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HomeMy WebLinkAboutChildren Families Commission of Fresno County First 5-Nurse-Family Partnership_A-22-375 A-16-683.pdf COtj Hall of Records, Room 301 County of Fresno 2281 Tulare Street 9 Fresno,California '0 Board of Supervisors 93721-2198 O 185G O Telephone: (559)600-3529 FRB't) Minute Order Toll Free: 1-800-742-1011 www.co.fresno.ca.us August 23, 2022 Present: 5- Supervisor Steve Brandau, Supervisor Nathan Magsig, Supervisor Buddy Mendes, Chairman Brian Pacheco, and Vice Chairman Sal Quintero Agenda No. 33. Public Health File ID: 22-0739 Re: Approve and authorize the Vice Chairman to execute retroactive Amendment V to Agreement with Children and Families Commission of Fresno County,for the Nurse-Family Partnership program extending the term by two years from July 1, 2022 to June 30, 2024 and increasing the maximum by $420,498 to a total of$1,667,933; approve and authorize the Vice Chairman to execute retroactive Amendment V to Agreement with Children and Families Commission of Fresno County,for the Nurse Liaison program extending the term by two years from July 1, 2022 to June 30, 2024 and increasing the maximum by$788,722 to a total of$2,966,374;and, approve and authorize the Vice Chairman to execute retroactive Second Amendment to Agreement with Children and Families Commission of Fresno County,for the Community Health Teams program extending the term by two years from July 1,2022 to June 30, 2024 and increasing the maximum by$1,790,780 to a total of$3,581,376 APPROVED AS RECOMMENDED Ayes: 5- Brandau, Magsig, Mendes, Pacheco,and Quintero Agreement No.22-375,Agreement No.22-376,Agreement No.22-377 County of Fresno Page 33 co Board Agenda Item 33 0 1896 0 FRE`'� DATE: August 23, 2022 TO: Board of Supervisors SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health SUBJECT: Retroactive Amendments to Agreements with Children and Families Commission of Fresno County RECOMMENDED ACTION(S): 1. Approve and authorize the Vice Chairman to execute retroactive Amendment V to Agreement with Children and Families Commission of Fresno County,for the Nurse-Family Partnership program extending the term by two years from July 1,2022 to June 30, 2024 and increasing the maximum by$420,498 to a total of$1,667,933. 2. Approve and authorize the Vice Chairman to execute retroactive Amendment V to Agreement with Children and Families Commission of Fresno County,for the Nurse Liaison program extending the term by two years from July 1, 2022 to June 30, 2024 and increasing the maximum by$788,722 to a total of$2,966,374. 3. Approve and authorize the Vice Chairman to execute retroactive Second Amendment to Agreement with Children and Families Commission of Fresno County,for the Community Health Teams program extending the term by two years from July 1, 2022 to June 30, 2024 and increasing the maximum by$1,790,780 to a total of$3,581,376. There is no additional Net County Cost associated with the recommended actions.Approval of the first and second recommended actions will provide the Department of Public Health (Department)with two additional years, for a total term of eight years of funding from Children and Families Commission of Fresno County (First 5)to support the existing Nurse-Family Partnership (NFP)and Nurse Liaison programs.Approval of the third recommended action will provide the Department with two additional years, for a total term of four years of funding from First 5 to support the Community Health Teams (CHT) program. The recommended amendments will allow the County to use the funds as the local match to draw down Federal Financial Participation (FPP)at around approximately fifty percent. The First 5 funding will continue to support salary and benefits for Public Health Nurses (PHN) and four subcontracts with local community-based organizations (CBOs)to provide direct home visitation services. This item is countywide. ALTERNATIVE ACTION(S): There are no viable alternative actions. Should your Board not approve the recommended actions, the Department would not be able to accept First 5 funds or draw down FFP funding, which supports salary and benefits, as well as operational and indirect costs for all three programs. Non-approval would also lead to a reduction in the Department's NFP, Nurse Liaison, and CHT staff and services that currently provide much needed assistance to children ages 0 to 5 and their families in Fresno County. RETROACTIVE AGREEMENT: The recommended actions are retroactive to July 1, 2022 as all amendments were received from First 5 in County of Fresno Page 1 File Number:22-0739 File Number.22-0739 May 2022. The time required to prepare and review the recommended actions did not allow presentation to your Board at an earlier date. FISCAL IMPACT: There is no increase in Net County Cost associated with the recommended actions. The first and second recommended actions provide additional funding and extend the agreements for an additional two years, for a total term of eight years. The third recommended action provides additional funding and extends the agreement for an additional two years, for a total term of four years. The NFP amendment will provide an additional $420,498. The Nurse Liaison amendment will provide an additional $788,722. The CHT amendment will provide an additional $1,790,780. The First 5 funds will support salary and benefits for PHNs and four subcontracts with local CBOs to provide direct home visitation services. In addition, the recommended amendments will allow the County to use the funds as the local match to draw down approximately$2.1 million of Federal dollars under Title XIX as FPP for eligible services. All three agreements allow for recovery of indirect cost at a maximum of 15%, the Departments current indirect rate for FY 2022-23 is 18.816%, the difference will be offset with Health Realignment funds. Sufficient appropriations and estimated revenues are included in the Department Org 5620 FY 2022-23 Recommended Budget and will be included in FY 2023-24 Recommended Budget. DISCUSSION: On December 6, 2016, the Board approved agreements with First 5 to receive funding supporting the NFP and Nurse Liaison programs for two years. PHNs in the NFP program provide evidence-based nurse home visitation services to low-income, pregnant, or parenting first-time mothers in the County. PHNs in the Nurse Liaison program work with Valley Children's Hospital and Community Regional Medical Center as well as the medical community outside these facilities to ensure that referred high-risk infants and children under six years of age living in the County receive medical care, resources, and support as needed. On August 7, 2018, September 10, 2019, September 1, 2020, and September 7, 2021, the Board approved first, second, third, and fourth amendments to extend the agreements with First 5 for an additional year with each amendment and receive additional funding supporting the NFP and Nurse Liaison programs. In FY 2021-22,the NFP program: • NFP PHNs served 149 pregnant and parenting women; • Completed 1,011 visits with clients, 642 in-person home visits and 369 telehealth; • 93% of women served initiated breastfeeding after birth of infants; • 92% of infants served were current on immunizations at 6-months; • 308 referrals completed for needed services including: mental health, dental services, Medi-Cal assistance, Women Infant and Children Nutritional Program, medical referrals, and referrals for developmental delays in children; • First 5 funded PHN position that had been vacated since December 2021 and was filled in April 2022. In FY 2021-22, the Nurse Liaison program: • Provided case management services to 182 children; • Administered developmental screening for 94 children; • Provided 220 referrals to children and families including mental health, dental, primary care, domestic violence assistance, early intervention and immunizations. • The rehospitalization rate for children in the Nurse Liaison Program was less than two (2) percent. On October 6, 2020, the Board approved the agreement with First 5 to receive funding supporting creation of CHT, which pairs a Department PHN with teams of paraprofessionals from local CBOs to provide research-based and evidence-informed home visitation services to underserved families in Fresno County County of Fresno page 2 File Number:22-0739 File Number:22-0739 communities. On October 19, 2021, the Board approved the first amendment to extend the agreement with First 5 for an additional year and receive additional funding supporting the CHT program. These teams provide much needed assistance to children ages 0 to 5 and their families who otherwise would not qualify for existing nurse-based home visitation programs. In FY 2021-22, the CHT provided: • Case management services to 240 families; • Developmental screening to 223 children; • Referrals for 227 children and family members for job assistance, Medi-Cal, primary care, mental health, diapers,food, housing, special education services and early intervention. Approval of the first and second recommended actions will accept two additional years of funding from First 5, providing the local match to leverage federal funding,further supporting the programs and allowing the NFP and Nurse Liaison programs to continue improving pregnancy outcomes, child health and development, and linkage to resources as needed. Approval of the third recommended action will accept two additional years of funding from First 5, providing a local match to leverage federal funding supporting the CHT and allowing the Department to continue using an integrated approach to enhance CBOs' capacity to provide licensed medical support, strengthening the early childhood system of care and promoting a "no-wrong-door"approach for families in the community. Prior to the Agreements expiring, the Department and First 5 agreed that the Agreements was to continue for an additional 2-years. The Chairman currently sits as the Commission Chair for First 5. Due to this reason, it is appropriate for the Vice Chairman to approve and execute the amendments. REFERENCE MATERIAL: BAI #50, September 7, 2021 BAI #30, October 19, 2021 BAI #33, September 1, 2020 BAI #46, September 10, 2019 BAI #47,August 7, 2018 BAI #35, December 6, 2016 ATTACHMENTS INCLUDED AND/OR ON FILE: On file with Clerk-Amendment V to Agreement No. 16-683 with First 5 for NFP On file with Clerk-Amendment V to Agreement No. 16-684 with First 5 for Nurse Liaison On file with Clerk-Second Amendment to Agreement No. 21-427 with First 5 for CHT CAO ANALYST: Ron Alexander County of Fresno Page 3 File Number:22-0739 Agreement No. 22-375 County of Fresno,Department of Public Health Contract#2016i7-o954 Nurse Family Partnership Page 1 Amendment V to Services Agreement Fiscal Years 2022-2024 Parties Commission: Children and Families Commission of Fresno County, California Contractor: County of Fresno,Department of Public Health Administrative Contract Number: 201617-0954 Recitals A. Commission and Contractor are parties to that certain Services Agreement (the"Agreement"),dated December 23,2016,the Term of which is from July 1,2016 to June 30,2018 (the"Original Term"). Commission and Contractor are also parties to Amendment I to the Agreement,dated August 28,2018,Amendment II to the Agreement,dated October 23,2019, Amendment III to the Agreement dated October 14,2020,and Amendment IV to the Agreement dated October 25,2021,extending the Term of the Agreement to June 30,2022. B. The Parties now desire to amend the Agreement to provide for an extension of the Term and to modify the Services and Project Budget all as defined in the Agreement. C. All capitalized terms used in this Amendment V to Services Agreement (this "Amendment V") shall have the meanings provided for in the Agreement unless otherwise specified in this Amendment V. Therefore,in consideration of the above recitals,which are incorporated into this Amendment V by reference,the Parties agree as follows: 1. Term. This Amendment V is made effective as of July 1,2022 (the"Effective Date"). The Term of the Agreement is extended until June 30,2024,unless terminated earlier under the Agreement (the"Term") or as specified in this Amendment V to the contrary. 2. Amendment to Section 2.1. Effective as of July 1,2022, Exhibit A will be replaced with the Exhibit A,"Scope of Work(2022-2024 Fiscal Years)"attached to this Amendment V and incorporated herein by this reference. As of July 1,2022,except as needed to interpret and enforce Contractor's responsibilities and obligations under the original Term of the Agreement,the original and prior Exhibit A attached to the Agreement and prior Amendment will have no further force and effect. Ro522(1&2) County of Fresno,Department of Public Health Contract#201617-0954 Nurse Family Partnership Page 2 3. Amendment to Section 4.1. Section 4.1 of the Agreement is deleted in its entirety and replaced with the following: 4.1 Project Budget. Compensation for the Services is based on actual costs as described in Exhibit B. Compensation for the Services will in no event exceed the total aggregate amount of$1.667ai.,� (the"Contract Amount'). The Contract Amount includes compensation for Services remaining under the original term of the Agreement,as well as the Services to be performed under the Term, as defined in this Amendment V. Compensation for Services provided prior to July 1,2022 shall be in accordance with the original Agreement,Amendment I,Amendment II,Amendment III,and Amendment IV. 4. Amendment to Section 4.2. The first sentence in Section 4.2 of the Agreement is deleted in its entirely and replaced with the following(the remainder of Section 4.2 is unaffected): Commission will reimburse Contractor for all necessary,reasonable,and justifiable expenses,as determined by Commission,incurred in accordance with the Exhibit B for providing the Services on behalf of Commission in an aggregate amount not to exceed the Contract Amount. 5. Controlling Document;No Other Amendment. In the event of any conflict between the terms of this Amendment V and the Agreement,the terms of this Amendment V shall control. Except as amended by this Amendment V,all terms of the Agreement shall remain in full force and effect, including,without limitation,all monitoring,evaluation,data collection,contract review,auditing,inspection,and record retention obligations set forth in the Agreement. 6. Binding Effect. The Agreement,as amended by this Amendment V,is binding upon,and inures to the benefit of,the respective heirs,executors, administrators,successors,and assigns of the Parties. 7. Headings and Construction. The subject headings of the sections and paragraphs of this Amendment V are included for purposes of convenience only and do not affect the construction or interpretation of any of its provisions. All words used in this Amendment V include the plural as well as the singular number,and vice versa;words used in this Amendment V in the present tense include the future as well as the present;and words used in this Amendment V in the masculine gender include the feminine and neuter genders,whenever the context so requires. No provision of this Amendment V will be interpreted for or against a Party because that Party or its legal representative drafted the provision,and this Amendment V will be construed as if jointly prepared by the Parties. 8. Counterparts. This Amendment V may be signed by the Parties in different counterparts and the signature pages combined to create one document binding on all Parties. Ro522(1&2) County of Fresno,Department of Public Health Contract#2o1617-0954 Nurse Family Partnership Page 3 9. Sianature Authority. Each Party represents that it has capacity,full power, and authority to enter into this Amendment V 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 V. Contractor must sign the signatory authorization,attached as Exhibit C and incorporated into this Amendment V. Contractor must complete and forward to Commission a new signatory authorization each time any name,title,or other information in the existing authorization is no longer current. 10. Electronic Signatures. Each Party acknowledges and agrees that this Amendment V may also be executed by electronic signature,which shall be considered as an original signature for all purposes and shall 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). Signatures COMMISSION CONTRACTOR CHILDREN AND FAMILIES COMMISSION COUNTY OF FRESNO,DEPARTMENT OF OF FRESNO COUNTY PUBLIC HEALTH REVIEWED AND RECOMMENDED FOR APP OV By: a PI ut ized epresentative By: Fabi a Gon a z cu ive Di ctor Date of Signature: 8-a3 —aa Date of Signature: ��— Name: Sal Quintero Vice Chairman of the Board of Supervisors of Title: the County of Fresno APPROVED AS TO LEGAL-PORM r Federal Tax ID Number: By: f/l/ L�""_- ATTEST: Ken eth Pr:ice,-Ifegal Counsel BERNICE E.SEIDEL �� �Z Clerk of the Board of Supervisors Date of Signature: County of Fresno,state of California �lBy Deputy By: 4L — -' Brian Pacheco,Commission Chair Date of Signature: Ct w 0 )a R0522(1&2) County of Fresno,Department of Public Health Contract#2o1617-0950 Nurse Family Partnership Page 4 EXHIBIT A Scope of Work (2022-2024 Fiscal Years) A-1 ©FIRSTS Direct Services Face Sheet & Scope of Work FRESNO COUNTY This document will be completed with First s Fresno County(F5FC)staff and Service Provider during a development meeting. A.Face Sheet Agency Name: County of Fresno, Department of Contract Number: 201617-0954 Public Health Project ID Number:0954-17 Project Name: Nurse-Family Partnership GL: 10-8602-00 100% Start date/End date: 07/01/2016-06/30/2024 FY 16-17:$190,412 FY 17-18:$195,756 FY 18-19:$215,126 Agency Address: 1221 Fulton Street,4th Floor, Contract amount: FY 19-20:$225,643 Fresno,CA 93721 $1,667,933 FY 20-21:$135,883 FY 21-22: $284,615 FY 22-23: $210,249 FY 23-24: $210,249 Other Project Funding: $1,389,170 BOS District:3 Agency phone#: 559-600-3330 Website:www.fcdph.org Project Description: Briefly address what F5FC is funding and why. If applicable,describe the goals/outcomes. This may be placed on the FSFC website. Nurse-Family Partnership(NFP) is an evidence-based community healthcare program that empowers low- income,vulnerable first-time mothers to become confident,knowledgeable,and responsible parents, and ensures that their babies have the best possible start in life. This program is voluntary,mothers are enrolled in the program early in pregnancy and receive ongoing nurse home visits that continue until the child reaches their second birthday. The nurse provides guidance for emotional,social,and physical challenges as expectant mothers prepare to become parents.The nurses support mothers by connecting them to prenatal care and preventative health practices,providing individualized guidance on specific child developmental stages,as well as assisting mothers in their maternal life course development.The three goals of the NFP program are: improving pregnancy outcomes,child health and development,and economic self-sufficiency of the family. F5FC Contract Manager: Liliana Salcedo Program Contact Person who runs day to day program o erations su ervisor coordinator mana er Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone#: 559-600-3330 Finance Contact Person responsible for submittingbud ets,financial reports and/or invoices Name: Michael Chu Title: Senior Accountant E-mail: mchu@fresnocountyea.gov Phone#: 559-600-6426 Notice Contact Person who has legal authority to sign contract Name: David Luchini Title: Director of Public Health E-mail: dluchini@fresnocountyca.gov Phone#:559-600-3200 Public Contact Person responsible for general public calls requesting ro ram info,how to access services,media,etc. Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone#: 559-600-3330 R0522(1&2) Page 1 of 9 ©FIRST5 Direct Services Face Sheet & Scope of Work FRESNO COUt: Program Contact Person responsible for entering data Name: Sophia Rodriguez Title: Office Assistant III E-mail: SXRodriguez@fresnocountyca.gov Phone#: 559-600-3330 Program Contact (Person responsible for entering data) Name: Valerie Wells Title: Supervising Office Assistant E-mail: vwells@fresnocountyca.gov Phone#: 559-600-3330 Program Contact Person responsible for entering data Name: Diana Colin Title: Office Assistant III E-mail: dcolin@fresnocountyca.gov Phone#: 559-600-3330 Program Contact Person responsible for entering data Name: Linda Willome Title: Office Assistant III E-mail: lwillome@fresnocountyca.gov Phone#:559-600-3330 Program Contact Person responsible for entering data Name: Christina Wyrick Title: Program Technician E-mail: clmoreno@fresnocountyca.gov Phone#:559-600-3330 Program Contact Person responsible for entering data Name:Martha Garcia Title: Office Assistant III E-mail: marthagarcia@fresnocountyca.gov Phone#: 559-600-3330 Program Contact (Person responsible for entering data Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone#:559-600-3330 Financial Contact Person responsible for entering financial information Name: Michael Chu Title: Senior Accountant E-mail: mchu@fresnocountyca.gov Phone#:559-600-6426 Financial Contact Person responsible for approvin financial information Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone#: 559-600-3330 Financial Contact Person responsible for approvin financial information Name:Aphivanh(Aphi) Xayavath Title: Staff Analyst E-mail: axayavath@fresnocountyca.gov Phone#: 559-600-3330 County of Fresno,Department of Public Health,Nurse-Family Partnership,#201617-0954 R0522(1&2) Page 2 of 9 ©FIRST5 Fnesrw COUNTDirect Services Face Sheet & Scope of Work Agency Service Locations: Location(s) District(s) Location 1: 1221 Fulton Street,4th Floor, Fresno, CA 93721 District 3 First 5 Fresno County Strategic Plan and First 5 CA Result and Service Area Alignment: Investment Area of F5FC Strategic Plan Percent of Funding Families 100% Strategy per F5FC Strategic Plan Percent of Funding Skill Building 100% State Service Area Percent of Percent of State Result Area/Outcome Clients Funding 3.Improved Child Health Early Intervention 100 % 100% Is this an evidence based or research-based program? (Please check one) ® Evidence Based ❑ Research Based ❑ N/A County of Fresno,Department of Public Health,Nurse-Family Partnership,#W1617-09s4 R0522(1&2) Page 3 of 9 FIRST5 _. Direct Services Face Sheet & Scope of Work B.Demographic and Geographic Client Served Details Types of Clients Served and Projected Numbers: Please note that these fields reflect the client type options in the contract management database and not family relationships.Include all client level and aggregate clients included in sections C and D. Type of Client Total#of Clients Total#of Clients FY2223 FY2324 Child 013 37 37 Child 3-5 0 0 Parent 37 37 Prenatal 8 8 Other(please specify): 0 0 TOTAL: 82 82 Projected Numbers Served in Each Geographic Region: Use the countywide box for programs providing services throughout the county. Geographical Location of Clients to be Served Total#of Clients Total#of Clients FY2223 FY2324 County Wide 82 82 Total: 82 82 Geographical Total#of Clients Percent Urban(%) Percent Rural(%) Location of Clients to be Served FY2223 FY2324 FY2223 FY2324 FY2223 FY2324 Countywide 82 82 go% go% 10% 10% County of Fresno,Department of Public Health,Nurse-Family Partnership,#201617-0954 R0522(1&2) Page 4 of 9 _ b a a v a 0 0 N ,O N O 0 0 � '� u v r a a 0 N o a a g 0 o a d d 0 0 En tl d y v v a C it o 0 0 Q) S2 ^o b o 0 0 0 z H v a c v v OT3 O aai a a as as C.y -0O T y o o � w ti w p a N w a a p +� o v v -d v v v O y a o 0 a a ti U v C M U rn C) u Co C C a v 04 ial as Q) �4- 3 3 > > Cl) cu C a p y 3 0 a a) a) ..Q a' C C o' a' C C � � o� •� v C C v w h h w o o w w w S S O04 co p ay a, Qj a, a U u ' Cl) zo E.o v N — z a-� § h M v w K O C. 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YN �nUnLn 0000 o00o y00 o co a s a (11 V`• p ;4 N M �t O •• fV Ch V' p g N M 4 O g N M 4 O .-i N C�', �t p g N &5 �} p :+ N M 4 L ~ � O zs v HdaaaHaaaaHaaaaHaaaaHaaaaHaaaaHaaaa '� '� v o a� a v o ro v a, 'u z Q C O a O Z} —co 0 ap, b 'b ac°i vc P� w U 0 0 N a _0 - a Ud Q w a, v U a w U a y v v m v ci cri u ti v `~ o b U a, v v LO m Q o (j co 04 (u �T {y Q co 0 v d Z C C w _ Qj u m 0 0 � y o O y v Q) � N v H E-� 0 0 �y a, Q 0 ca N U a ci LL ai ca y N w P m cl 0 a d0 0C] / a G t ƒ� z ƒ \ } 3 � o / \ \ � 2 \ � ƒ � 2 � 0 ° n S y c ƒ to 2 \ # d / \ � / Q) \ / �\ ± » \ w 7 0 \ _ & � \ \ ƒ { $ ƒ t n \ ■ � ƒ / > Ln \ \ \ Q � m ƒ k � � Ug)\ -\ � 6 �\ � !IFIRST5 Direct Services Face Sheet& Scope of Work FRESNO COUNTY Service Provider Staff Confidentiality Agreement&Request for Reporting Database System User Logon All staff members of FSFC funded programs and projects(Service Providers)who are responsible for gathering or maintaining confidential information and records must adhere to this agreement. Responsibilities During the performance of Service Provider assigned duties related to the FSFC project,Service Provider might have access to confidential client information and records required for effective coordination and delivery of services to children and their families.All confidential discussions,deliberations,records,and information generated or maintained in connection with these activities shall be disclosed only to persons who have the need to know and authority to access confidential consumer information or records.This includes information obtained and conveyed through all media including the reporting database system.Service Provider must not disclose any confidential client information to any third party without the written authorization from the client or legally authorized representative. Legal Liabilities Service Provider must adhere to the following: • Notice:All applicable employees,agents,and subcontractors shall be notified of state requirements for confidentiality and also notified that any person knowingly or intentionally violating the provisions of the state law is guilty of a misdemeanor. • Records pertaining to any individual recipient ofF5FC will be confidential and will not be open to examination for any purpose not directly connected with the administration of local evaluation. • No person will publish,disclose,use,or permit the use of,or cause to be published,disclosed or used,any confidential information pertaining to any individual recipient of FSFC services. Prohibition of Re-Disclosing Confidential Client Information Employment Confidentiality Agreement This notice accompanies a disclosure of confidential information concerning a consumer of services funded by the FSFC. The above referenced agency is prohibited from making any further disclosure of this confidential information unless further disclosure is expressly permitted by the written authorization to release the information of the person to whom it pertains or as otherwise permitted by these regulations.A general authorization for the release of confidential information is NOT sufficient for this purpose. Acknowledgement of Confidentiality and Prohibition of Re-Disclosing Confidential Client Information Employment Confidentiality Agreement The Agency acknowledges responsibility not to divulge any confidential information or records concerning clients of FSFC funded services without proper written authorization. By signing the Direct Services Agreement,the Agency accepts confidentiality and prohibition of re-disclosing confidential funding requirements. County of Fresno,Department of Public Health,Nurse-Family Partnership,#2o1617-0954 R0522(1&2) Page 7 of 9 'FIRST5 Direct Services Face Sheet & Scope of Work Type of Agreement:Amendment-Direct Service Type of Procurement: ❑ Informal ❑ Formal ® Sole Source Annual Contract Review: ® Formal ❑ Informal BFF Policy Agreement Form Completed: ® Yes ❑ No (attach form to contract) ❑ N/A EFT Form Completed: ® Yes ❑ No (attach form to contract) W-g Completed: ®Yes ❑ No Data Reporting System Set-Up: (check all that apply) ❑ No data-only basic info for state reporting ❑ Aggregate data ® Financial module ® Client level data reporting ❑Monthly reporting ® Narrative ®Quarterly reporting ®Performance module ❑ One time payment ❑Financial module ® State upload Type of Agency:(choose only one) ❑ City Government ❑ Private and/or for Profit Organization ❑ Community Benefit Organization(501(c)3 ❑ School District ® County Government ❑ State Government ❑ Faith Based Organization(attach policy) ❑ Other(please specify): ❑ Federal Government Agency ❑ Higher Education F.SFC Office Use Only Commission Approved Date: 06/01/2016 F5FC Staff Review and Approval FY 22-23 Contract Manager Approved 5/02/22 Reviewed&Approved by Director 5/13/22 Agency name: County of Fresno Department of Public Contract number: 201617-0954 Health Program name: Nurse-Family Partnership Contract amount: $1,667,933 R0522(1&2) Page 8 of 9 E]FIRST5 Direct Services Face Sheet & Scope of Work FRESNO COUNTY • See Description of Services (end notes)• Parent Partnership Home visit:NFP follows a home-visiting schedule to meet the program goals and integrates self-efficacy,human ecology,and attachment theories within its nursing framework creating a unique context for learning,growth and overall well-being.Frequency of home visits will vary as follows:once a week for the first 4 weeks;then every other week until the baby is born;once a week for 6 weeks after the baby's birth;every other week until the child is 21 months;and monthly until 24 months.Once the child turns two years old,the family is transitioned out of the program.The Nurse-Family Partnership model integrated a telehealth visit option in 2017 to increase client retention. Telehealth visits are incorporated in addition to in- person visits for clients who have returned to work or school. All client services are documented per NFP Telehealth Guidelines. z ASQ:Annually within go days of enrollment.ASQ-3 is authorized for initial use at 2 months of age. s ASQ:SE:Annually within go days of enrollment.ASQ-SE is authorized for initial use at 2 months. 4 Other assessment-PHQ-g:The Patient Health Questionnaire PHQ-g will be administered at intake and 32- 36 weeks antepartum,4-6 weeks postpartum,4 months,12 months and as needed.In addition,the client count includes an abuse assessment screening tool(partner relationship assessment)that will be administered at intake and 32-36 weeks antepartum,4-6 weeks postpartum,4 months,12 months and as needed.The total client count of 20 is a lower number of clients because the majority of clients in the program may not be antepartum/ postpartum.PHQ-g does vary on nurses'case load it may be that a nurse has more toddlers(to 2-year old) and not doing as many PHQ-gs. 5 Other assessment-DANCE:Dyadic Assessment of Naturalistic Caregiver-child Experiences(DANCE)is a strengths-based assessment tool to aid the nurse in identifying areas of strengths and areas of growth in Parents.Children who experience positive caregiver-child interactions will engage more with their caregivers, will reinforce caregivers'behaviors,and will develop a sense of trust in their relationships with their caregivers and others.DANCE will be completed by parents when their children are 2,9,16 and 22 months of age.The client count of i5 for this service is a lower number of clients based on the need of each client determined by the public health nurse.DANCE assessments vary on nurses'case load and it may be that a nurse has more pregnant mothers or infants. 6 Other referral:Total client count of 45 will receive more than one referral throughout the fiscal year. County of Fresno,Department of Public Health,Nurse-Family Partnership,#2o1617-0954 Ro522(1&2) Page 9 of 9 County of Fresno, Department of Public Health Contract#201617-0950 Nurse Family Partnership Page 5 EXHIBIT B Project Budget (2022-2024 Fiscal Years) 1 2 3 4 Agency Name: County of Fresno, Department of Public Health 5 Project Name: Nurse-Family Partnership 6 Contract Term: 07/01/2016-06/30/2024 7 Contract Number: 201617-0954 11 12 Year 1 Year 2 Year 3 13 Actuals Actuals Actual: 14 07101/16-6/30/17 07/01/17-06/30/18 07/01/18-06/3 15 Category 16 I. Personnel 17 A. Salaries 88,041 78,654 18 B. Benefits 62,417 65,606 19 C. Taxes 6,812 5,696 20 Total Personnel 157,270 149,956 21 II. Operating Expenses 22 A. Facilities Costs 434 444 23 B. Operational/Supplies 2,018 1,652 24 C. Training/Travel 4,449 1,129 25 Total Operating Expenses 6,901 3,225 26 III. Program Expenses 27 A. Materials and Supplies 3,519 3,302 28 Total Program Expenses 3,519 3,302 29 IV. Professional Services 0 0 30 V. Unallocated 0 0 31 VI. Indirect Costs 22,722 39,273 32 33 Total Program 190,412 195,756 34 Year 1 Year 2 Year 3 35 VII. Other Funding Actuals Actuals Actuals 36 A. Leveraged 166,680 39,273 le 37 B_ Other Fundina Snurr.P- - - S) § § ® E 0 § p ' ° _ U w k 3 Z Z ( / { E 3 3 U) m � / •§ ƒ ƒ / ( Cr � � 3 / § \ 2 2 \ LU / a 2 5 -0 o n L — e n o m E & 3U § $ 0 _ » 2 2m r- N CO � t \ Lo 2 § 0 ® 2 ® 2 / C a- 0 E \ ± 2 a) « m G E / Co $ � w 2 = ( 3 �uj CD CD k \ § ) $ 2 q \ Lo § c q { (D E ± £ 0 CDr \ � W3 2 \ q 3 E ¥ n q e e L = x = 2 2 0 2 / \ 0Q- ƒ (n as y m ƒ U) _\ : / R_ fg / / \ / / k % £ 6 0 @ a) a) .0 2 M / ƒ ° \ 7 / § ® $ 0) L \ m & e m E 0 � ° $ d © \ 0 2 o f \ & 2 2 2 U / 2 © Cf) ° k � % � � � n CL k ( k k w / 0 $ m I o 0 / d @ c \ = ± Q m o e wCD cf) ® k $ \ \ i $ � o / E ° ° / ■ k 0 J x � d / 0 / 2 2 c . m § k m 0 \ C \ / ffllr, ,2�L � w Ew ' 0 L� � Q q CO m o w c c � = = / � / T- % C14 q G a) a) E § LL \ � 2 E r / f m . 2 k / / 3 E E a) KE : 3 ƒ � / g k m E = co m a) ° \ E w ± o o 0 w E m •- •- E n L 00 � ¢ D E � & / Q U m & � 2 % o c \ 2 0 E r_ kmm k q ƒ \ � 2 \ ® ? 9 ? c ® co \ k % O « m $ @ / C,4 � / / ƒ ƒ § 7 7 % \ CD / E L g o a ± ) E / L CD e 2 k n ( � \ m E 9 c y § CL 2 � k § LO 2 2 = cl D 2 co 2 = q (D k = e k 0 / / = § § \ \ R E 3 / / 0 / t .R 0- En E £ £ $ / R C) (D a) a) E 7 / o / \ ƒ : 2 n 2 / L o c / � A ¢ ¢± / 0- 0 @ 0 ¥ Co y y \ / 2 k co $ § 3 / ° U) k k % @ m / c m .0k k w § m o 0 2 k 2 $ c : � ® � ¢ \ 7U_ $ + o Q E ° ° 2 L \ ° u E M Ca x �_ Co / a) « § k 4- \ / [Cr-) ) w@ 3 / % p U a IL m « cn a . ¥1 161 C51 I I I . « q CO IT o £ G c 3 � � / o Q T_ c c g N q County of Fresno,Department of Public Health Contract#201617-0950 Nurse Family Partnership Page 6 EXHIBIT C Signature Authorization I CERTIFY THE AGENCY OFFICIAL LISTED BELOW IS AUTHORIZED AND EMPOWERED TO SIGN AND ENTER INTO THIS AGREEMENT ON BEHALF OF THE AGENCY (CONTRACTOR) AND BY VIRTUE OF THAT PERSON'S SIGNATURE, BIND THE AGENCY. ORGANIZATION/AGENCY NAME (CONTRACTOR): County of Fresno SIGNATURE OF GOVERNING BODY OFFICIAL: DATE SIGNED: C?..23—a a PRINTED NAME: Sal Quintero TITLE: Vice Chairman of the Board of Supervisors of the Count of Fresno SIGNATURE OF AUTHORIZED AGENCY OFFICIAL: DATE SIGNED: TYPED NAME: Sal Quintero TITLE: Vice Chairman of the Board of Supervisors of the County of Fresno NOTE: SHOULD CIRCUMSTANCES REQUIRE A CHANGE IN THE ABOVE, A NEW SIGNATORY AUTHORIZATION MUST BE COMPLETED AND FORWARDED TO THE COMMISSION. ATTEST: BERNICE E.SEIDEL Clerk of the Board of Supervisors County of Fresno,State of California B-1 By �� Deputy