DATE: November 28, 2023
TO: Board of Supervisors
SUBMITTED BY: Paul Nerland, County Administrative Officer
SUBJECT: Amendment to State Local Fiscal Recovery Funds Subrecipient Agreement with Fresno Community Hospital and Medical Center
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute First Amendment to Subrecipient Agreement No. 22-340 for American Rescue Plan Act - State Local Fiscal Recovery Funds (ARPA-SLFRF) with Fresno Community Hospital and Medical Center to revise the expenditure plan, modification clause, and update the hold harmless clause, with no increase to maximum compensation ($2,720,670); and
2. Authorize the County Administrative Officer or designee to approve and execute written changes to line items in the project budget, which, when added together during the term of the Agreement do not exceed ten percent (10%) of the total maximum compensation payable to Subrecipient, and which do not result in any change to the maximum compensation amount payable to the Subrecipient.
REPORT
There is no Net County Cost associated with the recommended actions, which will revise the expenditure plan of Fresno Community Hospital and Medical Center (Subrecipient) to maximize the use of available funds. The recommended amendment also updates the Hold Harmless section to align with the most recent language used in standard County agreements. Recommended action item 2 delegates limited authority to the County Administrative Officer or designee to make the requested revisions to the budget, as long as the revisions, when added together during the term of the Agreement, do not exceed 10% of the Agreement maximum. This item is countywide.
ALTERNATIVE ACTION(S):
If the recommended action is not approved, the maximum allocation of ARPA-SLFRF would not become available to the Subrecipient to fund the installation of a new computed tomography (CT) scanner that will replace an aging CT scanner at the Clovis Community Medical Center which is necessary to support the local healthcare networks’ ongoing response, prevention, mitigation, and treatment of COVID-19. Improvements to the healthcare network would be delayed until another funding source becomes available to the Subrecipient.
FISCAL IMPACT:
There is no increase in Net County Cost or maximum compensation associated with the recommended action. The Program is fully funded with ARPA-SLFRF. Sufficient appropriations are included in the FY 2023-24 Adopted Budget for Auditor-Controller/Treasurer-Tax Collector Org. 1033 - Disaster Claiming, Fund 0026, Subclass 91021, Account 7845.
DISCUSSION:
The United States Department of the Treasury’s (Treasury) Title 31, Code of Federal Regulations, Part 35 Coronavirus SLFRF Interim Final Rule (“Interim Final Rule”) and Final Rule (“Final Rule”) establish a framework for determining the types of programs and services that are eligible under the ARPA. SLFRF may be used for eligible activities under the following general categories:
A. Respond to the COVID-19 public health emergency or its negative economic impacts;
B. Provide premium pay for essential workers;
C. Replace public sector revenue loss, subject to certain limitations; and
D. Make necessary investments in infrastructure such as in water, sewer, and broadband.
The Final Rule permits SLFRF to be used to cover costs for eligible activities within the four general categories for the period that begins March 3, 2021 and ends on December 31, 2024. Recipients and their subrecipients must return any funds to the Treasury which are not obligated by December 31, 2024, and any funds not expended to cover such obligations by December 31, 2026.
Under Section 602(c)(3) of the ARPA, the County may transfer SLFRF to private nonprofit organizations for eligible uses for the purpose of meeting ARPA’s goals. The Subrecipients is a nonprofit 501(c)(3) organization under the ARPA.
On February 1, 2022, your Board approved the Ad-Hoc Committee’s expenditure plan which earmarked funds for proposals that may be funded either in whole or in part by the County’s $194,063,657 allocation of SLFRF. The approved expenditure plan included $2,720,670 for the Subrecipient to fund the purchase of medical equipment.
On August 9, 2022, your Board approved Subrecipient Agreement No. 22-340, which provided funding assistance to the Subrecipient to purchase medical equipment for COVID-19 prevention and treatment, consisting of six adult Stryker beds for its Intensive Care Unit (ICU) at the Community Regional Medical Center, Fresno, as well as the purchase of a CT scanner and the associated installation and adaptation costs to replace the aging CT scanner at the Clovis Community Medical Center (Program).
Since then, SLFRF has helped the Subrecipient purchase the six adult Stryker beds and has paid the initial costs for the CT scanner replacement project. The Subrecipient represents that the cost to purchase the CT scanner has decreased, however, costs for the construction and installation of the CT scanner have significantly increased beyond the estimates in the approved expenditure plan, which will impact the Subrecipient’s ability to recover actual costs that would otherwise be reimbursed by the SLFRF Program. The Subrecipient represents that the Program’s cost savings in medical equipment can be maximized by redesignating $497,832 dollars, initially allocated for the purchase of the CT scanner, to instead cover increase costs for the installation and adaptation expenses for replacement of the CT scanner at the Clovis Community Medical Center.
Approval of the recommended action would revise the Program’s expenditure plan, include language in the modification clause that would allow the County’s Administrative Officer or designee to consider and approve future written requests for budget revisions totaling up to 10% of the maximum compensation, and update the Agreement’s Hold Harmless section to align with the most recent language used in standard County agreements, with no change to the maximum compensation.
REFERENCE MATERIAL:
BAI #32, August 9, 2022
BAI #03, February 1, 2022
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment to Agreement with Fresno Community Hospital and Medical Center
CAO ANALYST:
George Uc