DATE: November 17, 2026
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Director, Department of Public Health
SUBJECT: Future of Public Health Funding Award Agreement 2026-29
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Future of Public Health Award Agreement with California Department of Public Health, effective July 1, 2026 through June 30, 2029 ($18,035,946);
2. Retroactively authorize the Director of Public Health’s previous submittal of the Acknowledgement of Allocation Letter, acknowledging receipt of the letter and accepting the funds to be used as outlined under the Submission Requirements; and
3. Approve and authorize the Director of Public Health, or designee, as signatory on behalf of the Board of Supervisors on associated grant documents, including all future reports, claims, work plans, spend plans, and Annual Certification forms.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will provide the Department of Public Health (Department) with continued funding from the California Department of Public Health (CDPH) for public health workforce and infrastructure, referred to as Future of Public Health (FoPH) funding. The funding will continue to support permanent staff retention, training, equipment, supplies and other related administrative costs. The second recommended action will retroactively authorize the Director of Public Health’s submittal of the Acknowledgement of Allocation letter that was required by CDPH by July 30, 2026. The third recommended action will authorize the Director of Public Health, or designee, to sign and submit required documentation for this fiscal year and future year allocations including the Acknowledgement of Allocation letter, work plans, spend plans, invoices, reports, and Annual Certification form. 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 accept the FoPH funding to improve public health workforce and infrastructure, which will impact public health services to the community. The Department would need to submit an additional acknowledgement letter to CDPH rejecting the funds.
RETROACTIVE AGREEMENT:
The recommended allocation is retroactive to July 1, 2026. CDPH provided the funding memo on July 7, 2026, and requested documents completed to receive the recommended allocation. The time required to prepare the required documents, including the work and spend plans, did not allow presentation to your Board at an earlier date. The Acknowledgement of Allocation letter, work plan and spend plan were required by CDPH by July 30, 2026, in advance of the Annual Certification form; therefore, the Department submitted the letter before the due date contingent upon the Board’s approval. There are no pending invoices.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. CDPH approved a non-competitive FoPH funding allocation of $6,011,982 annually to the County for public health workforce and infrastructure. These funds are considered ongoing funds and are part of the ongoing baseline state budget, thus similar annual allocations are expected to continue until further notice. At least 70% of the funding ($4,208,387) must be dedicated to support hiring permanent staff, including benefits, training and activities that support the recruitment and retention of public health staff. No more than 30% ($1,803,595) may be used for equipment, supplies and other administrative purposes such as facility space, furnishings, and travel. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2026-27 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
On September 6, 2022, the Board approved the County’s first annual FoPH funding allocation to strengthen and expand local public health workforce. On October 10, 2023, the Board approved continued FoPH funding for the following three fiscal years. FoPH funding supported the County’s efforts to adapt and respond to the increasingly complex and emerging public health challenges facing its diverse communities. Approval of the recommended actions will allow the Department to continue using FoPH funding to improve workforce recruitment and retention, local health access to disadvantaged communities, surveillance and detection of communicable diseases, and overall population health. Since initial implementation of the FoPH allocation, the Department was able to complete several work plan activities including:
• Developed a new Department of Public Health 10-year Strategic Plan with input from staff, key stakeholders, and community members.
• Decreased the Department’s vacancy rate from 21.5% in FY 2022-23 to 13% by the end of FY 2025-26.
• Coordinated 817 Rural Mobile Health events with two subcontracted medical providers that served over 12,500 participants and included culturally competent and linguistically appropriate services from the Community Health Worker Network.
• Implemented a new Rural Emergency Medical Technician (EMT) Training program in Fresno County communities showing the highest need for employment pathways in geographic areas identified by Fresno County's Health Priority Index 2022.
Approval of the recommended actions will accept annual FoPH allocations in the same amount of $6,011,982 each year and certify the County’s commitment to FoPH funding requirements. FoPH funding shall be used to supplement and not supplant all other specific local County funds. At least 70% of the annual allocation must be dedicated to support hiring permanent staff, including benefits, training and activities that support the recruitment and retention of public health staff. No more than 30% may be used for equipment, supplies and other administrative costs such as facility space, furnishings, and travel. Approval of the recommended actions also authorizes the Director of Public Health, or designee, as signatory on behalf of the Board on associated FoPH grant documents, including submission of all future FoPH reports, claims, and work plans and spend plans, as well as the Annual Certification forms.
CDPH required submission of an Acknowledgment of Allocation Letter, work plan and spend plan, in advance of the Annual Certification form due date. The signed letter served to acknowledge receipt of the FoPH Allocation Memo and acceptance and agreement to use the funds as outlined under the Funding and Reporting Requirements. To meet the deadline, the Department submitted the work plan, spend plan, and acknowledgement letter signed by the Director of Public Health, contingent upon approval by your Board. Approval of the recommended actions would retroactively authorize the Director of Public Health’s submission of the acknowledgment letter and authorize the Director, or designee, to submit all future reports, claims, and subsequent FoPH funding work plans and spend plans, as well as the Annual Certification forms.
REFERENCE MATERIALS:
BAI #58, October 10, 2023
BAI #37, September 6, 2022
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - FoPH Funding Award Agreement FoPH-011
On file with Clerk - FoPH Acknowledgement of Allocation Letter 2026-27
CAO ANALYST:
Ron Alexander