DATE: January 9, 2018
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Revenue Agreement with California Department of Public Health
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive revenue Agreement with California Department of Public Health, for the Maternal, Child and Adolescent Health programs, effective July 1, 2017 through June 30, 2018 ($6,841,257).
REPORT
Approval of the recommended action will provide the Department of Public Health with an additional year of California Department of Public Health (CDPH) funding for the Maternal, Child and Adolescent Health (MCAH) programs. MCAH uses local grant funding ($3,958,081) as local match to draw down Federal Financial Participation (FFP) Federal Title XIX funds. The funding will support salary and benefits, operational, indirect, and subcontract costs to execute the required services. The programs provide outreach, home visitation, health education, and linkage to community resources to County pregnant and parenting women and their families, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended action, the Department would not be able to accept these program specific CDPH funds, resulting in a staff and program reduction.
RETROACTIVE AGREEMENT:
The recommended revenue agreement is retroactive to July 1, 2017. The agreement was received from CDPH on October 31, 2017. The time required preparing and reviewing the recommended agreement did not allow presentation to your Board at an earlier date.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The non-competitive allocation ($2,883,176) to the County for the MCAH programs includes funding from:
• FFP (Federal Title XIX) ($2,665,009)
• Federal Title V (210,795)
• Sudden Infant Death Syndrome ($7,372)
The local match ($3,958,081) includes funding from:
• Children and Families Commission of Fresno County ($1,368,633)
• Fresno County Superintendent of Schools ($379,904)
• Department of Behavioral Health ($252,992)
• Public Health Realignment ($1,956,552)
The recommended agreement allows indirect cost recovery of 25%; the Department’s indirect cost rate is 26.19%; the 1.19% difference ($49,824) will be covered with Health Realignment. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2017-18 Adopted Budget.
DISCUSSION:
CDPH funding has supported the Department’s MCAH programs including Fetal-Infant Mortality Review, Nurse-Family Partnership (NFP), High Risk Infant, Nurse Liaison, Babies First Case Management, and Help Me Grow Fresno County for over three decades. The programs primarily provide case management services to approximately 1,700 high-risk pregnant and parenting women and their families annually.
The recommended agreement will continue to provide funding for staff salary and benefits, operational expenses, subcontracts, and indirect costs for MCAH to:
• reduce infant mortality;
• reduce maternal morbidity and mortality;
• support the physical and cognitive development of children;
• help raise awareness and understanding of which groups are most vulnerable to disease;
• promote exclusive breastfeeding;
• optimize the health and well-being of the client populations across their life span; and,
• link the client populations to needed community services.
Approval of the recommended agreement indicates the County’s agreement to the terms of the CDPH MCAH Division Fiscal Administration Policy & Procedures Manual, in which the County agrees to:
• indemnify the State in connection with the performance of the agreement and for any intellectual property claims arising from the agreement;
• seek dispute resolution if a dispute should arise; and,
• allow the State to cancel the agreement without cause while the County may only cancel the agreement with cause.
REFERENCE MATERIAL:
BAI # 35, January 10, 2017
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - MCAH Revenue Agreement 201710
CAO ANALYST:
Sonia M. De La Rosa