DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger, MPH, PhD
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT:
Ratifying the execution of an amendment to an agreement with Triple P America, Inc. associated with the San Antonio Metropolitan Health District’s Violence Prevention Program for a term ending September 30, 2020.
SUMMARY:
This Ordinance ratifies the execution of an agreement with Triple P America, Inc., for training services for the San Antonio Metropolitan Health District in an amount up to $180,801.85 for a term beginning on February 1, 2020 and ending September 30, 2020.
BACKGROUND INFORMATION:
The San Antonio Metropolitan Health District’s (Metro Health’s) Violence Prevention Program aims to prevent violence and violence-related deaths in the community. As part of a comprehensive approach to stopping violence before it starts, Metro Health will be implementing the Triple P program to support positive parenting and reduce child abuse. San Antonio has the highest rate of confirmed child abuse cases of all major metropolitan Texas cities.
Treating violence as a public health issue and requiring both immediate treatments to stop the detriment and long term systems change to prevent the causes of violence is an urgent community need. Major components of Metro Health’s Violence Prevention program include domestic violence prevention through the Collaborative Commission on Domestic Violence (CCDV), the Love Is...Domestic Violence prevention media campaign, gun violence prevention through Stand UP SA Violence Interrupters, the development of a Gun Violence Prevention Plan, implementation of the school-based Too Good for Violence program, and child abuse prevention through the Triple P Parenting Program. Though these are different approaches to addressing violence prevention, experiencing one form of violence increases the risk of experiencing other forms of violence.
The Triple P Parenting program is one of only two programs identified to work at a population level to reduce child abuse and maltreatment, and it is rated as the top parenting program in the world by the United Nations. Most parenting programs operate at the individual or family unit level using clinical practices to provide targeted intervention. Though many are useful for the population served, generally, these programs fail to achieve shifts in outcomes at the level of a city or county. Triple P utilizes a multi-level integrated system of interventions to support a change of population norms and practices. Starting with Level 1, a community-wide media campaign, increasing intensity of support and contact for parents culminates in Level 5 interventions, which includes one on one targeted case management with families experiencing serious parenting challenges or high risk for poor parenting outcomes due to very challenging life circumstances. Through forty years of research and implementation, Triple P has been rigorously evaluated in 980 trials, including 135 randomized control trials according to research published in the Journal of Family Psychology, 2008. In the United States, trials have reported a 13% reduction in hospitalizations from abuse injuries, a 21% reduction in out of home placements, and 31% reduction in confirmed child abuse cases in communities where the full model has been deployed. The five levels of Triple P work in coordination to support a community change, and implementation of all levels is necessary to realize the full scope of possible improvement in outcomes.
Triple P America, Inc. provided training, support, and materials for the proprietary Triple P program. The Triple P program is an evidence-based, multi-tier intervention shown to be effective at reducing child abuse. Triple P America, Inc. provided in person and virtual training, including three components to participants selected by Metro Health: (1) Training; (2) Pre-certification Review; and, (3) Provider Certification. Training was provided on four separate interventions: (1) Selected Seminars; (2) Primary Care Intervention; (3) Discussion Group Intervention; and, (4) Group Intervention. Practitioners who attended the training and met requirements are certified to provide the Triple P interventions out in the community through partner agencies.
ISSUE:
Experiencing abuse as a child is strongly associated with experiencing domestic violence as an adult, either as a perpetrator or a victim. Bexar County continues to report increases in child abuse. In addition to being unacceptable, child abuse also predicts a future with sustained violence in San Antonio.
Due to the COVID-19 pandemic, Metro Health seeks approval of an amendment to the agreement with Triple P to adjust the training, accompanying materials and compensation to Triple P America, Inc. for the implementation of the Triple P program in San Antonio.
ALTERNATIVES:
If this amendment is not approved, the original terms of the agreement will ensue. Due to the COVID-19 pandemic, however, the contractor was not able to fully meet the scope of services. Thus, the execution of an amendment was necessary to account for the changes to the scope of work and compensation to the contractor.
FISCAL IMPACT:
This ordinance ratifies the execution of an amendment to an agreement with Triple P America, Inc. for Metro Health’s Violence Prevention Program, in a total amount up to $180,801.85 for a term beginning February 1, 2020 and ending September 30, 2020.
Funding has been allocated in the FY 2020 General Fund Budget to support this agreement. Funding in the amount of $99,518.00 will be paid by the FY 2020 General Fund.
Additionally, funding in the amount of $81,283.85 is allocated by the Healthy Start Grant.
RECOMMENDATION:
Staff recommends City Council ratify the execution of the amendment to the agreement with Triple P America, Inc. in an amount up to $180,801.85 for a term beginning February 1, 2020 and ending September 30, 2020, to support Metro Health’s Violence Prevention Program.