DATE: June 18, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Agreement with Avenal Community Health Center dba, Aria Community Health Center, to implement intervention activities for Fresno County’s Community Health Worker Network
RECOMMENDED ACTION(S):
TITLE
1. Under Administrative Policy No. 34 for competitive bids or requests for proposals (AP 34), determine that an exception to the competitive bidding requirement under AP 34 is satisfied and a suspension of competition is warranted due to unusual or extraordinary circumstances, and that the best interests of the County would be served by entering into an agreement with Avenal Community Health Center dba, Aria Community Health Center (Aria) as Aria is the only federally qualified health center with access and training in the Department’s data management and referral platform; and
2. Approve and authorize the Chairman to execute an Agreement with Aria to promote community health support and to provide health intervention activities for Fresno County’s Community Health Worker Network, effective July 1, 2024 through May 31, 2028, which includes two optional one-year extensions, total not to exceed $464,068.
REPORT
There is no additional Net County Cost associated with the recommended actions, which will allow Avenal Community Health Center dba, Aria Community Health Center (Aria) to provide outreach and care coordination services to residents of western Fresno County with an emphasis on agricultural workers. This item is countywide with an emphasis on Districts 1 and 4.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, there would be no federally qualified health center (FQHC) contracted to provide community health worker (CHW) interventions to the targeted population of agricultural workers of western Fresno County, thus creating a gap in services to community members in most need of these services.
SUSPENSION OF COMPETITION:
It is requested that the County find under AP 34 that an exception to the competitive bidding requirement is satisfied, and a suspension of competition is warranted due to unusual or extraordinary circumstances, as Aria has demonstrated they are uniquely qualified and the only suitable vendor to carry out the programmatic activities due to their extensive experience in providing health literacy interventions and other health prevention measures to the targeted populations of agricultural workers and rural residents of Fresno County. Aria is also the only FQHC with access and training in the Department’s data management and referral platform for Fresno County’s CHW network. The Internal Services Department - Purchasing concurs with the Department’s assessment that this satisfies the exception to the competitive bidding process required by AP 34.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The agreement is fully funded by the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) grant funds. The total cost for the recommended Agreement is $464,068. Sufficient appropriations and estimated revenues are included in the Department of Public Health’s Org 5620 FY 2024-25 Recommended Budget and will be included in subsequent budget requests.
DISCUSSION:
On May 3, 2022, your Board approved Agreement A-22-182 which allowed the County to partner with Aria to provide health intervention activities for implementation of Fresno County’s Advancing Health Literacy Intervention Program (AHL), a grant funded program. The AHL program was one component of several coordinated CHW interventions. The overarching goal of the AHL program was to provide health materials and information to community members at an understandable level while also connecting them to healthcare services, such as primary providers. The AHL program also provided trainings and developed health materials for other CHW programs and funded partners. Because of Aria’s success implementing AHL program deliverables and their specialized knowledge as an FQHC, on June 20, 2023, your Board approved Agreement A-23-337 which amended Agreement A-22-182 to extend the agreement term by one year to continue delivering AHL services, funded by the Department’s realignment fund, after the Federal AHL grant expired.
Approval of the recommended actions will allow the Department to continue its partnership with Aria through a new agreement to fulfill and expand on AHL deliverables with alternative ELC funding. In addition to addressing barriers of health literacy, Aria will also address chronic disease prevention services and screen for various social determinants of health. The recommended action will also allow Aria to partner with the Department’s Rural Mobile Health program to assess the needs of community members and offer participants the opportunity to enroll into the CHW network at various events throughout the County.
REFERENCE MATERIAL:
BAI # 74, June 20, 2023
BAI # 42, May 3, 2022
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition
On file with Clerk - Agreement with Aria
CAO ANALYST:
Ron Alexander