DATE: March 28, 2023
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Retroactive Agreement with BLACK Wellness & Prosperity Center
RECOMMENDED ACTION(S):
TITLE
1. Accept a retroactive allocation award from the California Department of Public Health for the Black Infant Health program, effective July 1, 2022 through June 30, 2023 ($2,226,936).
2. Make a finding that it is in the best interest of the County to suspend the competitive bidding process consistent with Administrative Policy No. 34 for unusual or extraordinary circumstances as BLACK Wellness & Prosperity Center is able to provide education and support centered around Black/African American maternal and infant health, aligning with the Black Infant Health program.
3. Approve and authorize the Chairman to execute a retroactive Agreement with BLACK Wellness & Prosperity Center for the provision to improve infant and maternal health of Black Birthing People by promoting health knowledge and healthy behaviors, effective March 14, 2023 through June 30, 2024, with the option to extend two additional 12-month periods, total not to exceed $500,000.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the first recommended action will provide the Department of Public Health (Department) with the normal yearly ongoing allocation and a one-time additional funding for the California Department of Public Health (CDPH) - Black Infant Health (program) aimed to improve black infant birth outcomes and reducing black maternal and infant mortality. Approval of the second and third recommended actions will allow the County to partner with BLACK Wellness & Prosperity Center (BWPC) to engage the Black or Black Ancestry community to support Black Birthing families’ health and well-being with education and outreach efforts. Additionally, the partnership will support efforts to educate the public about the factors leading to the disparities in Black maternal and infant birth outcomes by providing consistent and culturally responsive information and promote enrollment in the CDPH - BIH program and other available resources. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, the Department will not be able to accept the additional one-time funding for the BIH program for FY 2022-23. Should your Board not approve recommended action two and three, the Department will not be able to utilize the additional funding to partner with BWPC to serve and provide education and outreach efforts to Black Birthing families, to improve birth outcomes in the Black/African American community.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
The Department requests to suspend the competitive bidding process consistent with Administrative Policy No. 34 under unusual and extraordinary circumstances as BWPC specializes in education and support centered around Black/African American maternal and infant health, aligning with the BIH program. BWPC is dedicated to improving birth outcomes in the Black/African American community and identifying additional ways to provide support and access to needed services. BWPC’s unique qualities include a website that provides a variety of support, utilizing their comprehensive maternal and child health and prenatal/postpartum care resources. The website is also a hub for public health information and advocacy tools for Black/African American birthing individuals in health care settings. BWPC also has a BLACK Mobile Health Unit, a vehicle equipped to complement the doula training program and host community health education events for Black/African American birthing people and their families. The Internal Service Department - Purchasing concurs with the Department’s request to suspend the competitive bidding process.
RETROACTIVE AGREEMENT:
The Department received the FY 2022-23 BIH expansion approval letter on November 18, 2022. The recommended Agreement is retroactive to March 14, 2023 due to the length of time required to prepare the agreement and have it reviewed and approved in accordance with the agenda item processing time.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. Funding for the agreement is being made through a one-time funding opportunity from the CDPH - BIH grant. CDPH first awarded $938,936 to the Department’s BIH program for FY 2022-23 and recently awarded an additional $1,288,000 in State General Fund (SGF) to the BIH program for FY 2022-23 to be utilized solely for the purpose of improving Black infant birth outcomes and reducing black maternal and infant mortality through the expansion of the exiting BIH program. The CDPH intends to continue supporting these activities through the ongoing BIH allocation in future years. The new total award allocation for the Department’s BIH program for FY 2022-23 is $2,226,936. The maximum payable under the third recommended action is $500,000. There are sufficient appropriations and estimated revenue in the Department’s Org 5620 FY 2022-23 Adopted Budget and will be included in future budget requests for the duration of the contract.
DISCUSSION:
On November 8, 2022, your Board approved Agreement No. A-22-513, approving a retroactive revenue Agreement with CDPH for the Maternal, Child and Adolescent Health (MCAH) program ($7,771,084) and BIH program ($1,230,267), effective July 1, 2022 through June 30, 2023. For over three decades, CDPH funding has supported the Department’s BIH programs in providing outreach, home visitation, health education and linkage to community resources for pregnant and parenting Black/African American women and their families. In FY 2021-22, the BIH program served 106 women through an 18-group series, with 77 women served through the Group/Life Planning Model and 29 women were served through the Case Management Only Model.
BWPC was established in 2019 with the implementation of Fresno’s first Black Maternal Health Week and created Fresno’s first BLACK Maternal Child Health & Wellness (BMHW) kit that serviced 1,000 Black, Indigenous, People of Color (BIPOC) mothers. BWPC has extensive and authentic experience in designing and implementing comprehensive interventions focusing on decreasing health disparities in Fresno’s Black community and building a foundational vision of Black-centered public health. Over the past years, BWPC has been conducting research with Black women and doulas to understand the gaps, barriers, and opportunities and use these insights to inform scalable policy solutions and changes in health care systems. BWPC led the “Ready for Baby - Learn the Facts!” campaign focused on the Black pregnant population.
BWPC have their own BLACK Mobile Health Unit, a vehicle equipped to complement the doula training program and host community health education events for Black Birthing people and Black families in their neighborhood. The design replicates a hospital-based delivery room, intended to enable doula candidates to familiarize themselves with a hospital environment and equipment. The doula focused provider training and resources prepares licensed providers for the integration of doulas into the payor and the impact of Medi-Cal expansion covering doula services. The provider-informed training resources cover doula scope of practice under the new Medi-Cal benefit and the role of doulas, and the patient-care coordination opportunities in improving patient experiences. The doula operation feed into the key infrastructure development operation which is the BLACK Doula Network (Network). The Network is a muti-faceted approach aimed to increase access to culturally relevant community-based doula-care among Black Birthing persons in Fresno.
Approval of the recommended actions will allow the Department to accept the additional funding from CDPH and utilize the funds to partner with BWPC to engage the Black or Black Ancestry community to support Black Birthing families’ health and well-being with education and outreach efforts, educate the public about the factors leading to the disparities in Black maternal and infant birth outcomes by providing consistent and culturally responsive information, and promote enrollment in the CDPH - BIH program. The agreement contains non-standard language allowing the contractor to request an advance payment up to 25% of the maximum compensation. The agreement also contains a budget modification clause allowing the Director to approve changes to budget line items of up to 10% of the maximum compensation with no change to the agreement maximum payable amount.
REFERENCE MATERIAL:
BAI #33, November 8, 2022
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition Acquisition
On file with Clerk - Agreement with BLACK Wellness & Prosperity Center
On file with Clerk - Award Allocation with CDPH
CAO ANALYST:
Ron Alexander