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HomeMy WebLinkAboutFresno Metropolitan Ministry-Fresno Community Health Improvement Partnership_A-23-047 A-21-539.pdf coU Y Count of Fresno Hall of Records, Room 301 2281 Tulare Street Fresno,California Board of Supervisors 93721-2198 O Telephone:(559)600-3529 -PR E`'� Minute Order Toll Free: 1-800-742-1011 www.co.fresno.ca.us January 24, 2023 Present: 5- Supervisor Steve Brandau,Vice Chairman Nathan Magsig, Supervisor Buddy Mendes, Supervisor Brian Pacheco, and Chairman Sal Quintero Agenda No. 39. Public Health File ID: 22-1273 Re: Approve and authorize the Chairman to execute First Amendment to Agreement with Fresno Metropolitan Ministry to continue the work with Fresno Community Health Improvement Partnership to develop a Community Health Worker Network Hub, effective upon execution to extend the base term by twelve(12)months and continue with the option to extend for an additional two twelve(12)months for a full term of December 14, 2021 to July 31,2026, and increase the total maximum compensation by$2,400,000 to a total of$9,612,976 A MOTION WAS MADE BY SUPERVISOR BRANDAU,SECONDED BY VICE CHAIRMAN MAGSIG, THAT THIS MATTER BE APPROVED AS RECOMMENDED.THE MOTION CARRIED BY THE FOLLOWING VOTE: Ayes: 5- Brandau, Magsig, Mendes, Pacheco, and Quintero Agreement No.23-047 County of Fresno Page 40 co Board Agenda Item 39 O 1$56 O � FRE`'� DATE: January 24, 2023 TO: Board of Supervisors SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health SUBJECT: First Amendment to Agreement with Fresno Metropolitan Ministry RECOMMENDED ACTION(S): Approve and authorize the Chairman to execute First Amendment to Agreement with Fresno Metropolitan Ministry to continue the work with Fresno Community Health Improvement Partnership to develop a Community Health Worker Network Hub,effective upon execution to extend the base term by twelve (12) months and continue with the option to extend for an additional two twelve (12) months for a full term of December 14, 2021 to July 31, 2026, and increase the total maximum compensation by$2,400,000 to a total of$9,612,976. There is no additional Net County Cost associated with the recommended action. The recommended action will allow Fresno Metropolitan Ministry(FMM)to continue their partnership with Fresno Community Health Improvement Partnership (FCHIP)and subcontracted agencies to continue providing essential services to Fresno County residents through the Community Health Worker(CHW) HUB by increasing FMM's budget by$2,400,000, increasing the term of the agreement by a year, and updating the scope of work to reflect changes. All recommended actions are fully funded with existing grant funds. This item is countywide. ALTERNATIVE ACTION(S): Should your Board not approve the recommended action, FCHIP's CHW HUB will be working with a limited time and resources to adequately carry out scope of work activities, which includes COVID-19 recovery interventions and providing substantial capacity building to the CHW network. The CHW HUB infrastructure would be limited to shorter outcomes, with limited time to focus on sustainable approaches that will have longer-lasting impacts beyond the contracted period. FISCAL IMPACT: There is no increase in Net County Cost associated with the recommended action. The maximum compensation of the agreement with FMM will increase by$2,400,000 to$9,612,976 for the term. The agreement is fully funded by federal grant revenue from The Center for Disease Control and Prevention's Initiative to Address COVID-19 Related Health Disparities (Health Disparities), Epidemiology and Laboratory Capacity COVID-19 (ELC), and the Immunization Local Assistance program. Sufficient appropriations and estimated revenues are included in the Department's Org 5620 FY 2022-23 Adopted Budget. DISCUSSION: On December 14, 2021, your board approved agreement No. 21-539 which allowed the County to partner with FMM to allow FMM to act as the fiscal sponsor for FCHIP. This agreement also allowed FCHIP to contract with community-based organizations (CBO)to continue critical COVID-19 response activities as County,of Fresno page 1 File Number:22-1273 File Number.-22-1273 well as develop a CHW Network HUB that would provide service delivery through a nationally recognized evidence-based model. This agreement builds off the successful foundation laid by the COVID Equity Project, where CBOs were contracted through a coalition structure to serve specific populations throughout the county that were disproportionately affected by COVID-19. Through COVID-19 county specific data, the Department was able to identify areas heavily impacted by COVID-19 to deploy community partners and resources to mitigate negative impacts in health burdened areas. From December 14, 2021 through January of 2022, FCHIP was able to renegotiate contracts with twelve of the twenty-one original COVID Equity CBOs either through direct contracts or a coalition structure. These contracts ensured Fresno County residents were still able to receive critical services during the COVID-19 surge months and prevent a gap in services. In February of 2022, FCHIP launched the Fresno HOPE Pathways Community Hub (HOPE HUB)and released a request for applications for 18-month contracts. The contracted period was designed as a three-phase implementation process to allow for a structured timeline to carry out contracted activities,which includes COVID-19 mitigation efforts and provides capacity building to CBO partners. Culminating in a transition during phase three to a fiscally sustainable payment for outcome structure. The payment for outcome structure allows for organizations to be reimbursed based on successfully providing care-coordination services by leveraging the skills of community health workers. The seven subcontracted CBOs are: • Centro La Familia Advocacy Services • The Fresno Center • Fresno Interdenominational Refugee Ministries (FIRM) • Cultiva La Salud • Exceptional Parents Unlimited (EPU) • Fresno Economic Opportunities Commission (EOC), African American Campaign (AAC) • Valley Center for the Blind (VCB) This swift transition of the seven CBOs contracted under the HOPE HUB structure allowed organizations to continue providing direct services during the COVID-19 winter surge months. These services include isolation and quarantine support, vaccination and testing, COVID-19 education and outreach, community linkages and other wrap around services.At the launch of the HOPE HUB, there were some unexpected challenges that were met, which required modifications in order to continue to deliver services in the most impacted areas in the County. Some of these challenges included CBO contracts being fully executed at different intervals, delays with hiring new program HOPE HUB staff due to labor shortages and transitioning into a new evidence-based model. These initial challenges were coupled with an increase in isolation and quarantine support requests due to a surge of COVID-19 positive cases. During this time, the HOPE HUB was able to successfully adjust and continue to deliver these crucial services while actively working on establishing the infrastructure for a more sustainable CHW network approach. The HOPE HUB has been able to reach 25,451 community members through outreach, education, testing, and vaccines events since January 2022. The HUB has also provided wrap around services to over 300 families financially impacted by COVID-19, over 80% of which reside in the most health burdened areas of Fresno County. Phase one of implementation,which concluded in August 2022, served as a capacity building period for the HOPE HUB and contracted partners. The innovative nature of the HUB required organizations to complete extensive training in a standardized and linguistically appropriate manner. CHWs and supervisors completed 300 hours of evidence-based training through the nationally recognized Pathways Community Hub Institute (PCHI). The HOPE HUB and contracted partners also received training in the Care Coordination Systems (CCS)which serves as the integrated data management system that standardizes data tracking and provides invoicing capabilities. Additionally, CBOs were crucial in processing isolation and quarantine support requests for community members by utilizing their expertise and unique approaches when serving specialized populations and offering services in 15 different languages. Other capacity building efforts include the successful launch of a multi-part disability training developed in partnership with Valley Center for the Blind, which is a training focused on disability inclusivity and competencies around County of Fresno Page 2 File Number.22-1273 File Number:22-1273 person-centered care. This multi-part training will also be offered to non-contracted agencies, at a cost, and will support in generating revenue as a sustainable approach. It also enhances the HOPE HUB's capacity to provide technical assistance to other CHW led efforts beyond the contracted period. In September of 2022, the HOPE HUB began phase two of the implementation process. During phase two, CHWs recruit clients through an in-depth enrollment process that includes the completion of a social determinants of health (SDOH)screening tool. Once enrolled, clients begin evidenced based interventions (Pathways)to address their previously determined barriers to health. Pathway completion times vary, depending on individualized needs of the client, and other identified barriers. From September 1, 2022 through December 31, 2022 the HOPE HUB has enrolled 395 clients, conducted 267 SDOH screenings, hosted 190 outreach events, opened 508 pathways, and successfully completed 189 pathways (Attachment A).Also, during phase two, CBOs have been submitting data to support the evidence-based model into CCS, and thus allowing a CBO to observe what level of reimbursement they can earn based on the outcome-based structure. Upon approval and term extension, phase two will also be extended and further evaluated to establish best practices and ensure an uninterrupted transition to phase three. During phase three, the new outcome-based reimbursement will be fully implemented and carried out for the remainder of term of the Agreement. Phase three will also allow for blended funding through outside sources, providing sustainable revenue for the HOPE HUB past the lifetime of the agreement. In addition to providing resources to underserved residents of the County, the HOPE HUB has created job opportunities for over 35 new positions, many of which were filled by individuals that live in the same communities they are serving. The HOPE HUB is also invested in capacity building for local organizations through its offering of a nationally certified CHW certification training, which has already been completed by all CHWs currently employed by the HOPE HUB. Cross sector partnerships have been created through various taskforces and advisory councils including the Community Advisory Council, which has memberships from local hospitals, managed care programs, community foundations, mental health care providers, government agencies, as well as CBOs. To remain sustainable, the HOPE HUB has begun assessing funding opportunities including The California Department of Health Care Services' CHW Benefit, CaIAIM, Kaiser Permanente, Substance Abuse and Mental Health Services Administration, and other local managed care programs or community investment opportunities. Securing additional funding will be pivotal in the HOPE HUB's sustainability after initial federal and state funded grants have expired in 2024. Approval of the recommend action will allow the County to continue to partner with FMM and FCHIP to continue to provide critical services to residents of Fresno County through the HOPE HUB during the COVID-19 recovery phase. With the extension of the ELC and Health Disparities grant funds, the County has an opportunity to continue to support FCHIP in their transition to a fiscally sustainable model by contracting and leveraging with other payors that will provide reimbursement for these services beyond the contracted period. The extension and supplementation of funds will also allow the HOPE HUB to strengthen their infrastructure to serve as a provider of capacity building and technical assistance for the CHW network, extending their reach beyond their contracted partners for a more equitable service delivery to our Fresno County residents. With an extended term, the HOPE HUB will have more time to implement lessons learned, continue with quality improvement in ensuring adherence to the evidence-based model, and address gaps in service delivery, from previous phases that may not be as easily identified and corrected during a shorter term. One example of changes already taking place is the HOPE HUB's review and corrective process to ensure that contracted partners are expending budgeted funds at an appropriate rate. This approach has also served as a capacity building opportunity for CBOs to enhance their fiscal capabilities. Since this practice was implemented, invoices have been more consistent with initial expectations and projections of additional funding. If approved, the recommended action would allow FMM's agreement to be extended for an additional year, increase their budget by$2,400,000, and allow for a reallocation of funds in Personnel, Operating Costs, and Other Costs budget categories. This recommended action will also allow the scope of work to be updated to specify activity descriptions in Exhibit A of the agreement. County of Fresno Page 3 File Number:22-1273 File Number. 22-1273 REFERENCE MATERIAL: BAI #68, December 14, 2021 ATTACHMENTS INCLUDED AND/OR ON FILE: On file with Clerk-Attachment A Phase Two Data On file with Clerk-First Amendment to Agreement with Fresno Metropolitan Ministries CAO ANALYST: Ron Alexander County of Fresno Page 4 File Number:22-1273 Agreement No. 23-047 1 AMENDMENT I TO AGREEMENT 2 THIS FIRST AMENDMENT TO AGREEMENT (hereinafter"Amendment") is made and entered 3 into this 24th day of January 2023, by and between COUNTY OF FRESNO, a Political 4 Subdivision of the State of California, Fresno, California (hereinafter "COUNTY"), and Fresno 5 Metropolitan Ministry, a California Non-Profit Corporation, whose address is 3845 N. Clark St. Suite 6 101, Fresno, California 93726, hereinafter referred to as "CONTRACTOR". 7 WITNESSETH: 8 WHEREAS, COUNTY and CONTRACTOR entered into Agreement number A-21-539, dated 9 the 14th of December 2021 (hereinafter"Agreement"); and 10 WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement in order to 11 extend the term of the Agreement; and 12 WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement in order to 13 increase the total compensation of the Agreement; and 14 WHEREAS COUNTY and CONTRACTOR now desire to amend the Agreement in order to 15 update the Scope of Work of the Agreement. 16 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of 17 which is hereby acknowledged, COUNTY and CONTRACTOR agree as follows: 18 1. Paragraph Three (3)—TERM, of the Agreement, on Page Three (3), Line Six (6) and ending on 19 Page Three (3), Line Eleven (11) with the word "performance" shall be deleted in its entirety and 20 replaced with the following: 21 "3. TERM 22 The term of this Agreement shall commence upon execution and be for a period 23 through and including July 31, 2024. This Agreement may be extended for two (2) additional 24 consecutive twelve (12) month periods upon written approval of both parties no later than the last day 25 of the current term. The Director or his or her designee is authorized to execute such written approval 26 on behalf of COUNTY based on CONTRACTOR'S satisfactory performance and availability of funds." 27 2. That all references in Agreement to "Exhibit B" shall be changed to read "Revised Exhibit B". 28 Revised Exhibit B is attached hereto and incorporated herein by this reference. - 1 - 1 3. That Paragraph Four (5)— COMPENSATION/INVOICING, of the Agreement, on Page Four(4), 2 Line Ten (10) and ending on Page Five (5), Line Eighteen (18) with the word "amount" shall be deleted 3 in its entirety and replaced with the following: 4 "5. COMPENSATION/INVOICING: 5 A. COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation at 6 the rates as identified in Revised Exhibit B, attached hereto and incorporated herein by this reference. 7 CONTRACTOR shall submit monthly invoices in triplicate by the thirtieth (30th)working day of each 8 month for prior month's services using a template to be provided by COUNTY with full appropriate 9 supporting documentation (e.g., activity logs, receipts, invoices) to the County of Fresno, Department 10 of Public Health, HPW-Health Disparities Program, Attention: HPW-Health Disparities 11 Program Staff Analyst at DPHBOAP@fresnocountyca.gov or addressed to the County of Fresno, 12 Department of Public Health, HPW-Health Disparities Program, P.O. Box 11867, Fresno, CA 93775, 13 Attention: HPW-Health Disparities Program Staff Analyst. 14 B. In no event shall services performed under this Agreement by CONTRACTOR be in 15 excess of Nine Million Six Hundred Twelve Thousand Nine Hundred Seventy-Six and No/100 Dollars 16 ($9,612,976) during the term of this Agreement. It is understood that all expenses incidental to 17 CONTRACTOR'S performance of services under this Agreement shall be borne by CONTRACTOR. 18 C. CONTRACTOR may request an advance payment of up to 25% of the maximum 19 compensation. CONTRACTOR shall reconcile the advance payment with full, appropriate supporting 20 documentation for all expenses incurred. The Director of his or her designee may make a 21 determination of an appropriate date of reconciling the main advance payment funds. 22 D. Notwithstanding the above, payments made by COUNTY shall be in arrears, for 23 services provided during the preceding month, within forty-five (45) days after receipt and verification 24 of CONTRACTOR's invoices by COUNTY's Department of Public Health. Invoice verification shall 25 consist of: review of supporting documentation for all expenditures, which may include but not limited 26 to timesheets, receipts, mileage records, quarantine support records, and subcontractor invoices 27 including all like supporting documentation; documentation is compliant with Section 12 of this 28 Agreement; line item totals detail in Revised Exhibit B attached hereto have not been over-expended; - 2 - 1 indirect costs have been correctly calculated; and the required invoice template has been submitted. 2 E. CONTRACTOR shall submit quarterly qualitative reports on a template to be 3 provided by COUNTY in accordance with the scope of work attached hereto as Revised Exhibit A. 4 CONTRACTOR shall submit quarterly reports by the thirtieth (30th) working day following the three 5 month's services. 6 F. CONTRACTOR shall submit monthly quantitative reports with key metrics (e.g., 7 number of people receiving education and outreach, number of vaccine/testing events supported, 8 number of vaccine/testing events hosted) using the REDCap database or a system agreed by the 9 COUNTY no later than receipt of the monthly invoice. COUNTY shall withhold ten percent (10%) of the 10 CONTRACTOR's invoiced amount when monthly metric reports are not completed. 11 CONTRACTOR's monthly invoice shall demonstrate a ten percent (10%) withholding from 12 subcontractors when monthly metric reports are not completed by the subcontractors or 13 CONTRACTOR. COUNTY will assess each invoice and determine if the ten percent (10%)withholding 14 will be applied to subcontractor level costs and/or to CONTRACTOR's total invoiced amount. Upon 15 completion of the monthly report, COUNTY shall pay CONTRACTOR the withheld amount." 16 4. That all references in Agreement to "Exhibit A" shall be changed to read "Revised Exhibit A". 17 Revised Exhibit A is attached hereto and incorporated herein by this reference. 18 COUNTY and CONTRACTOR agree that this First Amendment is sufficient to amend the 19 Agreement, and that upon execution of this First Amendment, the Agreement and this First 20 Amendment together shall be considered the Agreement. 21 The parties agree that this First Amendment may be executed by electronic signature as 22 provided in this section. An "electronic signature" means any symbol or process intended by an 23 individual signing this Amendment to represent their signature, including but not limited to (1) a digital 24 signature; (2) a faxed version of an original handwritten signature; or (3) an electronically scanned and 25 transmitted (for example by PDF document) of a handwritten signature. Each electronic signature 26 affixed or attached to this Amendment (1) is deemed equivalent to a valid original handwritten 27 signature of the person signing this Amendment for all purposes, including but not limited to 28 evidentiary proof in any administrative or judicial proceeding, and (2) has the same force and effect as - 3 - 1 the valid original handwritten signature of that person. The provisions of this section satisfy the 2 requirements of Civil Code section 1633.5, subdivision (b), in the Uniform Electronic Transaction Act 3 (Civil Code, Division 3, Part 2, Title 2.5, beginning with section 1633.1). Each party using a digital 4 signature represents that it has undertaken and satisfied the requirements of Government Code 5 section 16.5, subdivision (a), paragraphs (1) through (5), and agrees that each other party may rely 6 upon that representation. This Amendment is not conditioned upon the parties conducting the 7 transactions under it by electronic means and either party may sign this Amendment with an original 8 handwritten signature. 9 The Agreement, as hereby amended, is ratified and continued. All provisions, terms, 10 covenants, conditions, and promises contained in the Agreement and not amended herein shall 11 remain in full force and effect. This Amendment shall become effective upon execution. 12 13 14 15 16 17 18 /// 19 /// 20 /// 21 /// 22 /// 23 /// 24 /// 25 /// 26 /// 27 28 - 4 - ii DocuSign Envelope ID: 1F5202E2-BBEC-44D2-9214-7AE81A1EBC46 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment I as of the day and 2 year first hereinabove written. 3 4 CONTRACTOR COUNTY OFFRESNO Fresno Metropolitan Ministry 5 DocuSipned by:,�J, (Auorize Signature) S I Q iq ero, 7 th C airman-ofithe Board of Supervisors of 8 the County of Fresno Keith Bergthold, Executive Director 9 12/6/2022 1 5:27 PM PST 10 Date 11 12 Mailing Address: ATTEST: 3845 N. Clark Street#101 Bernice E. Seidel 13 Fresno, CA 93726 Clerk of the Board of Supervisors County of Fresno, State of California 14 15 By: Deputy 16 FOR ACCOUNTING USE ONLY: 17 Fund/Subclass: 0001/10000 18 Organization: 56201558, 56201018, 56201019 19 Account: 7295 20 21 22 23 24 25 26 27 28 - 5 - N U_ o moo- tt� .S 96 7 N Di V O N@ O 9 • W 0 0 S�- cod Z ° • N � v�(Y �, p., v • • O � cd i 0�- _ ° O O O 9 U 1) CO N u. CO m ao 06 co ~ U ° to 0 � o � c N CIO ui coo L) G O ° �U= G O N co O cN c O N O-I ,N co U Cll G O m � i ? 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Q _ _ b\ � = b co = _ ± \ § 0 0 2 @ E E § m y E y@ e -c ° Co / ° � 2 M t / CD \ / $ c > ® 2 & k 0 k k ƒ — 2 0 ] b 0 ƒ 3 ( � 7 a § § n a > a § 2 » £ CL E § § & �ƒ Q ¢ y U) : : - % o 3 O @ E o 2 t b , - - - - - @ 2 = Q . ■ E n 2 / � \ f > « ± : : � � «_ � . s . . . . x w � ■ : > CD 0 ¥ m § F E � � k ƒ 2 f Q g t 5 CL co % / k o � = « / 2 \ o k ƒ � f CI- a) CL c y \ ) a >N _ f U) O ® � ' § E _E z § � 2 § E cu � cu= § �k � >, q o c ' = o E \ ¥ O « E E Co \ ) 2 \ o ƒ U § 0 = ULL- m 7 § k ƒ / 3 2 CL 0- U) 00 In d U 3 g U U- U- IL IL q / ■ § - - - - - ® - - - . , . a Revised Exhibit B Fresno HOPE PCH Budget Proposal Date Proposed:October 19,2022 Term:December 15,2021-July 31,2024 Approved Budget Amended Budget Personnel December 15,2021- December 15,2021-July July 31.2023 31.2024 HUB Program Director-1 FTE(17 mo112 mo129 mo) $ 125,615.00 $ 195,419.00 Fiscal and Contracts Management-1 FTE(15 mo/12 mo/27 mo) $ 80,000.00 $ 136,968.00 FCHIP Program Director-.3 FTE(19 months/12 months at.1 FTE/31 mo) $ 39,005.00 $ 39,005.00 FCHIP Manager-.20 FTE(1 mo) $ 2.166.00 $ 2,166.00 FCHIP Marketing Coordinator-.10 FTE(1 mo) $ 1,247.00 $ 796.00 FCHIP Communications Coordinator-FY 22-23 @.20 FTE I FY 23-24 @ $ 12,408.00 $ 14,905.00 .10 FTE (19 mo112 mo/31 mo) HUB Admin-1 FTE(18 mo) $ 59,280.00 $ 90,682.00 Care Coordination HUB Manager -Special Projects-1 FTE (17 mo/12 $ 87,833.00 $ 122,475.00 mo/29 mo) Care Coordination Partner Liaison for 4 CBOs and Quality Assurance/Audit $ 77,917.00 $ 120,960.00 Manager-1 FTE (17 mo) Care Coordination Partner Liaison for 4 CBOs(HUB's Train the Trainer) $ 77,917.00 $ 84,241.00 Training Lead -1 FTE(17 mo) Care Coordination Partner Liaison for 4 CBOs and Referral Lead(17 mo) $ 77,917.00 $ 109,352.00 Personnel Sub-Total $ 641,305.00 $ 916,969.00 Fringe @ 32% $ 205,218.00 $ 293,431.00 Total Personnel $ 846,523.00 $ 1,210,400.00 Operating Costs Fiscal Sponsor-Fresno Metropolitan Ministry $ 204,200.00 $ 360,200.00 HUB Staff General Expense(office supplies,Adobe subscription,copy, $ 6,451.00 $ 12,904.00 print,etc.) HUB Staff Facilities,Security,utilities,maintenance $ 36,000.00 $ 42,360.00 HUB Staff Workspace Furniture($1 k x 6.5 FTEs-one time expense) $ 6,500.00 $ 6,500.00 HUB Staff Equipment and Software(Laptops and MS Word Suite($2.2K x $ 14,300.00 $ 14,300.00 6.5-one time expense) HUB Staff Communications-Cell Phone Stipends,Internet,Mailchimp, $ 19,225.00 $ 18,026.00 Survey Monkey Meetings-Zoom subscription,Equipment-Conference Camera for hybrid $ 5,600.00 $ 11,100.00 meetings,materials,community resident stipends,refreshments for meetings. HUB Staff Travel"(mileage reimbursement for local travel @.625/mile @ $ 5,000.00 $ 15,039.00 $333.33/mo x 15 mo/12 mo127 mo) IT/Reflective Practice Support for 25 CHWs and HUB Staff $ 28.500.00 $ 28,500.00 Total Operating $ 325,776.00 $ 508,929.00 Direct Costs $ 1,172,299.00 $ 1,719,329.00 Indirect Costs @ $ Total Direct and Indirect $ 1,172,299.00 $ 1,719,329.00 Other Costs(not included in indirect) Subcontracts $ 5,334,900.00 $ 6,739,767.00 Consultants(Legal Counsel,Supplemental Training,Bilingual Trainer,and $ 61,000.00 $ 66,280.00 other consultant as needed) Isolation Quarantine Support(IQS) $ 528,100.00 $ 920,623.00 Consultant-HUB Technical Assistance Contractor-Pathways Community $ 60,000.00 $ 80,000.00 HUB Institute and Certification Fees Marketing Services- build a website,logo,and branding for Fresno HOPE $ 14,000.00 $ 14,000.00 PCH Consultant-data tracking and reporting $ 30,300.00 $ 60.600.00 Consultant-translation services $ 12,377.00 $ 12,377.00 Other Costs Subtotal $ 6,040,677.00 $ 7,893,647.00 Grand Total $ 7,212,976.00 $ 9,612,976.00 am O Z 02 C uO 'O O O O p 0 - 0- = V u 0o E N O a� >+ °' w bO V C tA Ul O C - p Q O _0 V U UO a _U) C. 4-P `a G. 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