DATE: March 28, 2023
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Multiple Agreements with Community Based Organizations to Implement Department of Public Health’s Health Disparities Program
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Agreements with the following vendors to provide health intervention activities for implementation of Fresno County’s Initiative to Address COVID-19 Related Health Disparities, effective March 28, 2023 through December 31, 2024, with two optional one-year extension periods:
1) Reading and Beyond with a total not to exceed amount of $1,260,000,
2) Centro La Famila Advocacy Services with a total not to exceed amount of $1,335,000,
3) Cultiva La Salud with a total not to exceed amount of $1,155,000,
4) Centro Binacional para el Desarrollo Indigena Oaxaqueño with a total not to exceed compensation of $750,000,
5) West Fresno Health Care Coalition with a total not to exceed amount of $996,818,
6) Exceptional Parents Unlimited with a total not to exceed amount of $750,000, and
7) Fresno Economic Opportunities Commission with a total not to exceed amount of $1,253,181.
REPORT
There is no additional Net County Cost associated with the recommended actions, which will allow seven contracted community-based organizations (CBO) to provide care coordination services to underserved residents of Fresno County through a variety of outreach, education, and referral intervention strategies. These interventions are funded through braided funding from the United States Department of Health and Human Services (DHHS) Centers for Disease Control and Prevention’s (CDC) Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC); the CDC’s Activities to Support State, Tribal, Local, and Territorial Health Department Response to Public Health or Healthcare Crises; and the United States Department of the Treasury Coronavirus State and Local Fiscal Recovery Funds (ARPA). This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the County would not be able to contract with the seven vendors selected through the County’s request for proposal (RFP) process. Not selecting these vendors would result in a failure to deliver crucial services to community members experiencing health disparities in currently underserved areas of Fresno County. Not approving the recommended actions would also result in another RFP process, which would drastically shorten the implementation timeline for scope of work activities and result in a significant amount of grant funds unutilized once the grant term expires.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended agreements are fully funded with federal and state grants. The total costs for each recommended agreement are outlined below:
Reading and Beyond
• Year One (3/28/2023 - 7/31/2023): $291,744
• Year Two (8/1/2023 - 7/31/2024): $632,256
• Year Three (8/1/2024 - 12/31/2024): $336,000
• Term Maximum: $ 1,260,000
Centro La Familia
• Year One (3/28/2023 - 7/31/2023): $311,681
• Year Two (8/1/2023 - 7/31/2024): $667,319
• Year Three (8/1/2024 - 12/31/2024): $356,000
• Term Maximum: $ 1,335,000
Cultiva La Salud
• Year One (3/28/2023 - 7/31/2023): $246,233
• Year Two (8/1/2023 - 7/31/2024): $600,767
• Year Three (8/1/2024 - 12/31/2024): $308,000
• Term Maximum: $ 1,155,000
Centro Binacional para el Desarrollo Indigena Oaxaqueño
• Year One (3/28/2023 - 7/31/2023): $165,604
• Year Two (8/1/2023 - 7/31/2024): $384,396
• Year Three (8/1/2024 - 12/31/2024): $200,000
• Term Maximum: $ 750,000
West Fresno Health Care Coalition
• Year One (3/28/2023 - 7/31/2023): $215,000
• Year Two (8/1/2023 - 7/31/2024): $516,000
• Year Three (8/1/2024 - 12/31/2024): $265,818
• Term Maximum: $ 996,818
Exceptional Parents Unlimited
• Year One (3/28/2023 - 7/31/2023): $159,168
• Year Two (8/1/2023 - 7/31/2024): $390,832
• Year Three (8/1/2024 - 12/31/2024): $200,000
• Term Maximum: $ 750,000
Fresno Economic Opportunities Commission
• Year One (3/28/2023 - 7/31/2023): $261,402
• Year Two (8/1/2023 - 7/31/2024): $657,598
• Year Three (8/1/2024 - 12/31/2024): $334,181
• Term Maximum: $ 1,253,181
Sufficient appropriations and estimated revenues are included in the Department of Public Health’s Org 5620 FY 2022-23 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
On July 13, 2021, your Board approved the National Initiative to Address COVID-19 Health Disparities grant from the CDC through DHHS. The goal of the grant is to address COVID-19 related health disparities through identifying and integrating a community information exchange system (CIE) to increase CBO capacity for resource coordination, referrals to services, health screenings as well as outreach and education for community members throughout the County. Since the grant was accepted, the Department has been fulfilling the scope of work deliverables through community health worker (CHW) interventions in various programs including the Fresno HOPE Pathways Community HUB, which provides wrap around services to community members through evidence-based interventions. Another CHW led effort is the Department’s Health Literacy program, which provides outreach and education regarding COVID-19 and provides linkages to community resources and assistance. The Department is strategically working towards standardizing CHW led efforts by aligning trainings, enhancing referral coordination, and aligning targeted reach to maximize interventions within Fresno County. In addition, the Department is working towards increasing capacity within the CBOs by utilizing a centralized data management system and adopting processes that will facilitate the transition into an outcome-based reimbursement model as a sustainable approach beyond this contracted period. If approved, the seven organizations will complement current CHW programs by targeting unique populations in high need areas in Fresno County currently not being served by other Department led CHW interventions.
On July 13, 2022, the Department released RFP #22-060 for up to seven qualified vendors to provide health intervention activities for implementation of Fresno County’s Initiative to Address COVID-19 Related Health Disparities, which includes recruiting, training, and deploying CHWs to improve and address COVID-19 related health disparities and advance equity in underserved and disproportionately affected populations within Fresno County. The RFP closed on August 22, 2022 with proposals received from thirteen vendors.
An RFP evaluation team convened on October 4, 2022 and reached consensus to recommend awards to Reading and Beyond, Centro La Familia Advocacy Services, Cultiva La Salud, Centro Binacional para el Desarrollo Indigena Oaxaqueño, West Fresno Health Care Coalition, Exceptional Parents Unlimited, and Fresno Economic Opportunities Commission based on each proposal’s implementation plan, fiscally sound budget, target population, and overall strength of proposal. The RFP evaluation team was comprised of two representatives from the Fresno County Department of Public Health, one representative from the Fresno County Department of Behavioral Health, one representative from the City of Fresno, and one representative from the Fresno County Administrative Office.
Approval of the recommended actions will allow the Department to partner with the seven selected organizations to expand CHW interventions to currently unreached populations of Fresno County.
REFERENCE MATERIAL:
BAI #43, July 13, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Reading and Beyond
On file with Clerk - Agreement with Centro La Familia
On file with Clerk - Agreement with Cultiva La Salud
On file with Clerk - Agreement with Centro Binacional para el Desarrollo Indigena Oaxaqueño
On file with Clerk - Agreement with West Fresno Health Care Coalition
On file with Clerk - Agreement with Exceptional Parents Unlimited
On file with Clerk - Agreement with Fresno Economic Opportunities Commission
CAO ANALYST:
Ron Alexander