DATE: January 27, 2026
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Director, Department of Public Health
SUBJECT: Retroactive Amendment No. 4 to Agreement with Fresno Metropolitan
Ministry
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute retroactive Amendment No. 4 to Agreement No. 25-545 with Fresno Metropolitan Ministry, to add Perinatal Equity Initiative Program activities to the scope of work for health intervention activities for Fresno County’s Community Health Worker Network, effective October 21, 2025 with no change to the term of December 14, 2021 through December 31, 2026, or compensation maximum of $12,496,869.
REPORT
There is no additional Net County Cost associated with the recommended action which will approve a retroactive amendment to revise the scope of work to include additional care coordination services related to pregnant women, new fathers, and their families through community health worker interventions to align with the date the budget was approved and language was updated to include the American Rescue Plan Act (ARPA) as one of the funding sources. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, any work related to the revised scope of work would not be funded and/or a delay in the services offered to pregnant or expectant women, new fathers, and their families.
RETROACTIVE AGREEMENT:
The recommended action is retroactive to October 21, 2025, the date the respective budget was approved, and the recommended action was originally scheduled. The Department seeks to align the start date to enable Fresno Metropolitan Ministry (FMM) to fully utilize its approved budget with the revised scope of work activities, thereby mitigating any potential gaps in service to the targeted population. This adjustment also corrects the clerical oversight that excluded the updated scope of work at the time of budget approval, ensuring implementation as originally intended.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. There are no changes to the maximum compensation amount ($12,496,869), which will continue to be funded with braided funding which includes Population Health Management, Health Disparities, and ARPA grant funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2025-26 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
On December 14, 2021, the Board approved Agreement No. 21-539 which allowed the County to partner with FMM to act as the fiscal sponsor of the Fresno Community Health Improvement Partnership (FCHIP) to create the FCHIP HOPE Pathways Community Hub and provide service delivery through a nationally recognized evidence-based Community Health Worker model.
On January 24, 2023, the Board approved Amendment No. 1 to Agreement No. 23-047 to extend the Agreement through July 31, 2024, and increase the total maximum compensation by $2,400,000 to sustain services through this extension period.
On July 9, 2024, the Board approved Amendment No. 2 to Agreement No. 24-386 to extend the Agreement through May 31, 2026, and increase the maximum compensation by $2,883,893 to sustain services through this extension period.
On October 21, 2025, the Board approved Amendment No. 3 to Agreement No. 25-545 to extend the Agreement through December 31, 2026.
The recommended action is in alignment with the Department’s plan of securing supplemental funding to support these critical services. The additional service deliverables include an emphasis on improving maternal and infant health outcomes by providing additional care coordination services to pregnant women, new fathers, and their families, including, education, training, community events, and additional navigation support. Language regarding the funding sources was also updated in the recommended Amendment No. 4 to acknowledge ARPA grant funds as one of the funding sources.
REFERENCE MATERIAL:
BAI #50, October 21, 2025
BAI #50, July 9, 2024
BAI #39, January 24, 2023
BAI #68, December 14, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 4 to Agreement with FMM
CAO ANALYST:
Ron Alexander