DATE: October 6, 2026
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Director, Department of Public Health
SUBJECT: Retroactive FY 2026-29 California Home Visiting Program Agreement Funding Application with California Department of Public Health
RECOMMENDED ACTION(S):
TITLE
1. 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, 2026, through June 30, 2029 ($13,289,193); and
2. Approve and authorize the Director of Public Health to approve amendments to the contract expenditure category limits for FY 2027-28 and 2028-29 when notices are received from the California Department of Public Health regarding funding changes and budget changes.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the first 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 supports salaries, benefits, and operational costs to continue the Nurse-Family Partnership (NFP) program and Healthy Families America (HFA) program services provided by the Department. The programs provide outreach, home visitation, health education, and linkage to community resources for Fresno County pregnant and parenting women and their families. Approval of the second recommended action will authorize the Director of Public Health to approve amendments to the budgets for fiscal year (FY) 2027-28 and 2028-29 when notices are received from CDPH regarding funding and budget changes. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, 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, 2026. The process for receiving the CHVP MIECHV and CHVP SGF EBHV funding requires submittal of an Agreement Funding Application (AFA) to CDPH. The Department received the CHVP AFA on April 13, 2026. The AFA requires CDPH’s pre-approval of the budgets and all documents before the item could be presented to your Board for approval. The Department received the necessary pre-approvals on July 31, 2026, 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 actions. The agreement will now be for three (3) years to help reduce the administrative burden and invoicing delays. However, CDPH requires submittal of program budgets for each of the years of the agreement. The breakdown of each program’s budget for each of the year is as follows:
FY 2026-27
• CHVP MIECHV $1,051,966
• CHVP SGF EBHV $3,351,619 (Federal Title XIX $1,625,103, CHVP - EBHV $1,726,516)
FY 2027-28
• CHVP MIECHV $1,051,966
• CHVP SGF EBHV $3,382,331 (Federal Title XIX $1,655,815, CHVP - EBHV $1,726,516)
FY 2028-29
• CHVP MIECHV $1,051,966
• CHVP SGF EBHV $3,399,345 (Federal Title XIX $1,672,829, CHVP - EBHV $1,726,516)
The budgets for FY 2027-28 and 2028-29 will be amended near the end of the FY once notice is received from CDPH regarding funding and budget changes. Approval of the recommended actions provides funding to support salaries, benefits, and operational costs to continue the NFP and HFA services provided by the Department for FY 2026-27, 2027-28, and 2028-29. Both grants allow the Department’s indirect cost rate of 22.85%. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2026-27 Adopted Budget and will be included in future budget requests.
DISCUSSION:
CDPH funding has supported the CHVP in Fresno County since 2012. On December 9, 2025, your Board approved and signed the CHVP MIECHV and CHVP SGF EBHV AFA for FY 2025-26, accepting the $3,889,410 allocation to support salaries, 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 (PHNs) with specialized training visit with mothers, fathers, and extended family members to monitor the health of both the mother and child, as well as assess 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.
The HFA program is a home visiting program designed to support parents and caregivers, share information about child development and parenting, promoting healthy and nurturing parent-child relationships, and provide information and referrals to strengthen families.
FY 2025-26 CHVP MIECHV Program outcomes:
• 53 referrals received and 34 families enrolled into program services;
• 98 families and 82 children served, 34 new clients enrolled, 26 graduated from the program;
• 962 in-person and 139 telehealth home visits completed;
• 30 children born to enrolled families;
• 96.55% of clients initiated breastfeeding at birth;
• provided 96 infants/toddlers with developmental assessments using the Ages & Stages Questionnaire (ASQ3) at 4, 10, 18 and 24 months of age and ASQ-Social Emotional (SE) at 6, 12, 18 and 24 months of age; and 1 referral was made for abnormal ASQ screening; and
• 104 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 2025-26 CHVP SGF EBHV Program outcomes:
• 146 referrals received and 70 families enrolled in program services;
• 209 families and 176 children served, 70 new clients enrolled, 45 graduated from the program;
• 1,650 in-person and 307 telehealth home visits completed;
• 62 children born to enrolled families;
• 93% of clients initiated breastfeeding at birth;
• provided 173 infants/toddlers with developmental assessments using the ASQ3 at 4, 10, 18 and 24 months of age and ASQ-SE at 6, 12, 18 and 24 months of age; 2 referrals were made for abnormal ASQ screening; and
• 151 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 2025-26, the Fresno County CHVP SGF EBHV - HFA Program outcomes:
• 24 referrals received, 14 were eligible and 12 families enrolled in program services;
• 20 families and 17 children served;
• 297 in-person and 44 telehealth home visits completed;
• 13 children born to enrolled families;
• 12 clients initiated breastfeeding at birth;
• 6 infants up to date on immunizations at 6 months of age; and
• 44 ASQs and 5 ASQ-SE were completed for 12 infants; 1 referral was made for abnormal ASQ screening.
CHVP provides 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.
Only pre-approval of the CHVP AFA was received due to one of the documents requiring the Chairman’s signature. CDPH will issue the CHVP MIECHV and CHVP SGF EBHV award letter after the AFA is officially approved.
REFERENCE MATERIAL:
BAI #70, December 9, 2025
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 2026-29 CHVP Agreement Funding Application with CDPH
CAO ANALYST:
Ron Alexander