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HomeMy WebLinkAboutSTATE DPH-Prevention Forward Program_A-22-184 A-21-087.pdf Co. County of Fresno Hall of Records,Room 301 2281 Tulare Street Fresno,California Board of Supervisors 93721-2198 is56 O Telephone:(559)600-3529 Minute Order Toll Free: 1-800-742-1011 www.co.fresno.ca.us May 3, 2022 Present: 5- Supervisor Steve Brandau, Supervisor Nathan Magsig, Supervisor Buddy Mendes, Chairman Brian Pacheco, and Vice Chairman Sal Quintero Agenda No. 43. Public Health File ID: 22-0256 Re: Approve and authorize the Chairman to execute a retroactive first Amendment to revenue Agreement with the California Department of Public Health,to provide prevention and self-management support services to high burden/underserved adult populations diagnosed or at risk for Type 2 Diabetes, effective April 22,2021 with no change to the term through June 29,2023,or compensation maximum of$156,397 APPROVED AS RECOMMENDED Ayes: 5- Brandau, Magsig, Mendes, Pacheco, and Quintero Agreement No.22-184 County of Fresno Page 43 coU�� (60 t Board Agenda Item 43 O 1856 O DATE: May 3, 2022 TO: Board of Supervisors SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health SUBJECT: Amendment to Revenue Agreement with the California Department of Public Health RECOMMENDED ACTION(S): Approve and authorize the Chairman to execute a retroactive first Amendment to revenue Agreement with the California Department of Public Health,to provide prevention and self-management support services to high burden/underserved adult populations diagnosed or at risk for Type 2 Diabetes, effective April 22, 2021 with no change to the term through June 29, 2023, or compensation maximum of$156,397. There is no additional Net County Cost associated with the recommended action which shifts unspent funds from Year 1 to Year 2, amends the Scope of Work(SOW) by adding an activity to increase Comprehensive Medication Management services and extend timeline/deliverable dates due to updated grant funding requirements. Some program deliverables were delayed due to COVID-19 restrictions. This item is countywide. ALTERNATIVE ACTION(S): Should your Board not approve the recommended amendment, the Department would not have the current SOW or budget, which would lead to the inability to complete all required activities under the agreement. The Department would need to reduce support for current activities resulting in the risk for future funding reductions for non-compliance. RETROACTIVE AGREEMENT: The recommended Amendment is retroactive to the beginning of the agreement, April 22, 2021, due to the funding adjustments to the first year of the agreement. COVID-19 interruptions made it impossible to complete all the budgeted activities during the first year resulting in unspent funds. Shifting the unspent funds to the current FY 2021-22 will allow sufficient revenue to offset expected costs. The recommended Amendment was received from the California Department of Public Health (CDPH) on February 22, 2022 and is being brought to your Board in accordance with the agenda item processing timelines. FISCAL IMPACT: There is no increase in Net County Cost associated with the recommended action. The recommended amendment is funded by the CDPH for local Prevention Forward Program interventions, provided by the Centers for Disease Control and Prevention (CDC). The maximum compensation of$156,397 is adjusted as follows: April 22, 2021 through June 30, 2021 $25,736 (decrease$49,345) County of Fresno Page 1 File Number.22-0256 File Number:22-0256 July 1, 2021 through June 30, 2022 $92,003 (increase$49,345) July 1, 2022 through June 29, 2023 $38,658 (no change) Sufficient appropriations and estimated revenues are included in the Department's Org 5620 FY 2021-22 Adopted Budget and will be included in future budget requests for the duration of the contract. DISCUSSION: On March 23, 2021, the Board approved revenue agreement No. 21-087 (State agreement No. 20-10704) with the CDPH for the Department to provide chronic disease prevention and self-management support services to local programs and organizations that serve high burden/underserved adults diagnosed or at risk for Type 2 Diabetes. The recommended amendment will allow the Prevention Forward Program to continue to work with local organizations and community health workers to provide interventions through a team-based care process to increase chronic disease support services and improve patient intervention management systems through Health Information Technology, Health Information Exchange, and Electronic Health Records. The recommended amendment will also allow the Department to increase and improve referrals to nationally recognized self-management programs such as lifestyle change, nutrition improvement, and chronic disease. COVID-19 restrictions caused some of the program activities to be paused or delayed during the first year, and many of these activities did not resume until after the first budget year had ended. If approved the recommended amendment will revise the budget to shift unspent Year I (April 22, 2021-June 30, 2021)funds ($49,345)to Year II (July 1, 2021-June 30, 2022) budget and extend the timeline/deliverable dates to complete unfinished activities in the current year. A new activity has been added to the SOW to help increase patient coordination with non-physician care team members. The goal is to work with our pharmacy partners to increase the patient Comprehensive Medication Management services and refer targeted patients to national Diabetes Prevention Programs or Diabetes Self-Management Education and Support services. This team-based care process is one way local communities can increase knowledge, skills, and opportunities to prevent or control diabetes. REFERENCE MATERIAL: BAI#45, March 23, 2021 ATTACHMENTS INCLUDED AND/OR ON FILE: On file with Clerk-Amendment Al with CDPH CAO ANALYST: Ron Alexander County of Fresno page 2 File Number:22-0256 STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES SCO ID:4265-2010704-A1 STANDARD AGREEMENT-AMENDMENT STD 213A(Rev.4/2020) AGREEMENT NUMBER AMENDMENT NUMBER Purchasing Authority Number CHECK HERE IF ADDITIONAL PAGES ARE ATTACHED PAGESF 20-10704 1 1.This Agreement is entered into between the Contracting Agency and the Contractor named below: CONTRACTING AGENCY NAME California Department of Public Health CONTRACTOR NAME County of Fresno 2.The term of this Agreement is: START DATE April 22,2021 THROUGH END DATE June 29,2023 3.The maximum amount of this Agreement after this Amendment is: $156,397.00 One Hundred Fifty Six Thousand Three Hundred Ninety Seven Dollars and zero cents 4.The parties mutually agree to this amendment as follows.All actions noted below are by this reference made a part of the Agreement and incorporated herein: I.Purpose of amendment: Due to updated grant funding requirements,this amendment shifts unspent funds from Year 1 to Year 2,as identified in Exhibit B,Budget Year 2-A,Attachment II-A,amends the Scope of Work by adding an activity and extending Timeline/Deliverables dates. II.Certain changes made in this amendment are shown as: Text additions are displayed in bold and underline. Text deletions are displayed as strike through text(i.e.,Strike). III.Exhibit A,Scope of Work,is hereby replaced in its entirety and shall now read Exhibit A,Al,Scope of Work. IV.Exhibit B,Budget Detail and Payment Provisions,is hereby replaced in its entirety and shall now read Exhibit B,Al,Budget Detail and Payment Provisions. V.Exhibit B,Attachment I,Budget Year 1,is hereby replaced in its entirety and shall now read Exhibit B,Al,Attachment I,Budget Year 1. VI. Exhibit B,Attachment II-A,Budget Year 2-A,is hereby incorporated and made a part of this Agreement and hereby augments Budget Year 2. All other terms and conditions shall remain the same. IN WITNESS WHEREOF,THIS AGREEMENT HAS BEEN EXECUTED BY THE PARTIES HERETO. CONTRACTOR CONTRACTOR NAME(if other than an individual,state whether a corporation,partnership,etc.) County of Fresno CONTRACTOR BUSINESS ADDRESS CITY STATE 711 1221 Fulton Street Fresno CA 3721 PRINTED NAME OF PERSON SIGNING TITLE Brian Pacheco Chairman of the Board of Supervisors of the County of Fresno CONTRACTLU�O�SIGNATURE DATE SIGNED Sr- 3 a R. ATTEST: BERNICE E.SEIDEL Clerk of the Board of Supervisors County of Fresno,State of California By eputy Page 1 of 2 STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES SCO ID:4265-2010704-A 1 STANDARD AGREEMENT-AMENDMENT STD 213A(Rev.4/2020) AGREEMENT NUMBER AMENDMENT NUMBER Purchasing Authority Number CHECK HERE IF ADDITIONAL PAGES ARE ATTACHED PAGES 20-10704 1 STATE OF CALIFORNIA CONTRACTING AGENCY NAME California Department of Public Health CONTRACTING AGENCY ADDRESS CITY STATE ZIP 1616 Capitol Avenue,Suite 74.262,MS 1802,PO Box 997377 Sacramento CA 95899 PRINTED NAME OF PERSON SIGNING TITLE Joseph Torrez Jeannie Galarpe for Chief,Contracts Management Unit CONTRACTING AGENCY AUTHORIZED SIGNATURE DATE SIGNED 05/18/2022 CALIFORNIA DEPARTMENT OF GEN .1 EXEMPTION(If Applicable) APPROVED J U N 6-2022 EE:th OFFICE OF LEGAL SERVICES DEPT. OF GENERAL SERVICES Page 2 of 2 County of Fresno 20-10704 Al Page 1 of 18 Exhibit A Scope of Work 1. Service Overview Pursuant to California Health and Safety Code Sections 131058 and 131085 the County of Fresno, Department of Public Health (Contractor) will provide prevention and self-management support to high burden/underserved adult populations diagnosed or at risk for Type 2 Diabetes (diabetes). Contractor services will increase chronic disease support services to target population health status and improve patient intervention management systems through Health Information Technology (HIT), Health Information Exchange (HIE), and Electronic Health Records (EHR). Increase and improve referrals for nationally recognized lifestyle change and chronic disease self- management programs. Service coordination, such as, meetings, consultations and reporting scope of work activities will be conducted with public health and safety priorities. Service coordination will be conducted using social distancing measures throughout the duration of the Coronavirus pandemic, such as, virtual online platforms, telehealth, conference phone calls, computer assisted coordination and emails. The Centers for Disease Control and Prevention (CDC), CFDA number 93.426, Grant Number NU58DP006540, funding awarded to the CDPH for Contractor Local Assistance provides California Prevention Forward (PF) interventions; including required objectives and strategies as described in the Scope of Work and in compliance with the CDC Grant. 2. Service Location The services shall be performed at applicable facilities and/or remotely in the County of Fresno as prescribed in the Scope of Work. 3. Service Hours The services shall be provided during normal Contractor workdays, 8 am — 5 pm, Monday through Friday, except official holidays. 4. Project Representatives A. The project representatives during the term of this agreement will be: California Department of Public Health Fresno County Department of Public Lisa Pulido Health Telephone: (916) 552-9948 Melanie Ruvalcaba, Program Manager Fax: (916) 552-9729 Telephone: (559) 600-6449 E-mail: Lisa.PuIido@cdph.ca.gov Fax: (559) 600-7687 E-mail: mruvalcaba[c@fresnocountyca.gov County of Fresno 20-10704 Al Page 2 of 18 Exhibit A Scope of Work B. Direct all inquiries to: California Department of Public Health Fresno County Department of Public Chronic Disease Control Branch Health Attention: Jessica Nunez de Ybarra Office of Health Policy and Wellness P.O. Box 997377, MS 7208 Attention: Melanie Ruvalcaba, Program Sacramento, CA 95899-7377 Manager 1221 Fulton Street Telephone: (916) 522-9877 Fresno, CA 93721 Fax: (916) 552-9729 E-mail: Telephone: (559) 600-6449 Jessica.NunezdeYbarra2(cDcdph.ca.gov Fax: (559) 600-7687 E-mail: mruvalcaba@fresnocountyca.gov C. All payments from CDPH to the Contractor shall be sent to the following address: Remittance Address Contractor: [County of Fresno ;Attention Bruna Chavez, DPH Business Manager PO Box 11800 Fresno, CA, 93775 559-600-6438 559-600-7687 dphboap@fresnocountyca.gov D. Either party may make changes to the information above by giving written notice to the other party. Said changes shall not require an amendment to this agreement. 5. Services to be Performed are in the Exhibit A, Attachment I, Scope of Work Below: 0 .v -0 -0 oo C6 UO N% � t6N NUL N N ce) 0 p AG 0 N N 7 t6i6G �i � 1= o� N o Uv �o � p, C) N ° CO aj to ' 9 N O N r- N O C1) v V ✓_ O .�� { N A ° T d� 0 9 Q M O G O 49 � N G o NN� �S� O 'er@ pa c NN cad 0- (10 G ✓ 95 N N G ` 'L= N � Z 015, O �� `�` gip"✓ N %a vvim -o ? G � O0, -o G C6 ✓ N O O p G a ce) O O O Oto, Cld @ O- T ✓G G V a) 4 c5 O 9 ? 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O U 0 s o W o U O O O N cQ4 '' ✓ O � O cA O O @O. N -p td O G O O N O O U) .d � 0 O p N O c06 9 000 , N rc o Sow ^� c ° o G =' ° N c o 0 N N N (d �' N N@ a O N ' O jc:�� O O Q N U N O N o ) O O N N NO tc5 Q N U O x7j v U G9 t[ O OCsL G ? G pp0 O 0 Wm O � N O G tUb 0 N@ % � 'o .L G O ,� ' O (fl N � O O Cd V m t6 't3 0, Z a 0 9 Exhibit B,Al,Budget Detail and Payment Provisions County of Fresno 20-10704 Al Exhibit B Budget Detail and Payment Provisions 1. Invoicing and Payment A. In no event shall the Contractor request reimbursement from the State for obligations entered into or for costs incurred prior to the commencement date or after the expiration of this Agreement. B. For services satisfactorily rendered, and upon receipt and approval of the invoices, CDPH agrees to compensate the Contractor for actual expenditures incurred in accordance with the Budget Line Item amounts specified in Attachment I, II, II-A and III of this Exhibit. C. Invoices shall include the Agreement Number, CDCB Address, and shall be submitted electronically, not more frequently than quarterly, in arrears to: CDCBlnvoices(a-)cdph.ca.gov California Department of Public Health Chronic Disease Control Branch P.O. Box 997377, MS 7208 Sacramento, CA 95899-7377 The State, at its discretion, may designate an alternate invoice submission address. A change in the invoice address shall be accomplished via a written notice to the Contractor by the State and shall not require an amendment to this agreement. D. Invoices shall: 2) Identify the billing and/nr peFfn FrnaRG e period Geyered by the in,ieinn 3) itemize GOStS for the billing peried On the sarne eF greater level ef detail as indiGated OR this agreement. Subject to the teFrns ef this agreement, reirnbursernent may only be se6lg#tf(�r these Gests and/eF G9St Gategeries expressly ideRtified as allewable OR thus agreement and approved by GDPH. 1) Be prepared using the CDPHC/CDCB approved template, which will be provided by the CDPH/CDCB Contract Manager. Invoices must include contractor letterhead and be signed by an authorized official, employee or agent certifying that the expenditures claimed represent activities performed and are in accordance with Exhibit A. 2) Invoices must be submitted to CDPH electronically only, according to naming convention (refer to 10 below) Hard copies are not required and will not be accepted. 3) Identify the billing and/or performance period covered by the invoice. 4) Itemize costs for the billing period in the same or greater level of detail as indicated in this agreement. Subiect to the terms of this agreement, reimbursement may only be sought for those costs and/or cost categories expressly identified as allowable in this agreement and approved by CDPH. 5) Bear the Contractor's name, as shown on the Agreement. 6) Show an invoice date reflecting when the invoice was prepared. 7) Submitted electronically, no later than five (5) days after the invoice date. 8) Show the Agreement number assigned by CDPH. 9) Show the Contractor's remittance address. Page 1 of 4 Exhibit B,Al,Budget Detail and Payment Provisions County of Fresno 20-10704 Al Exhibit B Budget Detail and Payment Provisions 10)Electronic invoices must be submitted to read on the subiect line as follows: Contract Number, Vendor Name, State Fiscal Year, Invoice Number. E. Amounts Payable The amounts payable under this agreement shall not exceed $156,397.00, as indicated in Attachment I, II, II-A and III of this Exhibit. 2. Budget Contingency Clause A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of no further force and effect. In this event, the State shall have no liability to pay any funds whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be obligated to perform any provisions of this Agreement. B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State shall have the option to either cancel this Agreement with no liability occurring to the State or offer an agreement amendment to Contractor to reflect the reduced amount. 3. Prompt Payment Clause Payment will be made in accordance with, and within the time specified in, Government Code Chapter 4.5, commencing with Section 927. 4. Timely Submission of Final Invoice A. Final undisputed invoice shall be submitted for payment no more than ih�sixty(334 60 calendar days following the expiration or termination date of this agreement, unless a later or alternate deadline is agreed to in writing by the program contract manager. Said invoice should be clearly marked "Final Invoice", indicating that all payment obligations of the State under this agreement have ceased and that no further payments are due or outstanding. The State may, at its discretion, choose not to honor any delinquent final invoice if the Contractor fails to obtain prior written State approval of an alternate final invoice submission deadline. B. The Contractor is hereby advised of its obligation to submit to the state, with the final invoice, a completed copy of the "Contractor's Release (Exhibit H)". 5. Expense Allowability/ Fiscal Documentation A. Invoices, received from the Contractor and accepted for payment by the State, shall not be deemed evidence of allowable agreement costs. B. Contractor shall maintain for review and audit and supply to CDPH upon request, adequate documentation of all expenses claimed pursuant to this agreement to permit a determination of expense allowability. C. If the allowability of an expense cannot be determined by the State because invoice detail, fiscal records, or backup documentation is nonexistent or inadequate according to generally accepted accounting principles or practices, all questionable costs may be disallowed, and payment may be withheld by the State. Upon receipt of adequate documentation supporting a disallowed or Page 2 of 4 Exhibit B,Al,Budget Detail and Payment Provisions County of Fresno 20-10704 Al Exhibit B Budget Detail and Payment Provisions questionable expense, reimbursement may resume for the amount substantiated and deemed allowable. 6. Recovery of Overpayments A. Contractor agrees that claims based upon the terms of this agreement or an audit finding and/or an audit finding that is appealed and upheld, will be recovered by the State by one of the following options: 1) Contractor's remittance to the State of the full amount of the audit exception within 30 days following the State's request for repayment; 2) A repayment schedule which is agreeable to both the State and the Contractor. B. The State reserves the right to select which option as indicated above in paragraph A will be employed and the Contractor will be notified by the State in writing of the claim procedure to be utilized. C. Interest on the unpaid balance of the audit finding or debt will accrue at a rate equal to the monthly average of the rate received on investments in the Pooled Money Investment Fund commencing on the date that an audit or examination finding is mailed to the Contractor, beginning 30 days after Contractor's receipt of the State's demand for repayment. D. If the Contractor has filed a valid appeal regarding the report of audit findings, recovery of the overpayments will be deferred until a final administrative decision on the appeal has been reached. If the Contractor loses the final administrative appeal, Contractor shall repay, to the State, the over-claimed or disallowed expenses, plus accrued interest. Interest accrues from the Contractor's first receipt of State's notice requesting reimbursement of questioned audit costs or disallowed expenses. 7. Advance Payments No advance payment is allowed under this Contract. 8. Travel and Per Diem Reimbursement Any reimbursement for necessary travel and per diem shall, unless otherwise specified in this Agreement, be at the rates currently in effect, as established by the California Department of Human Resources (Cal HR). If the Cal HR rates change during the term of the Agreement, the new rates shall apply upon their effective date and no amendment to this Agreement shall be necessary. No travel outside the state of California shall be reimbursed without prior authorization from the CDPH. Verbal authorization should be confirmed in writing. Written authorization may be in a form including fax or email confirmation. Refer to CaIHR website. Page 3 of 4 Exhibit B,Al,Budget Detail and Payment Provision County of Fresno 20-10704 Al Exhibit B Budget Detail and Payment Provisions 9. Invoice Reporting Requirements and Billing Instructions A. Quarterly Invoice Schedule - Contractor shall submit electronic quarterly invoice in accordance with the following schedule: Quarter Dates Due 1 07/01 thru 09/30 11/1 2 10/01 thru 12/31 2/1 3 01/01 thru 03/31 5/1 -8/4 4 04/01 thru 6/30 8/30 B. Contractor shall have the right to issue a supplemental invoice for expenditures incurred after quarter four (4) final invoice has been submitted to recover in full all actual costs, as specified in the executed Exhibit B, Budget Attachment(s) for this agreement. submitted tO Fead OR the s ihinnt lino as fellews: GenrtFanc Number, Vender Name, State Girc EaTI Year IRVGrOv Number Page 4 of 4 Exhibit B,Al,Attachment I Budget Year 1 Exhibit B,Attachment I County of Fresno Budget Year 1 20-10704 Al (3/n 04/22/2021 -6/30/2021) Category A Category A Total Total Diabetes Diabetes A. PERSONNEL F$49,3384.001 Monthly % of Position Title FTMonths Salary Fund Subtotal Subtotal Total Cost Total Cost Program Manager 33% 4 $2,731.90 100% $'n�,-o Qom° $8,124.18 $444g� $8,124.18 Health Education Specialist 39% 4 $1,596.48 100% $6 3895 $4,422.28 $44-9094 $4,422.28 Total Salaries $17,,31-3.52 $12,546.46 $29,859.98 $12,546.46 FRINGE BENEFITS 67% $ 4,6W 06 $8,406.13 $24,00"1 $8,406.13 Total Personnel Costsi 1 $2", 4-1-581 �20,952.591 $¢9;468 7 $20,952.59 Category A Category A Total Total Diabetes Diabetes B. OPERATING EXPENSES DETAIL % of Subtotal Subtotal Total Cost Total Cost Fund General Expense (office supplies): 98% $24.9$7 $0.00 $249-97 $0.00 Communication/Software (input methodology): 100% $2,844-89 $0.00 $2,064,gg $0.00 Space/Rent ($625 Rate x 4 Months-$2,500): 100% $2 500:98 $32.56 $2,500.00 $32.56 Total Operating $4,M W $32.56 $4;g43- $32.56 Category A Category A Total Total Diabetes Diabetes C. SUBCONTRACTORS % of Subtotal Subtotal Total Cost Total Cost Fund NatiGRal DPP Provider . 100-% $4,500.00 $0.00 $4 ag0:0g 1 $0.00 48w% sio,ow.gol $0.00 $4g 0g0 gg $0.00 Total Other Costs $1-1�60�08 $0.00 1$44-,WA 0g I $0.00 Category A Category A Total Total Diabetes Diabetes D. OTHER COSTS % of Subtotal Subtotal Total Cost Total Cost Fund Meeting DeemC a 01% $�8e $0.00 $4140 90 O.oO E i�ne�n and t aine=rg-f ate Fials enrt DortiGipa+len fees: -nl— vj. ,,000, $2,1 •28 vn`•0 $0.00 2,1 � 0.00 � 1 2 4.1 7. Q 1 Q 94 g- tttd 7B � L� �� '-,fir L f1C�AGC/nlllDD nertifiGati9R fees and materi-als fer Health System Ghamp:sflts�Qh*. 2, 2.1, Q n 1• nh 10.1 & 1 n 2• Goal n nh 11 2 �0-04 $28�gg�g $0.00 $20,000 09 0.00 1110R- 1162 Total Other Costs $22 62Z-08 $0.00 $22,628.08 LQ..00 Category A Category A Total Total E. INDIRECT Diabetes Diabetes % of Subtotal -Subtotal Total Cost Total Cost Total Personnel Cost 1 25.00% 400% $',''� $4,750.791$42466.54 $7,228.39 Total Indirect Cost $7 22� $4,750.791 Category A Category A Diabetes Diabetes Total Total TOTAL EXPENSES $75;081 00 25,735.940��gg ja5 735.94 *Rounding may occur Exhibit B,Attachment II-A,Budget Year 2-A Exhibit B, Attachment II-A County of Fresno Budget Year 2-A 20-10704 Al (7/1/2021 -6/30/2022) Category A Total Diabetes A.OPERATING EXPENSES DETAIL %of Subtotal Total Cost Fund General Expense (office supplies): 100% $ 500.06 $ 500.06 Communication/Software (input methodology): 100% $ 3,500.00 $ 3,500.00 Space/Rent ($625 Rate x 4 Months-$2,500): 100% $ 5,500.00 $ 5,500.00 Total Operatingi $ 9,500.06 $ 9,500.06 Category A Total Diabetes B. SUBCONTRACTORS % of Subtotal Total Cost Fund National DPP Provider subcontractor: Obj. 6.1 100% $ 1,500.00 $ 1,500.00 Pharmacist subcontractor: -Obj. 10.2 100% $ 28,345.00 $ 28,345.00 Total Other Costsi $ 29,845.00 1 $ 29,845.00 Category A Total Diabetes C. OTHER COSTS % of Subtotal Total Cost Fund Education and training materials and Participation fees: -Obj. 2.1, 2.2, 2.3, 100% 3.1, 3.2, 4.1, 5.2, 7.2, 8.1, 8.2, 9.1, 9.2 $ 5,000.00 $ 5,000.00 DSMES/NDPP certification fees and materials for Health System Champion(s). -Obj. 2, 2.1, &4.1; Obj. 10.1 & 10.2; Goal 4, Obj. 11.2, 11.10 100% $ 5,000.00 $ 5,000.00 & 11.8 Total Other Costs $ 10,000.00 $ 10,000.00 Category A Total Diabetes TOTAL EXPENSES $ 49,345.06 $ 49,345.06 *Rounding may occur Amendment I to Agreement Between the County of Fresno and the California Department of Public Health Amendment Name: CDPH Prevention Forward for Type 2 Diabetes (State Agreement No. 20-10704-1) Fund/Subclass: 0001/10000 Organization #: 56201556 . Revenue Account #: 4380