DATE: December 9, 2025
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Director, Department of Public Health
SUBJECT: Retroactive FY 2025-26 California Home Visiting Program Agreement Funding Application with California Department of Public Health
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive Agreement Funding Application with California Department of Public Health, for the California Home Visiting Program - Maternal, Infant, and Early Childhood Home Visiting and California Home Visiting Program - State General Fund - Evidence-Based Home Visiting programs, effective July 1, 2025 through June 30, 2026 ($3,889,410).
REPORT
There is no additional Net County Cost associated with the recommended action. Approval of the recommended action will provide the Fresno County Department of Public Health (Department) with California Department of Public Health (CDPH) funding from the California Home Visiting Program (CHVP) - Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program and the CHVP State General Fund (SGF) - Evidence-Based Home Visiting (EBHV) program. The funding will support salary and benefits, and operational costs to expand the Nurse-Family Partnership (NFP) program services provided by the Department. The program provides outreach, home visitation, health education and linkage to community resources for Fresno County pregnant and parenting women and their families. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended action, the Department would not have sufficient funds to operate these critical programs and will be unable to provide MIECHV and EBHV services to pregnant and parenting women and their families.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to July 1, 2025. The process for receiving the CHVP MIECHV and CHVP SGF EBHV funding requires submittal of an Agreement Funding Application (AFA). The Department received the CHVP AFA on April 25, 2025. The AFA required the State’s pre-approval of the budget and all documents before the item could be presented to your Board for approval. The Department received the necessary pre-approvals on October 14, 2025 and is bringing this item in accordance with Agenda Item timelines.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. CDPH is allocating $895,429 to the Department’s CHVP MIECHV program and $2,993,981 to the Department’s CHVP SGF EBHV program for FY 2025-26. Approval of the recommended action will provide funding to support salary and benefits, and operational costs to expand the NFP services provided by the Department for FY 2025-26. Both grants allow the Department’s indirect cost rate of 24.47%, however, the indirect cost rates were reduced to 15.47% for CHVP MIECHV and 1.77% for CHVP SGF EBHV to remain within the grant allocations. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2025-26 Adopted Budget.
DISCUSSION:
CDPH funding has supported the CHVP in Fresno County since 2012. On June 9, 2020, your Board accepted SGF from CDPH to expand the CHVP, increasing services in the City of Fresno and a CHVP site in the City of Selma. On November 16, 2021, your Board approved and accepted a retroactive award funding for the CHVP SGF Expansion for FY 2020-23. On April 25, 2023, your Board approved and signed the CHVP SGF Expansion Year 1 AFA, accepting $748,835 in additional allocation to support salary and benefits, and operational costs to expand the NFP program services provided by the Department for FY 2022-23. On October 10, 2023, your Board approved and signed the CHVP MIECHV and CHVP SGF EBHV AFA for FY 2023-24, accepting the $2,531,710 allocation to support salary and benefits, and operational costs of the two programs. On December 3, 2024, your Board approved and signed the CHVP MIECHV and CHVP SGF EBHV AFA for FY2024-25, accepting the $2,531,711 allocation to support salary and benefits, and operational costs of the two programs.
The Department provides NFP services countywide. The program provides nurse home visitation services to low-income, first-time mothers and their families following the evidence based NFP model. From pregnancy through the child’s second birthday, Public Health Nurses (PHN) with specialized training visit with mothers, fathers, and extended family members to monitor the health of both the mother and child, as well as the environment. PHNs also provide information on pregnancy, parenting skills, healthy relationships, disease prevention, and appropriate community services. During their visits, the PHNs encourage positive health choices, such as:
• Avoiding smoking, drinking, and using drugs;
• Seeking prenatal care;
• Eating nutritious foods;
• Increasing intervals between births; and,
• Setting achievable life goals.
FY 2024-25 CHVP MIECHV Program:
• 42 referrals received and 42 families enrolled into program services;
• 98 families and 80 children served, 46 new clients enrolled, 24 graduated from the program;
• 885 in-person and 156 telehealth home visits completed;
• 28 children born to enrolled families;
• 100% of clients initiated breastfeeding at birth;
• provided 85 infants/toddlers with developmental assessments using the ASQ3 at 4, 10, 18 and 24 months of age and ASQ-Social Emotional at 6, 12, 18 and 24 months of age; and 6 referrals were made for abnormal ASQ screening; and
• 127 referrals were completed for government assistance, crisis intervention, mental health, substance use, health care services, education programs and other services including transportation, housing, and job training.
FY 2024-25 CHVP SGF EBHV Program:
• 60 referrals received and 46 families enrolled into program services;
• 89 families and 65 children served, 46 new clients enrolled, 13 graduated from the program;
• 766 in-person and 72 telehealth home visits completed;
• 25 children born to enrolled families;
• 96.5% of clients-initiate breastfeeding at birth;
• provided 54 infants/toddlers with developmental assessments using the ASQ3 at 4, 10, 18 and 24 months of age and ASQ-Social Emotional at 6, 12, 18 and 24 months of age; 5 referrals were made for abnormal ASQ screening; and
• 53 referrals were completed for government assistance, crisis intervention, mental health, substance use, health care services, education programs and other services including transportation, housing, and job training.
In FY 2024-25, the Fresno County CHVP SGF EBHV - Healthy Families Program, began enrolling eligible moms in December 2024 with the following impact:
• 16 referrals received, 14 were eligible and 9 families enrolled into program services;
• 9 families and 5 children served;
• 90 in-person home visits completed;
• 2 children born to enrolled families;
• 2 moms-initiate breastfeeding at birth;
• 2 infants up to date on immunizations at 6 months of age;
• provided 4 infants/toddlers with developmental assessments using the ASQ3 at 2, 4, 6, 8, 9, 10, 12, 18 and 24 months of age and ASQ-Social Emotional at 6, 12, 18 and 24 months of age; 2 was screened at 2 months, 2 were screened at 4, 6, and 8; and no referrals were made for abnormal ASQ screening; and
• 9 referrals were completed for government assistance, crisis intervention, mental health, substance use, health care services, education programs and other services including transportation, housing, and job training.
CHVP provided clients with linkage and health care services and other resources including childcare, job training, housing, transportation, injury prevention, childbirth and lactation classes/services, charitable and legal services, as well as early childhood intervention and dental services. Clients were also connected to crisis intervention services including intimate partner violence, mental health, and substance abuse cessations.
CDPH will issue the CHVP MIECHV and CHVP SGF EBHV award letter after the Agreement Funding Application is approved.
REFERENCE MATERIAL:
BAI #61, December 3, 2024
BAI #56, October 10, 2023
BAI #38, April 25, 2023
BAI #35, November 8, 2022
BAI #45, November 16, 2021
BAI #29, June 9, 2020
BAI #34, January 7, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - FY 2025-26 CHVP Agreement Funding Application with CDPH
CAO ANALYST:
Ron Alexander