DATE: October 21, 2025
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Interim Director, Department of Public Health
SUBJECT: Multiple Amendments to Agreements with Community Based Organizations to Implement Department of Public Health’s Community Health Worker Network Intervention Activities
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment No. 3 to Agreement with Reading and Beyond to continue providing health intervention activities for Fresno County’s Community Health Worker Network, effective upon execution, extending the three-year base contract term by seven months from June 1, 2026, through December 31, 2026, with the two optional one-year extensions bringing the expiration date to December 31, 2028, and increasing the maximum compensation by $189,000 to a total of $1,449,000;
2. Approve and authorize the Chairman to execute Amendment No. 1 to Agreement with Avenal Community Health Center dba Aria Community Health Center to continue providing health intervention activities for Fresno County’s Community Health Worker Network, effective upon execution, extending the two-year base contract term by seven months from June 1, 2026, through December 31, 2026, with the two optional one-year extensions bringing the expiration date to December 31, 2028, and increasing the maximum compensation by $111,385 to a total of $575,453; and
3. Approve and authorize the Chairman to execute Amendment No. 3 to Agreement with Fresno Metropolitan Ministry to continue providing health intervention activities for Fresno County’s Community Health Worker Network, effective upon execution, extending the four-year and five-month contract term by seven months from June 1, 2026, through December 31, 2026, with no change to the maximum compensation of $12,496,869.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will allow Reading and Beyond, Avenal Community Health Center dba Aria Community Health Center (Aria), and Fresno Metropolitan Ministry (FMM) to continue providing essential services to residents of Fresno County experiencing health disparities through community health worker (CHW) interventions by increasing the term of each Agreement by seven months to align with new funding timelines and increasing Reading and Beyond and Aria’s budgets by $189,000 and $111,385, respectively, to sustain program activities through the extended term. The recommended actions will also amend each agreement to include additional language prohibiting the duplication of services through other funding sources. The third recommended action will also amend the scope of work of FMM’s agreement to include additional services identified as applicable by the Department and in alignment with health priorities. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, these Agreements will be terminated early, as there will be no alternative funding available to support program activities. Critical services that address health needs of residents in Fresno County will end and unspent grant funds for these services will be returned to the granting agencies.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum compensation of the Agreement with Reading and Beyond will increase by $189,000 to $1,449,000 and the maximum compensation of the Agreement with Aria will increase by $111,385 to $575,453 for the proposed extended term. The agreements will all be fully funded with braided funding which include Population Health Management, Health Disparities, and American Rescue Plan Act (ARPA) grant funds through the end of the proposed agreement term. Sufficient appropriations and estimated revenues are included in the Department of Public Health’s Org 5620 FY 2025-26 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
Agreement with Reading and Beyond Background
On March 28, 2023, the Board approved Agreement A-23-129 which allowed the County to partner with Reading and Beyond to promote community health support and to provide health intervention activities for implementation of Fresno County’s Health Disparities Program in underserved areas of Fresno County. Agreement A-23-129 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-24-127 which allowed Reading and Beyond 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 Second Amendment A-24-688, 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. Reading and Beyond has provided outreach to 12,858 individuals, made 1,600 medical and social service referrals to community members, and enrolled 280 unique clients to receive tailored care-coordination services. The first recommended action would allow the Agreement with Reading and Beyond to be extended through December 31, 2026, increase the Agreement’s maximum compensation by $189,000, and amend the Agreement language to add a provision prohibiting the duplication of services through other funding sources.
Agreement with Aria Community Health Center Background
On June 18, 2024 the Board approved Agreement A-24-327 which allowed the County to Partner with Aria to promote community health support and to provide health intervention activities in a rural clinic setting with a focus on type-2 diabetes mitigation efforts. Aria has provided outreach to 13,603 individuals, made over 1,100 social service and medical referrals to residents in rural communities of Fresno County, and has enrolled over 390 unique clients to receive tailored care-coordination services. The second recommended action would allow the Agreement with Aria to be extended through December 31, 2026, increase the Agreement’s maximum compensation by $111,385, and amend the language of the Agreement to add a provision prohibiting the duplication of services through other funding sources.
Agreement with Fresno Metropolitan Ministry Background
On December 14, 2021 the Board approved Agreement A-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 (HOPE HUB) and provide service delivery through a nationally recognized evidence-based CHW model. On January 24, 2023 the Board approved First Amendment A-23-047 which allowed the Agreement to be extended through July 31, 2024, and increased the total maximum compensation by $2,400,000 to sustain services through this extension period. On July 9, 2024 the Board approved Second Amendment A-24-386 which allowed the Agreement to be extended through May 31, 2026 and increased the maximum compensation by $2,883,893 to sustain services through this extension period. The HOPE HUB provides wraparound services to over 1,600 residents, annually, throughout Fresno County. The third recommended action would allow the Agreement with FMM to be extended through December 31, 2026, and amend the scope of work of the Agreement to add additional service deliverables for the Department’s Public Health Nursing Division, which align with their service delivery model.
Population Health Management Grant Funding Background
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 these Agreements through December 31, 2026. The service Agreements with Aria, FMM, and Reading and Beyond were previously funded by federal funds, if approved, the recommended action would allow for services of the Agreements to continue with the addition of PHM funding. The recommended actions would also allow the Agreements to be extended through December 31, 2026, in alignment with the PHM grant timeline, and increase the maximum compensation of the Agreements 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 Agreements if the PHM grant is extended or additional grant funding becomes available. The recommended actions are in alignment with the Department’s plan of securing supplemental funding to support these critical services.
REFERENCE MATERIAL:
BAI #35.1, May 6, 2025
BAI #62, December 17, 2024
BAI #50, July 9, 2024
BAI #65, June 18, 2024
BAI #45, March 19, 2024
BAI #48, March 28, 2023
BAI #39, January 24, 2023
BAI #68, December 14, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 3 to Agreement with Reading and Beyond
On file with Clerk - Amendment No. 1 to Agreement with Aria
On file with Clerk - Amendment No. 3 to Agreement with FMM
CAO ANALYST:
Ron Alexander