1.
City Council Work Session
- Meeting Date:
- 11/02/2026
- TITLE
- RiverStone Health – Nurse-Family Partnership Funding Change and Proposed Use of City Prevention Funds
- PRESENTED BY:
- Kevin Iffland
- Department:
- City Hall Administration
Presentation:
Yes
Legal Review:
No
Project Number:
N/A
RECOMMENDATION
RiverStone Health will brief City Council on the loss of state-administered Nurse-Family Partnership (NFP) funding and its proposal to redirect existing City prevention funding to other home visiting programs. Staff recommends Council receive the presentation, ask questions, and provide direction on whether staff should evaluate a potential amendment to the existing funding agreement. No formal action or funding change is requested at this work session.
EXECUTIVE SUMMARY
RiverStone Health has advised that the Montana Department of Public Health and Human Services (DPHHS) will stop funding NFP effective January 1, 2027. DPHHS funds account for approximately 40% of RiverStone’s NFP budget. RiverStone indicates the loss of this funding, together with additional program operating costs, makes continuation of NFP financially unsustainable. RiverStone requests consideration of using the City’s existing NFP prevention funding for a broader group of home visiting services supporting at-risk pregnant women and families. The November 2 work session is intended to obtain Council’s initial direction before any proposed agreement changes are developed.
BACKGROUND (Consistency with Adopted Plans and Policies, if applicable)
The City currently provides prevention funding to RiverStone Health to expand the number of families served through NFP. On October 5, 2026, RiverStone notified the City that DPHHS had announced the discontinuation of NFP funding to local health departments effective January 1, 2027.
RiverStone proposes applying the City’s existing funding to other ongoing home visiting services, including Parents as Teachers (PAT), Maternal Child Health, Kids First, and Welcome Baby. These programs serve somewhat different populations but share the goal of improving outcomes for pregnant women, infants, children, and families. RiverStone is also developing a service approach for higher-risk pregnant women and infants as NFP winds down.
According to RiverStone, its NFP clients experience higher-than-national-average risks involving domestic violence, mental health, substance use, and foster care involvement. RiverStone believes greater flexibility in the use of City funding would preserve home visiting capacity while remaining consistent with the original prevention purpose. Staff has not yet evaluated the proposed programs against the existing agreement’s eligibility, scope, reporting, or performance requirements.
RiverStone proposes applying the City’s existing funding to other ongoing home visiting services, including Parents as Teachers (PAT), Maternal Child Health, Kids First, and Welcome Baby. These programs serve somewhat different populations but share the goal of improving outcomes for pregnant women, infants, children, and families. RiverStone is also developing a service approach for higher-risk pregnant women and infants as NFP winds down.
According to RiverStone, its NFP clients experience higher-than-national-average risks involving domestic violence, mental health, substance use, and foster care involvement. RiverStone believes greater flexibility in the use of City funding would preserve home visiting capacity while remaining consistent with the original prevention purpose. Staff has not yet evaluated the proposed programs against the existing agreement’s eligibility, scope, reporting, or performance requirements.
FISCAL EFFECTS
RiverStone is proposing a change in the permitted use of existing City prevention funding, not requesting additional City funding at this time. The amount of City funding affected, remaining agreement term, allowable expenditures, and any administrative or performance-reporting implications should be confirmed before an amendment is considered. No budget amendment or financial authorization is requested at this work session.
STAKEHOLDERS
ALTERNATIVES
Council may direct staff to:
1. Evaluate an agreement amendment. Direct staff to work with RiverStone to evaluate redirecting existing City funding to eligible home visiting programs, with any proposed amendment returning to Council for formal consideration.
2. Request additional information. Direct staff to obtain additional financial, program, performance, and transition information before determining whether an amendment should be pursued.
3. Discontinue or reallocate funding. Direct staff to evaluate termination or modification of the existing funding agreement and potential reallocation of the remaining funds to other eligible prevention services, subject to applicable agreement requirements and Council approval.
This is a work session; any required formal approval would occur through a subsequent Council action.
1. Evaluate an agreement amendment. Direct staff to work with RiverStone to evaluate redirecting existing City funding to eligible home visiting programs, with any proposed amendment returning to Council for formal consideration.
2. Request additional information. Direct staff to obtain additional financial, program, performance, and transition information before determining whether an amendment should be pursued.
3. Discontinue or reallocate funding. Direct staff to evaluate termination or modification of the existing funding agreement and potential reallocation of the remaining funds to other eligible prevention services, subject to applicable agreement requirements and Council approval.
This is a work session; any required formal approval would occur through a subsequent Council action.