602

2 How much other funding and in-kind value is budgeted in FY 20/21 $552,249

THIS IS THE COST OF CURRENT SERVICE LEVELS------------------------------------------> $915,851

3 Operational Changes

►►►List and explain your assumptions and the overall net dollar effectBase Salary 664,728$ From Budget FY 20/21

Salary Adjustmentsa. Staff will be receiving a 3% COLA $17,162

$572,078 x 3% = $17,162b. Anticipated increases in benefits = 3% $17,162

$572,078 x 3% = $17,162c. $0

d. $0

Total Salaries after adjustments --------------------------> 699,052$

Base Benefits 183,065$ Rate-----> 27.5%

e. Change in benefits $9,453Total Benefits after adjustments --------------------------> 192,518$

Other Adjustmentsf. Proposed Efficiency Measures - Reduction in office supplies, storage space, and equipment costs ($20,000)

This reduction is as a result in upgraded in-house system efficienciesg. Volunteer Support - Bringing on two UC Davis lactation consultant interns ($5,000)

Estimated value of staff volunteers = $5,000 in cost savingsh. $0

THIS IS YOUR OPERATIONAL CHANGES------------------------------------------> $18,777

THIS IS YOUR TARGETED SUSTAINABILITY GOAL:------------------------------------------> $934,628

THIS IS THE NEW ESTIMATED FIRST 5 FUNDING LEVEL (30% REDUCTION)------------------------------------------> $254,521

THIS IS YOUR SUSTAINABILITY GAP------------------------------------------> $680,106

In order to provide the same level of service in FY 21/22 what kind of changes are needed for your budget? They can be negative or positive. If it is a reduction to the budget, the budget line item should be noted.


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Agency:Sustainability Contact:

Email: Phone:

Cost of Core Services to Sustain: 915,851$ *Operational Changes: 18,777$

934,628$

2021 SPFY 2017/18 FY 2018/19 FY 2019/20 FY 2020/21 FY 2021/22

Personnel 233,300 642,898 651,226 664,728 606,402Benefits 51,547 178,858 190,518 183,065 194,049Operating Expenses 17,322 55,610 71,268 71,733 71,733Subcontracts 0 0 0 0 0Indirect 30,195 79,053 85,878 76,975 76,975

Total Expenses 332,364$ 956,419$ 998,890$ 996,501$ 949,159$

Budgeted 2021 SPFY 2017/18 FY 2018/19 FY 2019/20 FY 2020/21 FY 2021/22

** First 5 Sacramento Funding 161,488 365,992 365,608 363,602 254,521

Guaranteed Funding1 WIC Grant 170,876 557,777 596,632 540,249 540,2492 Big Day of Giving 0 5,000 0 0 03 Agency Fundraising Efforts 0 4,000 8,000 12,000 18,0004 Black Child Legacy Campaign 0 650 0 0 0

Contractor Cash Match

Anticipated Funding1 Annual CRP Breastfeeding Celebration 0 3,000 3,000 3,000 3,0002 River City Medical Group Pilot Project 0 0 0 20,000 20,0003 Community Grants 0 20,000 20,000 50,000 100,0004 Black Child Legacy Campaign 0 0 650 650 6505 Big Day of Giving 0 0 5,000 7,000 9,000

In-Kind Collaboration (MOU) 0 0 0 0 0

In-Kind Volunteers 0 0 0 0 7,200

In-Kind Goods 0 0 0 0 0

Sub-Total Resources Available for Sustainability--------------------------------------------------------------------------------------------> 698,099

TOTAL RESOURCES 332,364$ 956,419$ 998,890$ 996,501$ 952,620$

FY 2017/18 FY 2018/19 FY 2019/20 FY 2020/21 FY 2021/22First 5 Sacramento Commission Funding: 161,488$ 365,992$ 365,608$ 363,602$ 254,521$

Contractor Match Funding: -$ -$ -$ -$ -$ Leveraged Cash: 170,876$ 590,427$ 633,282$ 632,899$ 690,899$

Value of In-Kind Goods & Services: -$ -$ -$ -$ 7,200$ Total Resources: 332,364$ 956,419$ 998,890$ 996,501$ 952,620$

Value of Services (Lost)/Gained: 17,992$ Sustainability Rate %: 102.6%

***

SUMMARY OF LEVERAGED RESOURCES & SUSTAINABILITY EFFORTS

Community Resource Project, Inc.Maureen Clark, Health Division [email protected] 916-326-5840

Targeted Sustainability Goal

2018 Strategic Plan

EXPENSES

2018 Strategic Plan

Revenue

Sustainability Resources

Operational Changes are the amount of savings/increases to the budget to provide current level services.First 5 funding is not guaranteed to any contractor. Actual amount to be cut for the 2021 Strategic Plan is not known, 30% is used as a Target.


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III. Implementation Plan A. Training and capacity building plan

1) Training completed during Certified Sustainable Training, Coaching or Capacity Building Completed Reason/Need and Benefit

CWA All CRP Staff Quarterly Training-Digital Storytelling, May 2017

Increase skills to translate our agency success into visual platforms

Certified Sustainable – Health Services Cohort, Meeting 1 Introduction to sustainability plan, discussions with cohort members

Certified Sustainable – Health Services Cohort, Meeting 2; training on Revenue Structure

Understanding basic financial management and revenue structure

Certified Sustainable – Innovation, Collaboration and Branding for Sustainability – October 2019

Awareness of Agency branding strategies and ideas to consider moving forward

Certified Sustainable – Agency meeting with Mark Simon, Storywalkers, Inc. –November 1, 2018

Discussions regarding Agency priorities and received assistance identifying top domains for First 5 Sustainability

Impact Foundry – What IF conference – February 6, 2019 Variety of workshops at the conference provided new tips, strategies and resources to manage current workload and consider new and innovative strategies to do things differently; networking time provided opportunity for our Agency to meet and interact with a diverse range of professionals in the non-profit world and a variety of funders that may lead to future collaborations and/or funding opportunities

Certified Sustainable - Culture, Difficult Choices & Change Management (if training is rescheduled)

Learn additional strategies to implement and manage change

WIC CDPH-WIC WIS conversion training March-Sept 2019

Staff training to prepare for Statewide Data system and Electronic benefit delivery system

Provision of Nutrition and Breastfeeding Education Support and Care-CWA 11/28/16

Learn billing strategies to cover these services in the WIC and community health based setting

Annual Breastfeeding Summit-California Breastfeeding Coalition 1/27/2019

Reach, Inclusivity, Structure and Effectiveness: How Coalitions RISE to the Challenge; The State of Breastfeeding: Global to Local; Cultural Humility: Connect Better with Individuals and Communities; Workshops- Breast pumps: Skills and Billing; Workshops- Breastfeeding Support through Social Media

Tim Martinez (Marketing Consultant) CRP WIC Staff Training-March 2019

Further develop our presence in social media platforms sharing our successes.


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2) Training and capacity building needed to effectively carryout the 5-year budget and work plan: Training, Coaching or Capacity

Building Needed How Specific Areas of Operations

Will be Enhanced Staff Participating in

Training Impact Foundry workshop – Self-care for nonprofit professionals

Learn and apply additional strategies and techniques to practice self-care and encourage team to stay well while working in a high-stress, fast-paced working environment

Health Division Director and supervisors; Executive team and Senior staff team

Training on billing for Reimbursable Nutrition and Lactation services through Clinical Preventive services programs (i.e. CPSP, FQHC)

Expand our current operational procedures to incorporate medical billing for these services into our infrastructure

Agency Controller and fiscal team; Health division Director and Breastfeeding Promotion Coordinator

Marketing Training/ Social Media Platforms Training

Expand knowledge base to better utilize these platforms to sustain and increase our reach in the community

All staff involved with outreach, marketing, and communications

California WIC Association Expand network and identify potential partners and supporters; receive critical updates on state and federal policy changes impacting services

WIC Director, Breastfeeding Promotion coordinator, RBL staff

Strategic Planning –Grant writing Impact foundry Grant Bootcamp

Enhance grant writing process and skills to maximize our efforts

Board of Directors and Senior Staff Team

Training on WIC WISE Staff demonstrate competency in both self-paced computer based and instructor lead training by 9/23/19 to prepare for Statewide Data system and Electronic benefit delivery system implementation

All WIC and First 5-funded Staff

B. Action Plan to Achieve Needed Efforts

Domain: #2 – Operational Framework Our primary goal in our operational framework endeavors is to integrate our sustainability plan for Lactation Consultant services into that of CRP’s overall Strategic plan. We intend to achieve this by implementing the following interventions:

1. Ensure First 5 services are clearly understood within organization. To implement this strategy the CEO, Fiscal team, Executive team, and Division Directors will identify markers of financial health at continuous regular meetings involving fiscal and program staff. The Health Division Director and Breastfeeding Promotion Coordinator will provide regular program updates to all Agency stakeholders on a continuous quarterly basis at staff meetings, and monthly Board of Directors and Senior Staff meetings.

2. Allocate available funds to fill funding gaps to maintain core services by identifying what portion of the health division and unrestricted funds can be realistically reallocated to Breastfeeding Support services and duration for next 5 years plan; pursue additional revenue generation and funding diversification. This will be conducted by the CEO, Fiscal


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team, Division directors, Breastfeeding Promotion coordinator and the business development team.

Domain: #5 - Measuring Impact and Accountability Our primary goal for measuring impact and accountability is to articulate our success with powerful data and strengthened with compelling success stories. We intend to achieve this by implementing the following actions:

1. Ensure pertinent data is collected in a standardized mechanism by identifying available data to analyze with our outreach and development team, Division Directors, and program staff. We will meet with our program managers to review available databanks to make progress efforts towards completing this intervention.

2. Highlights of our impact are collected and accessible to broadcast by creating an internal framework and various platforms to share success stories and our influence. Our 2018 annual report and monthly updated social media outlets carried out by our CEO, Executive Team, Division Directors, Marketing staff, and Program Staff will reflect our progress in this task.

3. Increase community awareness and education on the critical role that Lactation Consultant support services have in preventative services that in turn build community will to support CRP’s endeavors. Our Breastfeeding Promotion Coordinator, Division Director will incorporate service highlight summaries into all agency outreach events. Along with our Regional Breastfeeding Liaisons, and Business Development team, we will strengthen linkages to likeminded community based organization that share a mutual vision for improved community health. The Division Director’s reports, as well as regular meetings with Geographically Managed Care (GMS) providers, Sacramento Breastfeeding Coalition; FRC’s; and Black Child Legacy partners will help to broadcast our progress.

Implementation Steps to Secure New Funding 1) Dignity Health Foundation, March of Dimes, Other Community Grants

a) Step 1-Stay informed on critical dates for submission of Letters of Intent, and initial funding applications

b) Step 2- Inform key staff of timeline and follow guidelines from each potential funder to ensure all application guidelines are met.

c) Step 3- Meet with Fiscal and Admin staff to ensure to review budgetary and personnel projections for grants are accurate.

d) Step 4- Work with other community partners to gain verbal and written commitment for these endeavors to submit with application packet

e) Step 5 -Submit grants applications per deadline requirements 2) Subcontract through FQHC clinics that coordinate with CPSP for billing for Lactation

Consultant Services (part 1): These centers are licensed to provide services for nutrition and lactation direct services that can be billed and reimbursed. There are various examples of such


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partnerships with local WIC agencies entering into Memorandum of Understanding (MOU) with local FQHC’s to provide these ancillary services using ICD-10 codes. a) Step 1 – Coordinate meeting with Independent Physician Association/Medical Group

contracted with FQHCs – River City Medical Group. Invite affiliated Health Plans, if appropriate – Anthem Blue Cross Partnership Plan and Molina Healthcare of California Partner Plan, Inc., to determine necessary steps to bill for onsite lactation services.

b) Step 2- Set up an initial meeting with potential partners that are certified as FQHC, such as WellSpace Health, Sacramento Community Clinic/HALO, Native American Health Center, ELICA Health Centers and One Community Health.

c) Step 3 – Explore potential models for billing – If determined necessary, IBCLCs will apply for a National Provider Identifier (NPI) number to streamline billing process.

d) Step 4 - Once common goals are assessed and it is determined mutually beneficial to enter in to an MOU; determine logistics of where lactation services will be offered, reimbursement model, process for billable hours, criteria for hours to be billed on site at the health establishment.

3) Coordination with CPSP programs (part 2): There are a number of California WIC agencies using this option to help cover funding for nutritionist and lactation services. These programs have a requirement to provide a specific number of nutrition and breastfeeding services by a qualified professional. State CPSP requires a Dual Provider Agreement (DPA) with each and every private CPSP provider. State CPSP has to approve the DPA first. a) Step 1 – Determine CPSP Providers to target in our area – Wellspace Health, Capital

OB/GYN, Camellia Women’s Health, Sacramento Community Clinic/HALO. b) Step 2 – Explore potential models for billing – Under CPSP, an enrolled provider can bill

the services of an IBCLC if the IBCLC is also a Certified Nurse Midwife (CNM), Nurse Practitioner (NP), Registered Nurse (RN), Licensed Vocational Nurse (LVN), social worker, Registered Dietician (RD), Health Educator, Certified Childbirth Educator (CCE), or Comprehensive Perinatal Health Worker (CPHW).

c) Step 3 – If determined necessary, IBCLCs will apply for appropriate NPI identification numbers to streamline the billing process.

d) Step 4 – Set up an initial meeting with potential partners (i.e. CPSP providers). During this meeting determine reimbursement rate, potential restrictions or other requirements to meet guidelines needed for both partners to benefit from this agreement; also resolve potential challenges for the DPA documents to be executed.

e) Step 5 – Once common goals are assessed and it is determined to be mutually beneficial to enter in to a MOU Dual Provider Agreement (DPA); determine logistics and reimbursement models, process for billable hours, and criteria to bill at WIC site or an off-site location.

4) Partner with funded Black Child Legacy (BLC) Grantees: a) Step 1-Collect initial demographic data on our perinatal African American clients by clinic

and zip code. Compare these to the area CIL’s that correspond to the closest CRP WIC site and determine which of the 7 CIL agencies would be potential candidates with which to partner


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b) Step 2-Set up an initial meeting with current CIL recipient agency (ies) of BCL to explore potential opportunities for subcontracting to provide specialized Lactation Consultant services that are incorporated into current perinatal support programs that reduce infant death (Black Mothers United and Cultural Broker Home Visitors Program).

c) Step 3-Determine the number of anticipated clients their agencies help to estimate personnel time, realistic criteria to help meet the need for Lactation Consultant services.

d) Step 4-Execute a MOU with the agency (ies) based on prioritized areas of focus for both partners.

Our data and stories can work together to demonstrate our successes. Thus as part of our efforts to measure impact and accountably, we will put more concerted effort in this domain. This further ensures that both our organization and our close stakeholders are more keenly aware of the impact our lactation support services have to improve outcomes for young children as well as for the business and health care system.

Our strength as a non-profit is that we are afforded more flexibility to pursue potential unrestricted revenue streams, as indicated in the above summaries. Strengthening linkage with our current community partners behooves us all.

In conclusion, we aspire to maintain quality lactation services currently provided through First 5 funding with the various endeavors described above. We are grateful for the opportunity this certification process has afforded us. We look forward to strengthening our partnership and ushering in collective impact in our sustainability efforts to ensure quality lactation services continue to improve the health of our local community.

COMMUNITY LACTATION ASSISTANCE ... - Impact Foundry · efforts to ensure quality Lactation...

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