DATE: July 8, 2025
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Third Amendment to Agreement with Centro Binacional para el Desarrollo Indigena Oaxaqueño to Implement Department of Public Health’s Community Health Worker Network Intervention Activities
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment No. 3 to Agreement with Centro Binacional para el Desarrollo Indigena Oaxaqueño to continue providing health intervention activities for Fresno County’s Community Health Worker Network, effective upon execution, extending the term by seven months from June 1, 2026, through December 31, 2026, which includes two optional one-year extensions, and increasing the maximum compensation by $430,737 to a total of $1,180,737.
REPORT
There is no additional Net County Cost associated with the recommended action, which will allow Centro Binacional para el Desarrollo Indigena Oaxaqueño (CBDIO) to continue providing essential services to residents of Fresno County experiencing health disparities through community health worker (CHW) interventions by increasing the term of the Agreement by seven months to align with new funding timelines and increasing CBDIO’s budget by $430,737 to sustain program activities through the increased term. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, this Agreement will be terminated early, as there will be no funding available to support program activities. Critical services that primarily serve rural indigenous communities with specific language needs in Fresno County will end.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum compensation of the Agreement with CBDIO will increase by $430,737 to $1,180,737 for the proposed increased term. The agreement will be fully funded with Population Health Management grant funds and supplemented with other Public Health funds as they become available. Sufficient appropriations and estimated revenues are included in the Department of Public Health’s Org 5620 FY 2025-26 Recommended Budget and will be included in subsequent budget requests.
DISCUSSION:
On March 28, 2023, the Board approved Agreement A-23-132 which allowed the County to partner with CBDIO to promote community health support and to provide health intervention activities for implementation of Fresno County’s Health Disparities Program. Agreement A-23-132 was issued in accordance with a Request for Proposal that was issued on July 13, 2022.
On March 19, 2024, the Board approved First Amendment A-24-129 which allowed CBDIO to carryover unspent fiscal year one funds to fiscal year two and corrected language in Article 7.1 of the Agreement in accordance with federal funding. On December 17, 2024, the Board approved a second amendment to the Agreement (A-24-689), which allowed the Agreement term to be extended in alignment with a no cost extension provided by federal funding that was planned to fully fund the Agreement.
On May 6, 2025, your Board approved Agreements A-25-174, A-25-175, and A-25-176 which allowed the County to accept Population Health Management (PHM) grant funding through December 31, 2026. Acceptance of PHM grant funding allowed the Department to solidify funding to support this Agreement through December 31, 2026. This Agreement was previously funded by federal funds, if approved, the recommended action would allow for services of the Agreement to continue through PHM funding. The recommended action would also allow the Agreement to be extended through December 31, 2026, in alignment with the PHM grant timeline, and increase the maximum compensation of the Agreement to support services through this extended period. The PHM grant ends on December 31, 2026, the Department plans to only exercise the option to extend the Agreement with CBDIO if the PHM grant is extended or additional grant funding becomes available. The recommended action is in alignment with the Department’s plan of securing supplemental funding to support these critical services. CBDIO is a key partner in supporting Rural Mobile Health Services.
REFERENCE MATERIAL:
BAI #35.1, May 6, 2025
BAI #62, December 17, 2024
BAI #45, March 19, 2024
BAI #48, March 28, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 3 to Agreement with CBDIO
CAO ANALYST:
Ron Alexander