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HomeMy WebLinkAboutAgreement A-22-375 Amendment V to Agreement 16-683 with First 5 for NFP.pdf Agreement No. 22-375 County of Fresno,Department of Public Health Contract#201617-0954 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 g. 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$1,667,922 (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 g. Signature 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: ut ized epresentative By: Fabi a Gon a z cu ive D' ctor Date of Signature: a3 -aa Date of Signature: lorl G�l� Name: Sal Quintero Vice Chairman of the Board of Supervisors of Title: the County of Fresno APPROVED AS TO LEGAL-FiORM Federal Tax ID Number: BY /�'�``s9 ATTEST: Ken eth Price,` egal Counsel BERNICE E.SEIDEL Clerk of the Board of Supervisors Date of Signature: �� County of Fresno,state of California L By Deputy By: L Brian Pacheco,Commission Chair Date of Signature: 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 E]FIRST5 Direct Services Face Sheet & Scope of Work FRESNO COUNTY This document will be completed with First 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 1lblic Health Project ID Number:0954-17 Project Name: Nurse-Family Partnership GL: 10-8602-04 100 % Start date/End date: 07/01/2016-06/30/2024 FY 16-17:$190,412 FY 17-18:$195,756 FY 18-19:$e15,126 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: $ 1,389,9 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 F5FC 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 operations/supervisor/coordinator/manager) Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone#:559-600-3330 Finance Contact Person responsible for submitting budgets,financial reports and/or invoices) Name: Michael Chu Title: Senior Accountant E-mail: mchu@fresnocountyca.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 program 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 ©FIRSTS FRESNO IR COUNTY Direct Services Face Sheet & Scope of Work 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 approving financial information Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone#: 559-600-3330 Financial Contact (Person responsible for approving financial information) Name:Aphivanh(Aphi) Xayavath Title: Staff Analyst E-mail: aayavath@fresnocountyca.gov Phone#: 559-600-3330 County of Fresno,Department of Public Health,Nurse-Family Partnership,#201617-0954 Ros22(1&2) Page 2 of 9 ©FIRSTS FRESNO IR COUNTY Direct 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,#2016i7-09s4 Ros22(1&2) Page 3 of 9 ©FIRSTS FRESNO IR COUNTY Direct Services Face Sheet & Scope of Work B.Demographic and Geographic Client Served Details I ■ 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 Cli Total#of Cl FY2223 FY2324 Child 0<3 37 37 Child 3-5 0 0 Parent 37 37 Prenatal 8 8 Other(please specify): 0 0 TOTAL: 8A 82 Projected Numbers Served in Each Geographic Region: Use the countywide box for programs providing services throughout the county. Geographical Location Clients to be Served Total#of Clients Total#of Clients ff 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 Ros22(1&2) Page 4 of 9 E]FIRST5 Direct Services Face Sheet & Scope of Work FRESNO COUNTY C. Outputs:Services and Contacts All services listed in section D are required to be entered in the reporting databases system on a monthly basis,refer to the Funded Partner Manual for details.All clients served by F5FC funds must meet age and residency requirements.Service Provider is required to maintain back-up documentation. The information in the table below will remain the same for the full contract term(from one fiscal year to the next)unless otherwise specified or modified through a contract amendment request.Please note,total unduplicated number of clients are captured per deliverable.Quarterly breakdown of clients may overlap. Core Client Target# mIrr Core Client Target# Core (Expected#of clients (Expected#of clients Service Type Client Type receiving service) receiving service) Frequency Verification Method FY2223 FY2324 Total':45 Total2:45 Q1:40 Q1:40 Parent partnership home visit Parent Q2:4o Q2:4o Frequency varies,please see endnotes Service log Q3:40 Q3:40 Q4:40 Q4:40 Total:37 Total:37 Q1:6 Q1:6 SQ Child Q2:g Q2:g Annually within go days of enrollment ASQ/ASQ:SE Q3:10 Q3:10 Q4:12 Q4:12 Total:20 Total:20 Q1:5 Q1:5 SQ:SE Child Q2:5 Q2:5 Annually within go days of enrollment3 ASQ/ASQ:SE Q3:5 Q3:5 Q4:5 Q4:5 Total:20 Total:20 Other assessment PHQ-94 Qi:10 Qi:10 Parent Q2:10 Q2:10 Frequency varies,please see endnotes Other -complete copy of PHQg Q3:10 Q3:10 Q4:10 Q4:10 Total:15 Total:15 Qi:10 Qi:10 Other assessment -DANCE' Parent Q2:10 Q2:10 Frequency varies,please see endnotes Other -complete copy of PHQg Q3:10 Q3:10 Q4:10 Q4:10 Total:1 Total:1 Qi:0 Qi:o Developmental referral Child Q2:0 Q2:o As needed Q Service log 3.1 Q3:1 Q4:0 Q4:o Total:45 Total:45 Qi:i5 Qi:15 Other referral s Parent Q2:15 Q2:15 As needed Service log Q3:15 Q3:15 Q4:15 Q4:15 1 Total unduplicated clients to be served in the entire year 2 Total unduplicated clients to be served in the entire year County of Fresno,Department of Public Health,Nurse-Family Partnership,#201617-0954 Ros22(1&2) Page 5 of g E]FIRST5 Direct Services Face Sheet & Scope of Work FRESNO COUNTY D. Aggregate Services and Narrative - The information in the table below will remain the same for the full contract term(from one fiscal year to the next)unless otherwise specified or modified through a contract amendment request. Service Provider is required to maintain back-up documentation. Data due Quarterly. County of Fresno,Department of Public Health,Nurse-Family Partnership,#201617-0954 Ros22(1&2) Page 6 of 9 CIFIRST5S Direct Services Face Sheet & Scope of Work FRECOUNTY Service Provider Staff Confidentiality Agreement&Request for Reporting Database System User Logon All staff members of F5FC 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 F5FC 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 of F5FC 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 F5FC 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 F5FC. 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,#20i6i7-0954 Ros22(1&2) Page of 9 E]FIRST5 Direct Services Face Sheet & Scope of Work FRESNO COUNTY 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: o6/o1/2016 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: 11,667,933 R0522(1&2) Page 8 of g 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. 2 ASQ:Annually within go days of enrollment.ASQ-3 is authorized for initial use at 2 months of age. 3 ASQ:SE:Annually within go days of enrollment.ASQ-SE is authorized for initial use at 2 months. 4 Other assessment-PHQ-9:The Patient Health Questionnaire PHQ-9 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-9 does vary on nurses'case load it may be that a nurse has more toddlers(1 to 2-year old) and not doing as many PHQ-9s. s 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 15 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. s 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,#201617-o9s4 R0522(1&2) Page 9 of 9 County of Fresno,Department of Public Health Contract#2o1617-0950 Nurse Family Partnership Page 5 EXHIBIT B Project Budget (2022-2024 Fiscal Years) 1 FIRST 5 FRESNO COUNTY 2 Direct Service Budget 3 4 A enc Name: Count of Fresno,Department of Public Health 5 Project Name: Nurse-Family Partnership 6 1 Contract Term: 07/01/2016-06/30/2024 7 Contract Number: 201617-0954 11 12 Year Year Year Year Years Year6 Year Year 13 Actuals Actuals Actuals Actuals Actuals CAR Budget Budget Budget Total Program Amount 1Q 07/01/164130117 07101/1746130/18 07/01118-06/30119 07101/1946130/20 07101/2046130/21 0710112146130122 07/01122A6/30123 07/01/23-06/30124 15 Category 16 I. Personnel 17 A. Salaries 88,041 78,654 97,895 99,574 111,928 97,042 103,424 676,558 18 B. Benefits 62,417 65,606 73,083 70,989 80,305 63,677 67,001 483,078 19 C. Taxes 6,812 5,696 7,210 7,617 8,562 7,424 7,912 51,234 20- Total Personnel 157,270 149,956 178,188 178,181 116,102 200,795 168,143 178,337 1,326,972 21 ll.Operating Expenses 22 A. Facilities Costs 434 444 473 470 586 540 540 3,487 23 B. Operational/Supplies 2,018 1,652 1,978 3,000 3,011 2,839 720 15,218 24 C. Training/Travel 4,449 1,129 2,315 1,287 1,333 1,717 971 13,201 25 Total Operating Expenses 6,901 3,225 4,766 4,757 4,963 4,930 5,096 2,231 36,869 26 III.Program Expenses 27 A. Materials and Supplies 3,519 3,302 5,443 17,153 9,292 11,539 2,680 52,928 28 Total Program Expenses 3,519 3,302 5,443 17,153 8,821 9,292 11,539 2,680 61,749 29 IV.Professional Services 0 0 0.00 250 250 250 250 1,000 30 V. Unallocated 0 0 0.00 0 0 39,228 0 0 39,228 31 VI.Indirect Costs 22,722 39,273 26,729 25,302 5,997 30,119 25,221 26,751 202,114 32 33 Total Program 795,756 225,643 135,883 284,615 210,249 1,667,932.50 34 Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Total Other 35 VII.Other Funding Actuals Actuals Actuals Actuals Actuals Budget Budget Budget Funding 36 A.Leveraged 166,680 39,273 229,662 185,473 176,277 204,849 189,161 197,795 1,389,170 37 B.Other Funding Source: - - - - - - 38 C.Other Funding Source: 39 otal Other Funding 1 jAgency Name: lCounty of Fresno, Department of Public Health Contract Term: 07/01/2016-06/30/2024 2 1 Project Name: Nurse-Family Partnership Contract Number: 1201617-0954 3 4 YEAR 7 First 5 Amounts Leveraged Select Other Funding Source: 5 6 07/01/22-6130/23 07/01/22-6/30/23 07/01/22-6/30/23 7 I. Personnel Title FTE Amount Title FTE Amount Title FTE Amount 8 Supervising Public Health Nurse 6.40% 7,997 Supervising Public Health Nurse 8.60% 10,638 - 9 Public Health Nurse 1 53.90% 41,796 Public Health Nurse 1 46.10% 35,799 10 The "Amount" should be: Annual Public Health Nurse 1 50.40% 47,249 Public Health Nurse 1 49.60% 46,476 Salary X the FTE whenever possible. 11 12 1 FTE = 40 hours /week 13 14 15 A. Total Salaries & FTE 1.11 97,042 1.04 92,913 - - 16 B. Benefits 65.618% 63,677 60,968 - 17 C. Taxes 7.65% 7,424 7,108 - 18 Personnel Subtotal 168,143 160,989 - Justification of Benefits and Taxes: Justification of Benefits and Taxes: Estimated benefits rates reflect Unemployment Insurance (.0032718), Retirement (.5141 - .6527), OASDI 19 (.0765), Health Insurance ($9,605 - $12,476 per FTE per year)and Benefits Administration ($122 per FTE per year). 20 II. Operating Expenses 21 A. Facilities Costs 540 560 22 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 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 23 24 B. Operational/Supplies 2,839 1,681 25 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 ($3,000); postage ($150); and printing ($150). Medical supplies for PHNs to use during home Narrative/Justification visits ($1,220). 26 27 C. Training/Travel 1,717 1,783 28 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 training ($1,500). Staff private auto mileage reimbursement at a rate of$0.585 per mile ($2,000). Narrative/Justification 29 33 Operating Expenses Subtotal 5,096 4,024 - 34 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 35 calculations where applicable). 36 A. Materials and Supplies 11,539 - - 37 Subtotal 11,539 - - 38 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 ($8,539), Cribettes ($1,000) Narrative/Justification for Materials and Supplies 39 40 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 41 calculations where applicable). Any services exceeding $5,000 must have attached a narrative delineating services. 43 Subtotal 250 1 - Estimated costs for interpreters/translators who provide services for various languages through a Countywide contract. Narrative/Justification - 44 50 Program Totals 185,028 165,013 1 - 51 VI. Indirect (= Program Totals - Equipment x Percentage of Indirect) 52 Instructional Information In the Narrative/Justification box explain these costs, how they will support/benefit the program, and how the percentage was determined. 53 A. Indirect Rate 1 15.00% 25,221 1 24,148 Fresno County Department of Public Health's indirect cost rate is 22.579% of the total personnel costs, prepared following OMB's 2 CFR Part 200 guidelines and approved Narrative/Justification - by County of Fresno's Auditor-Controller/Treasure-Tax Collector Department. Lower rate applied to this budget to remain within maximum allowable rate. 54 55 Total Proposed Budget 210,249 189,161 - 1 JAgency Name: lCounty of Fresno, Department of Public Health Contract Term: 07/01/2016-06/30/2024 2 Project Name: Nurse-Family Partnership Contract Number: 1201617-0954 3 4 YEAR 8 First 5 Amounts Leveraged Select Other Funding Source: 5 6 07/01/23-6/30/24 07/01123-6/30/24 07/01/23-6/30/24 7 I. Personnel Title FTE Amount Title FTE Amount Title FTE Amount 8 Supervising Public Health Nurse 6.40% 7,997 Supervising Public Health Nurse 8.60% 10,638 - 9 Public Health Nurse 1 50.40% 45,789 Public Health Nurse 1 49.60% 39,219 10 The "Amount" should be: Annual Public Health Nurse 1 53.96% 49,638 Public Health Nurse 1 46.10% 48,826 Salary X the FTE whenever possible. 11 12 1 FTE = 40 hours /week 13 14 15 A. Total Salaries & FTE 1.11 1 103,424 1.04 1 98,683 - - 16 B. Benefits 64.783% 67,001 63,930 - 17 C. Taxes 7.65% 7,912 7,549 - 18 Personnel Subtotal 178,337 170,162 - Justification of Benefits and Taxes: Justification of Benefits and Taxes: Estimated benefits rates reflect Unemployment Insurance (.0032718), Retirement (.5141 - .6527), 19 OASDI (.0765), Health Insurance ($9,605 - $12,476 per FTE per year)and Benefits Administration ($122 per FTE per year). 20 II. Operating Expenses 21 A. Facilities Costs 540 560 - 22 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 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 23 24 B. Operational/Supplies 720 540 - 25 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 ($800); postage ($200); and printing ($60). Medical supplies for PHNs to use during home Narrative/Justification visits ($200). 26 27 C. Training/Travel 971 1,009 - 28 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 training ($500). Staff private auto mileage reimbursement at a rate of$0.585 per mile ($1480). Narrative/Justification 29 33 Operating Expenses Subtotal 2,231 2,109 - 34 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 35 (include calculations where applicable). 36 A. Materials and Supplies 2,680 - - 37 au btota 11 2,680 - - 38 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 ($150). Forms, pamphlets, educational materials to evaluate and assist NFP Narrative/Justification for Materials and Supplies Narrative/Justification for Materials and Supplies 39 clients ($2530) 40 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 41 calculations where applicable). Any services exceeding $5,000 must have attached a narrative delineating services. 43 Subtotal 250 - - Estimated costs for interpreters/translators who provide services for various languages through a Narrative/Justification — Narrative/Justification — 44 Countywide contract. 50 Program Totals 183,498 1 172,271 1 - 51 VI. Indirect (= Program Totals - Equipment x Percentage of Indirect) 52 Instructional Information In the Narrative/Justification box explain these costs, how they will support/benefit the program, and how the percentage was determined. 53 A. Indirect Rate 1 15.00% 26,751 1 25,524 Fresno County Department of Public Health's indirect cost rate is 22.579% of the total personnel costs, prepared following OMB's 2 CFR Part 200 guidelines and approved Narrative/Justification — by County of Fresno's Auditor-Controller/Treasure-Tax Collector Department. Lower rate applied to this budget to remain within maximum allowable rate. 54 55 Total Proposed Budget 210,249 197,795 - 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: o�-- PRINTED NAME: Sal Quintero TITLE: Vice Chairman of the Board of Supervisors of the County 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 Cierk of the Board of Supervisors County of FFrreesno,State of California B-1 By_ "'" Deputy