HomeMy WebLinkAboutAgreement A-16-684-4 with First 5 for Nurse Liaison.pdfAgreement No. 16-684-4
County of Fresno, Department of Public Health
Contract #201617-0950
Nurse Liaison
Page3
9 . 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 h as
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 signatu re, which shall be
considered as an original signature for all purposes and sh all have the same force
and effect as an original signature. Without limitation, "electronic signature" shall
include faxed versions of an original signature, electronically scanned and
transmitted versions of an original signature, or an "e-signed" document (e .g .
DocuSign).
Ill
Signa ture s
COMMISSION CONTRACTOR
CHILDREN AND FAMILIES COMMISSION
OF FRESNO COUNTY
REVIEWED AND RECOMMENDED
FORAPP W'A
f l o -z '> --z.. ( Date o Signature: _____ '----~---
By:------'L--==---· -'---~.l.. __
Brian Pacheco, Commission Chair
tv-)i; ~.)_,
Date of Signature: ------~---
Ro521(1&2)
COUNTY OF FRESNO, DEPARTMENT OF ::BLI A½ -
Authorized Representative
Date of Signature: __ Q......_..1,:J--"'-1\r-"'~=~'~-
Name: Steve Brandau
Cha irman of th e Boa rd of Sup erv is ors
Title: of the Co unty of Fresno
Federal Tax ID Number:
ATTEST :
Be rni ce E. Seidel
C le rk of th e Board of S upe rvi so rs
Cou nty of Fre sno , Stat e of Ca li fo rni a
By_~~...-14-,.J:::Lu.-~·'---lc~d~d-d~,JL.-_Deputy
D. Aggregate Services and Narrative
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•
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1
2
3
4
5
6
7
11
12 A B C D E F
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
17 144,171 135,693 173,854 187,729 192,887 193,886 1,028,220
18 96,882 96,858 117,470 128,942 149,360 149,905 739,417
19 11,188 10,006 12,397 14,361 14,756 14,832 77,540
20 252,241 242,557 303,721 331,032 357,003 358,623 1,845,177
21
22 4,579 4,826 4,705 5,366 5,789 5,789 31,054
23 3,069 2,611 3,080 1,832 1,326 1,326 13,244
24 2,832 1,200 2,764 4,575 3,289 3,289 17,949
25 10,480 8,637 10,549 11,773 10,404 10,404 62,247
26
27 2,889 2,983 4,000 14,929 4,104 4,103 33,008
28 2,889 2,983 4,000 14,929 4,104 4,103 33,008
29 7,000 6,060 4,585 8,000 5,000 3,300 33,945
30 40,007 63,525 45,557 18,405 17,850 17,931 203,275
31
32 312,617 323,762 368,412 384,139 394,361 394,361 2,177,652$
33
34
Year 1
Actuals
Year 2
Actuals
Year 3
Actuals
Year 4
Actuals
Year 5
Budget
Year 6
Budget
Total Other
Funding
35 A.Leveraged 344,725 376,600 504,244 459,245 493,917 496,750 2,675,481
36 B.Select Other Funding Source:0 0 0 0 0 0 0
37 C.Other Funding Source:0 0 0 0 0 0 0
38 344,725 376,600 504,244 459,245 493,917 496,750 2,675,481
FIRST 5 FRESNO COUNTY
Category
Agency Name:
Project Name:
Contract Term:
Contract Number:
Direct Service Budget
Total Program
Amount
County of Fresno, Department of Public Health
Nurse Liaison
Total Program Expenses
C. Training/Travel
Total Operating Expenses
III. Program Expenses
A. Materials and Supplies
07/01/16-06/30/22
201617-0950
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 0.31 35,684 Supervising Public Health Nurse 0.39 44,755 -
9 Public Health Nurse II 0.42 41,817 Public Health Nurse II 0.58 58,497
10 Public Health Nurse I 0.38 32,975 Public Health Nurse I 0.62 53,351
11 Public Health Nurse I 0.49 36,789 Public Health Nurse I 0.51 38,547
12 Public Health Nurse II 0.46 46,621 Public Health Nurse II 0.54 54,293
13
14
15 2.06 193,886 2.64 249,443 - -
16 B. Benefits 77.316%
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 5.000%
54
55 Total Proposed Budget
YEAR 6 Budget
First 5 Amounts Leveraged Select Other Funding Source:
County of Fresno, Department of Public Health 07/01/16-06/30/22
Nurse Liaison 201617-0950
A B C
07/01/21-6/30/22 07/01/21-6/30/22 07/01/21-6/30/22
I. Personnel
The "Amount" should be: Annual
Salary X the FTE whenever possible.
1 FTE = 40 hours / week
A. Total Salaries & FTE
149,905 192,859 -
14,832 19,082 -
Personnel Subtotal 358,623 461,385 -
Justification of Benefits and Taxes: Estimated benefits rates reflect Unemployment Insurance (.00206), Retirement (.526-.7077), OASDI (.0765), Health Insurance
($8,943-$11,810 per FTE per year) and Benefits Administration ($113 per FTE per year).
II. Operating Expenses
A. Facilities Costs 5,789 7,411 -
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
Fresno County Department of Public Health, 1221 Fulton St, 4th floor, Fresno, CA 93721. Telephones ($2,000), facility operation/maintenance/household services
($5,600), utilities ($4,000), and security/alarm ($1,600). These are all Internal Service Funds charges by square footage and assigned phone lines for the program.
General Services Administration provides base amount for the department. Nurse Liaison staff account for approximately 950 sq ft.
Narrative/Justification –
B. Operational/Supplies 1,326 674 -
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).
A. Materials and Supplies 4,103 - -
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
General office supplies such as paper, pencils, envelopes and filing supplies ($900), printing ($100) and postage ($200). Medical supplies for PHNs to use during
home visits ($800).
Narrative/Justification –
C. Training/Travel 3,289 4,211 -
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
Fees for staff to attend local meetings, conferences, and trainings ($2,000). Staff private auto mileage reimbursement at a rate of $0.575 per mile ($2,500). County
vehicle maintenance/usage/garage ($3,000).
Narrative/Justification –
Operating Expenses Subtotal 10,404 12,296 -
376,430 473,681 -
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.
Subtotal 4,103 - -
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.
Forms, pamphlets, educational materials (books and toys for children) to evaluate, educate and foster
physical/mental/social growth in Nurse Liaison clients.
Narrative/Justification for Materials and Supplies Narrative/Justification for Materials and Supplies
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 3,300 - -
Estimated costs for interpreters/translators who provide services for various languages through a
Countywide contract. Interpreting services at a rate of $40.00 per hour.
Narrative/Justification – Narrative/Justification –
394,361 496,750 -
17,931 23,069
Fresno County Department of Public Health’s indirect cost rate is 25.42% 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 ensure sufficient funding for direct costs
and remaining within funding award amount.
Narrative/Justification –