DATE: June 30, 2026
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Director, Department of Public Health
SUBJECT: Approve Amendment No. 3 to Agreements with Community-Based Organizations for the Community Health Teams Program
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment No. 3 to Agreement No. A-24-330 with Central Valley Children’s Services Network for the Community Health Teams program, extending the term by one year from July 1, 2026 to June 30, 2027 and increasing the maximum compensation by $294,448 to a total of $1,941,136;
2. Approve and authorize the Chairman to execute Amendment No. 3 to Agreement No. A-24-331 with Centro La Familia Advocacy Services for the Community Health Teams program, extending the term by one year from July 1, 2026 to June 30, 2027 and increasing the maximum compensation by $281,229 to a total of $1,847,900;
3. Approve and authorize the Chairman to execute Amendment No. 3 to Agreement No. A-24-332 with Exceptional Parents Unlimited for the Community Health Teams program, extending the term by one year from July 1, 2026 to June 30, 2027 and increasing the maximum compensation by $295,000 to a total of $1,945,000; and
4. Approve and authorize the Chairman to execute Amendment No. 3 to Agreement No. A-24-333 with Fresno County Economic Opportunities Commission for the Community Health Teams program, extending the term by one year from July 1, 2026 to June 30, 2027 and increasing the maximum compensation by $295,000 to a total of $1,945,000.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will 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) for one final year, through June 30, 2027. 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 Fresno County Department of Public Health (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. The Department will need to issue a Request for Proposal (RFP), resulting in a gap in services to underserved families with children ages 0 - 5 in Fresno County.
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 2026-27
Central Valley Children’s Services Network $294,448
Centro La Familia Advocacy Services $281,229
Exceptional Parents Unlimited $295,000
Fresno County Economic Opportunities Commission $295,000
Funding is provided by a grant from the Children and Families Commission of Fresno County (First 5) 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 2026-27 Recommended Budget.
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 for one additional year 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 2024-26, the CHT program:
• Provided case management services to 720 total clients which consists of 226 children ages 0 - 3, 127 children ages 3 - 5, and 367 parents/caregivers;
• Services were distributed among Fresno County families living in rural (44.39%) and urban (55.61%) areas;
• Provided developmental screening to 420 children;
• Provided referrals for 427 children and family members for job assistance, Medi-Cal, health insurance, financial assistance and public benefits enrollment, primary care, dental, vision, mental health, diapers, food and food assistance programs, housing, parenting education/support groups, domestic violence and family safety resources, employment and job training services, child care and preschool programs, transportation assistance, special education services, and early intervention; and
• Provided depression screening to 306 parents/caregivers.
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.
County Counsel approves the amendments; however, stated these will be the last amendments for these CBOs. The Department will need to issue an RFP if First 5 amends the CHT program services beyond FY 2026-27.
REFERENCE MATERIAL:
BAI #69, June 18, 2024
BAI #71, June 21, 2022
BAI #42, October 6, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 3 to Agreement with CVCSN
On file with Clerk - Amendment No. 3 to Agreement with CLFA
On file with Clerk - Amendment No. 3 to Agreement with EPU
On file with Clerk - Amendment No. 3 to Agreement with Fresno EOC
CAO ANALYST:
Rox Alexander