DATE: September 1, 2020
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Ratification of Agreements with Fresno Economic Opportunities Commission for COVID-19 Equity Project
RECOMMENDED ACTION(S):
TITLE
1. Ratify the Agreement and First Amendment with Fresno Economic Opportunities Commission for the COVID-19 Equity Project - Base, previously executed by the County Administrative Officer acting as the Emergency Services Director, effective August 19, 2020 through December 30, 2020 ($4,039,556).
2. Ratify the Agreement with Fresno Economic Opportunities Commission for the COVID-19 Equity Project - African American Coalition, previously executed by the County Administrative Officer acting as Emergency Services Director, effective August 7, 2020 through December 30, 2020 ($1,648,671).
REPORT
Approval of the recommended actions will ratify two agreements with Fresno Economic Opportunities Commission (EOC) to implement the COVID-19 Equity Project. The project will support residents who face increased risk of COVID-19 exposure, hospitalization, and death due to work or living conditions. Fresno EOC will provide fiscal sponsorship to Fresno Building Healthy Communities (BHC) who will lead six CBOs serving vulnerable residents in both urban and rural areas under the base agreement for the project. Fresno EOC will also directly oversee five community-based organizations (CBOs) to implement the project’s scope of work dedicated to the County’s African American community. There is no Net County Cost associated with the recommended actions. This item is Countywide.
ALTERNATIVE ACTION(S):
Should your Board not ratify the agreements, the Department would solicit additional proposals for similar services to meet the critical need for response activities dedicated to vulnerable populations. However, the delay would cause detrimental effects of unknown scope especially as the Department and community begin to prepare for flu season and as COVID-19 cases surge.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The agreements will be fully funded with CARES Act funding. Fresno EOC will receive $4,039,556 for the Base contract, and $1,648,671 for the African American Coalition contract through December 30, 2020, when CARES Act funding expires. There are no outstanding invoices pending related to these agreements. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2020-21 Recommended Budget.
DISCUSSION:
On March 15, 2020, the County declared a State of Emergency to increase response capacity for the COVID-19 pandemic. The County has been overwhelmed with increasing transmission and hospitalization rates. Since June 1, 2020, positive cases have increased over tenfold. As of August 27, 2020, over 24,000 residents have been infected, 218 patients are currently hospitalized, and 254 people have died. These numbers are expected to continue to rise with sustained community spread as the County balances the priorities of stabilizing the economy, reopening schools, and strengthening health systems.
Approval of the recommended actions will allow the Department to support vulnerable residents facing challenges to testing, isolation, and sheltering-in-place during this crisis. The Department seeks to mobilize and build upon the unique community ties the Equity Project coalition partners have developed over years of working directly with vulnerable residents within rural and metropolitan areas of the County. The County is in need of widespread community messaging to its economically, culturally, linguistically, and geographically diverse population delivered through trusted community leaders to enable and improve voluntary compliance with community containment and mitigation measures.
The first recommended action will establish Fresno EOC as the fiscal agent for Fresno BHC and their subcontractors as Fresno BHC oversees and implements initiatives related to health equity, resident outreach and engagement, direct resource delivery, and public education to vulnerable residents throughout the County. The first recommended action includes an amendment which corrects a clerical error in the stated maximum compensation. The second recommended action will allow Fresno EOC to directly oversee and implement the same scope of work focused on serving the County’s African American community. Together, these organizations will employ a total of over 90 community health workers to provide contract tracing support and relevant education and outreach services to farm laborers, essential workers, refugees, people of color and County residents living in poverty with access to few resources. These residents are experiencing higher rates of infection and hospitalization because they are more likely to work in an essential occupation that cannot self-isolate or shelter-in-place, to live in a high-density or multi-generational household, and to delay medical care due to cost, access, or other factors. Targeted residents have also borne a disproportionate burden related to the economic downturn in terms of lost jobs and wages.
The Department received a narrative proposal from its community partners on June 29, 2020. The Department has worked with Fresno EOC and Fresno BHC to refine the proposal to include specific outcomes and structure within the scope of work activities, identify data analysis parameters, and establish ongoing tracking of quarantine support funds disbursed to residents. The Department has established guidelines to direct approximately 60 percent of the total funding to education and outreach activities, 30 percent to direct resident quarantine support, and 10 percent to contact tracing activities to supplement Departmental operations. The Department will review and approve all scope of work plans developed by the coalition prior to full implementation, and will approve all media and materials prior to publication to ensure cohesive, unified messaging.
The recommended agreements contain non-standard language in that they contain a provision allowing the contractors to request an advance payment of up to 20 percent of their maximum compensation in order to quickly onboard the eleven subcontractors. The agreements also contain a mutual without-cause termination clause upon 30 days advance written notice, a budget modification clause allowing the Director to approve line item changes of up to ten percent of the maximum compensation, and a clause allowing the Director to approve subcontracts with additional community benefit organizations.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Fresno EOC - Equity Project Base
On file with Clerk - First Amendment to Agreement with EOC - Equity Project Base
On file with Clerk - Agreement with Fresno EOC - Equity Project African American Coalition
CAO ANALYST:
Raul Guerra