DATE: September 23, 2025
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Interim Director, Department of Public Health
SUBJECT: Amendments to Agreements for Rural Mobile Health Program
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment No. 1 to Agreement No. 23-020 with Saint Agnes Medical Center for Rural Mobile Health program services, effective upon execution, extending the term by approximately one year from November 13, 2025, through December 31, 2026, and increasing the maximum compensation by $200,000 to a total of $1,238,211; and
2. Approve and authorize the Chairman to execute Amendment No. 1 to Agreement No. 23-021 with The Regents of the University of California, San Francisco for Rural Mobile Health program services, effective upon execution, extending the term by approximately one year from November 13, 2025, through December 31, 2026, and increasing the maximum compensation by $800,000 to a total of $4,944,993.
REPORT
There is no Net County Cost associated with the recommended actions. Approval of the recommended actions will increase the maximum compensation and extend the terms of the agreements with Saint Agnes Medical Center (SAMC) and The Regents of the University of California, San Francisco (UCSF) by approximately one year. Approval of the recommended actions will allow SAMC and UCSF to continue providing Rural Mobile Health (RMH) program services including health screenings, immunizations, and linkage for patients to primary care clinics in the County’s disadvantaged communities. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board elect not to approve the recommended actions, RMH services will end November 12, 2025. This will leave a gap in health care services to Fresno County’s vulnerable populations who already have limited access to proper health care.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. Upon execution of the recommended amendments, the maximum compensation for the agreement with SAMC will increase by $200,000 to a total of $1,238,211, and the maximum compensation for the agreement with UCSF will increase by $800,000 to a total of $4,944,993. The additional funding will be provided by California Department of Public Health Care Services Medi-Cal Managed Care Plan funding (MCP). Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2025-26 Adopted Budget and will be included in the subsequent budget requests.
DISCUSSION:
On January 3, 2023, the Board approved agreements with SAMC and UCSF to implement the RMH program in Fresno County. Currently funded by the Department’s allocation of the American Rescue Plan Act - State Local Fiscal Recovery Funds (ARPA-SLRF), the RMH program provides preventive care screenings, vaccinations, STD testing, eye exams, and more, ensuring that essential health care services reach Fresno County’s underserved populations and patients are connected to community services and primary care doctors for continued care.
Both contracted medical providers, SAMC and UCSF, travel to multiple rural locations and agricultural workplaces in Fresno County several times a week to provide RMH services. Eye exams and on-the-spot prescription eyeglasses were also provided at RMH events through a separate contract with Tzu Chi Mobile Clinic. Additionally, Fresno County’s Community Health Worker (CHW) Network assists individuals at RMH events by providing wrap-around care coordination services and health education on topics such as nutrition, mental health, diabetes, and heart disease.
Since the RMH program’s launch, SAMC and UCSF have completed over 545 RMH events and provided essential health care services to over 13,600 patients at these RMH events. Tzu Chi Mobile Clinic provided eye exams and prescription eyeglasses at 25 RMH events to 437 patients. The CHW Network reached more than 90,000 community members through resources and more than 23,900 educational materials given out during interactions at RMH events.
Approval of the recommended amendments will add MCP funding to both medical provider agreements, increase the maximum compensation of each upon execution, and extend the term of the agreements through December 31, 2026. The additional MCP funding will also allow RMH services to expand beyond rural and agricultural communities into other disadvantaged communities within Fresno County, including metropolitan areas. Approval of the recommended actions will help ensure the County is committed to expanding access to essential health care services and supporting the well-being of all residents.
REFERENCE MATERIAL:
BAI #25, January 3, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 1 to Agreement with SAMC
On file with Clerk - Amendment No. 1 to Agreement with UCSF
CAO ANALYST:
Ron Alexander