HomeMy WebLinkAboutAgreement A-16-683-4 with First 5 for NFP.pdfAgreement No. 16-683-4
County of Fresno, Department of Public Health
Contract #201617-0954
Nurse-Family Partnership
Pa ge3
g , Signature Authority. Each Party represents that it has capacity, full power,
and authority to enter into this Amendment IV and perform under modified terms of
the Agreement, and the person signing this Agreement on behalf of each Party has
been properly authorized and empowered to enter into this Amendment IV.
10. Electronic Signatures. Each Party acknowledges and agrees that this
Amendment IV may also be executed by electronic signature, which shall be
considered as an original signature for all purposes and shall have the same force
a n d effect as an original signature. Without limitation, "electronic signature" shall
include faxe d versions of an original sign ature, electronically scanned and
transmitted versions of an original signature, or an "e-signed" document (e.g.
DocuSign).
Ill
Signa t u res
COMMI SSION CONTRACTOR
CHILDREN AND FAMILIES COMMISSION
OF FRESNO COUNTY
REVIEWED AND RECOMMENDED
FOR APP
Director
LFORM
By: --1.~'4,1;~,L.L~====--------
Kenneth Pric , Legal Counsel
lo ,...z_'t--?,/ Date of Signature: _________ _
By:_JL~· ~_1-__
Brian Pacheco, Commission Chair
tv -).,;-).1 Date of Signature: ____ __,_ ___ _
Ro521(1&2)
COUNTY OF FREr;_, DEPARTMENT OF PUBLIC?H
By:_,,,_L__j_ __ ~---------
Authorized Representative
Date of Signature: __ C\~b~\ .... ~_t,_\ __
Name: Steve Brandau
Cha irman of the Board of S upe rvi sors
Title: of the Cou nty of Fres no
Federal Tax ID Number:
ATTEST:
Bern ice E. Seidel
Cle rk of the Board of S uperv isors
Cou nty of Fresno , State of Cal iforn ia
By ~~ Deputy
D. Aggregate Services and Narrative
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•
•
1
1
2
3
4 County of Fresno, Department of Public Health
5 Nurse-Family Partnership
6 07/01/2016-06/30/2022
7 201617-0954
11
12 A B C E F G
13
Year 1
Actuals
Year 2
Actuals
Year 3
Actuals
Year 4
Actuals
Year 5
Budget
Year 6
Budget
14 07/01/16-6/30/17 07/01/17-06/30/18 07/01/18-06/30/19 07/01/19-06/30/20 07/01/20-06/30/21 07/01/21-06/30/22
15
16
17 88,041 78,654 97,895 99,574 97,715 97,715 559,594
18 62,417 65,606 73,083 70,989 79,628 69,427 421,151
19 6,812 5,696 7,210 7,617 8,078 7,475 42,889
20 157,270 149,956 178,188 178,181 193,298 174,618 1,031,510
21
22 434 444 473 470 517 586 2,924
23 2,018 1,652 1,978 3,000 1,840 1,978 12,466
24 4,449 1,129 2,315 1,287 1,333 1,333 11,846
25 6,901 3,225 4,766 4,757 3,690 3,897 27,236
26
27 3,519 3,302 5,443 17,153 3,346 5,292 38,055
28 3,519 3,302 5,443 17,153 3,346 5,292 38,055
29 0 0 0.00 250 250 250 750
30 22,722 39,273 26,729 25,302 9,665 26,193 149,884
31
32 190,412 195,756 215,126 225,643 210,249 210,249 1,247,435
33
34
Year 1
Actuals
Year 2
Actuals
Year 3
Actuals
Year 4
Budget
Year 5
Budget
Year 6
Budget
Total Other
Funding
35 A.Leveraged 166,680 39,273 229,662 185,473 176,277 177,693 975,058
36 B.Other Funding Source:- - - - - -
37 C.Other Funding Source:- - - - - -
38 166,680 39,273 229,662 185,473 176,277 177,693 975,058
FIRST 5 FRESNO COUNTY
Category
Agency Name:
Project Name:
Contract Term:
Contract Number:
Direct Service Budget
Total Program
Amount
Total Program Expenses
C. Training/Travel
Total Operating Expenses
III. Program Expenses
A. Materials and Supplies
Total Other Funding
IV. Professional Services
VI. Indirect Costs
VII. Other Funding
Total Program
I. Personnel
A. Facilities Costs
B. Operational/Supplies
A. Salaries
B. Benefits
C. Taxes
Total Personnel
II. Operating Expenses
1 Agency Name:Contract Term:
2 Project Name:Contract Number:
3
4
5
6
7 Title FTE Amount Title FTE Amount Title FTE Amount
8 Supervising Public Health Nurse 0.08 9,670 Supervising Public Health Nurse 0.07 8,593 -
9 Public Health Nurse I 0.50 40,948 Public Health Nurse I 0.50 41,334
10 Public Health Nurse I 0.57 47,097 Public Health Nurse I 0.43 35,185
11
12
13
14
15 1.15 97,715 1.00 85,112 - -
16 B. Benefits 71.051%
17 C. Taxes 7.65%
18
19
20
21
22
23
24
25
26
27
28
29
33
34
35
36
37
38
39
40
41
43
44
50 Program Totals
51
52
53 A. Indirect Rate 15.00%
54
55 Total Proposed Budget
Select Other Funding Source:
I. Personnel
The "Amount" should be: Annual
Salary X the FTE whenever possible.
1 FTE = 40 hours / week
A. Total Salaries & FTE
-
-
6,511
60,473
Personnel Subtotal 174,618 152,096 -
II. Operating Expenses
A. Facilities Costs
County of Fresno, Department of Public Health 07/01/2016-06/30/2022
Nurse-Family Partnership 201617-0954
A B C
First 5 Amounts Leveraged
69,427
7,475
07/01/21-6/30/22 07/01/21-6/30/22
YEAR 6
07/01/21-6/30/22
586 514 -
Justification of Benefits and Taxes: Estimated benefits rates reflect Unemployment Insurance (.002068), Retirement (.572-.7077), OASDI (.0765), Health Insurance
($8,943-$11,941 per FTE per year) and Benefits Administration ($113 per FTE per year).
Narrative/Justification – Explain these costs and how they apply to the program, then state methodology (FTE, Square Footage, etc) for these costs and provide the calculation
C. Training/Travel 1,333 1,167 -
Fees for staff to attend local meetings, conferences, and training ($500). Staff private auto mileage reimbursement at a rate of $0.575 per mile ($2,000).
Telephone communication costs used by program staff ($1,100). Rate provided by Fresno County Department of Internal Services and is based on the type of
device used.
Narrative/Justification – Explain these costs and how they apply to the program, then state methodology (materials, services, leases) for these costs and provide the calculation
Narrative/Justification
B. Operational/Supplies 1,978 1,102 -
General office supplies such as paper, pencils, envelopes and filing supplies ($2,000); postage ($300); and printing ($60). Medical supplies for PHNs to use during
home visits ($720).
Narrative/Justification
Operating Expenses Subtotal 3,897 2,783 -
III. Program Expenses
Instructional Information In the Narrative/Justification box provide a detailed explanation of all program expenses considered on this line item and how they are to support the program
participants (include calculations where applicable).
Narrative/Justification – Explain these costs and how they apply to the program, then state methodology (name of local conferences & trainings) for these costs and provide the calculation
Narrative/Justification
Subtotal 5,292 - -
A. Materials and Supplies 5,292 - -
IV. Professional Services (Contracts, MOU's, Sub agreements, etc.)
Instructional Information In the Narrative/Justification box provide a detailed explanation of all professional services considered on this line item and how they are to support the program or staff
(include calculations where applicable). Any services exceeding $5,000 must have attached a narrative delineating services.
Subtotal 250 -
Narrative/Justification – Provide the number of participants, cost per item, a description of the item, and justification for all expenses that support the clients of the program.
Books and publications ($2,000). Forms, pamphlets, educational materials to evaluate and assist NFP
clients ($3,292).
Narrative/Justification for Materials and Supplies Narrative/Justification for Materials and Supplies
210,249 177,693 -
Fresno County Department of Public Health’s indirect cost rate is 22.674% of the total personnel costs, prepared following OMB’s 2 CFR Part 200 guidelines and
approved by County of Fresno’s Auditor-Controller/Treasure-Tax Collector Department. Lower rate applied to this budget to remain within maximum allowable rate.
-
184,057 154,879 -
Estimated costs for interpreters/translators who provide services for various languages through a
Countywide contract.
Narrative/Justification – Narrative/Justification –
VI. Indirect (= Program Totals - Equipment x Percentage of Indirect)
Instructional Information In the Narrative/Justification box explain these costs, how they will support/benefit the program, and how the percentage was determined.
26,193 22,814
Narrative/Justification –