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HomeMy WebLinkAboutChildren Families Commission of Fresno County First 5-Community Health Teams_A-22-377 A20-402 A-21-427.pdf COU Y Count of Fresno Hall of Records,Room301 2281 Tulare Street Fresno,California +" Board of Supervisors 93721-2198 O� 1856 Telephone:(559)600-3529 FR Minute Order Toll Free: 1-800-742-1011 vmw.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 1 Board Agenda Item 33 0 1$56 0 FRE'_77 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. 22-31 County of Fresno, Department of Public Health Community Health Teams Contract#202021-2242 Page 1 SECOND AMENDMENT TO PROGRAM SERVICES AGREEMENT Parties Commission: Children and Families Commission of Fresno County, California Contractor: County of Fresno Administrative Contract Number: 202021-2242 Recitals A. Commission and Contractor are parties to that certain Program Services Agreement(the"Agreement"),dated December 8,2020,the Term of which is from July 1, 2020 to June 30, 2021(the"Original Term").Commission and Contractor are also parties to First Amendment to the Agreement,dated November 19,2021,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 Second Amendment to Program Services Agreement (this"Second Amendment") shall have the meanings provided for in the Agreement unless otherwise specified in this Second Amendment. Therefore,in consideration of the above recitals,which are incorporated into this Second Amendment by reference,the Parties agree as follows: 1. Term. This Second Amendment is made effective as of July 1,2022 (the "Effective Date"). Notwithstanding anything in the Agreement to the contrary,the original term of the Agreement is extended until June 30,2024,unless terminated earlier under the Agreement (the"Term"). 2. Amendment to Section 2.1 and 2.2. As of Effective Date,Exhibit A will be replaced with the Exhibit A,"FY 2022-2023 Revised Scope of Work and Budget" attached to this Second Amendment and incorporated herein by this reference. As of Effective Date,except as needed to interpret Contractor's responsibilities and obligations under the Agreement,the original and prior Exhibit A attached to the Agreement and prior Amendment will have no further force and effect. 3. Amendment to Section 4.1. Section 4.1 of the Agreement is deleted in its entirety and replaced with the following: o522(1&2) County of Fresno, Department of Public Health Community Health Teams Contract#202021-2242 Page 2 4.1 Project Budget. Compensation for the Services is based on actual costs as described in Exhibit A. Compensation for the Services will in no event exceed the total aggregate amount of$2.581-976 (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 Second Amendment. Compensation for Services provided prior to July 1,2022 shall be in accordance with the original Agreement and First Amendment. 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 Exhibit A for providing the Services on behalf of Commission in an amount not to exceed the Contract Amount. 5. Controlling Document; No Other Amendment. In the event of any conflict between the terms of this Second Amendment and the Agreement,the terms of this Second Amendment shall control. Except as amended by this Second Amendment, 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 Second Amendment,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 Second Amendment 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 Second Amendment include the plural as well as the singular number, and vice versa;words used in this Second Amendment in the present tense include the future as well as the present; and words used in this Second Amendment in the masculine gender include the feminine and neuter genders,whenever the context so requires. No provision of this Second Amendment will be interpreted for or against a Party because that Party or its legal representative drafted the provision, and this Second Amendment will be construed as if jointly prepared by the Parties. 8. Counterparts. This Second Amendment may be signed by the Parties in different counterparts and the signature pages combined to create one document binding on all Parties. g. Signature AuthoritX. Each Party represents that it has capacity, full power, and authority to enter into this Second Amendment and perform under modified terms of the Agreement, and the person signing this Agreement on behalf of each 0522(1&2) County of Fresno,Department of Public Health Community Health Teams Contract#202021-2242 Page 3 Party has been properly authorized and empowered to enter into this Second Amendment. Contractor must sign the signatory authorization,attached as Exhibit - B and incorporated into this Second Amendment. 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 Second Amendment 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,a political OF FRESNO COUNTY subdivision of the State of California REVIEWED AND RECOMMENDED P FOR AP R V By: i2ckized epresentative By: Fa ola onz ez,�E{ cutive irector Date of Signature: l��9 3- 9,a'` Date of Signature: 0 1 U �Z� Name: Sal Quintero Vice Chairman of the Board of Supervisors Title: of the County of Fresno APPROVED AS TO LEGAL-PORM i Federal Tax ID Number: By: ATTEST: Ken th Price,6 egal Counsel BERNICE E.SEIDEL J�J� Clerk of the Board of Supervisors Date of Signature: County of Fresno,State of California L By By: Brian Pacheco,Commission Chair Date of Signature: o522(1&2) County of Fresno,Department of Public Health Community Health Teams Contract#202021-2242 Page 4 EXHIBIT A FY 2022-2023 Revised Scope of Work and Budget Direct Services Face Sheet Scope of Work This document will be completed with Firsts Fresno County(FSFC)staff and Service Provider during a development meeting. County of Fresno,Department of Public Health 202021-224z Program Community Health Teams J $3,581,376 Project Name Community Health Teams Contract Number 202021-2242 Agency Name County of Fresno,Department of Public Health Contract Amount $3,581376 GL i0-8602-00 Start Date-End Date July 1,2020-June 30,2024 Project ID 2242-20 �06tice Contact Name David Luchini,PHN,RN FY2020-21 I $895,206 Actual 1 $673,519 1 Other 1 $338,082 Title Director FY2021-22 $895,390 Actual I $o Other $414,720 Phone (559)600-3200 FY2022-23 I $895,390 Actual I $o I Other 1 $396,148 E-mail dluchini@fresnocountyca.gov FY2023-24 I $895,390 Actual 1 $o 1 Other 1 $396,148 Commission Approval Date: December 4,2019 Total 1 $3,581,376 1 Balance $2.907.857 1 Tot.Other $1,545,099 Project Description A cost-effective model pairing a public health nurse with teams of para-professionals from community based organizations to provide research-based home visitation services to underserved families without the eligibility guidelines of otherfederally and state funded programs. In this model Department of Public Health(DPH)will contract with multiple community-based organizations(CBOs)creating Community Health Teams in targeted Fresno County communities. DPH will contract with approximately four CBOs to provide research-based or evidence-informed home visitation services to underserved families with children ages 0-5 in targeted Fresno County communities. The home visitation models selected must address one or more of the key challenges facing families as cited in the Commission's strategic plan. Secondary services that support the target population may also be included in the program model(e.g.socialization groups,parent support groups, etc.).Primary services must be completed in the home or similar setting. Teleconferencing can be used in lieu of in person visitation when COVID 19 restrictions are in place.Home visitors from the selected CBOs will be paired with a public health nurse,who will provide guidance and support on medically challenging cases and complete joint home visits as needed. These Community Health Teams will meet on a regular basis for trainings,case consultations and other program issues. Services must directly serve families with children ages 0-5 who are not being served by other home visitation programs(e.g. Nurse-Family Partnership,Healthy Families America,and Early Head Start). Agency Information Phone:559-600-3330 Mailing Address(if different from left):N/A Website:www.fcdph.org Address:1221 Fulton Street Fresno,CA 93721 Program Contact Finance Contact (Operations Supervisor/Coordinator) (Submits budgets,financial reports,invoices) Name:Megan Gunn Name:Michael Chu Title:Supervising Public Health Nurse Title:Senior Accountant Phone:559-600-3330 Phone:559-600-6426 E-mail:mgunn@fresnocountyca.gov E-mail:mchu@fresnocountyca.gov Program Contact Financial Approval (Enters programmatic data) (Submits budgets,financial reports,invoices) Name:Christina Wyrick Name:Megan Gunn Title:Program Technician Title:Supervising Public Health Nurse Phone:(559)600-3330 Phone:559-600-3330 E-mail:cwyrick@fresnocountyca.gov E-mail:mgunn@fresnocountyca.gov Program Contact Financial Approval (Enters programmatic data) (Submits budgets,financial reports,invoices) Name:Megan Gunn Name:Aphivanh Xayavath Title:Supervising Public Health Nurse Title:Staff Analyst III Phone:559-600-3330 Phone:559-600-3330 E-mail:mgunn@fresnocountyca.gov E-mail:axayavath@fresnocountyca.gov Data system Data Approval (Submits programmatic data) Name:Megan Gunn Title:Supervising Public Health Nurse Phone:559-600-3330 E]FIRST5 1 Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(F5FC)staff and Service Provider during a development meeting. ©FIRST,5 FRES2 Direct Services Face Sheet Scope of Work This document will he completed with First 5 Fresno County(FSFC)staff and Service Provider during a development meeting. Agency: County of Fresno,Department of Public Health Program Name: Community Health Teams Contract Number: 202021-2242 Contract Amount: $3,581,376 Agency Service Locations List all physical addresses where FSFC services take place. If more than three sites,please include in this document by adding another row. Refer to the Fresno County website to find the correct County District for each service location. Location District 1 1221 Fulton Street Fresno,CA 93721 3 Click here to access the Fresno County district lookup page of Wts 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. Number of Clients Type of Client FY2020-21 FY2021-22 FY2022-23 FY2023-24 Child 013 80 80 100 100 Child 3-5 80 80 100 100 Parent 160 160 200 200 Prenatal 0 0 0 0 Other(please specify): 0 0 0 0 Total 320 320 400 400 Provider Category Number of Clients FY2020-21 FY2021-22 FY2022-23 FY2023-24 Center-based ECE Providers o 0 0 0 Home/Family-based ECE Providers o 0 0 0 Health Care Providers o 0 0 0 Mental Health Providers o 0 0 0 Internal Program Staff o 0 0 0 Interns/Students/Volunteers 0 0 0 0 Other(specify: CBO Home Visitors) 12 12 12 12 Total 12 12 12 12 Geographical Location of Clients to be Served Fiscal Year FY2020-21 FY2021-22 FY2022-23 FY2023-24 Percent Urban 70% 70% 70% 70% Percent Rural 30% 30% 30% 30% Total#of Clients Countywide 332 332 412 412 FaFISRST5 3 Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(FSFC)staff and Service Provider during a development meeting. Agency:I County of Fresno,Department of Public Health Program Name: Community Health Teams Contract Number: 202021-2242 Contract Amount: $3,581,376 Projected Numbers Served in Each Geographic Region: Use the countywide box for programs providing services throughout the county. Geographical Location of Clients to Number of Clients be Served FY2020-21 FY2021-22 FY2022-23 FY2023-24 1 County Wide 332 332 412 412 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total 3321 3321 412 412 Description of"Other" ir"IRST5 4 L a 6 m C C p - - - e E >" w O O E w ' a a E w n U v Cl C u C " A G O 0 y{ yy 3 y ° O w 0 ami m Sp O O m n a O O O e „ a E c r 1. S a °S yT a0. ya o O „ V N C ° pp o ;n 4 E w w c E o C a y 9 x a g O o 0 0 o � o mom x L m , 0 9 m L `o I a o v g � g a m b l+ E c o v a E m b o 0 0 § 9 r m 0.m E o , , 0" v u 0 a gg w E - Y! A b U Ca W L1 4 " ti— s ti C Y m ya°. a a a a F a a d a a w U 9 W , U T -O 'H „ o W o a .o w Ewww b s q u E w ' `� a A O „ �' i0 61 .�� b V 0 'L 'S .a fj"p C V c a o Ow H N o a'o a C u W m x c a k s c ° > r o 0 0 o m�p u zi 0 as wa'w „ S rnx m.s NSU °� O w rn a Q N N O O b �A m m c 0 0 °m b o ._i �/� m G t LO z c m 0 F aez ¢ u yoc its a � F �.•�. uu 2 — , o .R y w s >` o >a > > V C a a G a c C a $ C y C c E o 'S O o'S — a a ev 6 c E w s5 M v o o�o 0 0 `o' ^ m o N°o a o E m= yE E m E o O o ° O m O chi N w N ° ° r ^ w w w w o n '`o S� •2E a s mt = E � rn rn m q vol o 0 a o 0 o U o o a a ° a5 U w ~U w m U w v u o o o o 0N v o 0 0 0 ° ° a E Y I w N y �w m rd m o m m a m m m m n m c m rd n a a a a a a a a a a a a a a a g b F aaaaF aaaaH aaaaF aaaa F F F F F v a U V U V U a V a k. o v 'O N CY F _ " N o ° - w t. A c N� i 0 p r� O'OFaziW � _ E � a �'u a n v o A x m « E Q O a m � a N d 3 a alol. O w o = O m o m m d C y N .O S ,o 0w o o U U .p vai o w H w ry q �— 'O U d O u > a y 7 3 z o ° vu y w a.c°_° d q L E N u °� w .. m L F U x C w z N 3 N j F W V 0 w O b of b h o m o 0 m o 0 •l m p p c o y � m 4L b a N H o W N A W p a w CL .[+a1 u '^ A r » T • O O O O O O O O O O O O w mp m 4 ¢ m Ot v V m rn G! M O � -tea N 3 C d+ » O p m O m N N e x � P a o m m N x a v w d o O O O y fA E- H E- O.F E N N N y A� O O O N N N fN Wd m h N N f/Wf x Y y z w w w a N m ~ H W W Wco W � 66 r°Gj a a a ¢ a N O w w w Ul) T 0 x O 3 o o a o w v C V C b M � d % ro j C ry C a C a O C d 7� o 3 c a :p x C w C O o O W V 0. y L O o [ti ° o o 0 0 ° p m b ro' w v` °o o co o v v v m m m 00 N� d '^ 'p 4 W C Y o o O "m! O O n .pi •� y m m d N 4 N A W s 3 p O O ti O v p O -N O Ci O O Ol Cl m C N n - F N m mm m m X � F H v C Service Provider Staff Confidentialit7Agreement&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 lnformation 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. AcImowledgement of Confidentialityand Prohibition ofRe Disclosing Confidential Client Information Employment ConfidentialityAgreement The Agency acknowledges responsibility not to divulge any confidential information or records concerning clients of F5FC funded services without proper written authorization. By signing the Direct Services Agreement,the Agency accepts confidentiality and prohibition of re-disclosing confidential funding requirements. E]FIRST5SCOUN FRE9 County of Fresno,Department of Public Health Community Health Teams Contract#202021.-2242 Page S EXHIBIT B Signatory Authority I CERTIFY THE AGENCY OFFICIAL LISTED BELOW IS AUTHORIZED AND EMPOWERED TO SIGN AND ENTER INTO THIS SECOND AMENDMENT ON BEHALF OF THE AGENCY (CONTRACTOR)AND BY VIRTUE OF THAT PERSON'S SIGNATURE, BIND THE AGENCY. ORGANIZATION/AGENCY County of Fresno NAME (CONTRACTOR): SIGNATURE OF GOVERNING BODY OFFICIAL: DATE SIGNED: PRINTED NAME: Sal Quintero TITLE: Vice Chairman of the Board of Supervisors of the I County of Fresno SIGNATURE OF AUTHORIZED -- AGENCY OFFICIAL: DATE SIGNED: g _ TYPED NAME: Sal Quintero TITLE: Vice Chairman of the Board of Supervisors of the County f 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 CO!„^^tr �f`Fra;nn Sty tagf C;�,IjfOrnla By, _Deputy County of Fresno,Department of Public Health Community Health Teams Contract#202021-2242 Page 5 EXHIBIT B Signatory Authority I CERTIFY THE AGENCY OFFICIAL LISTED BELOW IS AUTHORIZED AND EMPOWERED TO SIGN AND ENTER INTO THIS SECOND AMENDMENT ON BEHALF OF THE AGENCY (CONTRACTOR)AND BY VIRTUE OF THAT PERSON'S SIGNATURE, BIND THE AGENCY. ORGANIZATION/AGENCY County of Fresno NAME (CONTRACTOR): SIGNATURE OF GOVERNING BODY OFFICIAL: DATE SIGNED: PRINTED NAME: 5a l O u.vi+e ro Chairman o�-' e r o TITLE: s SnIK D}�- pYes'h e SIGNATURE OF AUTHORIZED AGENCY OFFICIAL: DATE SIGNED: 9--a,.3 ��- TYPED NAME: S'a/ o c uh-ferb O'ce G, aif shah D e D TITLE: rso�s 040 -7%e 6ou�y 4r �n NOTE: SHOULD CIRCUMSTANCES REQUIRE A CHANGE IN THE ABOVE, A NEW SIGNATORY AUTHORIZATION MUST BE COMPLETED AND FORWARDED TO THE COMMISSION.