DATE: March 19, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: First Amendments to Agreements with Community Based Organizations to Implement Department of Public Health’s Health Disparities Program
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment No. 1 to Agreements with the following vendors to allow unspent fiscal year one funds to be carried over to fiscal year two, allow fiscal year two funds to be redirected to other line items, and amend Article 7.1 of each agreement, with no changes to the maximum compensation, or to the term of March 28, 2023 through December 31, 2024, with two optional one-year extension periods:
1) Reading and Beyond with a total not to exceed amount of $1,260,000,
2) Centro La Familia Advocacy Services with a total not to exceed amount of $1,335,000,
3) Centro Binacional para el Desarrollo Indigena Oaxaqueño with a total not to exceed amount of $750,000,
4) West Fresno Health Care Coalition with a total not to exceed amount of $996,818, and
5) Cultiva La Salud with a total not to exceed amount of $1,155,000.
REPORT
There is no additional Net County Cost associated with the recommended actions, which will move unspent funds from year one to year two in each Agreement’s budget and reallocates funds to adjust for previously unanticipated costs. The recommended actions will also allow for each Agreement to be updated to acknowledge the Center for Disease Control and Prevention’s (CDC) grant as one of the funding sources for these agreements by including the grant’s Catalog of Federal Domestic Assistance number. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, these organizations will be limited in their ability to effectively serve the needs of community members through health disparities interventions. Furthermore, the full amount of funds initially agreed upon at the time of contract execution may not be maximized, causing the organizations and the County to have unspent funds at the end of the grant term.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The agreements will continue to be fully funded with federal grants. The total costs for each recommended action are outlined below:
Reading and Beyond
• Year One (3/28/2023 - 7/31/2023): $76,000
• Year Two (8/1/2023 - 7/31/2024): $848,000
• Year Three (8/1/2024 - 12/31/2024): $336,000
• Term Maximum: $ 1,260,000
Centro La Familia
• Year One (3/28/2023 - 7/31/2023): $66,712
• Year Two (8/1/2023 - 7/31/2024): $912,288
• Year Three (8/1/2024 - 12/31/2024): $356,000
• Term Maximum: $ 1,335,000
Centro Binacional para el Desarrollo Indigena Oaxaqueño
• Year One (3/28/2023 - 7/31/2023): $67,172
• Year Two (8/1/2023 - 7/31/2024): $482,828
• Year Three (8/1/2024 - 12/31/2024): $200,000
• Term Maximum: $ 750,000
West Fresno Health Care Coalition
• Year One (3/28/2023 - 7/31/2023): $62,173
• Year Two (8/1/2023 - 7/31/2024): $668,827
• Year Three (8/1/2024 - 12/31/2024): $265,818
• Term Maximum: $ 996,818
Cultiva La Salud
• Year One (3/28/2023 - 7/31/2023): $82,470
• Year Two (8/1/2023 - 7/31/2024): $764,530
• Year Three (8/1/2024 - 12/31/2024): $308,000
• Term Maximum: $ 1,155,000
Sufficient appropriations and estimated revenues are included in the Department of Public Health’s Org 5620 FY 2023-24 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
On March 28, 2023, your Board approved Agreements A-23-129, A-23-130, A-23-131, A-23-132, and A-23-133 which allowed the County to partner with multiple organizations to promote community health support and to provide health intervention activities for implementation of Fresno County’s Initiative to Address COVID-19 Related Health Disparities. Contracted agencies collaborate with The Department of Public Health’s Rural Mobile Health Program and offer clients an opportunity to enroll into the community health worker (CHW) network through an initial social determinants of health screener used to assess the client’s unique needs and develop an individualized approach to address barriers to health while providing wrap around services to enrolled clients. In less than a year of implementation, contracted agencies have hosted and participated in 703 events, provided outreach to over 26,000 community members, and have completed 2,200 social service and medical referrals, which include connecting patients to a primary health care provider. Other mitigation efforts include addressing emerging health trends within Fresno County, guided by disease surveillance indicators, and dissemination of linguistically and culturally appropriate health education materials within targeted communities.
The Agreements were initially delayed in finalization and execution causing funds that were originally budgeted for the first fiscal year of the program to remain unspent. A carryover of unused funds would allow each organization to fully utilize the resources provided in the original Agreements and maximize the impacts of the program in the community. If approved, the recommended actions would allow changes to each organization’s budget to reflect actuals in year one and increase the year two budget with carryover amounts from unspent year one funds. The recommended actions would also allow for a correction in the wording of Article 7.1 in each Agreement to include the correct Catalog of Federal Domestic Assistance Number to acknowledge the CDC as one of the Federal funding sources of these Agreements. No changes were made to the term or maximum total compensation.
REFERENCE MATERIAL:
BAI #48, March 28, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - First Amendment to Agreement with Reading and Beyond
On file with Clerk - First Amendment to Agreement with Centro La Familia
On file with Clerk - First Amendment to Agreement with Centro Binacional para el Desarrollo Indigena Oaxaqueño
On file with Clerk - First Amendment to Agreement with West Fresno Health Care Coalition
On file with Clerk - First Amendment to Agreement with Cultiva La Salud
CAO ANALYST:
Ron Alexander