DATE: June 18, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Approve Second Amendment to Agreements for the Community Health Teams
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute the Second Amendment to Agreement with Central Valley Children’s Services Network for the Community Health Teams program, to revise the scope of work to provide home visitation services to unduplicated families with at least one (1) parent/caregiver attending each visit, extending the term by two years from July 1, 2024 to June 30, 2026, and increasing the compensation by $548,896 to a total of $1,646,688.
2. Approve and authorize the Chairman to execute the Second Amendment to Agreement with Centro La Familia Advocacy Services for the Community Health Teams program, to revise the scope of work to provide home visitation services to unduplicated families with at least one (1) parent/caregiver attending each visit, extending the term by two years from July 1, 2024 to June 30, 2026, and increasing the compensation by $522,458 to a total of $1,565,968.
3. Approve and authorize the Chairman to execute the Second Amendment to Agreement with Exceptional Parents Unlimited for the Community Health Teams program, to revise the scope of work to provide home visitation services to unduplicated families with at least one (1) parent/caregiver attending each visit, extending the term by two years from July 1, 2024 to June 30, 2026, and increasing the compensation by $550,000 to a total of $1,650,000.
4. Approve and authorize the Chairman to execute the Second Amendment to Agreement with Fresno County Economic Opportunities Commission for the Community Health Teams program, to revise the scope of work to provide home visitation services to unduplicated families with at least one (1) parent/caregiver attending each visit, extending the term by two years from July 1, 2024 to June 30, 2026, and increasing the compensation by $550,000 to a total of $1,650,000.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will revise the scope of work to provide home visitation to unduplicated families with at least one (1) parent/caregiver attending each visit and allow the Department to extend the agreements with Central Valley Children’s Services Network (CVCSN), Centro La Familia Advocacy Services (CLFA), Exceptional Parents Unlimited (EPU), and Fresno County Economic Opportunities Commission (Fresno EOC) through June 30, 2026. The contracted partners provide research-based and evidence-informed home visitation services for the Community Health Teams (CHT) program. The recommended actions will also increase the total maximum compensation of each agreement and will be offset with grant funds. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, the Department would not be able to continue the partnerships with the four community-based organizations (CBOs) providing research-based and evidence-informed home visitation services for the County’s CHT program.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The annual compensation for each of the recommended amendments is as follows:
Contractor FY 2024-25 FY 2025-26
Central Valley Children’s Services Network $274,448 $274,448
Centro La Familia Advocacy Services $261,229 $261,229
Exceptional Parents Unlimited $275,000 $275,000
Fresno County Economic Opportunities Commission $275,000 $275,000
Funding is provided by a grant from the Children and Families Commission of Fresno County (First 5 Fresno) and Federal Title XIX through the State Maternal, Child and Adolescent Health program. Sufficient appropriations and estimated revenues will be included in the Department’s Org 5620 FY 2024-25 Recommended Budget and will be included in subsequent budget requests.
DISCUSSION:
On October 6, 2020, the Board approved the agreements with CVCSN, CLFA, EPU, and Fresno EOC to provide research-based and evidence-informed home visitation services to underserved families in Fresno County communities. On June 21, 2022, the Board approved the first amendments to the agreements with the four CBOs, extending the services for an additional two years through June 30, 2024. As part of the CHT, a Public Health Nurse (PHN) from the Department is paired with teams of paraprofessionals from the contracted CBOs to provide a cost-effective approach to home visitation services to families who otherwise would not qualify for an existing nurse-based home visitation program.
Approval of the recommended actions will allow the Department to continue the partnerships with the four CBOs and efforts to improve home visitation services in Fresno County. The PHN provides guidance and support on medically challenging cases to the CBO home visitors who provide direct home visitation services. Depending on the home visitation model used by each CBO, the home visitors provide social support, health information, referrals to community resources, family planning, and serve as a literacy teacher and parenting coach. This is a unique home visitation model that provides a team approach to provide wraparound case management services to families. The CHT meets on a regular basis for training, case consultations, and other program issues.
In FY 2022-23, the CHT program:
• Provided case management services to 254 families;
• Provided developmental screening to 254 children; and
• Provided referrals for 264 children and family members for job assistance, Medi-Cal, health insurance, financial assistance, primary care, dental, vision, mental health, diapers, food, housing, special education services, and early intervention.
Approval of the recommended actions will allow the Department to continue using an integrated approach to enhance our partner CBOs’ capacity to provide licensed medical support, strengthening the early childhood system of care, and promoting a “no-wrong-door” approach for families in the community.
REFERENCE MATERIAL:
BAI #71, June 21, 2022
BAI #42, October 6, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Second Amendment with CVCSN
On file with Clerk - Second Amendment with CLFA
On file with Clerk - Second Amendment with EPU
On file with Clerk - Second Amendment with Fresno EOC
CAO ANALYST:
Ron Alexander