HomeMy WebLinkAboutAgreement A-17-398 with University of the Pacific School of Dentistry.pdf Agreement No. 17-398
1 AGREEMENT
2 THIS AGREEMENT is made and entered into this 11th day of July , 2017,
3 by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California,
4 hereinafter referred to as "COUNTY", and UNIVERSITY OF THE PACIFIC—ARTHUR A.
5 DUGONI SCHOOL OF DENTISTRY, a University, whose address is 155 51h Street, San Francisco,
6 California, 94103, hereinafter referred to as "CONTRACTOR".
7 WITNESSETH:
8 WHEREAS, COUNTY, through its Department of Public Health, requires qualified instructors
9 to provide training, consultation, and technical assistance services regarding the operation of Virtual
10 Dental Homes to its contracted dentists participating in Fresno County's Local Dental Pilot Project
11 (LDPP); and
12 WHEREAS, CONTRACTOR, has the experience, personnel and capacity to perform such
13 services; and
14 WHEREAS, CONTRACTOR, is qualified and is willing to provide such services,pursuant to
15 the terms and conditions of this Agreement.
16 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
17 hereto agree as follows:
18 1. Services
19 A. CONTRACTOR shall perform all services and fulfill all responsibilities
20 identified in Exhibit A, Scope of Work, and Exhibit D, California State Department of Health Care
21 Services approved LDPP proposal, both attached hereto and by this reference incorporated herein.
22 B. CONTRACTOR warrants that it possesses all licenses and certificates required
23 by local, State of California, and/or Federal laws and regulations for the conduct of its business and
24 shall operate its business in accordance with all applicable laws and regulations. CONTRACTOR
25 further warrants that all of its personnel performing services under this Agreement shall be licensed
26 and certified where required, to lawfully perform their duties and shall maintain such licensure and
27 certifications throughout the term of this Agreement.
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1 C. CONTRACTOR shall maintain copies of all licenses and certifications noted
2 above and shall allow COUNTY DPH staff to review the documents upon request.
3 2. TERM
4 This Agreement shall become effective on the 1 st day of July, 2017 and shall terminate
5 on the 31 st day of December, 2020.
6 3. TERMINATION
7 A. Non-Allocation of Funds - The terms of this Agreement, and the services to be
8 provided thereunder, are contingent on the approval of funds by the appropriating government agency.
9 Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
10 terminated at any time by giving CONTRACTOR thirty(30) days advance written notice. Should
11 sufficient funds not be allocated, this Agreement may also be terminated by CONTRACTOR at any
12 time by giving COUNTY thirty(30) days advance written notice.
13 B. Breach of Contract - COUNTY may immediately suspend or terminate this
14 Agreement in whole or in part, where in the determination of COUNTY there is:
15 1) An illegal or improper use of funds;
16 2) A failure to comply with any term of this Agreement;
17 3) A substantially incorrect or incomplete report submitted to COUNTY;
18 4) Improperly performed service.
19 In no event shall any payment by COUNTY constitute a waiver by COUNTY of any
20 breach of this Agreement or any default which may then exist on the part of CONTRACTOR. Neither
21 shall such payment impair or prejudice any remedy available to COUNTY with respect to the breach
22 or default. COUNTY shall have the right to demand of CONTRACTOR the repayment to COUNTY
23 of any funds disbursed to CONTRACTOR under this Agreement, which in the judgment of COUNTY
24 were not expended in accordance with the terms of this Agreement. CONTRACTOR shall promptly
25 refund any such funds upon demand or, at COUNTY's option, such repayment shall be deducted from
26 future payments owing to CONTRACTOR under this Agreement.
27 C. Without Cause -Under circumstances other than those set forth above, this
28 Agreement may be terminated by COUNTY upon the giving of thirty(30) days advance written notice
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1 of an intention to terminate to CONTRACTOR.
2 4. COMPENSATION
3 For training, consultation, and technical assistance services regarding the operation of
4 Virtual Dental Homes COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to
5 receive compensation based upon the budgeted amounts in Exhibit B. In no event shall actual services
6 performed under this Agreement be in excess of Ninety-Six Thousand,Nine Hundred Five and
7 No/100 Dollars ($96,905) during the period of July 1, 2017 through December 31, 2017; One Hundred
8 Nineteen Thousand, Two Hundred Thirty-Two and No/100 Dollars ($119,232) during the period of
9 January 1, 2018 through December 31, 2018; Sixty-Five Thousand, Seven Hundred Eighty-Seven and
10 No/100 ($65,787) during the period of January 1, 2019 through December 31, 2019; and Fifty
11 Thousand, Seven Hundred Two and No/100 Dollars ($50,702) during the period of January 1, 2020
12 through December 31, 2020. It is understood that all expenses incidental to CONTRACTOR's
13 performance of actual services under this Agreement shall be borne by CONTRACTOR.
14 Payments by COUNTY shall be in arrears, for services provided during the preceding
15 month, within forty-five (45) days after receipt and verification of CONTRACTOR's invoices by
16 COUNTY's Department of Public Health. If CONTRACTOR should fail to comply with any
17 provision of this Agreement, COUNTY shall be relieved of its obligation for further compensation.
18 5. INVOICING
19 CONTRACTOR shall invoice COUNTY monthly addressed to the County of Fresno,
20 Department of Public Health, California Children's Services, P.O. Box. 11867, Fresno, CA 93775,
21 Attention: Supervising Account Clerk. Invoices shall detail line items as specified in Exhibit B,
22 including original budget amount(s), current month's expenses, year-to-date expenses, and budget
23 balances. In addition, invoices shall also include all relevant supporting documentation including but
24 not limited to copies of original statements,program expense receipts, payroll records and mileage
25 claims.
26 6. INDEPENDENT CONTRACTOR
27 In performance of the work, duties, and obligations assumed by CONTRACTOR under
28 this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of
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1 CONTRACTOR's officers, agents, and employees will at all times be acting and performing as an
2 independent contractor, and shall act in an independent capacity and not as an officer, agent, servant,
3 employee,joint venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have
4 no right to control or supervise or direct the manner or method by which CONTRACTOR shall
5 perform its work and function. However, COUNTY shall retain the right to administer this
6 Agreement so as to verify that CONTRACTOR is performing its obligations in accordance with the
7 terms and conditions thereof. CONTRACTOR and COUNTY shall comply with all applicable
8 provisions of law and the rules and regulations, if any, of governmental authorities having jurisdiction
9 over matters which are directly or indirectly the subject of this Agreement.
10 Because of its status as an independent contractor, CONTRACTOR shall have
11 absolutely no right to employment rights and benefits available to COUNTY employees.
12 CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its employees
13 all legally-required employee benefits. In addition, CONTRACTOR shall be solely responsible and
14 save COUNTY harmless from all matters relating to payment of CONTRACTOR's employees,
15 including compliance with Social Security,withholding, and all other regulations governing such
16 matters. It is acknowledged that during the term of this Agreement, CONTRACTOR may be
17 providing services to others unrelated to the COUNTY or to this Agreement.
18 7. MODIFICATION
19 Any matters of this Agreement may be modified from time to time by the written
20 consent of all the parties without, in any way, affecting the remainder. Notwithstanding the above,
21 changes to line items in the budget, attached hereto as Exhibit B, that do not exceed ten percent(10%)
22 of the maximum compensation payable to the CONTRACTOR may be made with written approval of
23 COUNTY's Department of Public Health Director, or designee, and the designee of DHCS.
24 8. NON-ASSIGNMENT
25 Neither party shall assign, transfer or subcontract this Agreement nor their rights or
26 duties under this Agreement without the prior written consent of the other party.
27 9. HOLD-HARMLESS
28 CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request,
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1 defend the COUNTY, its officers, agents and employees from any and all costs and expenses,
2 including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to
3 COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers,
4 agents or employees under this Agreement, and from any and all costs and expenses, including
5 attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to any
6 person, firm or corporation who may be injured or damaged by the performance, or failure to perform,
7 of CONTRACTOR, its officers, agents or employees under this Agreement.
8 COUNTY agrees to indemnify, save, hold harmless, and at CONTRACTOR's request,
9 defend the CONTRACTOR, its officers, agents and employees from any and all costs and expenses,
10 including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to
11 CONTRACTOR in connection with the performance, or failure to perform,by COUNTY, its officers,
12 agents or employees under this Agreement, and from any and all costs and expenses, including
13 attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to any
14 person, firm or corporation who may be injured or damaged by the performance, or failure to perform,
15 of COUNTY, its officers, agents or employees under this Agreement.
16 10. INSURANCE
17 Without limiting the COUNTY's right to obtain indemnification from CONTRACTOR
18 or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect the
19 following insurance policies throughout the term of this Agreement:
20 A. Commercial General Liability
21 Commercial General Liability Insurance with limits of not less than One Million
22 Dollars ($1,000,000)per occurrence and an annual aggregate of Two Million
Dollars ($2,000,000). This policy shall be issued on a per occurrence basis.
23 COUNTY may require specific coverage including completed operations,
product liability, contractual liability, Explosion, Collapse, and Underground
24 (XCU), fire legal liability or any other liability insurance deemed necessary
25 because of the nature of the Agreement.
26 B. Automobile Liability
27 Comprehensive Automobile Liability Insurance with limits for bodily injury of
not less than Two Hundred Fifty Thousand Dollars ($250,000)per person, Five
28 Hundred Thousand Dollars ($500,000)per accident and for property damages of
not less than Fifty Thousand Dollars ($50,000), or such coverage with a
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1 combined single limit of Five Hundred Thousand Dollars ($500,000). Coverage
should include owned and non-owned vehicles used in connection with this
2 Agreement.
3
C. Professional Liability
4
If CONTRACTOR employs licensed professional staff(e.g. Ph.D., R.N.,
5 L.C.S.W., M.F.C.C.) in providing services, Professional Liability Insurance with
6 limits of not less than One Million Dollars ($1,000,000)per occurrence, Three
Million Dollars ($3,000,000) annual aggregate.
7
D. Worker's Compensation
8
A policy of Worker's Compensation Insurance as may be required by the
9 California Labor Code.
10
CONTRACTOR shall obtain endorsements to the Commercial General Liability
11
insurance naming the County of Fresno, its officers, agents, and employees, individually and
12
collectively, as additional insured, but only insofar as the operations under this Agreement are
13
concerned. Such coverage for additional insured shall apply as primary insurance and any other
14
insurance, or self-insurance, maintained by the COUNTY, its officers, agents and employees shall be
15
excess only and not contributing with insurance provided under the CONTRACTOR's policies herein.
16
This insurance shall not be cancelled or changed without a minimum of thirty(30) days advance
17
written notice given to COUNTY.
18
Within thirty(30) days from the date CONTRACTOR executes this Agreement,
19
CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of the
20
foregoing policies, as required herein, to the County of Fresno, Department of Public Health, P.O. Box
21
11867, Fresno, California, 93775, Attention: Contracts Section—6th Floor, stating that such insurance
22
coverage have been obtained and are in full force; that the County of Fresno, its officers, agents and
23
employees will not be responsible for any premiums on the policies; that such Commercial General
24
Liability insurance names the County of Fresno, its officers, agents and employees, individually and
25
collectively, as additional insured, but only insofar as the operations under this Agreement are
26
concerned; that such coverage for additional insured shall apply as primary insurance and any other
27
insurance, or self-insurance, maintained by the COUNTY, its officers, agents and employees, shall be
28
excess only and not contributing with insurance provided under the CONTRACTOR's policies herein;
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1 and that this insurance shall not be cancelled or changed without a minimum of thirty(30) days
2 advance, written notice given to COUNTY.
3 In the event CONTRACTOR fails to keep in effect at all times insurance coverage as
4 herein provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate
5 this Agreement upon the occurrence of such event.
6 All policies shall be with admitted insurers licensed to do business in the State of
7 California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating
8 of A FSC VII or better.
9 11. CONFIDENTIALITY
10 All services performed by CONTRACTOR under this Agreement shall be in strict
11 conformance with all applicable Federal, State of California and/or local laws and regulations relating
12 to confidentiality.
13 12. NON-DISCRIMINATION
14 During the performance of this Agreement, CONTRACTOR shall not unlawfully
15 discriminate against any employee or applicant for employment, or recipient of services,because of
16 race, religious creed, color,national origin, ancestry,physical disability, mental disability, medical
17 condition, genetic information, marital status, sex, gender, gender identity, gender expression, age,
18 sexual orientation, or military or veteran status pursuant to all applicable State of California and
19 Federal statutes and regulations.
20 13. DISCLOSURE OF SELF-DEALING TRANSACTIONS
21 This provision is only applicable if the CONTRACTOR is operating as a corporation (a
22 for-profit or non-profit corporation) or if during the term of this Agreement, the CONTRACTOR
23 changes its status to operate as a corporation.
24 Members of the CONTRACTOR's Board of Directors shall disclose any self-dealing
25 transactions that they are a party to while CONTRACTOR is providing goods or performing services
26 under this agreement. A self-dealing transaction shall mean a transaction to which the
27 CONTRACTOR is a party and in which one or more of its directors has a material financial interest.
28 Members of the Board of Directors shall disclose any self-dealing transactions that they are a party to
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1 by completing and signing a Self-Dealing Transaction Disclosure Form, attached hereto as Exhibit C
2 and incorporated herein by reference, and submitting it to the COUNTY prior to commencing with the
3 self-dealing transaction or immediately thereafter.
4 14. AUDITS AND INSPECTIONS
5 CONTRACTOR shall at any time during business hours, and as often as the COUNTY
6 may deem necessary, make available to the COUNTY for examination all of its records and data with
7 respect to the matters covered by this Agreement. CONTRACTOR shall,upon request by the
8 COUNTY,permit the COUNTY to audit and inspect all such records and data necessary to ensure
9 CONTRACTOR's compliance with the terms of this Agreement.
10 If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00),
11 CONTRACTOR shall be subject to the examination and audit of the State Auditor for a period of
12 three (3) years after final payment under contract (Government Code Section 8546.7).
13 CONTRACTOR agrees to maintain and preserve, until three (3) years after termination of this
14 Agreement and final payment from DHCS to the COUNTY, to permit DHCS or any duly authorized
15 representative, to have access to, examine or audit any pertinent books, documents, papers and records
16 related to this Agreement and to allow interviews of any employees who might reasonably have
17 information related to such records.
18 15. NOTICES
19 The persons and their addresses having authority to give and receive notices under this
20 Agreement include the following:
21 COUNTY CONTRACTOR
22 Director, County of Fresno Director,
Department of Public Health Pacific Center for Special Care
2 3 P.O. Box 11867 155 51h Street
24 Fresno, CA 93775 San Francisco, CA 94103
25 Any and all notices between the COUNTY and the CONTRACTOR provided for or
26 permitted under this Agreement or by law shall be in writing and shall be deemed duly served when
27 personally delivered to one of the parties, or in lieu of such personal service,when deposited in the
28 United States Mail,postage prepaid, addressed to such party.
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1 16. GOVERNING LAW
2 The parties agree, that for the purposes of venue, performance under this Agreement is
3 to be in Fresno County, California.
4 The rights and obligations of the parties and all interpretation and performance of this
5 Agreement shall be governed in all respects by the laws of the State of California.
6 17. SEVERABILITY
7 The provisions of this Agreement are severable. The invalidity or unenforceability of
8 any one provision in the Agreement shall not affect the other provisions.
9 18. ENTIRE AGREEMENT
10 This Agreement, including all exhibits, constitutes the entire agreement between the
11 CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes all previous
12 Agreement negotiations,proposals, commitments,writings, advertisements, publications, and
13 understanding of any nature whatsoever unless expressly included in this Agreement.
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1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
2 year first hereinabove written.
3
4 CONTRACTOR: COUNTY OF FRESNO:
5 UNIVERSITY OF THE PACIFIC
ARTHUR A. DUGONI
6 SCHOOL OF DE TISTRY
7 B By
��
8 Brian Pacheco
Chairman, Board of Supervisors
9 Print Name: James Uchizono, PharmD, Ph.D
10 Title: Associate Provost of Research Date: 11 1
11 Chairman of the Board, or
President, or any Vice President
12
Date: BERNICE E. SEIDEL, Clerk
13 Board of Supervisors
14
By
15
Print Name: By
16
17 Title: Date: ` t t
Sec/Astant
orporation), or
18 anyecretary, or
19 Chi Officer, or
anyreasurer
20
Date: PLEASE SEE ADDITIONAL
21 SIGNATURE PAGE ATTACHED
22
23
24
25 Mailing Address:
155 5"' Street
26 San Francisco, CA 94103
Phone#: (415) 929-6490
27 Contact: Dr. Paul Glassman
28
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I
2 APPROVED AS 'rO LEGAL FORM:
DANIEL C.CEDERBORG, COUNTY COUNSEL
3
APPROVED AS TO ACCOUNTING FORM:
OSCAR J. GARCIA, C.P.A., AUDITOR-CONTROLLER/
TREASURER-TAX COLLECTOR
9
10 By Cwd
11
2 REVIEWED AND RECOMMENDED FOR APPROVAL:
11
By PnAJ Ll
David Pomavil e
Director
Department of Public I lealth
is
19
20
21 Fund/Subclass: 0001/10000
??
Organization: 56201602 ($332,626)
Account #: 7295
24
16
27
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11 — COLINI'Y'OIL I;RP N(
I"resm, ( \
Exhibit A
Page 1 of 2
Scope of Work
ORGANIZATION: University of the Pacific -Arthur A. Dugoni School of Dentistry
ADDRESS: 155 5th Street, San Francisco, California, 94103
CONTACT: Dr. Paul Glassman, (415) 929-6490
SERVICES: Virtual Dental Home Training, Consultation, and Technical Assistance
CONTRACT PERIOD July 1, 2017 through December 31, 2017 ($96,905)
AND AMOUNTS: January 1, 2018 through December 31, 2018 ($119,232)
January 1, 2019 through December 31, 2019 ($65,787)
January 1, 2020 through December 31, 2020 ($50,702)
SUMMARY OF SERVICES
The University of the Pacific - Arthur A. Dugoni School of Dentistry (UOP) shall be responsible for
providing training, consultation, and technical assistance to the dentists participating in the Fresno
County Local Dental Pilot Project's (LDPP) Virtual Dental Homes (VDH) and other involved
agencies.
CONTRACTOR RESPONSIBILITIES
UOP shall provide training, consultation, and technical assistance needed to conduct the
Department's LDPP. The following list is meant to serve as samples of the duties and
responsibilities to be performed by UOP and is neither inclusive nor exclusive, but indicative of
several general types of duties to be performed.
UOP shall provide the following services:
1. Staff Recruitment/Reallocation
• Project Director:
UOP shall perform the duties required to recruit and hire, or reallocate, a Project
Director that will be responsible for overseeing and coordinating all activities with
collaborative partners and stakeholders while providing direct and indirect
supervision of project design, implementation, contract compliance, quality
assurance, budget adherence and program outcomes.
• Director of Operations:
UOP shall perform the duties required to recruit and hire, or reallocate, a Director
of Operations that will be responsible for overseeing all communications and
implementation with providers and sites.
• Program Managers:
UOP shall perform the duties required to recruit and hire, or reallocate, two (2)
Program Managers that will be responsible for scheduling and tracking
deliverables, reporting, training, and monitoring activities.
Exhibit A
Page 2 of 2
• Program Content Expert:
UOP shall perform the duties required to recruit and hire, or reallocate, a
Program Content Expert that will be responsible for providing expert
consultation on scientific, dental practice, and operational workflow integration.
• Contracts Manager:
UOP shall perform the duties required to recruit and hire, or reallocate, a
Contracts Manager that will be responsible for contract, expenses, and reporting
systems.
2. Miscellaneous
• Creating VDH System Structure
• Coordinating Training Needs of Providers and Community Organizations
• Coordinating Activates with Involved Agencies
• Assessing and Assisting in Agreements/MOUs
• Planning and Developing VDH Data Collection
• Developing Operation Protocols and Customized Documentation
• Assisting with Economic Analysis and Forecasting of ROI for Providers
• Facilitating Group Learning (Meetings, Webinars, Conference Calls, etc.)
PERFORMANCE MEASUREMENTS
The above mentioned staff shall perform the duties necessary to provide training hours to the
dentists participating in the Fresno County LDPP Virtual Dental Homes in the amounts depicted
below. These hours are based on the projected amount of two participating dentists.
020
Training Hours 534 454 124 58
Exhibit B
Page 1 of 5
BUDGET SUMMARY
CY 2017-2020
Page 1 of 1
ORGANIZATION: University of the Pacific-Arthur A. Dugoni School of Dentistry
SERVICES: Virtual Dental Home Training, Consultation, and Technical Assistance
CONTRACT PERIOD: July 1, 2017 through December 31, 2020
CONTRACT AMOUNT: $332,626
BUDGET CATEGORIES 2017 2018 2019 2020
SALARIES& BENEFITS
Salaries $ 55,757 $ 68,672 $ 35,177 $ 25,200
Fringe Benefits $ 17,396 $ 21,426 $ 10,975 $ 7,862
$ 73,153 $ 90,098 $ 46,152 $ 33,062
OPERATING EXPENSES
Training/Meeting Expenses $ 4,200 $ 4,200 $ 4,200 $ 4,200
$ 4,200 $ 4,200 $ 4,200 $ 4,200
Travel
Mileage $ 8,400 $ 11,200 $ 8,400 $ 8,400
$ 8,400 $ 11,200 $ 8,400 $ 8,400
Indirect Costs
Indirect Costs $ 11,151 $ 13,734 $ 7,035 $ 5,040
$ 11,151 $ 13,734 $ 7,035 $ 5,040
TOTAL $ 96,905 $ 119,232 $ 65,787 $ 50,702
Exhibit B
Page 2 of 5
BUDGET DETAIL
JULY 1, 2017- DECEMBER 31, 2017
Page 1 of 1
ORGANIZATION: University of the Pacific-Arthur A. Dugoni School of Dentistry
SERVICES: Virtual Dental Home Training, Consultation, and Technical Assistance
CONTRACT PERIOD: July 1, 2017 through December 31, 2017
CONTRACT AMOUNT: $96,904
SALRIES& BENEFITS
Position/Title No. of FTE Total Cost
Positions
Project Director 1 0.02 $ 5,576
Director of Operations 1 0.06 $ 5,576
Program Managers 2 0.16 $ 27,878
Program Content Expert 1 0.07 $ 8,363
Contracts Manager 1 0.03 $ 2,788
Assistant Project Manager 1 0.07 $ 5,576
Total Salary $ 55,757
Fringe Benefits (31.2%) $ 17,396
Total Personnel $ 73,153
OPERATING EXPENSES
Training/Meeting Expenses $ 4,200
(Development of training materials, supplies, etc.)
Total Operating Expenses $ 4,200
Travel
Mileage $ 8,400
(Gas Milage Reimbursement at Standard CaIHR Rate Only)
Total Travel Expense $ 8,400
Indirect Costs
Indirect Costs $ 11,151
(20% of Personnel Cost)
Total Indirect Costs $ 11,151
Total Costs for Contract Term July 1, 2017 through December 31, 2017 $ 96,904
Exhibit B
Page 3 of 5
BUDGET DETAIL
JANUARY 1, 2018- DECEMBER 31, 2018
Page 1 of 1
ORGANIZATION: University of the Pacific-Arthur A. Dugoni School of Dentistry
SERVICES: Virtual Dental Home Training, Consultation, and Technical Assistance
CONTRACT PERIOD: January 1, 2018 through December 31, 2018
CONTRACT AMOUNT: $119,232
SALRIES& BENEFITS
Position/Title No. of FTE Total Cost
Positions
Project Director 1 0.04 $ 6,867
Director of Operations 1 0.11 $ 6,867
Program Managers 2 0.29 $ 34,336
Program Content Expert 1 0.12 $ 10,301
Contracts Manager 1 0.06 $ 3,434
Assistant Project Manager 1 0.12 $ 6,867
Total Salary $ 68,672
Fringe Benefits (31.2%) $ 21,426
Total Personnel $ 90,098
OPERATING EXPENSES
Training/Meeting Expenses $ 4,200
(Development of training materials, supplies, etc.)
Total Operating Expenses $ 4,200
Travel
Mileage $ 11,200
(Gas Milage Reimbursement at Standard CaIHR Rate Only)
Total Travel Expense $ 11,200
Indirect Costs
Indirect Costs $ 13,734
(20% of Personnel Cost)
Total Indirect Costs $ 13,734
Total Costs for Contract Term January 1, 2018 through December 31, 2018 $ 119,232
Exhibit B
Page 4 of 5
BUDGET DETAIL
JANUARY 1,2019- DECEMBER 31, 2019
Page 1 of 1
ORGANIZATION: University of the Pacific-Arthur A. Dugoni School of Dentistry
SERVICES: Virtual Dental Home Training, Consultation, and Technical Assistance
CONTRACT PERIOD: January 1, 2019 through December 31, 2019
CONTRACT AMOUNT: $65,787
SALRIES& BENEFITS
Position/Title No. of FTE Total Cost
Positions
Project Director 1 0.02 $ 3,518
Director of Operations 1 0.06 $ 3,518
Program Managers 2 0.15 $ 17,588
Program Content Expert 1 0.06 $ 5,276
Contracts Manager 1 0.03 $ 1,759
Assistant Project Manager 1 0.06 $ 3,518
Total Salary $ 35,177
Fringe Benefits (31.2%) $ 10,975
Total Personnel $ 46,152
OPERATING EXPENSES
Training/Meeting Expenses $ 4,200
(Development of training materials, supplies, etc.)
Total Operating Expenses $ 4,200
Travel
Mileage $ 8,400
(Gas Milage Reimbursement at Standard CaIHR Rate Only)
Total Travel Expense $ 8,400
Indirect Costs
Indirect Costs $ 7,035
(20% of Personnel Cost)
Total Indirect Costs $ 7,035
Total Costs for Contract Term January 1, 2019 through December 31, 2019 $ 65,787
Exhibit B
Page 5 of 5
BUDGET DETAIL
JANUARY 1,2020- DECEMBER 31, 2020
Page 1 of 1
ORGANIZATION: University of the Pacific-Arthur A. Dugoni School of Dentistry
SERVICES: Virtual Dental Home Training, Consultation, and Technical Assistance
CONTRACT PERIOD: January 1, 2020 through December 31, 2020
CONTRACT AMOUNT: $50,702
SALRIES& BENEFITS
Position/Title Account No. of FTE Total Cost
Number Positions
Project Director 1 0.02 $ 2,520
Director of Operations 1 0.04 $ 2,520
Program Managers 2 0.11 $ 12,600
Program Content Expert 1 0.04 $ 3,780
Contracts Manager 1 0.02 $ 1,260
Assistant Project Manager 1 0.05 $ 2,520
Total Salary $ 25,200
Fringe Benefits (31.2%) $ 7,862
Total Personnel $ 33,062
OPERATING EXPENSES
Training/Meeting Expenses $ 4,200
(Development of training materials, supplies, etc.)
Total Operating Expenses $ 4,200
Travel
Mileage $ 8,400
(Gas Milage Reimbursement at Standard CaIHR Rate Only)
Total Travel Expense $ 8,400
Indirect Costs
Indirect Costs $ 5,040
(20% of Personnel Cost)
Total Indirect Costs $ 5,040
Total Costs for Contract Term January 1, 2020 through December 31, 2020 $ 50,702
Exhibit C
SELF-DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as "County"), members
of a contractor's board of directors (hereinafter referred to as "County Contractor"), must disclose any
self-dealing transactions that they are a party to while providing goods, performing services, or both
for the County. A self-dealing transaction is defined below:
"A self-dealing transaction means a transaction to which the corporation is a party and in which one
or more of its directors has a material financial interest."
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1) Enter board member's name,job title (if applicable), and date this disclosure is being made.
(2) Enter the board member's company/agency name and address.
(3) Describe in detail the nature of the self-dealing transaction that is being disclosed to the
County. At a minimum, include a description of the following:
a. The name of the agency/company with which the Corporation has the transaction;
and
b. The nature of the material financial interest in the Corporation's transaction that the
board member has.
(4) Describe in detail why the self-dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5) Form must be signed by the board member that is involved in the self-dealing transaction
described in Sections (3) and (4).
Page l of 2
Exhibit C
(1)Company Board Member Information:
Name: Date:
Job Title:
(2)Company/Agency Name and Address:
(3)Disclosure(Please describe the nature of the self-dealing transaction you are a party to):
(4)Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233(a):
(5)Authorized Signature
Signature: Date:
Page 2 of 2
Exhibit D
Medi-Cal 2020 Waiver,
Dental Transformation Initiative
County of Fresno ,— Department of Public Health
Local Dental Pilot Project
TABLE OF CONTENTS
Section Page
1. LDPP Lead Entity and Participating Entity Information
1.1 3
1.2 5
1.3 7
1.4 7
2. General Information and Target Population 11
3. Services, Interventions, Care Coordination and Data sharing
3.1 15
3.2 19
3.3 27
3.4 28
4. Progress Reports and Ongoing Monitoring
4.1 29
4.2 36
5. Financing
5.1 37
5.2 38
5.3 38
6. Attestation and Certification 40
7. Exhibit B Budget
APPENDICES
1. Letters of Support / Participation
LDPP County of Fresno Page 2
Section 1: LDPP Lead Entity and Participating Entity Information
EXECUTIVE SUMMARY
1.1
The DHCS California 1115 Waiver, Dental Transformation Initiative
The California Department of Health Care Services (DHCS) has announced the Center for
Medicare and Medicaid Services (CMS) approved 1115 Waiver renewal titled the "California Medi-
Cal 2020 Demonstration." The demonstration includes $750 million in funding for a Dental
Transformation Initiative (DTI). The DTI is divided into four (4) "domains." Domain 1, to increase
dental preventive services utilization for children; Domain 2, increase caries risk assessment and
disease management, Domain 3, increase continuity of care among Medi-Cal children. The first
three domains will take place in counties to be designated by DHCS and payments will go directly
to dentists in those counties based on performance measures. DHCS for the fourth domain, called
the "Local Dental Pilot Projects" (LDPPs) will accept applications for innovative approaches to
achieving the overall DTI goals.
The County of Fresno Department of Public Health (DPH) is submitting this innovative Dental
Transformation Initiative (DTI) — Local Dental Project Plan (LDPP-Domain 4) proposal and will
serve as the Lead Entity for the Project. The Fresno LDPP project plan will further two of the DTI
goals of 1. Increased preventive services utilization for children; and 3. Increased continuity of
care.
The DPH is prepared and has the experience to fulfill its role as the Lead Entity in the proposed
and innovative program that has been designed to meet the goals of the DTI. The proposed LDPP
for the Fresno County area, referred to in this proposal as the Fresno-LDPP, will add interventions
to increase oral health education and preventive and treatment participation. The goals, outcomes
and performance metrics included in the Fresno LDPP are consistent with and build upon the
performance metrics of the DTI and all possible efforts have been made to avoid redundancy on
approaches taken in Domains 1 and3.
The innovative strategy we are proposing is to test a multidisciplinary outreach collaboration
among diverse providers and health teams with the focus on changing behavior addressing access
to care. Addressing pervasive and persistent disparities in Fresno County this strategy requires
multi-pronged preventive approach including coordinating data in oral health programs, oral health
education, patient engagement, self-management and goal setting guidance all employed
consistently over time in settings that will promote ongoing continuity of care. This strategy is
significantly different than the activities that are currently being utilized in the traditional dental
setting in Fresno County in which for children ages 0-20 yrs 56% of services are restorative while
only 44% of services year to year are preventive. The numbers for 0-5 are darker yet with nearly
80% of children 0-5 enrolled in Medi-Cal and according to California analysis less than 25% of this
age received preventive services. The specific innovation and strategies that will be tested
include; outreach, oral health education, dental provider relations/recruitment and
teledentistry/University of Pacific Virtual Dental Home. Participating Partner entities are a diverse
set of key local community partners, educational entities, Medi-Cal providers, and stakeholders
who have demonstrated community support and collaboration. The participating partners are
LDPP County of Fresno Page 3
experienced with our target population, and the social determinants of oral disease and improving
access to dental care. The target population will be Medi-Cal children 0-20 years old in Fresno
with a concentrated effort planned in area zip codes of 93701, 93702 and 93722. Domain 1 and 3
outcomes will be tracked and evaluated. The strategy proposed includes the Telehealth model of
Virtual Dental Home in which care is brought to the communities in which people congregate.
Starting with the pre-birth we have the unique advantage with our participating partner Fresno
Economic Opportunities Commission (EOC) to have direct contact and interaction with pregnant
mothers at the teen pregnancy health centers, this continuity of care and collaboration of health
continues through birth and childhood at the EOC centers and at the Reading and Beyond Health
Services and Education (RAB-HSE at community and schools sites within our targeted and general
Fresno County population area.
The DPH is requesting $11,127,285 over a three year and six-month period to fund the innovative
Fresno LDPP with added interventions to improve oral health. The two largest components of the
budget are (a) personnel (to support oral health education and provider relations), and (b)
teledentistry/University of Pacific (UOP) Virtual Dental Home (VDH). This budget does not include
Denti-Cal billable services that will be rendered through services of Registered Dental Hygienist
and by providers associated with the virtual dental home.
For the purposes of this proposal, Participating Partners are defined as those partners where a
budget is included in the Fresno LDPP requested budget. Stakeholders are those partners that
are intricately involved in the proposed interventions and strategies and whose services will be
supported by the proposed interventions.
DTI — LDPP Lead Entity
Fresno County Department of Public Health
®County ❑ County Entity1 ❑City and County
❑Tribe ❑Indian Health Program
Type of Entity ❑UC or CSU Campus
❑Consortium of counties serving a region consisting of more than one
county
Contact Brandon Heberer
Person
Title Fresno County Department of Public Health
Children's Medical Services
Staff Analyst
Telephone (559) 600-6521
Email Address bheberer@co.fresno.ca.us
Mailing 1221 Fulton Mall
Address Fresno, CA 93721
LDPP County of Fresno Page 4
1.2 Participating Entities
Noted below is a complete listing of Participating Partners/Entities in support of the Fresno County
LDPP
DescriptionEnanization Name=% and Address •
1) Fresno County Local Government Delfino Neira Participating Partner
Department of Social Department of Social Services
Services Director
(559) 600-2301
dneira@co.fresno.ca.us
2) Fresno EOC Community Brian Angus Participating Partner;
1920 Mariposa Mall Organization Chief Executive Officer Will employ LDPP
Fresno, CA 93721 (559) 263-1000 outreach health
Brian.angus@fresnoeoc.org educators and
provider relations
representatives
3) RAB-HSE Community I Luis Santana, Executive Director, Participating Partner;
4670 E. Butler Ave Organization (559) 342-8625, Will employ LDPP
Fresno, Ca 93702 LSantana@readingandbeyond.org outreach health
educators and
provider relations
representatives
4) Paul Glassman Pacific Center for Dr. Glassman Participating Partner
DDS, MA, MBA Special Care - UOP VDH Project Director
Professor of Dental University of the (415) 929-6490
Practice Director Pacific pglassman@pacific.edu
5) Dr. Hilario Dentist Dr. Hilario Relevant
SNF Dental Care Dental Practice Stakeholder; In
4811 E. Olive Avenue (559) 225-5228 support of Fresno
Fresno, CA 93727 enhdds@gmail.com LDPP
6) Fresno Unified Largest county Gail Williams; Director of Health Relevant
School District school district Services for Fresno, Stakeholder;
2309 Tulare St. (559) 457-3294, facilitates
Fresno, CA 93721 Gail.Williams@fresnounified. HealthySmiles mobile
units at school sites
7) Fresno Unified Largest county Luis Chavez Relevant
School District school district School Board President Stakeholder; In
2309 Tulare St, (559) 457-3727 support of Fresno
Fresno, CA 93721 LDPP
8) Fresno County County Office of Alma McKenry Relevant
Office of Education Education Health Services Director Stakeholder; In
1111 Van Ness Avenue (559) (559) 265-3026 support of Fresno
Fresno, CA 93721 amckenry@fcoe.org LDPP
9) Rhoda Howell- Registered Dental Rhoda Gonzales-Howell Participating Partner;
Gonzales 202 W. River Hygienist Alternative Private Practice RHDAP Denti-Cal provider
Ridge Avenue Fresno, Practice (RDHAP (559) 960-2232
CA 93711 1 rhoda@deliveringsmiles.net
LDPP County of Fresno Page 5
Organization Name Descriptio Contact Name, Title, Role in LDPP
k- and Address Organizat�ion' &elephone and Email j Emi
10) Judith Renee Registered Dental Judith Renee Brown Participating Partner;
Brown Hygienist Alternative RDHAP Denti-Cal provider
923 La Jolla Avenue Practice (RDHAP) (559) 331-4879
Clovis, CA 93619 z2thfare@yahoo.com
11) Central Valley California State Marlene Bengiamin, PhD, Relevant Stakeholder
Health Policy Institute University, Fresno Research Director,
1625 E. Shaw Ste# (559) 228-2167,
146, Fresno, CA 93710 marleneb@csufresno.edu
1 12) Healthy Smiles Mobile Dental Suzan Kodama Participating Partner;
Mobile Dental Center Chief Executive Office Denti-Cal provider,
1275 W Shaw Ave Ste (559) 229-6437 Will coordinate with
101, Fresno, CA 93711 susan@healthysmiles.us Fresno LDPP for
case mgt. assistance
13) Fresno City Health Community College Lisa Chaney Relevant Stakeholder
Center Health Center Health Services Coordinator
1101 E. University Ave. (559) 442-8268
Fresno, CA 93741 lisa.chaney@fresnocitycollege.edu
1 14) Fresno City Community College Joanne Pacheco Relevant Stakeholder
College Department of Health Center Academic Chair
Dental Hygiene (559) 244-2622
1101 E. University Ave. Joanne.pacheco@fresnocity
Fresno, CA 93741 1 colleg.edu
15) Assemblyman State Assemblyman, Dr. Joaquin Arambula Fresno LDPP
Dr. Joaquin Arambula 31St District Assemblyman Supporter
P.O. Box 4469 (559) 264-3131
Fresno, CA 93744 ■ Maria.Lemus@asm.ca.gov
16) Fresno Madera Regional Dental Merriam Osmondson Relevant Stakeholder
Dental Society Society Executive Director
371 E. Bullard Ste 120 fmds@fmds.com
Fresno, CA 93710 (559) 438-7284
17) Representative Jim U.S. Representative I Jim Costa Fresno LDPP
Costa - Fresno Office 16th congressional U.S. Representative Supporter
855 M Street, Suite 940 district (559) 495-1620
Fresno, CA 93721
r 18) Cradle to Career Community I Linda Gleason Relevant Stakeholder
5260 N Palm Ave, 122 Organization Executive Director
Fresno, CA 93704 (559)696-4095
I linda@fresnoc2c.org
19) City Council Councilmember Sal Quintero Relevant
Sal Quintero VP2600 District 5 Councilmember Stakeholder;
Fresno St. Fresno CA (559) 490-5395
93721
1:-
20) Dr. Cheney Dentist Retired DDS Relevant
620 S. Fairbanks, (559) 907-1305 Stakeholder; In
Sanger, CA 93657 support of Fresno
LDPP
LDPP County of Fresno Page 6
1.3 Letters of Participation/Support: See Appendices
Participating Partners/Entities
1) Fresno County Department of Social Services
2) Fresno EOC
3) RAB-HSE
4) University of the Pacific — School of Dentistry
5) Dr. Hilario — Virtual Dental Home participating dentist
6) Dr. Cheney — Virtual Dental Home participating dentist
Stakeholders
7) Fresno Unified School District — Health Services Director
8) Fresno Unified School District — School Board President
9) Fresno County Office of Education (FCOE)
10) Rhoda Howell-Gonzales; RDHAP
11) Renee Brown — RDHAP
12) Valley Health Policy Institute California State University, Fresno
13) Healthy Smiles Mobile Dental
14) Fresno City College — Health Center
15) Fresno City College — Department of Dental Hygiene
16) State Assemblyman Dr. Joaquin Arambula
17) Fresno-Madera Dental Society
18) U.S. Representative Jim Costa
19) Cradle to Career
20) Councilmember Sal Quintero
1.4 Collaboration Plan
The County of Fresno DPH's core purpose is to promote, preserve and protect the well-being of
the community and to ensure the optimal health of the public. The mission of DPH is the
promotion, preservation and protection of the community's health. This is accomplished through
identifying community health needs, assuring the availability of quality health services and
providing effective leadership in developing public health policies. DPH is committed to working in
partnership with its communities to eliminate health disparities.
Fresno EOC has the resources, experience, and established network of partnerships necessary to
successfully implement the proposed program. Fresno EOC, a nonprofit 501(c)(3) organization, is
Fresno County's designated community action agency and is widely recognized as one of the
largest of its kind in the nation. Founded under the Federal Economic Opportunities Commission
Act of 1965, Fresno EOC has grown steadily over the last 51 years to meet the challenges of a
region beset by swelling population pressures and seemingly unabated need, to become one of
the nation's finest models for innovative, effective economic and community development. Fresno
EOC remains faithful, effective, and consistent with its mission to humanely focus all available
resources to empower low-income families and individuals working toward the skills, knowledge,
and motivation for self-sufficiency.
LDPP County of Fresno Page 7
Fresno EOC serves approximately 175,000 people each year through its various departments
providing a comprehensive array of services including health services with specialization in primary
care, family planning and reproductive health, pre-natal care, Women's Infant and Children (WIC);
employment training; a full range of educational services, including two charter schools; a 45-site
network of Head Start centers and school-age child care; a 150-unit transportation fleet for client
transit needs; the delivery of over 7,500 congregate and home-bound meals prepared in its own
food service center; homeless outreach, emergency and transitional housing; construction
rehabilitation for eligible low-income families; energy conservation and emergency assistance;
refugee services; and micro-enterprise, small business incubation and technical assistance. The
philosophy behind all of Fresno EOC's programs reflects a commitment to providing quality
essential services to those in need. Fresno EOC has built a strong foundation of services that offer
support to people in all phases of life. Programs designed to meet the needs of youth are a major
focus part of Fresno EOC's services.
For nearly two decades, the nonprofit organization RAB-HSE's mission has been to empower
children and families to reach productive, self-reliant lives through cradle-to-career educational
programs for children and parents. Through their programs, they serve hundreds of children (0 -18)
and adults on a daily basis at their sites located at Community Centers, Schools and Churches
located in high need areas throughout Fresno County. RAB-HSE has a strong focus on zip codes
93701 and 93702 because their high level of poverty. Because their dual generation approach and
their long term commitment with the population they serve, they have built a close connection with
hundreds of families. They would use their connection with families they already have to expand
and reach out to other families insuring all children in those neighborhoods selected by them also
benefit from the LDPP program. Their existing partnerships with other community based
organizations, such as Boys & Girls Clubs, Catholic Charities, Community Food Bank and United
Way will open doors to access/leverage their connection with families who may qualify for this
program. Lastly, their staff of more than 200 employees has diverse backgrounds and are able to
speak English, Spanish, Hmong, Arabic, Russian, Portuguese as well as other languages and
dialects. They are confident as they team with EOC that they will be able to successfully reach and
engage children and families through the LDPP program.
The Pacific Center for Special Care at the UOP, Arthur A. Dugoni School of Dentistry is
demonstrating a new model of care,by creating a VDH. The Pacific Center has experience
partnering with a number of funding organizations to implement this demonstration project to bring
much-needed oral health services to underserved populations. These populations range from
children in Head Start Preschools and elementary schools to older or disabled adults in residential
care settings or nursing homes.
DPH as the LDPP Lead Entity will fulfill its role of identifying participating entities to provide high
quality dental prevention services, caries risk assessment, disease management, and continuity of
care by contracting with the proposed partner agencies to evaluate performance outcomes,
facilitate periodic partner meetings, address performance shortcomings or need for staffing
augmentation or changes, and relay activity reports including any known cost avoidance by the
LDPP to the State.
LDPP County of Fresno Page 8
The Lead Entity will facilitate monthly meetings individually with each of the participating partners
in order to review performance metrics and measures, staffing levels, productivity, training
accountability, client and provider satisfaction, and the overall opportunity for improvement and
adherence to state pilot requirements. The Lead Entity will also facilitate the Advisory Board
meetings where these same metrics will be evaluated and discussed. The Advisory Board
meetings will be held initially on a monthly basis, after the first year the frequency would be
reduced to a bi-monthly with special sessions being called as required. In order to reduce possible
service silos the LDPP Lead Entity will ensure that each participating partner will be responsible for
conducting project team meetings with their respective staff concerning all aspects of the project
including; performance metrics and measures, staffing levels, productivity, training accountability
and the overall opportunity for improvement and adherence to state pilot requirements.
Participating Partners will have autonomy in the operations of their LDPP roles within the
boundaries of the Projects goals and objectives and state pilot requirements and LDPP Special
Terms and Conditions (STCs). Should issues arise between or among the parties the Lead Entity
will be the determination member as they are ultimately responsible for the Project's success and
are required to enforce the project's accountability measures.
The Fresno LDPP communication management plan includes the establishment of an Advisory
Board which is comprised of local governmental agencies, professional and community based
advocacy organizations, academic institutions and health agencies.
Communication is critical to the Fresno LDPP as it guides the messages to a project's affected
stakeholders and ultimately the consumers we seek to assist in improving their oral health. The
Fresno LDPP communication management plan includes the establishment of an Advisory Board
which is comprised of local governmental agencies, professional and community based advocacy
organizations, academic institutions and health agencies.
The Advisory Board will strategically inform, align, and leverage resources with the goal of
improving oral health in Fresno County. Membership will include; DPH, RAB-HSE, EOC, Fresno
Unified School District, Fresno City College, UOP, VDH Operating Partners (to be named once
subcontracting is completed), Fresno-Madera Dental Society, Cradle to Career (community
organization that works across sectors to strategically inform, align, and leverage resources
throughout Fresno County), Valley Health Policy Institute California State University, Fresno, and
two (2) consumers for a total membership of twelve (12). In addition, the voice of the dental
consumer and dental providers will be heard through surveys to inform project leadership.
Depicted in the table below is the management communication plan with workgroups expected to
be developed as the project moves forward in its implementation. Additionally a Kick-Off meeting is
planned once notification of award has been received. The overall purpose of the committees is to
increase knowledge about the project and why it is important, create a dialogue among
Participating Partners and Stakeholders and to provide opportunity for feedback from stakeholder
groups. Should an issue arise where consensus cannot be reached the Lead Entity will make the
final determination.
LDPP County of Fresno Page 9
PURPOSE FREQUENCY MEETING Facilitation
SUMMARIES
Review project objective activity Monthly during Assignment
reports, organizational overview of the initial year will be rotated
operational issues such as; and thereafter among
Fresno LDPP performance metrics and measures, bi-monthly; membership
Advisory Board staffing levels, training, activity and with special
financial reports sessions being
called as
required.
Operational issues such as; Monthly Lead Entity
performance metrics and measures,
EOC staffing levels, training, activity and
financial reports Fresno
LDPP
Administrator
Operational issues such as; Monthly Lead Entity
performance metrics and measures,
RAB-HSE staffing levels, training, activity and
financial reports
Operational issues such as; Monthly Lead Entity
VDH performance metrics and measures,
(UOP and VDH staffing levels, training, activity and
site Operators) financial reports
In order to provide learnings for potential future local efforts beyond the term of this demonstration
our materials, lessons learned, reports and policy and procedures will be retained and available for
local future efforts through the Lead Entity (DPH) and the Advisory Board. The VDH may be
sustainable following the end of the pilot with the successful education of the Medi-Cal population.
The communication infrastructure anchored by the continuation of the Dental Health Advisory
Board would still possibly serve a role but it is unlikely that the pilot infrastructure would be able to
sustain itself in absence of Federal and State funding.
LDPP County of Fresno Page 10
Section 2: General Information and Target Population
2. Target Population-
General Information: County of Fresno — Project Area Information
Fresno County, located in the heart of California's Central Valley, is one of the world's most
productive agricultural areas yet is also among the nation's most impoverished regions. Fresno
County is the 6th largest county in California (spanning 6,000 square miles) and contains 15
incorporated and 37 unincorporated cities. Referred to as the "Appalachia of the West," Fresno
and the surrounding counties of the San Joaquin Valley are characterized by chronic
unemployment, high incidence of poverty, and low levels of educational attainment. Twenty-seven
percent of the 946,895 Fresno County residents live in poverty. Only 72.9% of Fresno County
residents have received a high school diploma, and just 18.8% have obtained a bachelor's degree
or higher (Census, 2012). The county's average 2015 unemployment rate of 10.18% compares to
a statewide 2015 average unemployment rate of 6.25% (U.S. Bureau of Labor Statistics 2015).
Years of potential life lost before age 75 (YPLL-75) is a measure used to reflect the impact of
premature mortality on a population. In 2007, the age-adjusted YPLL-75 rate per 100,000
population for all California residents was 5,641.7 years, which represented a decrease of 9.4
percent from the 2000 rate of 6,224.1 years. During this same time period the YPLL-75 rate for
Fresno County actually increased by .10% rather than decreased.
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As described in the Measure of America's "A Portrait of California 2014-15," the state can be
categorized into five different Californias based upon the American Human Development (HD)
Index. Fresno County's HD not only rates it as part of the "Struggling California" it is also the
county within this profile with the largest population.
LDPP County of Fresno Page 11
FIVE CALIFORNIAS
Inequalities in health, education, and earnings divide California communities in ways that
challenge conventional North-South and inland-coastal divisions in the state. By using the HD
Index score to sort county, town, and neighborhood clusters, "Five Californias" have each been
identified with its own distinct well-being profile.
• One Percent California consists of the two neighborhood clusters that score 9 or above out
of 10 on the HD Index; these neighborhoods are home to just under one in every one
hundred Californians.
• Elite Enclave California is made up of neighborhood clusters that score between 7 and
8.99 on the Index; 15 percent of Californians are part of this group.
• Main Street California comprises of neighborhood clusters that score between 5 and 6.99
and is home to 39 percent of Californians.
• Struggling California is home to the largest share of the state's population, 42 percent,
with these neighborhood clusters scoring between 3 and 4.99 on the Index.
• Disenfranchised California comprises of neighborhood clusters that score below 3 on the
HD Index; this California is home to roughly 3 percent of the state's population.
http://www.measureofamerica.org/california20l4-15/
Dental Health Needs
Fresno County Denti-Cal dentists were selected as eligible to participate in the LDPP Domains 1
and 3 incentives. Fresno is listed as the fourth highest county out of 58 in the state of California
with nearly 50% of our total population enrolled in Medi-Cal and greater than 75% of children aged
0-5 in Medi-Cal according to the September 2015 report. Currently data shows that only 44% of 0-
20 population return year after year for follow up dental preventive care in Fresno County. Our
Medi-Cal children 0-6 years old have been documented as having a high restorative procedure
rate of 46.23% in 2014-15, and a low preventive procedure rate of 53.77% being performed.
Additionally, per the Community Commons' report of August 13, 2015, Fresno County dentists per
100,000 population is 55.7 vs. the California rate of 77.5 making it even more critical that the
limited number of providers in our area be encouraged to participate in Denti-Cal and through the
proposed support systems the goal is to educate these providers of the need in the community and
the potential that the DTI Domains 1 and 3, provides to their practice. There are approximately
813 active dentists licensed in Fresno County per the Department of Consumer Affairs — Dental
Board of California and only 147 (18%) are Denti-Cal providers with only 87 (59%) of these
providers accepting new patients according to the DHCS report of Fee For Service providers in
Fresno County.
Conducted from February 2005 through April 2005, the Fresno County Smile Survey was part of
the statewide California Smile Survey in which 21,000 Kindergarten and 3rd grade students
received dental screenings at 186 elementary schools throughout California. The Fresno County
Smile Survey report included an additional data subset drawn from dental screenings of 1,473
Kindergarten and 3rd grade students from 18 elementary schools to provide a local "snapshot" of
the oral health status of children in Fresno County which is home to an ethnically diverse
LDPP County of Fresno Page 12
population, where Mexican-American children make up 47% of the population under 18 years of
age.
Key Findings:
• Sixty-five percent of Kindergarten and almost 80% of 3rd grade students have experienced
dental disease.
• Four out of ten children have untreated dental disease.
The Survey found that in Fresno County, 729 Kindergarten and 744 3rd grade students received a
dental screening. About half of the children screened were male (47%), 51% were Hispanic, 29%
were White, 11% were Asian, and 5% were African-American. More than 45% of the children
screened were from homes where parents speak a language other than English.
Target Population: The need for health services in Fresno County is extensive and well
documented. Dental caries, the disease that causes cavities, is an infectious, transmittable, but
preventable disease. By focusing on prevention, thousands of lost school days and millions of
dollars can be saved. The Fresno LDPP plans to target children 0-20 years old with a concentrated
effort planned in the zip code areas of 93701, 93702 and 93722. The need for health services in
Fresno County is extensive and well documented. This targeted area for concentrated efforts was
selected to leverage prior community organizational commitments. In the spring of 2009, the City
of Fresno determined to assist the Lowell neighborhood (zip code 93701/02) which is part of the
mission of revitalizing downtown Fresno and the neighborhoods of poverty surrounding the
downtown corridor. The neighborhood area of zip code 93722 was selected, as it is home to the
Central Valley Regional Center who has long advocated for oral health services and who is in
support of the proposed VDH and other LDPP services.
Partners and Stakeholders will be leveraging their community programs and infrastructure to
engage consumers. This includes providing the work space required for staff to deliver oral care
prevention and education and oral hygiene treatment. The participating partner entities are a
diverse set of key local community partners, educational entities, Denti-Cal providers, and
stakeholders who have demonstrated community support and collaboration. The Fresno LDPP
proposal calls for oral health education engagement through quarterly health fairs. Families will be
issued multiple mailings including refrigerator magnets identifying the health fair dates. Our ability
to reach our Medi-Cal population is a result of our collaboration with the Department of Social
Services and their willingness to partner with us by facilitating the direct mailing of educational
items. Attendance will be incentivized through drawings for oral health related items including
dental care health baskets etc. aimed at behavior modification. Families will be served between
our two community-based entities; Fresno EOC, and RAB-HSE. Technology such as a cloud
based Access Database for caseload management and tracking, 1-800 phone line for
communication (English/Spanish/Hmong), and text messaging will also be components of this
service area but the most important and effective aspect will be our well trained and culturally
competent staff. Activities will be made available during non-traditional hours to accommodate the
needs of our participants.
LDPP County of Fresno Page 13
Fresno County LDPP Goals and Outcomes to Improve DTI Domains 1 and 3
Fresno County Dental Transformation Initiative - Goal Summary
Domain 1 Domain 3
Percentage Additional Clients Total Number of Percentage Additional Clients Total Number of Eligible
Increase over Receiving Clients Receiving Increase Receiving Continuity of Clients Receiving
baseline Services Services over Care Continuity of Care
baseline
Baseline 56,631 38,361
Year 1 5 mo 3.27% 1,854 58,485 3.17% 1,216 39,577
Year 8-51% 4,821 61,452 824% 3,162 42,739
Year 3 12.84% 7 269 63,900 8.88% 3,405 46,143
Year 19.65% 11,126 67,757 9.51% 3,648 49,791
Number of Total LDPP
Health Family Caseload Individual Clients Domain 1
Educators Size
Increase for caseload Percentage Increase
Domain 1 based on County 2014- over the Domain 1
baseline 2015Average baseline
25%/25%/35%/50%
Year 1 5 mo 24 12,000 24,000 6,199 1,854 3%
Year 2 26 13,000 26,000 6,716 4,821 goo
Year 3 28 14,000 28,000 7,232 7,269 13°0
Year 4 30 15,000 30,000 7,749 1 11,126 2000
Number of Total LDPP
Health Family Caseload Individual Clients Domain 3
Educators Size
Domain 3 70%of all Domain 1 County Percentage
baseline clients in the LDPP will Increase over the
receive Domain 3 Domain 3 baseline
Year 1 5 mo 24 12,000 24,000 4,169 1,216 3-17%
Year 2 26 13,000 26,000 4,517 3,162 824%
Year 3 28 14,000 28,000 4,864 3,405 8.88%
Year 30 15,000 30,000 5,211 3,648 9.51%
Baseline Key
DOMAIN 1: 2014-2015 Fiscal Average*
Q1 Q2 Q3 Q4 Average
Eligible Clients 206,439 214,193 220,820 226,091 216,886
Clients Seen 26,837 51,192 68,233 80,262 56,631
Percent Utilized 13.00% 23.90% 30.90% 35.50% 25.83%
`Average numbers are based on the Four Quarters from The Department of Health Care Services-Beneficiary Utilization Performance Report-Fee-For-Service
Statewide by County-State Fiscal Year 2014-2015
DOMAIN 3:Based on DHCS-Fresno County Selection Data
County
Population Eligible Count As a% Continuity of Care Count As a%
219 761 86,758 39 48% 38 361 4422%
The Fresno LDPP meets the requirements outlined in STCs 106-108 in that there are specific
program performance metrics, oversight, monitoring and reporting incorporating into all three of the
proposed strategies with the goals, outcomes and performance metrics included in the Fresno
LDPP being consistent with, and build upon, the performance metrics of the DTI and all possible
efforts have been made to avoid redundancy on approaches taken in Domains 1-3. Fresno County
LDPP will address Domains 1 and 3 through alternative programs, using strategies focused on
high poverty areas including local care coordination initiatives and education partnerships. We
have broad-based provider and community support and incentives related to goals and metrics that
contribute to the overall goals listed in the application for LDPP.
LDPP County of Fresno Page 14
Section 3: Services, Interventions, Care Coordination and Data Sharing- 35 points
3.1 Services and Care Coordination:
The goal of the LDPP is to promote community based oral health programs and evidence-based
models of oral disease prevention through care coordination in the Fresno population. Care
coordination will be implemented by Fresno County DPH as the Lead entity in the LDPP. Fresno
County DPH will guide the partners and be responsible for overseeing the community level team
process and will take the lead in multidisciplinary and cross-system/agency collaboration.
Implementing coordination of care with multi-disciplinary agencies will include assessments,
identifying barriers to oral health care, plan development and implementation, collaboration,
identification of child and family needs, communication, monitoring/measuring progress, collecting
data, reporting, and continuously evolving and evaluating from lessons learned. Partnerships with
a broad group of stakeholders who are committed and accountable for implementation improve our
coordination of care. Local relevant stakeholders supporting the LDPP common goal and
coordination of care in this partnership is the Fresno DPH, Fresno County Department of Social
Services, local Legislators, Fresno Unified School District, FCOE, Fresno Madera Dental Society,
Fresno City College, Fresno State, Anthem Blue Cross, Central Valley Health Policy Institute, UOP
VDH, as well as local doctors, dentists, and primary care clinics. The responsibilities of the
participating entities are to bring a diverse unique set of resources as well as leveraging on the
existing presence of the participating entity in the community.
New infrastructure that will be taking place between the lead and participating entities is training,
education, data collection, reporting, and collaboration with a VDH community care system. We will
leverage and connect existing community infrastructure by tapping into the resources of Head Start
and WIC using the existing office space and positive encounters to expand upon and include
additional oral prevention education and services.
The County of Fresno LDPP will increase oral health education, preventive and treatment
participation. The specific innovation and strategies that will be tested include; 1) outreach, oral
health education and care coordination services, 2) dental provider relations and recruitment
services and 3) teledentistry/UOP VDH services. The participating partner entities are a diverse set
of key local community partners, educational entities, Denti-Cal providers, and stakeholders who
have demonstrated community support and collaboration. The participating partners and
stakeholders are experienced with our target population, the social determinants of oral disease
and improving access to dental care. Partners and stakeholders will be leveraging their community
programs and infrastructure to engage consumers. This includes providing the workspace required
for staff to deliver oral care prevention education and oral hygiene treatment.
In lieu of incentivizing Continuity of Care, which may be difficult, to sustain the Fresno LDPP
proposal calls for oral health education engagement through quarterly health fairs. Families will be
issued multiple mailings including refrigerator magnets identifying the health fair dates. Attendance
will be incentivized through drawings for oral health related items including dental care health
baskets etc.
Correspondence will be sent through the Fresno County Department of Social Services who will
act as an intermediary for the dissemination of the Fresno LDPP marketing material while still
LDPP County of Fresno Page 15
securing the families' confidentiality. We are proposing a media campaign that would consist of a
variety of elements including; television, radio and print. We will incorporate the Fresno LDPP in
Website/Social Media such as in the; Fresno County Website, DPH Facebook and Partner
websites and social media pages. Effectiveness of the media campaigns will be evaluated through
the collection of surveys completed by clients during intake. Based on client feedback, media
campaign will be adjusted for optimization.
The LDPP comprehensive plan is a three pronged approach involving Care Coordination, Dental
Provider Engagement, and Access to Care with Virtual Dental Home. The Fresno County
population will be served between our two community-based entities; Fresno EOC, and RAB-HSE.
Outreach Oral Health Educators will be performing care coordination consisting of motivational
interviewing (MI), partnering providers with clients and their families, ensuring the families are linked
to the appropriate community resources, communicating to improve the oral health literacy of the
child as well as the entire family. The development of educational materials will be a mixture of
existing and new but education alone will not be sufficient. To change behavior, our proposal also
includes hands on demonstration of oral hygiene and its correlation with healthy eating and overall
healthy lifestyle provided by staff that are culturally competent and experienced with the population.
We are also implementing a curriculum with a pre- and post-annual assessment to test if the
engagement has successfully established habits that will lead to a reduction in early childhood
caries and/or reduction in missing, decayed or filled teeth. Based upon what is learned from pre
and post assessments Public Service Announcement will be utilized to reach the largest number of
families leveraging our community in a multidisciplinary approach with tracking and following up to
link individual cases to an Outreach Oral Health Educator for continuity of care. The Provider
Relations Representatives will work extensively with dental providers while the Outreach Oral
Health Educator will be involved in the individual care coordination. Together, the synergistic
approach coupled with preventive services of fluoride varnish and sealants will enhance the
experience, thus improving the outcomes and reducing cost of care.
Outreach Oral Health Educators will facilitate communication among healthcare teams including
primary care, specialty care, inpatient, emergency department etc.
Current measures to recruit Denti-Cal providers in Fresno County have not been effective and
recruitment has trailed the state and national average. Per the Community Commons' report of
August 2016, the rate of dentists per 100,000 population in Fresno County is 55.7 vs. the California
rate of 77.5 making it even more critical that the limited number of providers in our area be
encouraged to participate in Denti-Cal.The goal is to educate providers of the need in the
community and the incentives that the DTI Domains 1 and 3 may provide to their practice. There
are approximately 813 active dentists licensed in Fresno County per the Department of Consumer
Affairs — Dental Board of California and only 147 (18%) are Denti-Cal providers with only 87 (59%)
of these providers accepting new patients according to the DHCS report of Fee For Service
providers in Fresno County. Provider Relations Representatives effectiveness on expanding Denti-
Cal participation will be tracked through our planned Cloud database and monitored through
reports evaluated during and between monthly monitoring meetings with Participating Partners.
1) Outreach Oral Health Education and Care Coordination
LDPP County of Fresno Page 16
Consumers that opt to engage with us and participate in the project will be served between
our two community-based entities; Fresno EOC, and RAB-HSE. Technology such as a
cloud based Access Database for caseload management and tracking, 1-800 phone line for
communication (English/Spanish/Hmong), and text messaging will also be components of
this service area but the most important and effective aspect will be our well trained and
culturally competent staff. Activities will be made available during non-traditional hours to
accommodate the needs of our participants.
Children encountered that are not insured will be referred to Medi-Cal utilizing our
relationship with federally qualified health centers who are contracted by the Department of
Social Services as Medi-Cal Enrollment Assisters. No cost associated with Outreach Oral
Health Educators or treatment of non-Medi-Cal clients will be charged to the Fresno LDPP.
The cost for any services rendered that cannot be claimed to Medi-Cal will be absorbed by
the collaborating partner is involved.
Outreach Oral Health Educator responsibilities:
According to the DHCS "Medi-Cal Eligibles with Threshold Languages report", 32.35% of
Fresno County Medi-Cal clients speak Spanish and 3.41% speak Hmong. The Outreach
Oral Health Educators will provide the services noted below in the families language and in
a culturally appropriate manner.
■ Each Outreach Oral Health Educator will have a revolving active caseload of 500
families.
■ Education to improve oral health literacy
o Guidelines on dental periodicity schedule, preventive dental services, anticipatory
guidance/counseling and oral treatment for infants, children and adolescents
■ Provide a variety of materials for participants to take home, including informational
pamphlets on several oral health topics (also available in Spanish), stickers,
toothbrushes, toothpaste, dental floss, mouth mirrors, and two-minute timers
■ Contacting the family and ensuring that they have secured a dentist and if they have not
secured a provider then they will assist in the identification of a dentist or dental care
center
■ Assist with the initial appointment setting
■ Provide patient support in assisting them in arriving at their scheduled dental
appointments including transportation and will provide referrals to those families
expressing additional social or economic hardships utilizing the following tools;
o The Directory of Community Resources created by The Family Resource Center,
affiliated with the Fresno County Department of Social Services, and the 2-1-1
Fresno County Information and Referral Helpline will help connect consumers with
agencies and/or organizations that can provide assistance. 2-1-1 Fresno County is a
free and confidential service that is available 24 hours a day, 7 days a week, and 365
days a year in over 170 languages.
■ Track client contact and provide patient reports on the number of appointments
scheduled and the efforts made to remind patients of their appointments
■ Coordination of oral health services across multiple providers
LDPP County of Fresno Page 17
o Dental Hygienist, Mobile Dental Vans, Registered Dental Hygienist in Alternative
Practice and Dentists
■ Request authorization to send the family text reminders of appointments set for each of
the children.
■ Contact the family 24 hours after the scheduled visit
■ Contact dentist office to determine if the efforts to educate and support the patient/family
resulted in a kept appointment (level of success)
■ Determine why the appointment was not kept and assist in rescheduling
■ Address any rescheduling assistance or follow-up appointments that might be necessary
■ On a quarterly basis, families will be sent invitations to attend healthcare fairs where they
will be provided new toothbrushes, toothpaste calendars, etc. and can be entered into
drawings to win oral health products
2) Provider Relations and Recruitment responsibilities:
Fresno County Denti-Cal dentists were selected to be eligible to participate in the LDPP
Domains 1 and 3 incentives. Fresno is listed as the 4th highest county out of 58 in the state
of California with nearly 50% of our total population enrolled in Medi-Cal and greater than
75% of Children aged 0-5 in Medi-Cal according to the September 2015 report. Currently
data shows that only 44% of our 0-20 population return year after year for follow up dental
preventive care in Fresno County. Our Medi-Cal children 0-6 years old have been
documented to have a high restorative procedure rate of 46.23% in 2014/15, and a low
preventive procedure rate of 53.77% being performed.
Additionally, per the Community Commons report of August 13, 2015, Fresno County
dentists per 100,000 population is 55.7 vs. the California rate of 77.5 making it even more
critical that the limited number of providers in our area be encouraged to participate in Denti-
Cal and, through the proposed support systems, the goal is to educate these providers of
the need in the community and the potential that DTI Domains 1 and 3 provides to their
practice. There are 813 active dentists licensed in Fresno County per the Department of
Consumer Affairs — Dental Board of California as of 09/21/16, and only 147 (18%) are Denti-
Cal providers with only 87 (59%) of these providers accepting new patients according to the
DHCS report of Fee For Service providers in Fresno County.
Provider Relations Representative
■ Educate current Denti-Cal dentists on DTI
■ Encourage Denti-Cal dentists to become eligible for Domains 1 and 3
■ Learn the challenges and obstacles of current Denti-Cal Dentists who are not accepting
new patients and explain how our Outreach Oral Health Educators might be of
assistance (i.e. reduction in no-show rates and care coordination)
■ Outreach to Dentists who are not Denti-Cal providers to encourage them, through
education and support, to enroll in Denti-Cal
LDPP County of Fresno Page 18
■ Conduct Dental Provider Survey to learn the challenges and obstacles in engaging
dental providers in Denti-Cal
■ Increase the number of Denti-Cal providers by 2% each calendar year (e.g., 3 providers
per calendar year)
■ Total number of dentists will be divided equally among the four Provider Relations
Representatives
3.2 Innovations, Interventions, and Strategies:
Strategy Number (1) - Outreach Oral Health Education and Care Coordination Services; the
objective is to provide families with oral health education and an assigned care coordinator to
assist in the identification of available Denti-Cal providers and the scheduling of the initial and
recurring appointments with the goal of increased access to dental care and preventive dental
appointments as recommended with increased adherence to behaviors that contribute to good oral
health.
Strategy Number (2) - Dental Provider Relations and Recruitment Services; Provider Relations
Representatives will contact licensed Denti-Cal dentists including those Denti-Cal providers not
accepting new patients and will recruit those dentists who are not Denti-Cal providers through
onsite education and services on DTI Domains 1 and 3 and the Fresno LDPP in partnership with
the Fresno-Madera Dental Society.
Through the use of a cloud based database, information will be collected such as the pre and post
assessments to evaluate the achievement of the goals set for strategies (1) and (2). Evaluating
reports generated from the database will be used during monthly monitoring meetings with
participating partners to assess progress and identify any needs improvement and interventions
that may be required to maximize the effectiveness of the intervention and the process. Specific
anticipated outcome measurements are noted in Section 4.1
Strategy Number (3) — Virtual Dental Home
In section 3.1 we provided an overview of the first two (2) interventions that are proposed by the Fresno
LDPP and while both of the services described are certainly innovative in terms of their incorporation into an
oral health project, the most innovative aspect of our proposal is related to our third intervention a VDH. The
VDH model will be an accessible, continuous , comprehensive, family centered, coordinated, compassionate,
and culturally effective dental home based in the community at the Head Starts and after school program of
Fresno EOC and RAB-HSE and with the capability to mobilize to other locations of need. There is no current
VDH infrastructure in Fresno County.
The Virtual Dental Home (VDH) system of care has been developed and tested in a six-year grant
funded proof-of-concept demonstration. This demonstration established that telehealth-connected
teams can work and that dental hygienists can safely determine what radiographs to take and
place interim therapeutic restorations (ITRs) after being instructed to do so by a dentist.
This strategy includes development of a VDH system in Fresno County that uses Denti-Cal billing
to pay for the dental treatment provided. It will allow testing of the ability of the VDH system to
function and be sustainable.
LDPP County of Fresno Page 19
Although DHCS has adopted regulations that allow providers to bill for services performed using
store-and-forward teledentistry as required by AB1174, this is only a portion of the support needed
for providers to establish and sustain Virtual Dental Home systems. This model for providing
dental care is significantly different than the traditional dental care systems in use. The providers,
community sites and communities will require significant help in system design and customization,
training, and technical assistance over the grant period before these systems are established and
stabilized and they are in a position to be able to continue to provide services using this model in a
way that is self-sustaining based on program billing revenue. The activities and resources needed
for the required help in system design and customization, initial; equipment purchase, training, and
technical assistance are not claimable under the Denti-Cal system.
For this project, salaries related to patient care, patient care supplies, and equipment (with the
exception of portable equipment purchased in the start-up phase of the project) are part of normal
clinical care operations and will be paid by the providers. UOP has developed and tested an
innovative and customizable oral health delivery system called the VDH system of care. Paul
Glassman DDS, MA, MBA is the Director of the Pacific Center for Special care and will support the
project.
The success of the demonstration of the VDH system resulted in legislation being passed in 2014
that has now created a regulatory environment where this system can be expanded and local
programs can be established that will become self-sustaining using program revenue. However, it
is clear that providers and community organizations will continue to need help with system design,
training and technical support. Pacific is interested in using the DTI funding in the Medicaid 2020
waiver to expand the use of the VDH system, improve oral health of currently underserved groups,
and reduce the financial and human consequences of neglected dental disease.
This VDH will expand the capacity of the oral health care system in Fresno County by engaging the
VDH in various community centers, and after-school programs and will bring prevention and early
intervention oral health services to children that normally do not receive any care until they have
advanced disease. Linking prevention and early intervention care delivered by allied dental
personnel in these locations, with more advanced care in dental offices and clinics, will produce a
full system of care, improve the oral health of the population, and lower the significant personal,
societal, and financial costs that result from neglected dental disease.
VDH Project Goals
The goals of this project will be to demonstrate that incorporating a Virtual Dental Home system
focused on children can allow the system to:
• Reach many more Denti-Cal beneficiaries than are currently being reached in the
geographic areas where this demonstration will take place;
• Integrate oral health activities into the environment, activities, and processes of community
sites where children already are;
• Apply proven prevention and early intervention procedures in community locations such as
schools and pre-school programs;
• Establish a "continuous presence" system where the on-site dental team is present in the
community site throughout the school year. This is known to increase awareness and focus
LDPP County of Fresno Page 20
on oral health which is critical to support adoption of health-producing daily mouth care and
"tooth healthy" diets;
• Keep the majority of children healthy on site in the community site, and most importantly,
verify through the telehealth system that they are healthy. This is possible because the
dentist is involved through the telehealth system and can determine which children are
healthy, or can be made healthy, through services provided by the dental hygienists on-site;
• Refer those children with advanced disease to dental offices/clinics for treatment of those
problems while maintaining on-going diagnostic and prevention services in the community;
and
• Improve the oral health of the children served in this demonstration as measured by
incidence of untreated dental caries, signs of pain and infection, and use of the hospital
emergency department and operating room services for dental care.
VDH Participants
The following entities will participate in the Virtual Dental Home portion of this DTI project:
• Dental providers:
o To be subcontracted by DPH. Subcontract is only to dictate terms of VDH equipment
use and stipend issuance, not compensation.
• Community Sites:
VDH is to be utilized at community sites hosted by RAB and EOC including:
RAB-HSE Community and Head Fresno EOC Early Head Start and
Start Programs Head Start Locations
Roosevelt High School Highway City
4250 E. Tulare Street 4721 N. Jennifer, Suite 10
Fresno, CA 93702 Fresno, CA 93722
Central Unified School District FRANKLIN
4605 N. Polk Avenue 1189 Martin St.
Fresno, CA 93722 Fresno, CA 93706
Mosqueda Center FIREBAUGH
4670 E Butler Ave Hazel Bailey Elementary School
Fresno, CA 93702 1725 Saipan Ave.
Firebaugh, CA 93622
RAB-HSE Facility IVY Mary Ella Brown
190 N Van Ness Ave Community Center
Fresno, CA 93701 1350 E. Annadale
Fresno, CA 93706
RAB-HSE Facility MADISON
3730 W Shields Ave Madison Elementary School
Fresno, CA 93722 388 S. Brawley
Fresno, CA 93706
LDPP County of Fresno Page 21
MOLLY NEVAREZ
Central Community Church
4710 N. Polk Avenue
Fresno, CA 93722
EAST FRESNO-A
Home Base Satellite Office
4273 W. Richert, Suite# 107 & 108
Fresno, CA 93722
FRANKLIN
Home Base Satellite Office
4273 W. Richert, Suite# 107 & 108
Fresno, CA 93722
VDH targeted population — Each set of VDH clinic equipment is expected to be utilized a minimum
of three (3) days per week with a minimum of 750 clients per year being served. The LDPP
proposal requests two (2) VDH clinic equipment sets bringing the total number of projected clients
being served by VDH to 1,500 per year.
Roles and Responsibilities
The following is a list of roles and responsibilities that will ensure success of the demonstration.
Dental Providers
The dental care providers will:
• Hire and pay the salary of the community (on-site) dental teams, including dental hygienists
and dental assistant/navigators who will work in the community sites.
• Create or modify their IT system to be able to function in a virtual environment (i.e. the
hygienist is collecting records in one location and the dentist is reviewing those records in
another location at another time). Some considerations in evaluating a providers IT/EDR
systems include the following considerations:
• The hardware and software available to the community teams must allow the community
team to capture images (radiographic and photographic) in the community site as well as
scanned health histories and consent forms, record dental findings, progress notes and any
other aspect of the EDR.
• The information captured in the community must be available and able to be reviewed by a
dentist who is not in the community site. There are several mechanisms that can allow this
to happen: Use of a "cloud" based EDR system where all the information is uploaded and
stored on a cloud-based server. This is the ideal EDR system as it allows data entry and
access to the data from any location by multiple personnel.
• Data can be stored on an office or clinic-based server and accessed via a VPN or terminal
services connection. If this method is used, it is important that images and other information
collected in the community site can be uploaded to the server and accessed from all sites.
LDPP County of Fresno Page 22
• Accept referrals and provide treatment that cannot be provided in the community site for
patients who are deemed to have advanced disease that warrants a visit to a dental office.
Note: This will be far fewer in-office visits than traditionally needed since the majority of care
will take place in the community.
• Provide data on patients seen, services provided and costs incurred and revenue received
as a part of this project. Bill for services provided using store-and-forward teledentistry.
• Providers in Fresno County may be eligible to receive DTI Domain 1 and 3 incentive
payments for additional children receiving preventive services and continuity of care.
• Providers will learn how to operate in a system that is likely to produce improved oral health
outcomes compared to traditional oral health delivery systems. They will be well positioned
as the oral health system moves further into the Era of Accountability and payment methods
become tied to performance measures that include oral health outcomes.
Community Site and Other Participants
The host participating partners community site for this demonstration will be RAB-HSE and EOC
Program administrators will introduce the demonstration and support its adoption and integration.
Participating sites will:
■ Provide space and host the on-site dental teams;
■ Help develop and process agreements; and
• Help with arrangements for scheduling and integration of the system into school
activities and processes.
Anticipated schedule of participating sites:
Fresno Treatment and Education for Everyone on Teeth and Health
Virtual Dental Home Schedule
,� A. Madison A. Van Ness A.® A.
B. P/F/R
g, Mos ueda B. B. B. B.
A.® A. Ivy/EOC A.® A.® B.
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B. Mosqueda B. Madison B. Van Ness B. Highway City g.
ETTMIR"M Thursday
A. •� A.® A. Van Ness A.B. A.
B. Mos ueda B. B. B. B.
Legend
Franklin Head Start-EOC Ivy Mary Ella Brow,Corr,unity Cuter-EOC
Mosqueda Family-Reading and Beyond Van Ness Facility-Reading and Beyond
Madison Elementary-EOC Shields Facility-Reading and Beyond
Molly Nevarez Comm unity Church-EOC CentralC f.Schonloat.-3eacfngardaeye,d
H Igh,vay City-EOC Roosevelt High School-Reading and Beyond
Firebaugh Hazel Bailey Elementary-EOC I OPaperv.rk/F.Il..Llp/Re,,hedule,(P/F/R)
LDPP County of Fresno Page 23
The UOP will:
• Creating structure for VDH system
• Explanations, community organization, presentations, negotiations
• Planning training needs of providers, community organizations
• Coordinating Pacific activities with other involved agencies
• Assessment and assistance in MOUs and other agreements
• Assessing current enrollment program and forms and assisting in developing new
ones for VDH system
• Analyzing the current Dental Practice Management software and assisting use and
modification of IT systems
• Planning for and developing methods for VDH data collection
• Assistance in developing operation protocols and customized documentation for each
practice sites
• Facilitate group learning - meetings, webinars, calls
UOP planning, system design, and training topics include:
• Formation and use of advisory and steering committees.
• Planning for community awareness building about the system as it starts and grows.
• Selection of target populations for the system and investigation and understanding of
their characteristics, locations, unique needs, and services systems they are involved
with.
• Selection or engagement of the oral health providers that will participate and
investigation and understanding of their current training, capacity, and training needs
for the VDH system.
• Assessment of current agreements in place between providers and other participants
and community sites and the need for new agreements. Assistance with modifying
existing agreements or developing new ones for the VDH system.
• Assessment of current enrollment and program processes and forms in use by
providers and the need to modify or add new components and processes.
• Assistance with modifying existing enrollment and program processes and forms or
developing new ones for the VDH system.
• Assessment of provider and community site staffing arrangements and assistance
planning appropriate staffing organization and plans for the VDH system.
• Analysis of current provider electronic dental record (EDR) systems and assistance
using, modifying, or incorporating new components needed for theVDH system.
• Planning for program evaluation including selection of measures and developing
methods for collecting needed data.
• Assistance in developing operating protocols and documentation for use in
community sites.
LDPP County of Fresno Page 24
• Provide training including:
• The changing health care landscape, implications for the oral health system.
• Target populations and partner organizations, including culture, characteristics, and
integrating oral health services.
• The use of telehealth in the delivery of oral health services in social, educational and
general health systems including the use of telehealth in the delivery of oral health
services including, use of cloud-based record system in distributed team
environment, and function and communication of telehealth-connected teams.
• Legal considerations including HIPAA, consent, scope of practice laws and
regulations, telehealth billing regulations, and malpractice coverage.
• Operational protocols including arrangements with schools and other community
sites, use and arrangement for space, roles and responsibilities of provider staff and
school staff, scheduling, communications with administrators, staff, parents and other
stakeholders, and infection control in community locations
• EDR and Data management issues including using customized components of the
EDR system including risk assessment and basic measures, tracking VDH outcomes
using additional non-billing procedure codes, and using the EDR for communicating
in telehealth connected team practice.
• Scientific basis for VDH procedures including scientific basis for examination and
treatment planning using telehealth technology, risk adjusted prevention protocols,
partial caries removal, and criteria and technique for placing Interim Therapeutic
Restorations.
• Facilitating behavior change including factors that influence oral health,
• Principles influencing behavior change, and motivational interviewing
• Training dental hygienists to place Interim Therapeutic Restorations.
• Billing practice and strategies and other financial considerations.
The VDH model providing a dental home with focus on preventive services and care coordination
strategies as outlined in our proposal targets the highest concentration of need in Fresno County,
and throughout the state. Zip code 93701, has the highest amount of poverty per population of
10,000. Of 0-5 year olds in Fresno County 80% are receiving Medi-Cal. WIC programs, Head Start
centers as well as the Central Valley Regional Center provide services within the zip codes of
93701, 93702 and 93722 where we plan to concentrate our efforts. We know that the strategies
proposed will be an asset to our community and that we will do the work required to be successful
in our endeavors. Our plan includes motivational interviewing, health literacy activities, care
coordination, community outreach and education, as well as appointment reminder system.
According to numerous published studies barriers to care can removed with the above mentioned
items included. Our proposal includes the Triple Aim approach of improving access to care,
improving the experience and reducing costs. Based on these studies, we know that the
implemented proposal including the Triple Aim approach will be a success
The infrastructure needed to implement the proposed intervention consists mainly of those related
to the implementation of the VDH. We currently possess the remainder of the infrastructure
LDPP County of Fresno Page 25
including leadership, collaboration, surveillance capacity, planning and evaluation capacity.
However, to achieve the goal of improved oral health outcomes we must also be able to provide
the VDH evidence-based prevention and promotion programs combined with the comprehensive
care coordination that targets behaviors in families and communities leading to improved overall
health.
UOP will design and work with providers on a series of measures to find outcomes of these
projects. They will include both process measures and health outcomes measures. The VDH will
be directed by a contracted dentist who will be responsible for the tactics and technology of the
VDH operation to include; the setup of VDH equipment, making clinical referrals and tracking and
submission of information into the Electronic Dental Records (EDR) system and their time spent as
a mentee with UOP. The VDH contracted Dentist will also function as a Dental Provider billing any
clinical services to Denti-Cal with no duplicative billing. This VDH project will develop, strengthen
and stabilize over a 4 year time frame and will prepare the county to have this system continue on
a self-sustaining basis, supported by program revenue, after the grant period.
Through the shared data that the pilot project will collect, Outreach Oral Health Educators will be
able to coordinate the population's care more efficiently by being able to understand individual's
historical and scheduled procedures families will be assured timely, medically necessary care
through an Access Database, VDH dental providers providing preventive care will alert Outreach
Oral Health Educators identifying patients and families that need additional restorative care that
was unable to be provided in the VDH. It will be flagged as routine, or urgent. The Outreach Oral
Health Educators will follow up with families assisting them in making appointments with local
resources. By tracking and alerting in the cloud based Access database patients and families will
be followed and assisted in receiving the medically necessary care in a timely manner. Once the
recommended necessary treatment has been completed this will be updated as well in the
Database showing that the patient has received care.
Required quality improvement/corrective action plans will consistent of required performance
metrics andmeasures, deficient goals/ benchmarks, new/ revised processes, as well as client
and/or provider satisfaction surveys as appropriate. The Lead Entity will continuously monitor and
evaluate progress with the intent to improve processes, prevent problems and maximize the LDPP
success. A database will be implemented to house all of the data collected on the target population
that all participating entities will be able to access via HIPAA compliant cloud storage. If there are
technical issues the LDPP Lead Entity will leverage their staff analyst and partner agency staff to
provide assistance. We will also periodically request that Fresno County Department of Social
Services compare our LDPP listing of clients against active Medi-Cal client to identify those
families that have yet to be engaged and to whom further outreach efforts will be made.
As the LDPP Lead Entity, DPH will conduct ongoing monitoring and will make subsequent
adjustments should issues arise including the need to provide role clarification, performance
improvement plans, evaluation and, if necessary, termination of agreements. LDPP will assure
compliance with DHCS that specifies the requirements of the LDPP with STC109 and Attachment
JJ of the Medi-Cal 2020 Waiver Special Terms and Conditions.
LDPP County of Fresno Page 26
3.3 Accountability:
LDPP will monitor performance of the project and its individual partners on a monthly basis.
Information from site visits, monthly activity reports (derived from the Accountability and
Expectations table noted below), financial reports, customer service feedback (both by
professionals and families/children to be served) will be evaluated through surveys which will have
the option to be submitted by mail or by Survey Monkey. Information collected will be used to
identify issues, ensure that families the targeted population receive timely, medically necessary
care, evaluate potential corrective action plans or business process changes, communicate the
changes and then analyze if the changes implemented have produced the intended impact. If
there are technical issues the LDPP Lead Entity will leverage their staff analyst and partner agency
staff to provide assistance. We will also periodically request that Fresno County Department of
Social Services compare our LDPP listing of clients against active Medi-Cal clients to identify those
families that have yet to be engaged and to whom further invitations to participate will be sent.
Users of the Cloud based databases facilitating Outreach Oral Health Education and Provider
Relations and Recruitment will be staff referred by a participating partner and access granted by
the DPH LDPP Staff Analyst or designee.
As the LDPP Lead Entity, DPH will conduct ongoing monitoring and will make subsequent
adjustments should issues arise including the need to provide role clarification, performance
improvement plans, evaluation and, if necessary, termination of agreements with the advisement
and guidance of the Advisory Board. LDPP will assure compliance with DHCS that specifies the
requirements of the LDPP with STC109 and Attachment JJ of the Medi-Cal 2020 Waiver Special
Terms and Conditions. Aggregate data expected to be shared by DHCS via enrolled Medi-Cal
dental providers' submitted claims for reimbursement will further inform the Project of its progress
and provide an opportunity to identify areas to improve.
LDPP County of Fresno Page 27
3.4 Data Sharing:
Data sharing across the Fresno LDPP partners will occur through cloud computing that provides
shared computer processing resources in a securely encrypted manner. An Access database has
been created and will be utilized to store demographic information and information necessary for
care coordination. A secondary Access database will be created to track the work that will be
performed by Provider Relations Representatives and to manage the recruitment effort. The
Fresno LDPP client information will be requested by Outreach Oral Health Educators and retained
only once a Release of Information (ROI) is signed by the family. All LDPP staff will be provided
access to computers/laptops that will be able to access the internet; additionally, Provider
Relations Representatives will be provided have mobile virtual private network access. The
implementation of these databases and the cloud computing can be operational within 60-days of
notification of selection.
Fresno County DTI LDPP ��
Primary Adult Secondary Adult
Sameas Primary Fill]
Date of First Contact F- Street Address Date of First Contact Street Address
First Name F- APT# First Name F APT#
Middle Name F- City Middle Name F- city
Last Name F- State last Name F- State
DOB Zip DOB F- Zip
Sex email Address Sex F- email Address
Medi-Cal Recipient? Home Phone Medi-Cal Recipient? FF Home Phone
Medi-Cal# F- cell Phone Medi-Cal# F- Cell Phone
SSN/Pseudo 7- Text Message? SSN/Pseudo F-- Text Message?
Child Information
First Name � Medi-Cal Appointment Information
Middle Name Description Applications
Last Name
DOB F Y Date Time Covered CA Website
Age F- Provider Name
Sex Female Phone#F- Fax#
Comments Street Address
Suite/BLDG#
Subject Date 9/29/2016
City .
State
Zip
LDPP County of Fresno Page 28
The Fresno County DTI LDPP will use a Cloud based IT infrastructure to manage and share data
with the three participating entities.The Provider Relations Representatives will also be able to
access the system remotely from any location through a HIPAA compliant virtual private network.
i
DTI LDPP
Database
0 p
Q 0
RAB-HSE EOC.-HSE
[1-'H
Section 4: Progress Reports and Ongoing Monitoring- 30 points
4.1 LDPP Monitoring:
Outreach Oral Health Educators and Provider Relations Representatives personnel will input daily
client activity and provider contacts respectively into the cloud based Access database. In turn
there will be reports generated from this data that will help monitor their workload effectiveness and
efficiency. VDH performance will be based upon client satisfaction surveys which will also be
conducted for our Oral Health Educators and Provider Relations Representatives services.
Aggregate data reports derived from the Databases described in Section 3.4 will be created for
review during monthly contractor meetings between DPH, RAB-HSE, EOC, dental providers and
UOP. This information along with contractor financial reports will be reviewed during Fresno LDPP
Advisory Board meetings. The Advisory Board will utilize all information available to assess
performance and agency staff outcome comparisons. DPH will also submit timely quarterly and
annual reports as agreed to DHCS and CMS. Noted in the table below are the expected short-
term process measures whose planning will begin immediately upon notification of selection.
Depicted below is our short-term process measures or implementation plan.
LDPP County of Fresno Page 29
SHORT—TERM PROCESS MEASURES RESPONSIBILITY
Mo. Mo. Mo.
#1 #2 #3
Develop evaluation standards for each DPH / Advisory Board
staff position and contractors
Contract with EOC Health Services and DPH
Educations (EOC)
Contract with RAB-HSE DPH
Provide initial and ongoing training to RAB - HSE
personnel
Contract with University of Pacific UOP DPH / UOP
Launch Virtual Dental Home site EOC
Establish a VDH Agreement which will DPH
include as participants Dr. Hilario and Dr.
Cheney (Equipment Use &Stipends Only)
Initiate VDH Training UOP
Pre-testing period of new processes/ DPH; RAB-HSE; EOC; UOP
procedures
Participant recruitment Recruitment EOC; RAB — HSE; UOP
and enrollment Enrollment
Implement LDPP services EOC; RAB — HSE; UOP
Measurement of program outcomes DPH /Advisory Board
OUTREACH ORAL HEALTH EDUCATION AND CARE COORDINATION
GOAL
Fresno LDPP will increase oral health education, preventative and treatment participation
INTERVENTION DESCRIPTION Outreach Oral Health
Education and Care
Coordination Services
p OBJECTIVE STATEMENT: Families identified to receive oral health
o`o education will have received education, information and scheduled
n appointments with Denti-Cal Providers
OBJECTIVES:
1. Outreach to all Medi-Cal families with a concentrated effort on
m residing
zip codes 93701, 93702, 93722
� g �In p
2. Provide educational materials including pamphlets on several oral
health topics
MAJOR ACTIVITIES TIMELINE RESPONSIBLE
STAFF
1.1 Outreach to community partners, stakeholders, such as schools, WIC program, Head Start,
Early Head Start, youth services, medical and dental services programs to advertise,
recruit participants and secure access to venues to conduct outreach and provide oral
health materials.
LDPP County of Fresno Page 30
1.2 Identify other sites outside of the community partners where target population frequently
visits; such as supermarkets, swap meats, beauty salons, restaurants, movie theaters, etc.
1.3 Prepare all outreach materials needed for participants to take home including informational
pamphlets on oral health topics (also available in Spanish and Hmong) and other
incentives such as stickers, toothbrushes, toothpaste, dental floss, mouth mirrors, and two-
minute timers.
1.4 Call and meet with patients and provide education on oral hygiene and preventative
services.
1.5 Assist clients with identifying dentist and initial appointment setting
1.6 Provide patient support in assisting them in making and arriving at their scheduled dental
appointments
1.7 Track client contact and provide patient reports on the number of appointments scheduled
and the efforts made to remind patients of their appointments
1.8 Contact dentist office to determine if the efforts to educate and support the patient/family
resulted in a kept appointment (level of success)
1.9 Develop relationships and informal MOUs with Denti-Cal providers, dentists, and other
medical health and encourage them to accept and welcome new clients.
1.10 Make referrals to dentists who have opted-in on Domains 1 and 3 and all other providers
accepting Denti-Cal patient
1.11 Prepare reports summarizing activity outcomes utilizing the LDPP Access database
PERFORMANCE MEASURES AND TRACKING TOOLS
EXPECTED LEVEL OF JUL 1, 2017- JAN 1, 2018— JAN 1, 2019— JAN 1, 2020—
PERFORMANCE DEC 31, 2017 DEC 31, 2018 DEC 31, 2019 DEC 31, 2020
Performance 90% of OHE's 90% of OHE's 90% of OHE's 90% of OHE's
Measure 1: current caseload current caseload current caseload current caseload will
(450 Families) will (450 Families) (450 Families) (450 Families) have
OHE's will contact have knowledge will have will have knowledge and
and provide oral and awareness of knowledge and knowledge and awareness of oral
dental health oral health dental awareness of oral awareness of health dental care
materials to the care health dental care oral health
assigned caseload dental care
of 500/per year.
LDPP County of Fresno Page 31
Performance 25% of applicable 25% of applicable 50% of 80% of applicable
Measure 2: OHE targeted OHE targeted applicable OHE OHE targeted
population (125 population (125 targeted population (400
OHE's will refer Families) will be Families) will be population (250 Families) will be
targeted population to referred to Denti- referred to Denti- Families) will be referred to Denti-Cal
Denti-Cal providers Cal providers and Cal providers and referred to providers and
and ensure ensure scheduling ensure Denti-Cal ensure scheduling of
scheduling* of their of their initial scheduling of providers and their initial
initial appointments appointments their initial ensure appointments
and; appointments scheduling of
50% of the families in their initial
the OHE's caseload appointments
that have never seen Expected Expected Expected Expected Outcome:
a dentist will receive Outcome: Outcome: Outcome:
d of the OHE's
dental care 80%
80% of the OHE's 80% of the OHE's 80% of the caseload that have
*includes caseload that have caseload that OHE's caseload never seen a dentist
rescheduling of never seen a have never seen that have never will receive dental
missed appointments dentist will receive a dentist will seen a dentist care
dental care receive dental will receive
care dental care
Performance 95% of OHE's 95% of OHE's 95% of OHE's 95% of OHE's
Measure 3: current caseload current caseload current caseload current caseload
(475 Families) will (475 Families) will (475 Families) (475 Families) will
OHE's will ensure have continuity of have continuity of will have have continuity of
scheduling* of their care appointments care continuity of care appointments
caseloads continuity appointments care
of care appointments appointments
and; 70% of all Domain 70% of all 70% of all 70% of all Domain 1
Applicable clients in 1 clients in the Domain 1 clients Domain 1 clients clients in the LDPP
the OHE's caseload LDPP will receive in the LDPP will in the LDPP will will receive Domain
will receive continuity Domain 3 receive Domain 3 receive Domain 3
of care.*includes 3
rescheduling of
missed appointments
Tracking Tools
• Staff training certificates
• List of collaborative partners and stakeholders
• Roster of Head Start and Early Head Start sites
• WIC locations and number of clients they serve
• Presentation handouts and other materials
• Daily attendance roster for each family contact, phone and in person
• Attendance roster from in-services provided at partner locations
• List of agencies from resource guide
• Tracking log of Family contacts thru use of the LDPP Access database
• Pre and post surveys thru mail or Survey Monkey
• Health Fair and events sign in sheets
• Community Services Referral List (community clinics, food banks, advocacy services, etc.)
• Recruitment and Retention Plan
LDPP County of Fresno Page 32
PROVIDER RELATIONS AND RECRUITMENT
Goal:
Fresno LDPP will recruit, educate, and retain dental providers to participate in the Denti-
Cal Program to increase continuity of care for children enrolled in the Medi-Cal Pro am
INTERVENTION DESCRIPTION [Provider Relations and Recruitment
ices
OBJECTIVE STATEMENT: By December 30, 2017,the Provider Relations
Representatives will have contacted 100% of licensed Denti-Cal dentists will
have received information on DTI and in particular Domain 3 and 4, and would
O have begun recruitment efforts of those Denti-Cal providers who are not
W
C_ accepting new patients and, recruitment of dentists to become Denti-Cal
0 providers.
OBJECTIVES:
m 1. Outreach and provide information to current Denti-Cal providers on Fresno
LDPP and participation in Domain 3: Continuity of Care
2. Learn obstacles of current Denti-Cal providers who are not accepting new
patients and provide technical support to areas that will help with no-show rates
and other challenges.
3. Recruit and train licensed dentists to participate in the Denti-Cal program.
Provide assistance and technical support with the enrollment forms.
MAJOR ACTIVITIES TIMELINE RESPONSIBLE STAFF
2.1 Participate in DHCS provider training to gather more information on the provider
enrollment, documentation requirements, and basic billing information such as diagnosis codes,
treatment plans, reimbursement rates.
2.2 Contact Denti-Cal Providers and schedule appointments for in-services and provide them
with information on Fresno LDPP and Domains 1 and 3: Continuity of Care and how the Fresno
LDPP can be of assistance.
2.3 Outreach to licensed dentists that are not Denti-Cal providers. Schedule appointments for
in services and provide them with information on Denti-Cal and offer assistance to help complete
the enrollment forms and documentation requirements.
2.4 Connect and build relationships with community organizations and provider organizations
throughout assigned locations
2.5 Conduct trainings for Denti-Cal providers and their staff on program updates that are
beneficial to their practice
2.6 Prepare strategic plan to present to Denti-Cal providers to help with their no-show rates,
accepting new patients, and scheduling appointments for continuity of care
2.7 Prepare reports and summarize findings
1.8 Utilize the LDPP Provider Relations and Recruitment database to track service efforts
LDPP County of Fresno Page 33
PERFORMANCE MEASURES AND TRACKING TOOLS
EXPECTED LEVEL JUL 1, 2017- JAN 1, 2018— JAN 1, 2019— JAN 1, 2020—
OF PERFORMANCE DEC 31, 2017 DEC 31, 2018 DEC 31, 2019 DEC 31, 2020
Performance 90% of assigned 100% of all newly 100% of all newly 100% of all newly
Measure 4: Denti-Cal providers identified and identified and identified and
PRR's will contact (132 Providers) will assigned Denti-Cal assigned Denti-Cal assigned Denti-Cal
existing Denti-Cal receive information providers (Goal of providers (Goal of providers (Goal of
Providers on the Fresno 148) will receive 151) will receive 154) will receive
(Currently 147 LDPP and information on the information on the information on the
providers divided Domains 1 and 3: Fresno LDPP and Fresno LDPP and Fresno LDPP and
among 4 PPR's) Continuity of Care Domains 1 and 3: Domains 1 and 3: Domains 1 and 3:
Continuity of Care Continuity of Care Continuity of Care
Performance PRR's will attempt PRR's will attempt PRR's will attempt PRR's will attempt
Measure 5: to schedule to schedule to schedule to schedule
PRR's will appointments with appointments with appointments with appointments with
schedule assigned Denti- assigned Denti- assigned Denti- assigned Denti-
appointments with Cal providers for Cal providers for Cal providers for Cal providers for
Denti-Cal providers an in-service on an in-service on an in-service on an in-service on
for an in-service on DTI Domains 1 and DTI Domains 1 and DTI Domain s 1 DTI Domain s 1
DTI Domain s 1 3 and the Fresno 3 and the Fresno and 3 and the and 3 and the
and 3 Continuity of LDPP LDPP Fresno LDPP Fresno LDPP
Care and the Expected Expected Expected Expected
Fresno LDPP Outcome: Outcome: Outcome: Outcome:
70% of assigned 95% of assigned 95% of assigned 95% of assigned
Denti-Cal providers Denti-Cal providers Denti-Cal providers Denti-Cal providers
will receive the in- will receive the in- will receive the in- will receive the in-
service service service service
Performance PRR's will attempt PRR's will attempt PRR's will attempt PRR's will attempt
Measure 6: to successfully to successfully to successfully
to successfully o 0 0
PRR will o engage with 95% engage with 95/o engage with 95/o
successfully engage with Den%ti-
of assigned and of assigned and of assigned and
engage with Denti- of assigned s who remaining Denti- remaining Denti- remaining Denti-
Cal Providers who Cal Providers who Cal Providers who Cal Providers who Cal Providers who
will agree to accept will agree to accept atients will agree to accept will agree to accept will agree to accept
new patients. new p . new patients. new patients. new patients.
Expected Expected Expected Expected
Outcome: Outcome: Outcome: Outcome:
70% of the Denti- 70% of the Denti- 70% of the Denti- 70% of the Denti-
Cal Providers will Cal Providers will Cal Providers will Cal Providers will
agree to accept agree to accept agree to accept agree to accept
new Denti-Cal new Denti-Cal new Denti-Cal new Denti-Cal
patients patients patients patients
LDPP County of Fresno Page 34
Performance PRR's will attempt PRR's will attempt PRR's will attempt PRR's will attempt
Measure 7: to engage with to engage with to engage with to engage with
Licensed dentists 50% of assigned 50% of assigned 95% of assigned 95% of assigned
not enrolled in Dentists. and remaining and remaining and remaining
Denti-Cal will be Dentists. Dentists. Dentists.
contacted (through
multiple avenues
and attempts)to
promote and
encourage their
participation in
Denti-Cal
Performance PRR's will PRR's will PRR's will PRR's will
Measure 8: scheduled scheduled scheduled scheduled
Licensed dentists appointments for appointments for appointments for appointments for
will have scheduled 100% of dentists 100% of dentists 100% of dentists 100% of dentists
appointments for interested in interested in interested in interested in
training on Denti- training on Denti- training on Denti- training on Denti- training on Denti-
Cal enrollment Cal enrollment Cal enrollment Cal enrollment Cal enrollment
requirements and
in participating in
Domain s 1 and 3.
Performance PRR's will PRR's will PRR's will PRR's will
Measure 9: successfully enroll successfully enroll successfully enroll successfully enroll
Licensed dentists 2% of their provider 2% of their provider 2% of their provider 2% of their provider
will enroll as Denti- caseload in Denti- caseload in Denti- caseload in Denti- caseload in Denti-
Cal providers Cal Cal Cal Cal
Tracking Tools
• Staff training certificates and training log.
• List of collaborative partners and stakeholders
• List of State licensed providers
• List of Denti-Cal providers
• Denti-Cal presentation and training materials
• Denti-Cal forms completed and submitted
• Daily attendance roster for each dentist contact, phone and in person and their staff
• Attendance roster from in-services provided at partner locations
• Tracking log of dentist contacts
• Pre and post surveys thru mail or Survey Monkey
• Health fair and events sign in sheets
• Recruitment and Retention Planning utilizing the Relations and Recruitment database
VIRTUAL DENTAL HOME
Outcomes
Pacific will design and work with providers on a series of measures to find outcomes of these projects.
They will include both process measures and health outcomes measures.
Quantitative Process Measures
Measures of what was done in the project will include:
• Number of children seen
LDPP County of Fresno Page 35
• Characteristics of children seen
• Procedures performed with an emphasis on preventive procedures
• Risk assessments and subsequent interventions
• Decisions made by dentists about the need for children to be seen in-person by a dentist
• Recall and follow-up visits needed and kept.
• Costs and revenue attributable to this system
Qualitative Measures
• Opinions of participant providers and site personnel
• Satisfaction of children and parents
4.2 Data Analysis and Reporting:
As indicated in section 4.1: Aggregate data reports derived from the Databases described in
Section 3.4, will be created for review, by DPH staff, during monthly contractor meetings between
DPH, RAB-HSE, EOC, dental providers and UOP. This information along contractor financial
reports will be shared during Fresno LDPP Advisory Board meetings. The Advisory Board will
utilize all information available to assess performance, agency staff outcomes comparisons and
DPH will submit timely quarterly and annual reports as agreed to DHCS and CMS.
The Fresno LDPP performance of all partners will be evaluated during monthly advisory meetings
where the financial and activity reports from each agency will be reviewed. If in reviewing these
reports an issue it's determined it will be brought to the partners attention. If in the consecutive
month the issue is not resolved or satisfactory mitigation then a one on one meeting between the
project administrator and the partner will be held and a corrective action plan will be developed. If
at the end of the 90 day review period the issues have not been rectified a formal letter will be
issued by the DPH to the partner alerting them that they are in failure to perform status and that if
the issue is not corrected within 90 days to DPH's satisfaction, steps to terminate services will be
initiated. While this is an important program decision item to include its use is extremely unlikely as
the collaborating partners are all well-known and respected professions with a great deal of
experience working with the populations' unique social economic and cultural backgrounds.
The Lead Entity will facilitate monthly meetings individually with each of the Participating Partners
in order to review performance metrics and measures, staffing levels, productivity, training
accountability, client and provider satisfaction, and the overall opportunities for improvement and
adherence to state pilot requirements. The Lead Entity will also facilitate the Advisory Board
meetings where these same metrics will be reviewed and discussed. The Advisory Board
meetings will be held initially on a monthly basis, after the first year the frequency would be
reduced to a bi-monthly with special sessions being called as required.
As the LDPP Lead Entity, DPH will conduct ongoing monitoring and will make subsequent
adjustments should issues arise including the need to provide role clarification, performance
improvement plans, evaluation and, if necessary, termination of agreements. DPH will use
analyses for sustainability planning, including how the LDPP may be sustained post DTI funding.
Ultimately, the measure of our progress will be measured by aggregate data expected to be shared
with DHCS via enrolled Medi-Cal dental providers' submitted claims for reimbursement which will
further inform the DPH of its progress and provide opportunities to identify areas to improve.
LDPP County of Fresno Page 36
Section 5 Financing
5.1 Financing Structure
Activity, performance metrics and measures, financial reports and invoices from participating
partners (RAB-HSE, EOC, dental providers and UOP), will be due monthly by the 10t" of the month
following the month of service. These documents will be reviewed by the DPH Analyst who will
alert the LDPP Administrator of any irregularity or if additional questions are generated by the
reports submitted. Once the documents have been approved by the Administrator, the contractors
will be notified that the invoice will be held pending submission of the next quarterly DHCS DTI
LDPP claim period. DPH will submit a total claim amount derived from the participating partners
approved invoices and that of the DPH invoice. Once payment is received from DHCS the
participating partners will receive their payments within 15-days. The payment to dental providers
that are subcontracted will be limited to stipends to address training hours provided by UOP. This
process will be detailed in Fresno LDPP contractor agreements that will be instituted once
selection has been received and accepted.
DHCS
Release Review
Funds Invoices
Review Accept Submit Review
Invoices Funds Invoices Invoices
Lead Entity
Release DPH
Funds
Review Release Accept Submit Release
Invoices Funds Funds Invoices Funds
Submit Accept Submit Accept Submit Accept Accept Submit
Invoices Funds Invoices Funds Invoices Funds Funds
Invoices
RAB-HSE UOP -VDH VDH Dental Office EOC-HSE
LDPP County of Fresno Page 37
5.2 Funding Request
Year 1 Year 2 Year 3 Year 4 Total
DPH $231,299 $176,012 $162,604 $163,113 $733,028
RAB-HSESubcontract $719,840 $1,310,248 $1,404,134 $1,502,643 $4,936,865
EOC Subcontract $730,079 $1,343,251 $1,474,477 $1,576,203 $5,124,010
uOP Subcontract $96,904 $119,232 $65,787 $50,702 $332,626
TOTAL $1,778,122 $2,948,743 $3,107,003 $3,293,417 $11,127,285
5.3 Budget
Year 1 Year 2 Year 3 Year 4 Total
1)Personnel Costs $26,730 $52,564 $52,312 $53,533 $185,139
2)Fringe Benefits $20,048 $39,423 $39,234 $40,150 $138,855
3)Operating Expenses $67,850 $56,614 $57,546 $58,497 $240,507
4)Equipment Expenses $90,000 $- $- $- $90,000
5)Travel Expenses $- $- $- $- $-
6)Subcontractor Expenses $1,546,823 $2,772,731 $2,944,398 $3,129,548 $10,393,501
7)Other Costs $22,428 $19,068 $5,208 $3,192 $49,896
8)Indirect Costs $4,243 $8,343 $8,304 $8,497 $29,387
TOTAL $1,778,122 $2,948,743 $3,107,003 $3,292,661 $115127,285
Staffinq Plan
Staff Person Personnel Role and Responsibilities
(maximum)
Fresno LDPP- County of Fresno Department of Public Health
The Fresno LDPP Administrator will; Oversee contract negotiations and processing;
.10 Fresno LDPP Evaluate performance outcomes; Facilitate periodic partner meetings; Take appropriate
Administrator actions to address performance issues; Relay LDPP data and fiscal reports to the State and
Oversee LDPP staff training
The Staff Analyst will ensure adherence to the Fresno LDPP requirements and regulations.
.20 FTE Staff Analyst The Staff Analyst will perform a variety of assignments including research, analysis,
planning, evaluation, and administrative duties including preparation of contracts for Board
of Supervisor approval
.5 FTE Account Clerk Collect monthly activity reports; Log activity data; Process invoices once approved by the
Manager
.5 FTE Office Assistant Responsible for providing ancillary support mainly focusing on invoice processing from
subcontractors and tracking of requested dental provider entity training stipends
RAB-HSE
Program Director(at .50 Is responsible for the overall management, planning, evaluation, assessment, continuous
FTE) improvement, compliance, budget adherence and program outcomes of the DTI LDPP
Project. Oversees and coordinates all activities and efforts in building relationships with
LDPP County of Fresno Page 38
stakeholders and collaborative partners.
Will oversee and coordinate all activities with Program Director on program implementation
2 FTE Project and administration of project plan. Manage Outreach Health Educators for carrying out
Coordinator work plan, data collection instruments, providing technical assistance in administering tools
to collect data and performance measurements.
2 FTE Provider Provider Relations Representative -These individuals will have at least a Bachelor's Degree
Relations in Education/Social Sciences and at least three years of experience...
Representative
15 FTE Outreach Outreach Health Educator-These individuals will have at least a Bachelor's Degree in
Health Educator Education/ Social Sciences and at least three years of experience...
Fresno EOC
Is responsible for the overall management, planning, evaluation, assessment, continuous
Program Director(at .50 improvement, compliance, budget adherence and program outcomes of the DTI LDPP
FTE) Project. Oversees and coordinates all activities and efforts in building relationships with
stakeholders and collaborative partners.
Will oversee and coordinate all activities with Program Director on program implementation
2 FTE Project and administration of project plan. Manage Outreach Health Educators for carrying out
Coordinator work plan, data collection instruments, providing technical assistance in administering tools
to collect data and performance measurements.
2 FTE Provider Provider Relations Representative -These individuals will have at least a Bachelor's Degree
Relations in Education/Social Sciences and at least three years of experience
Representative
15 FTE Outreach Oral Outreach Health Educator-These individuals will have at least a Bachelor's Degree in
Health Educator Education/Social Sciences and at least three years of experience.
University of Pacific Virtual Dental Home - Personnel
Project Director Director of the Pacific Center for Special care and will direct the
(FTE.02 Y1,.04 Y2,.02 Y3&Y4) project.
Director of Operations Director of Grant Operations and will oversee communications and
(FTE.06 Y1,.11 Y2,.06 Y3,.04 Y4) implementation with providers and site.
Program Manager Project Manager will schedule and track deliverables, reporting,
(FTE.16 Y1,.29 Y2,.15 Y3,.11 Y4) training and monitoring activities.
Program Content Manager Will schedule and track deliverables, reporting, training and
(FTE.07 Y1,.12 Y2,.06 Y3,.04 Y4) monitoring activities.
Contracts Manager Business Manager and will be responsible for contracts, expenses,
(FTE.03 Y1,.06 Y2,.03 Y3,.02 Y4) reporting systems.
Asst. Project Manager Responsible for technical training and assistance on data systems
(FTE.07 Y1,.12 Y2,.06 Y3,.05 Y4) and equipment.
UOP's FTE percentages and budget are based on a formula that takes the amount of dental
providers participating in the LDPP per year and the amount of training, consultation, and technical
assistance (TCTA) that each entity will need into account. The calculations are based on a
decreasing need for TCTA an entity will need over the course of consecutive years of participation.
UOP anticipates that one dental provider entity will require 267 hours of training during their first
year of participation, 227 in their 2nd year, 62 in their 3rd year, and 29 in their 4th year. The Fresno
LDPP anticipates having two dental provider in Years 1-4 of the LDPP.
LDPP County of Fresno Page 39
Section 6: Attestations and Certification
6.1 Attestation I certify that, as the representative of the LDPP Lead Entity, the Lead Entity agrees
to the following conditions:
Q The LDPP Lead Entity will assure appropriate participation in regular Learning Collaboratives
to share best practices among participating entities, in accordance with STC 109.
® The LDPP Lead Entity will enter into an agreement with DHCS that specifies the requirements
of the LDPP with STC 109 and Attachment JJ of the Medi-Cal 2020 Waiver Special Terms and
Conditions. The agreement with DHCS will include a data sharing agreement. See Exhibit A
"HIPAA Business Associate Addendum (BAA)" of this Application. The provisions in the DI-ICS
boilerplate BAA apply only to BAA-covered information that is shared by DHCS with the LDPP
specifically for the purpose of LDPP operations and evaluation. DI-iCS does not anticipate that
BAA-covered information will be shared for the purpose of LDPP operations or evaluation.
DHCS anticipates limited, or no, BAA-covered information sharing from the LDPP to DHCS.
However, DHCS will include a BAA in the event that data needs to be shared. The BAA will
apply to the transfer of BAA-covered information should the need arise.
® The LDPP Lead Entity shall submit quarterly and annual reports in a manner specified by
DHCS and CMS. Continuation of the LDPP may be contingent on timely submission of the
quarterly and annual reports.
[=] The LDPP Lead Entity will report and submit timely and complete data to DHCS in a format
specified by the State and as defined in the LDPP's individual agreement with the State.
Incomplete and/or untimely data submissions may lead to a financial penalty after multiple
occurrences and technical assistance is provided by the State.
The LDPP Lead Entity will assure participation in program evaluation activities and will agree to
provide data to measure the success of key activities of the work plan throughout the duration
of the project,
I hereby certify that all information provided in this application is true and accurate to the best of my
knowledge, and that this application has been completed based on a thorough understanding of
program participation requirements as specified in the Medi-Cal 2020 Waiver Special Terms and
Conditions and Attachment JJ of said waiver.
/
Signature of LDPP Lead 0 a entati�a Date
LDPP County of Fresno Page 40
APPENDICES
1. Letters of Support / Participation
LDPP County of Fresno
Year 1 Year 2 Year 3 Year 4 Total
$ 26,730 $ 52,564 $ 52,312 $ 53,533 $ 185,139
$ 20,048 $ 39,423 $ 39,234 $ 40,150 $ 138,855
• $ 67,850 $ 56,614 $ 57,546 $ 58,497 $ 240,507
$ 90,000 $ - $ - $ - $ 90,000
$ 1,546,823 $ 2,772,731 $ 2,944,398 $ 3,129,548 $ 10,393,501
• $ 22,428 $ 19,068 $ 5,208 $ 3,192 $ 49,896
$ 4,243 $ 8,343 $ 8,304 $ 8,497 $ 29,387
Total $ 1,778,122 $ 2,948,743 $ 3,107,003 $ 3,293,417 $ 11,127,285
Year 1 Year 2 Year 3 Year 4 Total
' $ 231,299 $ 176,012 $ 162,604 $ 163,869 $ 733,784
$ 719,840 $ 1,310,248 $ 1,404,134 $ 1,502,643 $ 4,936,865
• $ 730,079 $ 1,343,251 $ 1,474,477 $ 1,576,203 $ 5,124,010
•' $ 96,904 $ 119,232 $ 65,787 $ 50,702 $ 332,626
Total $ 1,778,122 $ 2,948,743 $ 3,107,003 $ 3,293,417 $ 11,127,285
LDPP
Exhibit A Attachment I
Budget
Year
07/01/2017through 12/31/2017
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Division Manager 1 $7,500-$8,000 0.1 $ 4,750
Staff Analyst 1 $3,750- $4,750 0.2 $ 4,850
Office Assistant 1 $2,100-$2,600 0.5 $ 6,500
Systems & Procedures Analyst 1 $5,500- $6,000 0.1 $ 3,505
Account Clerk 1 $2,000- $2,500 0.5 $ 7,125
Total Salary $ 26,730
Fringe Benefits (75%)* $ 20,048
Total Personnell $ 46,778
Operating Expenses
Information Technology Infrastructure $ 45,000.00
Communications $ 22,850.00
Total Operating Expensesi $ 67,850
Equipment
Portable Equipment Sets X 2 $ 57,000
Nomad Pro 2 X-Ray w/Carrying Case X 2 $ 16,000
Digital X-Ray Sensor-Size 0 X 2 $ 13,800
plus Care Plan - 5 YR ADV Plan X 2 $ 3,200
Total Equipment Expenses $ 90,000.00
Subcontracts
Reading and Beyond - HSE
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$458,950 $134,375 $19,440 $35,075 $68,500 $3,500 $719,840
Fresno Economic Opportunities Commision
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$471,566 $124,513 $20,300 $41,800 $68,500 $3,400 $730,079
University of the Pacific
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$73,153 $4,200 $8,400 $0 $11,151 $0 $96,904
Total Subcontractsl $ 1,546,823
Other Costs
Dental Provider Entity Stipends $ 22,428
Total Other Costsi $ 22,428
Indirect Costs Indirect Costsi $ 4,243
Annual Budget Totall $ 1,778,122
*Fresno County Public Health employees'benefit rate includes Unemployment Insurance,Benefit Administration,OASDI,Health Insurance,and
Retirement. Retirement and Health Insurance are the primary contributors to a high benefit percentage.When the minimal amount for Benefit
Administration and Unemployment Insurance,and 7%for OASDI are included,the average benefit rate for these positions is just over 75%.
Page 1 of 8
LDPP
Exhibit A Attachment I
Budget Narrative
Year
07/01/2017through 12/31/2017
Division Manager: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct
and indirect supervision of project design, implementation, contract compliance, quality assurance,
budget adherence and program outcomes.
Staff Analyst: Responsible for report generation, subcontract development, performance monitoring, IT
implementation and development.
Office Assistant: Responsible for providing ancillary support mainly focusing on invoice processing from subcontractors
and tracking of dental provider training stipends as well as day-to-day activities of other staff.
Systems & Proced- Responsible for the development, implementation, and maintenance of the LDPP's Information
ures Analyst: Technology Infrastructure.
Account Clerk: Responsible for reviewing invoices submitted by subcontractors, maintaining adherence to budget, and
preparing invoices for submittal to DHCS.
Information Techno- License and maintenance fees for IT system and data management. Initial design of front-end user
logy Infrastructure: interface and back-end reporting. Staff training.
Communications: Media campaign to include DTI public service announcements via TV, Radio, Print, and Digital.
Development and production of educational materials.
Equipment: Portable dental equipment needed to run VDH includes Digital X-Ray Sensor size 1 and 2, Intra-Oral
Camera, Laptop, Portable Light, Portable Chair, Extra-Oral Camera, Curing Light, Amalgamator-
Touchpad, Clinical Instruments, Lead Apron (1 Adult, 1 Child), MiFi Hotspot,Aseptico Delivery Unit,
Aseptico Fiber Optics, Cavitron, Hand Pieces, and Instruments.
Other Costs: Stipends are to be provided at an hourly rate of$42 per UOP training attendee. Fresno LDPP
anticipates two provider entities partaking in year one.This equates to 534 potential training hours at
$42 per hour($22,428).
Indirect Costs: Fresno County Department of Public Health's Federally approved Indirect Cost rate of 15.873%of
salary.
Page 2 of 8
LDPP
Exhibit A Attachment I
Budget
Year II
01/01/2018through 12/31/2018
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Division Manager 1 $7,500-$8,000 0.1 $ 9,690
Staff Analyst 1 $3,750- $4,750 0.2 $ 9,894
Office Assistant 1 $2,100-$2,600 0.5 $ 13,390
Systems & Procedures Analyst 1 $5,500- $6,000 0.07 $ 5,055
Account Clerk 1 $2,000- $2,500 0.5 $ 14,535
Total Salary $ 52,564
Fringe Benefits (75%)* $ 39,423
Total Personnell $ 91,987
Operating Expenses
Information Technology Infrastructure $ 10,000.00
Communications $ 46,614.00
Total Operating Expensesi $ 56,614
Subcontracts
Reading and Beyond - HSE
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$993,744 $125,804 $38,880 $0 $148,320 $3,500 $1,310,248
Fresno Economic Opportunities Commision
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$1,011,631 $134,700 $42,400 $2,800 $148,320 $3,400 $1,343,251
University of the Pacific
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$90,098 $4,200 $11,200 $0 $13,734 $0 $119,232
Total Subcontractsi $ 2,772,731
Other Costs
Dental Provider Entity Stipends $ 19,068
Total Other Costsi $ 19,068
Indirect Costs $ 8,343
Indirect Costsl $ 8,343
Annual Budget Total I $ 2,948,743
*Fresno County Public Health employees'benefit rate includes Unemployment Insurance,Benefit Administration,OASDI,Health Insurance,and
Retirement. Retirement and Health Insurance are the primary contributors to a high benefit percentage.When the minimal amount for Benefit
Administration and Unemployment Insurance,and 7%for OASDI are included,the average benefit rate for these positions is just over 75%.
Page 3 of 8
LDPP
Exhibit A Attachment I
Budget Narrative
Year II
01/01/2018through 12/31/2018
Division Manager: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct
and indirect supervision of project design, implementation, contract compliance, quality assurance,
budget adherence and program outcomes.
Staff Analyst: Responsible for report generation, subcontract development, performance monitoring, IT
implementation and development.
Office Assistant: Responsible for providing ancillary support mainly focusing on invoice processing from subcontractors
and tracking of dental provider training stipends as well as day-to-day activities of other staff.
Systems & Proced- Responsible for the development, implementation, and maintenance of the LDPP's Information
ures Analyst: Technology Infrastructure.
Information Techno- License and maintenance fees for IT system and data management.
logy Infrastructure:
Account Clerk: Responsible for reviewing invoices submitted by subcontractors, maintaining adherence to budget, and
preparing invoices for submittal to DHCS.
Communications: Media campaign to include TV, Radio, Print, and Digital. Development and production of educational
materials.
Other Costs: Stipends are to be provided at an hourly rate of$42 per UOP training attendee. Fresno LDPP
anticipates two provider entities partaking in year two.This equates to 454 potential training hours at
$42 per hour($19,068).
Indirect Costs: Fresno County Department of Public Health's Federally approved Indirect Cost rate of 15.873%of
salary.
Page 4 of 8
LDPP
Exhibit A Attachment I
Budget
Year III
01/01/2019through 12/31/2019
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Division Manager 1 $7,500-$8,000 0.1 $ 9,884
Staff Analyst 1 $3,750- $4,750 0.2 $ 10,092
Office Assistant 1 $2,100-$2,600 0.5 $ 13,792
Systems & Procedures Analyst 1 $5,500- $6,000 0.05 $ 3,719
Account Clerk 1 $2,000- $2,500 0.5 $ 14,826
Total Salary $ 52,312
Fringe Benefits (75%)* $ 39,234
Total Personnell $ 91,546
Operating Expenses
Information Technology Infrastructure $ 10,000.00
Communications $ 47,546.00
Total Operating Expensesi $ 57,546
Subcontracts
Reading and Beyond - HSE
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$1,073,313 $128,245 $38,880 $0 $160,196 $3,S00 $1,404,134
Fresno Economic Opportunities Commision
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$1,124,381 $139,500 $44,200 $2,800 $160,196 $3,400 $1,474,477
University of the Pacific
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$46,152 $4,200 $8,400 $0 $7,035 $0 $65,787
Total Subcontractsi $ 2,944,398
Other Costs
Dental Provider Entity Stipends $ 5,208
Total Other Costsl $ 5,208
Indirect Costs $ 8,304
Indirect Costsi $ 8,304
Annual Budget Totall $ 3,107,003
*Fresno County Public Health employees'benefit rate includes Unemployment Insurance,Benefit Administration,OASDI,Health Insurance,and
Retirement. Retirement and Health Insurance are the primary contributors to a high benefit percentage.When the minimal amount for Benefit
Administration and Unemployment Insurance,and 7%for OASDI are included,the average benefit rate for these positions is just over 7S%.
Page 5 of 8
LDPP
Exhibit A Attachment I
Budget Narrative
Year III
01/01/2019through 12/31/2019
Division Manager: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct
and indirect supervision of project design, implementation, contract compliance, quality assurance,
budget adherence and program outcomes.
Office Assistant: Responsible for providing ancillary support mainly focusing on invoice processing from subcontractors
and tracking of dental provider training stipends as well as day-to-day activities of other staff.
Staff Analyst: Responsible for report generation, subcontract development, performance monitoring, IT
implementation and development.
Systems & Proced- Responsible for the development, implementation, and maintenance of the LDPP's Information
ures Analyst: Technology Infrastructure.
Information Techno- License and maintenance fees for IT system and data management.
logy Infrastructure:
Account Clerk: Responsible for reviewing invoices submitted by subcontractors, maintaining adherence to budget, and
preparing invoices for submittal to DHCS.
Communications: Media campaign to include TV, Radio, Print, and Digital. Development and production of educational
materials.
Other Costs: Stipends are to be provided at an hourly rate of$42 per UOP training attendee. Fresno LDPP
anticipates two provider entities partaking in year two.This equates to 124 potential training hours at
$42 per hour($5,208).
Indirect Costs: Fresno County Department of Public Health's Federally approved Indirect Cost rate of 15.873%of
salary.
Page 6 of 8
LDPP
Exhibit A Attachment I
Budget
Year IV
01/01/2020through 12/31/2020
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Division Manager 1 $7,500-$8,000 0.1 $ 10,081
Staff Analyst 1 $3,750- $4,750 0.2 $ 10,294
Office Assistant 1 $2,100-$2,600 0.5 $ 14,205
Systems & Procedures Analyst 1 $5,500- $6,000 0.05 $ 3,830
Account Clerk 1 $2,000- $2,500 0.5 $ 15,122
Total Salary $ 53,533
Fringe Benefits (75%)* $ 40,150
Total Personnell $ 93,683
Operating Expenses
Information Technology Infrastructure $ 10,000.00
Communications $ 48,497.00
Total Operating Expensesi $ 58,497
Subcontracts
Reading and Beyond - HSE
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$1,156,762 $130,850 $38,880 $0 $172,651 $3,S00 $1,502,643
Fresno Economic Opportunities Commision
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$1,207,052 $144,300 $46,000 $2,800 $172,651 $3,400 $1,576,203
University of the Pacific
Personnel Operating Expenses Travel Equipment Indirect Costs Other Costs Total Costs
$33,062 $4,200 $8,400 $0 $5,040 $0 $50,702
Total Subcontractsi $ 3,129,548
Other Costs
Dental Provider Entity Stipends $ 3,192
Total Other Costsl $ 3,192
Indirect Costs $ 8,497
Indirect Costsi $ 8,497
Annual Budget Totall $ 3,293,417
*Fresno County Public Health employees'benefit rate includes Unemployment Insurance,Benefit Administration,OASDI,Health Insurance,and
Retirement. Retirement and Health Insurance are the primary contributors to a high benefit percentage.When the minimal amount for Benefit
Administration and Unemployment Insurance,and 7%for OASDI are included,the average benefit rate for these positions is just over 7S%.
Page 7 of 8
LDPP
Exhibit A Attachment I
Budget Narrative
Year IV
01/01/2020through 12/31/2020
Division Manager: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct
and indirect supervision of project design, implementation, contract compliance, quality assurance,
budget adherence and program outcomes.
Staff Analyst: Responsible for report generation, subcontract development, performance monitoring, IT
implementation and development.
Office Assistant: Responsible for providing ancillary support mainly focusing on invoice processing from subcontractors
and tracking of dental provider training stipends as well as day-to-day activities of other staff.
Systems & Proced- Responsible for the development, implementation, and maintenance of the LDPP's Information
ures Analyst: Technology Infrastructure.
Information Techno- License and maintenance fees for IT system and data management.
logy Infrastructure:
Account Clerk: Responsible for reviewing invoices submitted by subcontractors, maintaining adherence to budget, and
preparing invoices for submittal to DHCS.
Communications: Media campaign to include TV, Radio, Print, and Digital. Development and production of educational
materials.
Other Costs: Stipends are to be provided at an hourly rate of$42 per UOP training attendee. Fresno LDPP
anticipates two provider entities partaking in year two.This equates to 76 potential training hours at
$42 per hour($3,192).
Indirect Costs: Fresno County Department of Public Health's Federally approved Indirect Cost rate of 15.873%of
salary.
Page 8 of 8
Reading and Beyond - HSE
Exhibit B Attachment I
Budget
Year
07/01/2017through 12/31/2017
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Program Director 1 $7,000-$8,000 0.5 $ 22,500
Project Coordinator 2 $4,500- $5,500 1 $ 60,000
Provider Relations Representative 2 $4,000-$4,500 1 $ 50,000
Outreach Oral Health Educator 12 $2,500- $3,500 1 $ 210,000
Total Salary $ 342,500
Fringe Benefits (34%) $ 116,450
Total Personnel $ 458,950
Operating Expenses
Facility Rental $ 34,650
Office Furniture $ 33,000
Office Supplies $ 10,800
Communications $ 29,200
Printer/Copier $ 5,200
Projectors/Projector Screens $ 2,925
Program Supplies $ 18,600
Total Operating Expenses $ 134,375
Equipment
VOIP Telephone System/Server $ 18,500
Laptops $ 16,575
Total Equipment Expenses $ 35,075
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 19,440
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Other Costs
Training $ 3,500
Total Other Costs $ 3,500
Indirect Costs $ 68,500
Indirect Costs $ 68,500
Annual Budget Total $ 719,840
Page 1 of 8
Reading and Beyond - HSE
Exhibit B Attachment I
Budget Narrative
Year
07/01/2017through 12/31/2017
Program Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Project Coordinator: Coordinates all activities with Project Director on program implementation and administration of project plan. Oversees day
to day activities of Outreach Health Educators. Will provide information and education to ensure implementation of work
plan activities. Oversees day to day activities of Outreach Health Educators and provide assistance in problem solving and
goal setting to meet high quality standards.
Provider Relations Recruit,train,enroll,retain,and build strong relationships with Dental Providers to participate in the Denti-Cal Program.
Representative: Providing in-services and continuing education to the dental and medical community.
Outreach Oral Health Year 1 begin with 12 Educators,Year 2 increase to 13 Educations,Year 3 increase to 14 Educators,and Year 4 increase to 15
Educators: Educators. Recruit,train,enroll,retain and build strong relationships with families and clients. Referral and facilitating
appointments to the dental providers and establish dental homes.
Facility Rental: Office space rent for for staff.
Office Furnature: Desks with overhead cabinets,office chairs,guest chairs,training tables,training chairs,filing cabinets,book shelves for staff,
white boards.
Office Supplies: Office and consumable supplies such as papers,pens,notepads,toners,folders,desk trays,folders,binders,electrocal cords,
extension cords.
Communications: Landline connections,Internet and WiFi connections,servers,cell phones.
Program Supplies: General and consumable supplies needed for outreach,recruitment and retention of clients and dentists to participate in the
program. Meeting and training supplies.
VOIP Telephone VOIP Telephone System and Server for the office needed to communicate with staff,clients and all day to day activities of the
System/Server: program.
Laptops: 17 laptops/Surface Pro for all staff. These equipment need to be portable and be carried to the actual sites of clients/provider
locations to gather data and help with enrollment with Denti-Cal and scheduling appointments with providers.
Printer Copier: For scanning,faxing and printing.
Projector/Screen: 2 portable projectors and 2 TVs for training and presentations inside the facility and outside training for inservices,
recruitment.
Travel: Mileage to and from meetings,recruitment of clients and providers,implementation of project.
Training: Training and conference fees required to implement project.
Indirect Expense: Calculated at 20%of wages-to contribute towards Reading and Beyond's documented administrative and overhead costs.
Page 2 of 8
Reading and Beyond - HSE
Exhibit B Attachment I
Budget
Year II
01/01/2018through 12/31/2018
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Program Director 1 $7,000-$8,000 0.5 $ 46,350
Project Coordinator 2 $4,500- $5,500 1 $ 123,600
Provider Relations Representative 2 $4,000-$4,500 1 $ 103,000
Outreach Oral Health Educator 13 $2,500- $3,500 1 $ 468,650
Total Salary $ 741,600
Fringe Benefits (34%) $ 252,144
Total Personnel $ 993,744
Operating Expenses
Facility Rental $ 71,379
Office Supplies $ 10,800
Communications $ 24,050
Laptops $ 975
Program Supplies $ 18,600
Total Operating Expenses $ 125,804
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 38,880
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Other Costs
Training $ 3,500
Total Other Costs $ 3,500
Indirect Costs $ 148,320
Indirect Costs $ 148,320
Annual Budget Total $ 1,310,248
Page 3 of 8
Reading and Beyond - HSE
Exhibit B Attachment I
Budget Narrative
Year II
01/01/2018through 12/31/2018
Program Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Project Coordinator: Coordinates all activities with Project Director on program implementation and administration of project plan. Oversees day
to day activities of Outreach Health Educators. Will provide information and education to ensure implementation of work
plan activities. Oversees day to day activities of Outreach Health Educators and provide assistance in problem solving and
goal setting to meet high quality standards.
Provider Relations Recruit,train,enroll,retain,and build strong relationships with Dental Providers to participate in the Denti-Cal Program.
Representative: Providing in-services and continuing education to the dental and medical community.
Outreach Oral Health Year 1 begin with 12 Educators,Year 2 increase to 13 Educations,Year 3 increase to 14 Educators,and Year 4 increase to 15
Educators: Educators. Recruit,train,enroll,retain and build strong relationships with families and clients. Referral and facilitating
appointments to the dental providers and establish dental homes.
Facility Rental: Office space rent for for staff
Office Supplies: Office and consumable supplies such as papers,pens,notepads,toners,folders,desk trays,folders,binders,electrocal cords,
extension cords,
Communications: Landline connections,Internet and Wil'i connections,servers,cell phones
Program Supplies: General and consumable supplies needed for outreach,recruitment and retention of clients and dentists to participate in the
program. Meeting and training supplies.
Laptops: 1 laptop and license for additional staff.
Travel: Mileage to and from meetings,recruitment of clients and providers,implementation of project.
Training: Training and conference fees required to implement project.
Indirect Costs: Calculated at 20%of wages-to contribute towards Reading and Beyond's documented administrative and overhead costs.
Page 4 of 8
Reading and Beyond - HSE
Exhibit B Attachment I
Budget
Year III
01/01/2019through 12/31/2019
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Program Director 1 $7,000-$8,000 0.5 $ 47,741
Project Coordinator 2 $4,500- $5,500 1 $ 127,308
Provider Relations Representative 2 $4,000-$4,500 1 $ 106,090
Outreach Oral Health Educator 14 $2,500- $3,500 1 $ 519,841
Total Salary $ 800,980
Fringe Benefits (34%) $ 272,333
Total Personnel $ 1,073,313
Operating Expenses
Facility Rental $ 73,520
Office Supplies $ 10,800
Communications $ 24,350
Laptops $ 975
Program Supplies $ 18,600
Total Operating Expenses $ 128,245
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 38,880
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Other Costs
Training $ 3,500
Total Other Costs $ 3,500
Indirect Costs $ 160,196
Indirect Costs $ 160,196
Annual Budget Total $ 1,404,134
Page 5 of 8
Reading and Beyond - HSE
Exhibit B Attachment I
Budget Narrative
Year III
01/01/2019through 12/31/2019
Program Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Project Coordinator: Coordinates all activities with Project Director on program implementation and administration of project plan. Oversees day
to day activities of Outreach Health Educators. Will provide information and education to ensure implementation of work
plan activities. Oversees day to day activities of Outreach Health Educators and provide assistance in problem solving and
goal setting to meet high quality standards.
Provider Relations Recruit,train,enroll,retain,and build strong relationships with Dental Providers to participate in the Denti-Cal Program.
Representative: Providing in-services and continuing education to the dental and medical community.
Outreach Oral Health Year 1 begin with 12 Educators,Year 2 increase to 13 Educations,Year 3 increase to 14 Educators,and Year 4 increase to 15
Educators: Educators. Recruit,train,enroll,retain and build strong relationships with families and clients. Referral and facilitating
appointments to the dental providers and establish dental homes.
Facility Rental: Office space rent for for staff.
Office Supplies: Office and consumable supplies such as papers,pens,notepads,toners,folders,desk trays,folders,binders,electrocal cords,
extension cords.
Communications: Landline connections,Internet and Wil'i connections,servers,cell phones.
Program Supplies: General and consumable supplies needed for outreach,recruitment and retention of clients and dentists to participate in the
program. Meeting and training supplies.
Laptops: 1 laptop and license for additional staff.
Travel: Mileage to and from meetings,recruitment of clients and providers,implementation of project.
Training: Training and conference fees required to implement project.
Indirect Costs: Calculated at 20%of wages-to contribute towards Reading and Beyond's documented administrative and overhead costs.
Page 6 of 8
Reading and Beyond - HSE
Exhibit B Attachment I
Budget
Year IV
01/01/2020through 12/31/2020
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Program Director 1 $7,000-$8,000 0.5 $ 49,173
Project Coordinator 2 $4,500- $5,500 1 $ 131,127
Provider Relations Representative 2 $4,000-$4,500 1 $ 109,273
Outreach Oral Health Educator 15 $2,500- $3,500 1 $ 573,682
Total Salary $ 863,255
Fringe Benefits (34%) $ 293,507
Total Personnel $ 1,156,762
Operating Expenses
Facility Rental $ 75,725
Office Supplies $ 10,800
Communications $ 24,750
Laptops $ 975
Program Supplies $ 18,600
Total Operating Expenses $ 130,850
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 38,880
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Other Costs
Training $ 3,500
Total Other Costs $ 3,500
Indirect Costs $ 172,651
Indirect Costs $ 172,651
Annual Budget Total $ 1,502,643
Page 7 of 8
Reading and Beyond - HSE
Exhibit B Attachment I
Budget Narrative
Year IV
01/01/2020through 12/31/2020
Program Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Project Coordinator: Coordinates all activities with Project Director on program implementation and administration of project plan. Oversees day
to day activities of Outreach Health Educators. Will provide information and education to ensure implementation of work
plan activities. Oversees day to day activities of Outreach Health Educators and provide assistance in problem solving and
goal setting to meet high quality standards.
Provider Relations Recruit,train,enroll,retain,and build strong relationships with Dental Providers to participate in the Denti-Cal Program.
Representative: Providing in-services and continuing education to the dental and medical community.
Outreach Oral Health Year 1 begin with 12 Educators,Year 2 increase to 13 Educations,Year 3 increase to 14 Educators,and Year 4 increase to 15
Educators: Educators. Recruit,train,enroll,retain and build strong relationships with families and clients. Referral and facilitating
appointments to the dental providers and establish dental homes.
Facility Rental: Office space rent for for staff.
Office Supplies: Office and consumable supplies such as papers,pens,notepads,toners,folders,desk trays,folders,binders,electrocal cords,
extension cords.
Communications: Landline connections,Internet and Wil'i connections,servers,cell phones.
Program Supplies: General and consumable supplies needed for outreach,recruitment and retention of clients and dentists to participate in the
program. Meeting and training supplies.
Laptops: 1 laptop and license for additional staff.
Travel: Mileage to and from meetings,recruitment of clients and providers,implementation of project.
Training: Training and conference fees required to implement project.
Indirect Costs: Calculated at 20%of wages-to contribute towards Reading and Beyond's documented administrative and overhead costs.
Page 8 of 8
Fresno Economic Opportunities Commission - HSE
Exhibit B Attachment II
Budget
Year
07/01/2017through 12/31/2017
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Program Director 1 $7,000-$8,000 0.5 $ 22,500
Project Coordinators 2 $4,500- $5,500 1 $ 60,000
Provider Relations Representative 2 $4,000-$4,500 1 $ 50,000
Outreach Oral Health Educator 12 $2,500- $3,500 1 $ 210,000
Total Salary $ 342,500
Fringe Benefits (38%)* $ 129,066
Total Personnel $ 471,566
Operating Expenses
Facility Rental $ 39,600
Office Supplies $ 6,000
Communications $ 29,313
Printer/Copier $ 3,000
Projectors and TV Monitors $ 3,000
Program Supplies $ 9,600
Office Furniture $ 34,000
Total Operating Expenses $ 124,513
Equipment
VOIP Telephone System/Server $ 18,000
Laptops $ 23,800
Total Equipment Expenses $ 41,800
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 20,300
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Other Costs
Training $ 3,400
Total Other Costs $ 3,400
Indirect Costs $ 68,500.00
Indirect Costs $ 68,500
Annual Budget Total $ 730,079
* Fringe Benefits calculated at a variable rate fo 36-40%to take into account different classification's benefit package.
Page 1 of 8
Fresno Economic Opportunities Commission - HSE
Exhibit B Attachment II
Budget Narrative
Year
07/01/2017through 12/31/2017
Program Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Project Coordinator: Coordinates all activities with Project Director on program implementation and administration of project plan. Oversees day
to day activities of Outreach Health Educators. Will provide information and education to ensure implementation of work
plan activities. Oversees day to day activities of Outreach Health Educators and provide assistance in problem solving and
goal setting to meet high quality standards.
Provider Relations Recruit,train,enroll,retain,and build strong relationships with Dental Providers to participate in the Denti-Cal Program.
Representative: Providing in-services and continuing education to the dental and medical community.
Outreach Oral Health Year 1 begin with 12 Educators,Year 2 increase to 13 Educations,Year 3 increase to 14 Educators,and Year 4 increase to 15
Educators: Educators. Recruit,train,enroll,retain and build strong relationships with families and clients. Referral and facilitating
appointments to the dental providers and establish dental homes.
Facility Rental: Office space rent for for staff.
Office Supplies: Office and consumable supplies such as papers,pens,notepads,toners,folders,desk trays,folders,binders,electrocal cords,
extension cords.
Communications: Landline connections,Internet and WiFi connections,servers,cell phones.
Program Supplies: General and consumable supplies needed for outreach,recruitment and retention of clients and dentists to participate in the
program. Meeting and training supplies.
Office Furniture Desks with overhead cabinets,office chairs,guest chairs,training tables,training chairs,filing cabinets,book shelves for staff,
white boards.
VOIP Telephone VOIP Telephone System and Server for the office needed to communicate with staff,clients and all day to day activities of the
System/Server: program.
Projectors and TV 2 portable projectors and 2 TVs for training and presentations inside the facility and outside training for inservices,
Monitors: recruitment.
Laptops: 17 laptops/Surface Pro for all staff. These equipment need to be portable and be carried to the actual sites of clients/provider
locations to gather data and help with enrollment with Denti-Cal and scheduling appointments with providers.
Printer/Copier: For scanning,faxing and printing.
Travel: Mileage to and from meetings,recruitment of clients and providers,implementation of project.
Training: Training and conference fees required to implement project.
Indirect Costs: 20%of Personnel excluding Fringe Benefits.
Page 2 of 8
Fresno Economic Opportunities Commission - HSE
Exhibit B Attachment II
Budget
Year II
01/01/2018through 12/31/2018
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Program Director 1 $7,000-$8,000 0.5 $ 46,350
Project Coordinators 2 $4,500- $5,500 1 $ 123,600
Provider Relations Representative 2 $4,000-$4,500 1 $ 103,000
Outreach Oral Health Educator 13 $2,500- $3,500 1 $ 468,650
Total Salary $ 741,600
Fringe Benefits (36%) $ 270,031
Total Personnel $ 1,011,631
Operating Expenses
Facility Rental $ 84,000
Office Supplies $ 12,000
Communications $ 25,200
Program Supplies $ 12,000
Office Furniture $ 1,500
Total Operating Expenses $ 134,700
Equipment
Laptops $ 2,800
Total Equipment Expenses $ 2,800
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 42,400
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Other Costs
Training $ 3,400
Total Other Costs $ 3,400
Indirect Costs $ 148,320
Indirect Costs $ 148,320
Annual Budget Total $ 1,343,251
* Fringe Benefits calculated at a variable rate fo 36-40%to take into account different classification's benefit package.
Page 3 of 8
Fresno Economic Opportunities Commission - HSE
Exhibit B Attachment II
Budget Narrative
Year II
01/01/2018through 12/31/2018
Program Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Project Coordinator: Coordinates all activities with Project Director on program implementation and administration of project plan. Oversees day
to day activities of Outreach Health Educators. Will provide information and education to ensure implementation of work
plan activities. Oversees day to day activities of Outreach Health Educators and provide assistance in problem solving and
goal setting to meet high quality standards.
Provider Relations Recruit,train,enroll,retain,and build strong relationships with Dental Providers to participate in the Denti-Cal Program.
Representative: Providing in-services and continuing education to the dental and medical community.
Outreach Oral Health Year 1 begin with 12 Educators,Year 2 increase to 13 Educations,Year 3 increase to 14 Educators,and Year 4 increase to 15
Educators: Educators. Recruit,train,enroll,retain and build strong relationships with families and clients. Referral and facilitating
appointments to the dental providers and establish dental homes.
Facility Rental: Office space rent for for staff
Office Supplies: Office and consumable supplies such as papers,pens,notepads,toners,folders,desk trays,folders,binders,electrocal cords,
extension cords,
Communications: Landline connections,Internet and Wil'i connections,servers,cell phones
Program Supplies: General and consumable supplies needed for outreach,recruitment and retention of clients and dentists to participate in the
program. Meeting and training supplies
Office Furniture Desks with overhead cabinets and office chair for additional staff
Laptops: 1 laptop and license for additional staff
Travel: Mileage to and from meetings,recruitment of clients and providers,implementation of project.
Training: Training and conference fees required to implement project
Indirect Costs: 20%of Personnel excluding Fringe Benefits.
Page 4 of 8
Fresno Economic Opportunities Commission - HSE
Exhibit B Attachment II
Budget
Year III
01/01/2019through 12/31/2019
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Program Director 1 $7,000-$8,000 0.5 $ 47,741
Project Coordinators 2 $4,500- $5,500 1 $ 127,308
Provider Relations Representative 2 $4,000-$4,500 1 $ 106,090
Outreach Oral Health Educator 14 $2,500- $3,500 1 $ 519,841
Total Salary $ 800,980
Fringe Benefits (40%) $ 323,401
Total Personnel $ 1,124,381
Operating Expenses
Facility Rental $ 88,800
Office Supplies $ 12,000
Communications $ 25,200
Program Supplies $ 12,000
Office Furniture $ 1,500
Total Operating Expenses $ 139,500
Equipment
Laptops $ 2,800
Total Equipment Expenses $ 2,800
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 44,200
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Other Costs
Training $ 3,400
Total Other Costs $ 3,400
Indirect Costs $ 160,196
Indirect Costs $ 160,196
Annual Budget Total I $ 1,474,477
* Fringe Benefits calculated at a variable rate fo 36-40%to take into account different classification's benefit package.
Page 5 of 8
Fresno Economic Opportunities Commission - HSE
Exhibit B Attachment II
Budget Narrative
Year III
01/01/2019through 12/31/2019
Program Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Project Coordinator: Coordinates all activities with Project Director on program implementation and administration of project plan. Oversees day
to day activities of Outreach Health Educators. Will provide information and education to ensure implementation of work
plan activities. Oversees day to day activities of Outreach Health Educators and provide assistance in problem solving and
goal setting to meet high quality standards.
Provider Relations Recruit,train,enroll,retain,and build strong relationships with Dental Providers to participate in the Denti-Cal Program.
Representative: Providing in-services and continuing education to the dental and medical community.
Outreach Oral Health Year 1 begin with 12 Educators,Year 2 increase to 13 Educations,Year 3 increase to 14 Educators,and Year 4 increase to 15
Educators. Recruit,train,enroll,retain and build strong relationships with families and clients. Referral and facilitating
Educators: appointments to the dental providers and establish dental homes.
Facility Rental: Office space rent for for staff
Office Supplies: Office and consumable supplies such as papers,pens,notepads,toners,folders,desk trays,folders,binders,electrocal cords,
extension cords,
Communications: Landline connections,Internet and Wil'i connections,servers,cell phones
Office Furniture Desks with overhead cabinets and office chair for additional staff
Laptops: 1 laptop and license for additional staff
Travel: Mileage to and from meetings,recruitment of clients and providers,implementation of project.
Training: Training and conference fees required to implement project
Indirect Costs: 20%of Personnel excluding Fringe Benefits.
Page 6 of 8
Fresno Economic Opportunities Commission - HSE
Exhibit B Attachment II
Budget
Year IV
01/01/2020through 12/31/2020
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Program Director 1 $7,000-$8,000 0.5 $ 49,173
Project Coordinators 2 $4,500- $5,500 1 $ 131,127
Provider Relations Representative 2 $4,000-$4,500 1 $ 109,273
Outreach Oral Health Educator 15 $2,500- $3,500 1 $ 573,682
Total Salary $ 863,255
Fringe Benefits (40%) $ 343,797
Total Personnel $ 1,207,052
Operating Expenses
Facility Rental $ 93,600
Office Supplies $ 12,000
Communications $ 25,200
Program Supplies $ 12,000
Office Furniture $ 1,500
Total Operating Expenses $ 144,300
Equipment
Laptops $ 2,800
Total Equipment Expenses $ 2,800
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 46,000
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Other Costs
Training $ 3,400
Total Other Costs $ 3,400
Indirect Costs $ 172,651
Indirect Costs $ 172,651
Annual Budget Total I $ 1,576,203
* Fringe Benefits calculated at a variable rate fo 36-40%to take into account different classification's benefit package.
Page 7 of 8
Fresno Economic Opportunities Commission - HSE
Exhibit B Attachment II
Budget Narrative
Year IV
01/01/2020through 12/31/2020
Program Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Project Coordinator: Coordinates all activities with Project Director on program implementation and administration of project plan. Oversees day
to day activities of Outreach Health Educators. Will provide information and education to ensure implementation of work
plan activities. Oversees day to day activities of Outreach Health Educators and provide assistance in problem solving and
goal setting to meet high quality standards.
Provider Relations Recruit,train,enroll,retain,and build strong relationships with Dental Providers to participate in the Denti-Cal Program.
Representative: Providing in-services and continuing education to the dental and medical community.
Outreach Oral Health Year 1 begin with 12 Educators,Year 2 increase to 13 Educations,Year 3 increase to 14 Educators,and Year 4 increase to 15
Educators: Educators. Recruit,train,enroll,retain and build strong relationships with families and clients. Referral and facilitating
appointments to the dental providers and establish dental homes.
Facility Rental: Office space rent for for staff
Office Supplies: Office and consumable supplies such as papers,pens,notepads,toners,folders,desk trays,folders,binders,electrocal cords,
extension cords,
Communications: Landline connections,Internet and Wil'i connections,servers,cell phones
Program Supplies: General and consumable supplies needed for outreach,recruitment and retention of clients and dentists to participate in the
program. Meeting and training supplies
Office Furniture Desks with overhead cabinets and office chair for additional staff
Laptops: 1 laptop and license for additional staff
Travel: Mileage to and from meetings,recruitment of clients and providers,implementation of project.
Training: Training and conference fees required to implement project
Indirect Costs: 20%of Personnel excluding Fringe Benefits.
Page 8 of 8
University of the Pacific
Exhibit B Attachment III
Budget
Year
07/01/2017through 12/31/2017
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Project Director 1 $20,000-$22,250 0.02 $ 5,576
Director of Operations 1 $7,250- $7,500 0.06 $ 5,576
Program Manager 2 $7,250-$7,501 0.16 $ 27,878
Program Content Expert 1 $10,000- $11,000 0.07 $ 8,363
Contracts Manager 1 $6,500-$7,000 0.03 $ 2,788
Assistant Project Manager 1 $5,250- $5,750 0.07 $ 5,576
Total Salary $ 55,757
Fringe Benefits (31.2%) $ 17,396
Total Personnel $ 73,153
Operating Expenses
Training/Meeting Expenses $ 4,200
Total Operating Expenses $ 4,200
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 8,400
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Indirect Costs $ 11,151
Indirect Costs $ 11,151
Annual Budget Total * $ 96,904
* See Page 39, Section 5.3 of LDPP Proposal for explanation of UOP's budget formulary.
Page 1 of 8
University of the Pacific
Exhibit B Attachment III
Budget Narrative
Year
07/01/2017through 12/31/2017
Project Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Director of Will oversee communications and implementation with providers and sites.
Operations:
Program Manager: Will schedule and track deliverables,reporting,training and monitoring activities.
Prgram Content Provide expert consultation on scientific,dental practice,and operational workflow integration.
Expert:
Contracts Manager: Will be responsible for contracts,expenses,reporting systems.
Assistant Will be responsible for technical training and assistance on data systems and equipment.
Projects Manager:
Page 2 of 8
University of the Pacific
Exhibit B Attachment III
Budget
Year II
01/01/2018through 12/31/2018
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Project Director 1 $20,000-$22,250 0.04 $ 6,867
Director of Operations 1 $7,250- $7,500 0.11 $ 6,867
Program Manager 2 $7,250-$7,501 0.29 $ 34,336
Program Content Expert 1 $10,000- $11,000 0.12 $ 10,301
Contracts Manager 1 $6,500-$7,000 0.06 $ 3,434
Assistant Project Manager 1 $5,250- $5,750 0.12 $ 6,867
Total Salary $ 68,672
Fringe Benefits (31.2%) $ 21,426
Total Personnel $ 90,098
Operating Expenses
Training/Meeting Expenses $ 4,200
Total Operating Expenses $ 4,200
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 11,200
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Indirect Costs $ 13,734
Indirect Costs $ 13,734
Annual Budget Total * $ 119,232
* See Page 39, Section 5.3 of LDPP Proposal for explanation of UOP's budget formulary.
Page 3 of 8
University of the Pacific
Exhibit B Attachment III
Budget Narrative
Year II
01/01/2018through 12/31/2018
Project Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Director of Will oversee communications and implementation with providers and sites.
Operations:
Program Manager: Will schedule and track deliverables,reporting,training and monitoring activities.
Prgram Content Provide expert consultation on scientific,dental practice,and operational workflow integration.
Expert:
Contracts Manager: Will be responsible for contracts,expenses,reporting systems.
Assistant Will be responsible for technical training and assistance on data systems and equipment.
Projects Manager:
Page 4 of 8
University of the Pacific
Exhibit B Attachment III
Budget
Year III
01/01/2019through 12/31/2019
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Project Director 1 $20,000-$22,250 0.02 $ 3,518
Director of Operations 1 $7,250- $7,500 0.06 $ 3,518
Program Manager 2 $7,250-$7,501 0.15 $ 17,588
Program Content Expert 1 $10,000- $11,000 0.06 $ 5,276
Contracts Manager 1 $6,500-$7,000 0.03 $ 1,759
Assistant Project Manager 1 $5,250- $5,750 0.06 $ 3,518
Total Salary $ 35,177
Fringe Benefits (31.2%) $ 10,975
Total Personnel $ 46,152
Operating Expenses
Training/Meeting Expenses $ 4,200
Total Operating Expenses $ 4,200
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 8,400
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Indirect Costs $ 7,035
Indirect Costs $ 7,035
Annual Budget Total * $ 65,787
* See Page 39, Section 5.3 of LDPP Proposal for explanation of UOP's budget formulary.
Page 5 of 8
University of the Pacific
Exhibit B Attachment III
Budget Narrative
Year III
01/01/2019through 12/31/2019
Project Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Director of Will oversee communications and implementation with providers and sites.
Operations:
Program Manager: Will schedule and track deliverables,reporting,training and monitoring activities.
Prgram Content Provide expert consultation on scientific,dental practice,and operational workflow integration.
Expert:
Contracts Manager: Will be responsible for contracts,expenses,reporting systems.
Assistant Will be responsible for technical training and assistance on data systems and equipment.
Projects Manager:
Page 6 of 8
University of the Pacific
Exhibit B Attachment III
Budget
Year IV
01/01/2020through 12/31/2020
Personnel
Position Title I#of Staff I Monthly Salary Range I FTE% JAnnual Cost
Project Director 1 $20,000-$22,250 0.02 $ 2,520
Director of Operations 1 $7,250- $7,500 0.04 $ 2,520
Program Manager 2 $7,250-$7,501 0.11 $ 12,600
Program Content Expert 1 $10,000- $11,000 0.04 $ 3,780
Contracts Manager 1 $6,500-$7,000 0.02 $ 1,260
Assistant Project Manager 1 $5,250- $5,750 0.05 $ 2,520
Total Salary $ 25,200
Fringe Benefits (31.2%) $ 7,862
Total Personnel $ 33,062
Operating Expenses
Training/Meeting Expenses $ 4,200
Total Operating Expenses $ 4,200
Travel (At CaIHR Reimbursement Rates) TotalTravell $ 8,400
Subcontracts
Name
Personnel Operating Expenses Travel Subcontracts Indirect Costs Total Costs
Total Subcontracts $ -
Indirect Costs $ 5,040
Indirect Costs $ 5,040
Annual Budget Total * $ 50,702
* See Page 39, Section 5.3 of LDPP Proposal for explanation of UOP's budget formulary.
Page 7 of 8
University of the Pacific
Exhibit B Attachment III
Budget Narrative
Year IV
01/01/2020through 12/31/2020
Project Director: Oversees and coordinates all activities with collaborative partners and stakeholders. Provides direct and indirect supervision
of project design,implementation,contract compliance,quality assurance,budget adherence and program outcomes.
Director of Will oversee communications and implementation with providers and sites.
Operations:
Program Manager: Will schedule and track deliverables,reporting,training and monitoring activities.
Prgram Content Provide expert consultation on scientific,dental practice,and operational workflow integration.
Expert:
Contracts Manager: Will be responsible for contracts,expenses,reporting systems.
Assistant Will be responsible for technical training and assistance on data systems and equipment.
Projects Manager:
Page 8 of 8