HomeMy WebLinkAboutAvenal Community Health Center dba Aria Community Health Center-Improving Prevention and Management of Heart Disease and Stroke_A-22-284 A-21-545.pdf COjl County of Fresno Hall of Records,Room 301
2281 Tulare Street
Fresno,California
Board of Supervisors 93721-2198
C) Telephone:(559)600-3529
PR Minute Minute Order Toll Free: 1-800-742-1011
www.co.fresno.ca.us
June 21, 2022
Present: 5- Supervisor Steve Brandau, Supervisor Nathan Magsig, Supervisor Buddy Mendes,
Chairman Brian Pacheco,and Vice Chairman Sal Quintero
Agenda No. 69. Public Health File ID: 22-0554
Re: Approve and authorize the Chairman to execute Amendment I to Agreement with Avenal Community
Health Center dba,Aria Community Health Center for budget revisions,with no change in the term of
December 14, 2021 through September 29, 2023 or compensation maximum of$375,762
APPROVED AS RECOMMENDED
Ayes: 5- Brandau, Magsig, Mendes, Pacheco, and Quintero
Agreement No. 22-284
County of Fresno Page 72
coU��
Board Agenda Item 69
O 1856 O
FRE`'�
DATE: June 21, 2022
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Amendment I to Agreement with Avenal Community Health
Center dba, Aria Community Health Center
RECOMMENDED ACTION(S):
Approve and authorize the Chairman to execute Amendment I to Agreement with Avenal Community
Health Center dba,Aria Community Health Center for budget revisions,with no change in the term
of December 14, 2021 through September 29, 2023 or compensation maximum of$375,762.
There is no additional Net County Cost associated with the recommended action,which will allow Avenal
Community Health Center dba, Aria Community Health Center(Aria)to add a remote patient monitoring
software platform to measure blood pressure and health education materials aimed at increasing the
patient's knowledge of their blood pressure numbers to help guide their care. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. If the recommended action is not approved, Aria will not be able to
afford the current patient monitored blood pressure platform and risk being unable to complete the terms of
the agreement.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. There are no changes
to the maximum compensation ($375,762), but rather an adjustment on how funds will be utilized to provide
more cost effective and efficient services. The recommended amendment is fully funded through the
Collaborating for Wellness grant provided through the Centers for Disease Control and Prevention (CDC)
Notice of Funding Opportunity DP18-1817. Sufficient appropriations and estimated revenues are included in
the Department's Org 5620 FY 2022-23 Recommended Budget and will be included in future budget
requests for the duration of the agreement.
DISCUSSION:
On December 14, 2021, your Board approved an agreement(No. A-21-545)with Aria to begin services for
improving prevention and management of heart disease and stroke of County residents at high risk.
If approved, the recommended amendment will revise the budget by reducing less than half of one Care
Team Member position to add a remote patient monitoring software platform. The decrease in staffing will
offset the software platform costs and provide an opportunity to increase patient selfcare knowledge. The
remote patient monitoring software platform was designed by physicians that support patient-directed
remote monitoring of blood pressure and other vitals. The portal provides the medical care provider full
County of Fresno Page 1 File Number:22-0554
File Number:22-0554
access to the patient's vital sign data (in real-time)with embedded analysis tools for interpretation of the
data. The new system will allow for more efficient usage of staff time and will streamline data entry
processes. The requested salary and benefits changes will not impact service delivery.
The purpose of self-monitored blood pressure (SMBP) is to increase patient knowledge of blood pressure
numbers to guide care. This platform will provide patients and medical providers with a snapshot of blood
pressure progress and identify barriers and outcomes to blood pressure management. The platform is
designed to have patients engage non-physician team members in their SMBP programs or interventions to
improve blood pressure control.
The utilization of the software platform has been approved by the funder, the CDC, and the management of
the platform will be performed by Aria.
REFERENCE MATERIAL:
BAI #71, December 14, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk-Amendment to Agreement with Aria
CAO ANALYST:
Ron Alexander
County of Fresno page 2 File Number:22-0554
Agreement No. 22-284
1 AMENDMENT I TO AGREEMENT
2 THIS FIRST AMENDMENT TO AGREEMENT (hereinafter"Amendment") is made and
3 entered into this 21 sc day of June , 2022, by and between COUNTY OF FRESNO, a
4 Political Subdivision of the State of California, Fresno, California (hereinafter "COUNTY"), and Avenal
5 Community Health Center dba, Aria Community Health Center, a California 501 C3 Non-Profit
6 corporation, whose address is 555 E. Street, Lemoore, California 93245, hereinafter referred to as
7 "CONTRACTOR".
8 WITNESSETH:
9 WHEREAS, COUNTY and CONTRACTOR entered into Agreement number A-21-545,
10 dated the 14th of December 2021 (hereinafter"Agreement"), pursuant to which CONTRACTOR agreed
11 to provide services for improving prevention and management of heart disease and stroke through
12 implementation of clinic-based strategies and community-clinical linkages; and
13 WHEREAS, COUNTY and CONTRACTOR would like to add a remote patient
14 monitoring software platform and education materials without exceeding the maximum compensation;
15 and
16 WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement in
17 order approve budget modifications.
18 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of
19 which is hereby acknowledged, COUNTY and CONTRACTOR agree as follows:
20 1. That all references in the Agreement to "Exhibit B", shall be changed to read
21 "Revised Exhibit B", where appropriate. A copy of Revised Exhibit B is attached hereto and
22 incorporated herein by reference.
23 COUNTY and CONTRACTOR agree that this Amendment is sufficient to amend the
24 Agreement and, that upon execution of this Amendment, the Agreement and this First Amendment
25 together shall be considered the Agreement.
26 The parties agree that this First Amendment may be executed by electronic signature as
27 provided in this section. An "electronic signature" means any symbol or process intended by an
28 individual signing this Amendment to represent their signature, including but not limited to (1) a digital
- 1 -
1 signature; (2) a faxed version of an original handwritten signature; or (3) an electronically scanned and
2 transmitted (for example by PDF document) of a handwritten signature. Each electronic signature
3 affixed or attached to this Amendment (1) is deemed equivalent to a valid original handwritten
4 signature of the person signing this Amendment for all purposes, including but not limited to
5 evidentiary proof in any administrative or judicial proceeding, and (2) has the same force and effect as
6 the valid original handwritten signature of that person. The provisions of this section satisfy the
7 requirements of Civil Code section 1633.5, subdivision (b), in the Uniform Electronic Transaction Act
8 (Civil Code, Division 3, Part 2, Title 2.5, beginning with section 1633.1). Each party using a digital
9 signature represents that it has undertaken and satisfied the requirements of Government Code
10 section 16.5, subdivision (a), paragraphs (1)through (5), and agrees that each other party may rely
11 upon that representation. This Amendment is not conditioned upon the parties conducting the
12 transactions under it by electronic means and either party may sign this Amendment with an original
13 handwritten signature.
14 The Agreement, as hereby amended, is ratified and continued. All provisions, terms,
15 covenants, conditions, and promises contained in the Agreement and not amended herein shall
16 remain in full force and effect.
17 ///
18
19
20 ///
21 ///
22 ///
23 ///
24 ///
25 ///
26 ///
27 ///
28 ///
- 2 -
I IN WITNESS WHEREOF, the parties hereto have executed this Amendment I as of the day and
2 year first hereinabove written.
3
4 CONTRACTOR COUNTY OF FRESNO
Avenal Community Health Center dba
5 ARIA COMMUNITY HEALTH CENTER
7
John BI ine, CEO Brian Pacheco,Chairman of the Board of
8 Supervisors of the County of Fresno
9
10
11
12
13 ATTEST:
Bernice E. Seidel
14 555 E Street, Lemoore, California 93230 Clerk of the Board of Supervisors
P.O. Box 580, Lemoore, California 93245 County of Fresno, State of California
15 Mailing Address
16 By:
17 Deputy
FOR ACCOUNTING USE ONLY:
18
Fund/Subclass: 0001/10000
19 Organization: 56201554
Account: 7295
20
21
22
23
24
25
26
27
28
-3-
ARIA p22-_SUPERSEDE5021-545 REVISED EXHIBIT B
Page 1 of 2
Year
12/14/2021through 9/29/2022
Personnel
Monthly Requested Position Title Salary Range Annual FTE% Months Amount Justification year 1
Health Educator with aid with program at site level.Budget covers going salary for
Fowler and Riverdale Locations) $ 3,270.00 100% 9 $29.430 position at Aria.
Patient Navigator 1.00 FIFE $ 3,120.00 100% 9 $28,080 Care Coordinator will identify patients who qualify In the program and initially make
Care Team Member will contact patients to setup initial appts and follow up visits.
Care Team Member 1.0 FTE $ 3,120.00 100% 9 $28,080 Rate is at Aria starting wage for position.
Care Team Member will contact patients to setup initial appts and follow up visits.
Care Team Member.45 FTE $ 3.120.00 45% 9 $12,636 Rate is at Aria starting wage for position.
E H R Trainers will train staff on how to enter data into system from Blood pressure
2 EHR Trainer x.25 FTE $ 8,161.67 $97,940 25% 9 $18,364 cuffs and historical information in E H R.
Total Personnel $116,590
Fringe Benefits @ 29% Benefits $33,811
Total $150,401
Operating Expenses
Printing 9 $300 Print handouts and posters to promote program.
Total Operating Expenses $300
Equipment
Laptop @$800 1 $800.00 $800 Equipment to purchase for new Health educator and Care coordinator.
Desktop Computer @$820 3 $820.00 $2.460 Equipment to purchase for new Health educator and Care coordinator.
Monitors @$150 6 $150.00 $900 Equipment to purchase for new Health educator and Care coordinator.
Desk @$250 2 $250.00 $500 Equipment to purchase for new Health educator and Care coordinator.
Equipment to purchase for new Health educator and Care coordinator.(Power supply
Small Equipment(Power supply, @$70,keyboard and mouse @$40,desktop phone @$144,telephone headset
keyboard and mouse,desktop @$158)
phone,telephone headset) 3 $412.00 $1,236
Tablets @$320 5 $320.00 $1,600 Five tablets @$320 each to download data from blood pressure cuffs.Total$1,600
Total Equipment Expenses $7,496
Travel
Rate) 1048 $0.585 613.08 Health Educator Travel between Riverdale,Coalinga and Fowler
Total Travel $613
Other Costs
Interface $10,000 For direct referrals from EMIR to Smokers Hotline
Sphygmo Virtual Care BP reading online monitoring system platform.
Health Education Materials $ 2,076 Books,Teaching Aids.
Total Other Costs $30,076
Indirect Costs Total Indirect Costs $0
TOTAL COSTS $188,886
ARIA t122-_SUPERSEDES R21-545 REVISED EXHIBIT B
Page 2 of 2
Year 11
9/3 012 0 2 2 through 912912023
Personnel
Month) Sala Requested
Position Title Range Annual FTE% Months Amount Justification Year11
Fowler and Riverdale $ 3,270.83 $39,250.00 100% 12 Health Educator with aid with program at site level.Budget covers going salary
$39,250 for position at Aria.
Care Coordinator will identify patients who qualify in the program and initially
$37,440.00 12 make contact with them.Rate is at Aria starting wage rate.
Patient Navigator 1.00 FTE $ 3,120.00 100% $37,440
Care Team Member will contact patients to setup initial appts and follow up
Care Team Member.30 FTE $ 3,120.00 $37,440.00 30% 1 12 $11 232 visits.Rate is at Aria starting wage for position.
Care Team Member 1.00 Care Team Member will contact patients to setup initial appts and follow up
FTE $ 3,120.00 $37,440.00 100% 12 $37,440 visits.Rate is at Aria starting wage for position.
Total Personnel $125,362
Fringe Benefits @ 29% Benefits $36,355
Total $161,717
Operating Expenses
Printing 12 $300 Print handouts and posters to promote program.
Total Operating Expenses $300
Equipment
(None for Year 2)
Equipment $0
Travel
Rate) 1000 $0.585 $585 Health Educator Travel between Riverdale,Coalinga and Fowler
(Health Educator) Total Travel $585
Other Costs
Blood Pressure Cuff 100 $50.00 $5,000 Blood Pressure cuffs for those added to program within Fresno County
Sphygmo Virtual Care $18,000.00 $18,000 BP reading online monitoring system platform.
Education Materials $ 1,274.00 $1,274 Books,Teaching Aids.
Total Other Costs $24,274
Indirect Costs Total Indirect Costs $0
TOTAL COSTS $186,876