DATE: May 21, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Retroactive Third Amendment to Revenue Agreement with the Department of Health and Human Services
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute retroactive Third Amendment to the Notice of Award and Agreement No. 23-137 with the Department of Health and Human Services, Centers for Disease Control and Prevention, effective February 8, 2024 to extend the Agreement term by twenty-four (24) months from June 1, 2024 to May 31, 2026 and amend the budget with no change to the total maximum compensation of $7,897,935.
REPORT
There is no additional Net County Cost associated with the recommended action. The recommended action will allow the County to extend the term of the agreement by 24 months and amend the budget to carryover unspent funds into Federal Fiscal Years 2024-25 and 2025-26, while also redirecting Budget Category line-item amounts to fulfill scope of work activities through May 31, 2026. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, Federal funding would end on May 31, 2024 and the awarded amount of $7,897,935 would not be fully expended. Additionally, agreements under the Department’s Health Disparities program would end on December 31, 2024 which would shorten their implementation period and not allow maximum utilization of their full contract amounts.
RETROACTIVE AGREEMENT:
The recommend action is retroactive to February 8, 2024, which is the date that the Department received the Notice of Award for the no cost extension. The action is being brought to your Board in accordance with the agenda item processing timeline.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended amendment does not result in a change to the maximum amount of the agreement of $7,897,935 and will be fully offset with federal grant funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2023-24 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
On July 13, 2021, your Board approved Agreement No. 21-265 which allowed the County to accept the grant award for a non-competitive National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities grant (CDC-RFA-OT21-2103) through the Centers For Disease Control and Prevention (CDC). The grant awarded was in the amount of $7,897,935 for the period from June 1, 2021 through May 31, 2023.
On March 28, 2023, your Board approved Agreement No. 23-136 and Agreement No. 23-137 amending the agreement to extend the term for an additional 12-month period and adjusted the budget to account for an additional 12 months of activities.
On January 30, 2024, the Department applied for an additional 24-month No Cost Extension of grant funding to extend the term of the agreement through May 31, 2026.
On February 8, 2024, the Department received a Notice of Award (NoA) for the Department’s submission of the No Cost Extension.
On March 1, 2024 the Department applied for a Budget Redirection in order to modify the previously submitted grant budget to account for an additional 24-months of extended activities. The terms and conditions of the Agreement allow for modifications without formal approval from the grantor and do not consider budget transfers under 25 percent of the total approved budget to be significant enough to elicit a new NoA. The total amount modified in the Budget Redirection was $651,965, eight percent of the total budget, and well below the 25 percent threshold. Attachment A includes the changes to the budget, excerpts from the Department of Health and Human Services Grants Policy Statement and emails from the grantor acknowledging that no formal approval is needed for changes below 25 percent.
Subcontracts executed with local nonprofit organizations under this funding only allowed for 21 months of activities due to the short length of the original grant term of 24 months, from June 1, 2021 through May 31, 2023. Approval of the recommended action will allow for the Department and contracted agencies to continue to provide critical resources and care coordination services to residents experiencing barriers to health throughout Fresno County. The recommended action will also provide additional time for the continued collection of robust person level data and allow for the maximum amount of grant funds to be utilized to benefit the residents of Fresno County.
The recommended Amendment does not include the County’s standard insurance language and limits. However, the grantor’s full terms and conditions were previously reviewed by Risk and Counsel and accepted when the Agreement was approved on July 13, 2021, as the Department is the recipient of grant funding from a federal agency.
REFERENCE MATERIAL:
BAI #49, March 28, 2023
BAI #43, July 13, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Third Amendment to Agreement with DHHS CDC
Attachment A
CAO ANALYST:
Ron Alexander