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HomeMy WebLinkAboutAgreement A-16-683-2 with First 5 for NFP.pdf Agreement No. 16-683-2 County of Fresno,Department of Public Health Contract#201617-0954 Nurse-Family Partnership Page 1 Amendment II to Services Agreement Fiscal Year 2019/2020 Parties Commission: Children and Families Commission of Fresno County, California Contractor: County of Fresno,Department of Public Health Administrative Original Contract Number: 201617-0954 Amendment 11 Contract Number: 201617-0954 Recitals A. Commission and Contractor are parties to that certain Program Services Agreement (the"Agreement'),dated July 1,2016,the Term of which is from July 1,2016 to June 30, 2018(the"Original Term'). B. The Parties now desire to amend the Agreement to provide for an extension of the Term and to modify the Services and Project Budget all as defined in the Agreement. C. All capitalized terms used in this Amendment II to Program Services Agreement (this"Amendment II") shall have the meanings provided for in the Agreement unless otherwise specified in this Amendment II. Therefore,in consideration of the above recitals,which are incorporated into this Amendment II by reference,the Parties agree as follows: 1. Term. This Amendment II is made effective as of July 1,2019 (the"Effective Date"). The Term of the Agreement is extended until June 30, 2020,unless terminated earlier under the Agreement (the"Term' or as specified in this Amendment II to the contrary. 2. Amendment to Section 2.1. Effective as of July 1,2019,Exhibit A will be replaced with the Exhibit A,"Scope of Work(2019-2o Fiscal Year)"attached to this Amendment II and incorporated herein by this reference. As of July 1,2019,except as needed to interpret and enforce Contractor's responsibilities and obligations under the original Term of the Agreement,the original Exhibit A attached to the Agreement will have no further force and effect. 3. Amendment to Section 4.1. Section 4.1 of the Agreement is deleted in its entirety and replaced with the following: Ro319(1&2) County of Fresno,Department of Public Health Contract#201617-0954 Nurse-Family Partnership Page 2 4.1 Project Budget. Compensation for the Services provided from July 1,2019 to June 30,2020 is based upon actual costs as described in Exhibit B. Compensation for the Services will in no event exceed the total amount of $8:95,952 (the"Contract Amount'o. The Contract Amount includes Compensation for Services remaining under the Original Term of the Agreement. Compensation for Services provided prior to July 1,2019 shall be in accordance with the original Agreement and this Amendment II. 4. Amendment to Section 4.2. The first sentence in Section 4.2 of the Agreement is deleted in its entirely and replaced with the following (the remainder of Section 4.2 is unaffected): Commission will reimburse Contractor for all necessary,reasonable,and justifiable expenses,as determined by Commission,incurred in accordance with the Project Budget for providing the Services on behalf of Commission in an amount not to exceed the Contract Amount. S. Controlling Document; No Other Amendment. In the event of any conflict between the terms of this Amendment II and the Agreement,the terms of this Amendment II shall control. Except as amended by this Amendment II,all terms of the Agreement shall remain in full force and effect,including,without limitation,all monitoring,evaluation,data collection,contract review,auditing,inspection,and record retention obligations set forth in Article 8 of the Agreement. 6. Bindincr Effect. The Agreement,as amended by this Amendment II,is binding upon,and inures to the benefit of,the respective heirs,executors, administrators,successors,and assigns of the Parties. 7. Headings and Construction. The subject headings of the sections and paragraphs of this Amendment II are included for purposes of convenience only and do not affect the construction or interpretation of any of its provisions. All words used in this Amendment II include the plural as well as the singular number,and vice versa;words used in this Amendment II in the present tense include the future as well as the present;and words used in this Amendment II in the masculine gender include the feminine and neuter genders,whenever the context so requires. No provision of this Amendment II will be interpreted for or against a Party because that Party or its legal representative drafted the provision,and this Amendment II will be construed as if jointly prepared by the Parties. 8. Counterparts. This Amendment II may be signed by the Parties in different counterparts and the signature pages combined to create one document binding on all Parties. 9. Sicrnature Authority. Each Party represents that it has capacity,full power, and authority to enter into this Amendment II and perform under modified terms of the Agreement,and the person signing this Agreement on behalf of each Party has been properly authorized and empowered to enter into this Amendment II. Ro319(1&2) County of Fresno,Department of Public Health Contract#201617-0954 Nurse-Family Partnership Page 3 Signatures COMMISSION CONTRACTOR CHILDREN AND FAMILIES COMMISSION COUNTY OF FRESNO, DEPARTMENT OF OF FRESNO COUNTY PUBLIC HEALTH REVIEWED AND RECOMMENDED FOR APPRO By: Authorized Represents ive By: Emilia Reyes,Executive ector Date of Signature: q lOI 19 Date of Signature: �� / / Name: Nathan Magsig Chairman of the Board of Supervisors Title: of the County of Fresno APPROVED AS TO LEGAL FORM Federal Tax ID Number:��-�DOO$�� By: A L"j " I Ken eth Pri e,Legal Counsel ATTEST: Date of Signature: �� /� BERNICE E. SEIDEL Clerk of the Board of Supervisors L County of Fresno State of California BYU B Brian Pacheco,Commission Chair Date of Signature: D FOR ACCOUNTING USE ONLY: ORG:56201719 Fund/Subclass:0001/10000 Revenue:3530 Ro3ig(1&2) County of Fresno,Department of Public Health Contract#2o1617-0954 Nurse-Family Partnership Page 4 EXHIBIT A Scope of Work (2019-20 Fiscal Year A-1 E]FIRST5 Direct Services Face Sheet & Scope of Work FRESNO COUNTY This document will be completed with First 5 Fresno County(F5FC)staff and Service Provider during a development meeting. A. Face Sheet Agency Name: County of Fresno, Department Contract Number: 201617-0954 of Public Health Project ID Number: 0954-17 GL: Project Name: Nurse-Family Partnership HP6 - 10-8504-00 100 % Start date/End date: 07/01/2016-06/30/2020 FY 16-17: $190,412 Agency Address: 1221 Fulton Street, 4th Floor, Contract amount: FY 17-18: $195,756 Fresno, CA 93721 $835,952 FY 18-19: $240,796 FY 19-20: $208,988 Other Project Funding: $ 603,337 BOS District: 3 Agency phone #: 559-600-3330 Mailing address if different than above: N/A Website: www.fcdph.org Strategic Plan Tier: Tier 1: Children Families Project Description: Briefly address what F5FC is funding and why. If applicable, describe the goals/outcomes. This will be placed on the F5FC website. Nurse-Family Partnership (NFP) is an evidence-based community healthcare program that empowers low-income, vulnerable first-time mothers to become confident, knowledgeable, and responsible parents, and ensures that their babies have the best possible start in life. This program is voluntary; mothers are enrolled in the program early in pregnancy and receive ongoing nurse home visits that continue until the child reaches their second birthday. The nurse provides guidance for emotional, social, and physical challenges as expectant mothers prepare to become parents. The nurses support mothers by connecting them to prenatal care and preventative health practices, providing individualized guidance on specific child developmental stages, as well as assisting mothers in their maternal life course development. The three goals of the NFP program are: improving pregnancy outcomes, child health and development, and economic self-sufficiency of the family. F5FC Contract Manager: Lupita Ramirez Program Contact Person who runs day today program operations/supervisor/coordinator/mana er Prefix: Mrs. Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone #: 559-600-3330 Finance Contact Person responsible for submitting budgets,financial reports and/or invoices Prefix: Mr. Name: Michael Chu Title: Accountant E-mail: mchu@fresnocountyca.gov Phone #: 559-600-6426 Notice Contact Person who has legal authority to sign contract Prefix: Mr. Name: David Pomaville Title: Director E-mail: dpomaville@fresnocountyca.gov Phone #: 559-600-3200 Public Contact Person responsible for general public calls requesting program info, how to access services, media, etc. Prefix: Mrs. Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone #: 559-600-3330 R0319(1&2) Page 1 of 10 ©FIRSTS Direct Services Face Sheet & Scope of Work FRESNOCOUNTY Persimmony Contact Program Module — PROGRAM DATA ENTRY Person responsible for entering data Prefix: Ms. Name: Sophia Rodriguez Title: Office Assistant III E-mail: SXRodriguez@fresnocountyca.gov Phone #: 559-600-3330 Training: Access and No Training Required Persimmony Contact Program Module — PROGRAM DATA ENTRY (Person responsible for entering data) Prefix: Ms. Name: Valerie Wells Title: Supervising Office Assistant E-mail: vwells@fresnocountyca.gov Phone #: 559-600-3330 Training: Access and No Training Required Persimmony Contact Program Module — PROGRAM DATA ENTRY Person responsible for entering data Prefix: Ms. Name: Diana Colin Title: Office Assistant III E-mail: dcolin@fresnocountyca.gov Phone #: 559-600-3330 Training: Access and No Training Required Persimmony Contact Program Module — PROGRAM DATA ENTRY (Person responsible for entering data) Prefix: Ms. Name: Linda Willome Title: Office Assistant III E-mail: Iwillome@fresnocountyca.gov Phone#: 559-600-3330 Training: Access and No Training Required Persimmony Contact Program Module — PROGRAM DATA ENTRY (Person responsible for entering data Prefix: Ms. Name: Christina Wyrick Title: Program Technician E-mail: clmoreno@fresnocountyca.gov Phone#: 559-600-3330 Training: Access and No Training Required Persimmony Contact Program Module — PROGRAM DATA ENTRY (Person responsible for entering data) Prefix: Mr. Name: Gabriel Torres Title: Office Assistant E-mail: gatorres@fresnocountyca.gov Phone M 559-600-3330 Training: Access and Training Required Persimmony Contact Program Module — PROGRAM DATA ENTRY Person responsible for entering data Prefix: Ms. Name: Martha Garcia Title: Office Assistant III E-mail: marthagarcia@fresnocountyca.gov Phone #: 559-600-3330 Training: Access and Training Required Persimmony Contact Program Module — PROGRAM DATA APPROVAL Person responsible for entering data Prefix: Mrs. Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone M 559-600-3330 Training: Access and No Training Required County of Fresno, Department of Public Health, Nurse-Family Partnership,#201617-0954 R0319(1&2) Page 2 of 10 ©FIRST5 Direct Services Face Sheet & Scope of Work FRESNOCOUNTY Persimmony Contact Financial Module — FINANCIAL DATA ENTRY Person responsible for entering financial information Prefix: Mr. Name: Michael Chu Title: Accountant E-mail: mchu@fresnocountyca.gov Phone #: 559-600-6426 Training: Access and No Training Required Persimmony Contact Financial Module — FINANCIAL APPROVAL (Person responsible for approving financial information) Prefix: Mrs. Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone #: 559-600-3330 Persimmony Contact Financial Module — FINANCIAL APPROVAL Person responsible for approving financial information Prefix: Ms. Name: Aphivanh (Aphi) Title: Staff Analyst Xa avath E-mail: axayavath@fresnocountyca.gov Phone #: 559-600-3330 Persimmony Monitoring Module —ANNUAL CONTRACT REVIEW (ACR) ACCESS Person responsible for responding to administrative and programmatic components of the ACR Prefix: Mrs. Name: Lorraine Hardy Title: Supervising Public Health Nurse E-mail: hardyl@fresnocountyca.gov Phone #: 559-600-3330 Persimmony Monitoring Module —ANNUAL CONTRACT REVIEW (ACR) ACCESS (Person responsible for responding to financial component of the ACR) Prefix: Mr. Name: Michael Chu Title: Accountant E-mail: mchu@fresnocountyca.gov Phone #: 559-600-6426 County of Fresno, Department of Public Health, Nurse-Family Partnership,#201617-0954 R0319(1&2) Page 3 of 10 ©FIRST5 Direct Services Face Sheet & Scope of Work FRESNOCOUNTY Agency Service Locations: List all physical addresses where F5FC services take place. If more than three sites, please include in this document by adding another row. Refer to the Fresno County website to find the correct County District for each service location. Location(s) District(s) Location 1: 1221 Fulton Street, 4th Floor, Fresno, CA 93721 District 3 First 5 Fresno County Strategic Plan and First 5 CA Result and Service Area Alignment: Percent of Funding Dollar Amount Goal per F5FC Strategic Plan: FY1920 FY1920 Goal 1: Health Promotion 100% $208,988 Primary Strategy per Percent of Funding Dollar Amount F5FC Strategic Plan: FY1920 FY1920 HP6 Pre-and post-natal support for families 1 00% $208,988 State Result Percent of Clients Percent of Funding Area/Outcome Refer to the Annual State Service Area Report&School FY1920 FY1920 Readiness Appendices Fiscal Year 3. Improved Child Healt 3e) Maternal and Child Health Care 100 % 100 % Is this an evidence based or research-based program? (Please check one) ® Evidence Based ❑ Research Based ❑ N/A County of Fresno, Department of Public Health, Nurse-Family Partnership,#201617-0954 R0319(1&2) Page 4 of 10 ©FIRSTS Direct Services Face Sheet & Scope of Work FRESNO B. Demographic and Geographic Client Served Details Types of Clients Served and Projected Numbers: Please note that these fields reflect the client type options in Persimmon y and not family relationships. Include all client level and aggregate clients included in sections C and D. Total#of Clients Type of Client FYI 920 Child 0<3 37 Child 3-5 0 Parent 37 Prenatal 8 Other(please specify): 0 TOTAL: 82 Projected Numbers Served in Each Geographic Region: Use the countywide box for programs providing services throughout the county. Total#of Clients Geographical Location of Clients to be Served FYI 920 County Wide 82 Other(specify: ) Total: 82 Geographical Total#of Clients Percent Urban (%) Percent Rural (%) Location of Clients to be Served FYI 920 FY1920 FYI 920 Countywide 82 90% 10% County of Fresno, Department of Public Health, Nurse-Family Partnership,#201617-0954 R0319(1&2) Page 5 of 10 FIRST5 Direct Services Face Sheet & Scope of Work C. Outputs: Services and Contacts All services listed in section C are required to be entered in Persimmony on a monthly basis, refer to the Service Provider Manual for details. All clients served by F5FC funds must meet age and residency requirements. Service Provider is required to maintain back-up documentation. The information in the table below will remain the same for the full contract term (from one fiscal year to the next) unless otherwise specified or modified throuah a contract amendment reauest. Core Client Target# Core (Expected#of clients Service Type F5FC Strategy Client receiving service) Frequency Verification Method Type FY1920 Total':45 Q1:40 Parent partnership home visit' HP6 Pre-and post-natal support for families Parent Q2:40 Frequency varies,please see endnotes Service log Q3:40 Q4:40 Total:37 Q1:6 SQ HP3 Development Screenings and Assessme Child Q2:9 Annually within 90 days of enrollment2 ASQ/ASQ:SE Q3:10 Q4:12 Total:20 SQ:SE HP3 Development Screenings and Assessme Child Q1:5 Annually within 90 days of enrollment' ASQ/ASQ:SE Q2:5 Q3:5 Q4:5 Total:20 Other assessment -PHQ-94 HPS Mental Health Early Identification and Int Parent Q2:10 Frequency varies,please see endnotes Other -complete copy of PHQ9 Q3:10 Q4:10 Total:15 Q1:10 Other assessment -DANCES HP6 Pre-and post-natal support for families Parent Q2:10 Frequency varies,please see endnotes Other -complete copy of PHQ9 Q3:10 Q4:10 Total:1 P6 Resource,referral,coordination,and alig Q1:0 Developmental referral Child Q2:0 As needed Service log Q3:1 Q4:0 Total:45 s P6 Resource,referral,coordination,and alig Q1:15 Other referral Parent Q2:15 As needed Service log Q3:15 Q4:15 Total unduplicated clients to be served in the entire year County of Fresno, Department of Public Health, Nurse-Family Partnership,#201617-0954 R0319(1&2) Page 6 of 10 Direct Services Face Sheet & Scope of Work ❑ Not Applicable-If your program does not provide core services, please check this box. D. Aggregate Services and Narrative The information in the table below will remain the same for the full contract term (from one fiscal year to the next) unless otherwise specified or modified through a contract amendment request. Service Provider is required to maintain back-up documentation. Data due Quarterly. ® Not Applicable -If your program does not provide aggregate services, please check this box County of Fresno, Department of Public Health, Nurse-Family Partnership,#201617-0954 R0319(1&2) Page 7 of 10 1RST5 Direct Services Face Sheet & Scope of Work Service Provider Staff Confidentiality Agreement& Request for Persimmony User Logon All staff members of FSFC funded programs and projects (Service Providers)who are responsible for gathering or maintaining confidential information and records must adhere to this agreement. Responsibilities During the performance of Service Provider assigned duties related to the FSFC project, Service Provider might have access to confidential client information and records required for effective coordination and delivery of services to children and their families. All confidential discussions, deliberations, records, and information generated or maintained in connection with these activities shall be disclosed only to persons who have the need to know and authority to access confidential consumer information or records. This includes information obtained and conveyed through all media including the Persimmony database. Service Provider must not disclose any confidential client information to any third party without the written authorization from the client or legally authorized representative. Legal Liabilities Service Provider must adhere to the following: • Notice:All applicable employees, agents, and subcontractors shall be notified of state requirements for confidentiality and also notified that any person knowingly or intentionally violating the provisions of the state law is guilty of a misdemeanor. • Records pertaining to any individual recipient of FSFC will be confidential and will not be open to examination for any purpose not directly connected with the administration of local evaluation. • No person will publish, disclose, use, or permit the use of, or cause to be published, disclosed or used, any confidential information pertaining to any individual recipient of FSFC services. Prohibition of Re-Disclosing Confidential Client Information Employment Confidentiality Agreement This notice accompanies a disclosure of confidential information concerning a consumer of services funded by the FSFC. The above referenced agency is prohibited from making any further disclosure of this confidential information unless further disclosure is expressly permitted by the written authorization to release the information of the person to whom it pertains or as otherwise permitted by these regulations. A general authorization for the release of confidential information is NOT sufficient for this purpose. Acknowledgement of Confidentiality and Prohibition of Re-Disclosing Confidential Client Information Employment Confidentiality Agreement The Agency acknowledges responsibility not to divulge any confidential information or records concerning clients of FSFC funded services without proper written authorization. By signing the Direct Services Agreement, the Agency accepts confidentiality and prohibition of re-disclosing confidential funding requirements. County of Fresno, Department of Public Health, Nurse-Family Partnership,#201617-0954 R0319(1&2) Page 8 of 10 1RST5 Direct Services Face Sheet & Scope of Work Type of Agreement: Amendment-Direct Service Type of Procurement: ❑ Informal ® Formal ❑ Sole Source Annual Contract Review: ® Formal ❑ Informal BFF Policy Agreement Form Completed: ❑ Yes❑ No (attach form to contract) ❑ N/A EFT Form Completed: ® Yes❑ No (attach form to contract) W-9 Completed: ® Yes ❑ No Persimmony Set-Up: (check all that apply) ❑ No data - only basic info for state reporting ❑ Aggregate data ® Financial module ® Client level data reporting ❑ Monthly reporting ® Narrative ® Quarterly reporting ® Performance module ❑ One time payment ❑ Financial module ® State upload Type of Agency: (choose only one) ❑ City Government ❑ Private and/or for Profit Organization ❑ Community Benefit Organization (501(c)3 ❑ School District ® County Government ❑ State Government ❑ Faith Based Organization (attach policy) ❑ Other (please specify): ❑ Federal Government Agency ❑ Higher Education F5FC Office Use Only Commission Approved Date: 06/01/2016 F5FC Staff Review and FY1617 FY1718 FY1819 FY1920 Approval Contract Manager 4/19/16 6/20/17 4/27/18 3/29/19 Approved Strategies Reviewed & Approved by Program & 4/19/16 6/23/17 N/A N/A Evaluation Director Agency name: County of Fresno Department of Public Contract number: 201617-0954 Health Program name: Nurse-Family Partnership Contract amount: $835,952 R0319(1&2) Page 9 of 10 =FIRST5 Direct Services Face Sheet & Scope of Work • See Description of Services (end notes) • Parent Partnership Home visit: NFP follows a home-visiting schedule to meet the program goals and integrates self-efficacy, human ecology, and attachment theories within its nursing framework creating a unique context for learning, growth and overall well-being. Frequency of home visits will vary as follows: once a week for the first 4 weeks; then every other week until the baby is born; once a week for 6 weeks after the baby's birth; every other week until the child is 21 months; and monthly until 24 months. Once the child turns two years old, the family is transitioned out of the program. 2 ASQ: Annually within 90 days of enrollment. ASQ-3 is authorized for initial use at 2 months of age. 3 ASQ: SE: Annually within 90 days of enrollment. ASQ-SE is authorized for initial use at 2 months. 4 Other assessment- PHQ-9: The Patient Health Questionnaire PHQ-9 will be administered at intake and 32-36 weeks antepartum, 4-6 weeks postpartum, 4 months, 12 months and as needed. In addition, the client count includes an abuse assessment screening tool (partner relationship assessment)that will be administered at intake and 32-36 weeks antepartum, 4-6 weeks postpartum, 4 months, 12 months and as needed. The total client count of 20 is a lower number of clients because the majority of clients in the program may not be antepartum/postpartum. PHQ-9 does vary on nurses' case load it may be that a nurse has more toddlers (1 to 2-year old) and not doing as many PHQ-9s. 5 Other assessment- DANCE: Dyadic Assessment of Naturalistic Caregiver-child Experiences (DANCE) is a strengths-based assessment tool to aid the nurse in identifying areas of strengths and areas of growth in Parents. Children who experience positive caregiver- child interactions will engage more with their caregivers, will reinforce caregivers' behaviors, and will develop a sense of trust in their relationships with their caregivers and others. DANCE will be completed by parents when their children are 2,9,16 and 22 months of age. The client count of 15 for this service is a lower number of clients based on the need of each client determined by the public health nurse. DANCE assessments vary on nurses' case load and it may be that a nurse has more pregnant mothers or infants. 6 Other referral: Total client count of 45 will receive more than one referral throughout the fiscal year. County of Fresno, Department of Public Health, Nurse-Family Partnership,#201617-0954 R0319(1&2) Page 10 of 10 County of Fresno,Department of Public Health Contract#2o1617-0954 Nurse-Family Partnership Page 5 EXHIBIT B Project Budget (2019-2o Fiscal Year) B-1 1 FIRST 5 FRESNO COUNTY 2 Direct Service Budget 3 4 Agency Name: County of Fresno, Department of Public Health 5 Project Name: Nurse-Family Partnership 6 Contract Term: 07/01/2016-06/30/2020 7 Contract Number: 201617-0954 8 Submission Date: 3/26/2019 9 Prepared by: Aphivanh Xayavath 10 Title: Staff Analyst 11 12 Year 1 Year 2 Year 3 Year 4 13 Actuals Actuals Budget Budget Total Program Amount 14 07/01/16-6/30/17 07/01/17-06/30/18 07/01/18-06/30/19 07/01/19-06/30/20 15 Category 16 I. Personnel 17 A. Salaries 88,041 78,654 106,397 99,574 372,666 18 B. Benefits 62,417 65,606 78,556 70,989 277,568 19 C. Taxes 6,812 5,696 8,139 7,617 28,264 20 Total Personnel 157,270 149,956 193,092 178,181 678,499 21 II. Operating Expenses 22 A. Facilities Costs 434 444 1,255 470 2,603 23 B. Operational/Supplies 2,018 1,652 2,916 1,016 7,602 24 C. Training/Travel 4,449 1,129 2,315 1,287 9,180 25 Total Operating Expenses 6,901 3,225 6,486 2,773 19,385 26 III. Program Expenses 27 A. Materials and Supplies 3,519 3,302 12,004 2,483 21,308 28 Total Program Expenses 3,519 3,302 12,004 2,483 21,308 29 IV. Professional Services 0 0 250.00 250 500 30 VI. Indirect Costs 22,722 39,273 28,964 25,302 116,260 31 32 Total Program 190,412 195,756 240,796 208,988 835,952 33 Year 1 Year 2 Year 3 Year 4 Total Other 34 VII. Other Funding Actuals Actuals Budget Budget Funding 35 A. Leveraged 166,680 39,273 212,710 184,673 603,337 36 B. Other Funding Source: - - - - - 37 C. Other Funding Source: - - - - - 38 Total Other Funding 166,680 39,273 212,710 184,673 603,337 Children Families Commission of Fresno County S FIR T 5 Service Provider Budget FRESNO COUNTY 1 Agency Name: County of Fresno, Department of Public Health Contract Term: 07/01/2016-06/30/2020 2 1 Project Name: Nurse-Family Partnership lContract Number: 201617-0954 3 4 YEAR 3 Budget First 5 Amounts Leveraged Select Other Funding Source: Select Other Funding Source: 5 6 07/01/18-6/30/19 07/01/18-6/30/19 07/01/18-6/30/19 07101/18-6/30119 7 I. Personnel Title FTE Amount Title FTE Amount Title FTE Amount Title FTE Amount 8 Supervising Public Health Nurse 0.10 10,863 Supervising Public Health Nurse 0.10 10,722 - - 9 The "Amount" should be: Annual Public Health Nurse II 0.48 46,334 Public Health Nurse II 0.52 50,079 10 Salary X the FTE whenever Public Health Nurse II 0.56 49,200 Public Health Nurse II 0.44 38,705 11 possible. 12 1 FTE = 40 hours /week 13 14 15 A. Total Salaries & FTE 1.14 106,397 1.06 99,506 - - - - 16 B. Benefits 73.833% 78,556.00 73,468 - - 17 C. Taxes 7.65% 8,139.00 7,612 - - 18 Personnel Subtotal 193,092.00 180,586 - - Justification of Benefits and Taxes: Estimated benefits rates reflect Unemployment Insurance (.0007738), Retirement(.5186-.6583), OASDI (.0765), Health Insurance ($7386-$9996 per FTE per year) and Benefits 19 Administration ($104 per FTE per year). 20 II. Operating Expenses 21 A. Facilities Costs 1,255 1,184 - - 22 Narrative/Justification — Explain these costs and how they apply to the program, then state methodology (FTE, Square Footage, etc) for these costs and provide the calculation Address: Fresno County Department of Public Health, 1221 Fulton Mall, 4th floor, Fresno, CA 93721. Costs cover telephone/communication ($880) and household expenses ($1,559), determined by square footage allocation to the program. These are all Internal Service Funds charges. General Services 23 Administration provides the base amount for the department. NFP staff use 1,225 sq ft. 24 B. Operational/Supplies 1 2,916 1,667 1 - - 25 Narrative/Justification — Explain these costs and how they apply to the program, then state methodology (materials, services, leases) for these costs and provide the calculation General office supplies such as paper, pencils, envelopes and filing supplies ($2,600); postage ($40); and printing ($100). Rent of storage container for archived files ($693). Medical supplies for PHNs to use during home visits ($1,150). 26 27 C. Training/Travel 2,315 2,185 - - 28 Narrative/Justification — Explain these costs and how they apply to the program, then state methodology (name of local conferences & trainings) for these costs and provide the calculation Fees for staff to attend local meetings, conferences, and training ($500). Staff private auto mileage reimbursement at a rate of$0.545 per mile ($2,000). County vehicle maintenance/usage/garage ($2,000). 29 33 Operating Expenses Subtotal 6,486 5,036 - - 34 III. Program Expenses Instructional Information In the Narrative/Justification box provide a detailed explanation of all program expenses considered on this line item and how they are to support the program participants (include calculations where applicable). 35 36 A. Materials and Supplies 12,004 - - - 37 Subtotal 12,004 - - - 38 Narrative/Justification — Provide the number of participants, cost per item, a description of the item, and justification for all expenses that support the clients of the program. Books and publications ($5,004). Forms, pamphlets, educational materials to evaluate and assist Narrative/Justification for Materials and Supplies Narrative/Justification for Materials and Supplies Narrative/Justification for Materials and Supplies NFP clients ($7,000). 39 40 IV. Professional Services (Contracts, MOU's, Sub agreements, etc.) Instructional Information In the Narrative/Justification box provide a detailed explanation of all professional services considered on this line item and how they are to support the program or staff (include calculations where applicable). Any 41 1 services exceeding $5,000 must have attached a narrative delineating services. 6/6/2019 2 of 4 Children Families Commission of Fresno County S FIR T 5 Service Provider Budget FIFRESNO COUNTY 43 Subtotqll 250 - - - Estimated costs for interpreters/translators who provide services for various languages through a Narrative/Justification — Narrative/Justification — Narrative/Justification — Countywide contract. 44 50 Program Totalsi 211,832 185,622 - - 51 VI. Indirect (= Program Totals - Equipment x Percentage of Indirect) Instructional Information In the Narrative/Justification box explain these costs, how they will support/benefit the program, and how the percentage was determined. 52 53 A. Indirect Rate 15.00% 28,964 27,088 Fresno County Department of Public Health's indirect cost rate is 26.5% of the total personnel costs, prepared following OMB's 2 CFR Part 200 guidelines Narrative/Justification — Narrative/Justification — and approved by County of Fresno's Auditor-Controller/Treasure-Tax Collector Department. Lower rate applied to this budget to ensure sufficient funding for 54 direct costs and remaining within funding award amount. 55 Total Proposed Budget 240,796 212,710 - - 6/6/2019 3 of 4 1 lAgency Name: ICounty of Fresno,Department of Public Health Contract Term: 4q 117/01/2016-06/30/2020 2 1 Project Name: I Nurse-Family Partnership Contract Number: 201617-0954 3 4 YEAR 4 Bud et 5 First 5 Amounts Leveraged Select Other Funding Source: Select Other Funding Source: 6 07101/19-6130120 07/01/19-6130/20 07101/19-6130120 07101/19-6130120 7 I. Personnel Title FTE Amount Title FTE Amount Title FTE Amount Title FTE Amount 8 Supervising Public Health Nurse 0.08 8,854 Supervising Public Health Nurse 0.07 8,734 9 Public Health Nurse 1 0.46 33,476 Public Health Nurse 1 0.54 38,978 - 10 The"Amount"should be:Annual Public Health Nurse 11 0.58 57,244 Public Health Nurse 11 0.42 41,586 11 Salary X the FTE whenever possible. 12 1 FTE=40 hours/week 13 14 15 A. Total Salaries&FTE 1.12 99,574 1.03 89,298 16 B. Benefits 71.293% 70,989.29 63,663.22 - 17 C. Taxes z65% 7,617.41 6,831.30 18 qF Personnel Subtotal 178,180.70 159,792.52 Justification of Benefits and Taxes: Estimated benefits rates reflect Unemployment Insurance(.00182),Retirement(.5116-.648),OASDI(.0765),Health Insurance($8,643- 19 $11,510 per FTE per year)and Benefits Administration($109 per FTE per year). 20 II. Operating Expenses 21 A. Facilities Costs 470 443 22 Narrative/Justification—Explain these costs and how they apply to the program,then state methodology(FTE,Square Footage,etc)for these costs and provide the calculation Telephone communication costs used by program staff($913). Rate provided by Fresno County Department of Internal Services and is based on the type of device used. 23 24 B. OperationallSupplies 1,016 534 25 Narrative/Justification—Explain these costs and how they apply to the program,then state methodology(materials,services,leases)for these costs and provide the calculation General office supplies such as paper,pencils,envelopes and filing supplies($1,000);postage($40);and printing($60).Medical supplies for PHNs to use during home visits($450). 26 27 1.Tralnln /Travel 1,287 1,213 28 Narrative/Justification—Explain these costs and how they apply to the program,then state methodology(name of local conferences&trainings)for these costs and provide the calculation Fees for staff to attend local meetings,conferences,and training($500).Staff private auto mileage reimbursement at a rate of$0.58 per mile($2,000). 29 33 Operating Expenses Subtotal 2,773 2,190 34 III. Program Expenses Instructional Information In the Narrative/Justification box provide a detailed explanation of all program expenses considered on this line item and how they are to support the program participants(include calculations where applicable). 35 36 A. Materials and Supplies 2,483 37 Subtotal 2,483 38 Narrative/Justification—Provide the number of participants,cost per item,a description of the item,and justification for all expenses that support the clients of the program. Books and publications($1,000).Forms,pamphlets,educational materials to evaluate and assist NFP Narrative/Justification for Materials and Supplies Narrative/Justification for Materials and Supplies clients($1,483). 39 40 IV. Professional Services(Contracts,MOU's,Sub agreements,etc.) Instructional Information In the Narrative/Justification box provide a detailed explanation of all professional services considered on this line item and how they are to support the program or staff(include calculations where applicable).Any services 41 exceeding$5,000 must have attached a narrative delineating services. 43 Subtotal 250 Estimated costs for interpreters/translators who provide services for various languages through a Narrative/Justification— Narrative/Justification— Narrative/Justification— Countywide contract. 44 50 Program Totals 3,687 161,983 51 VI.Indirect(=Program Totals-Equipment x Percentage of Indirect) Instructional Information In the Narrative/Justification box explain these costs,how they will support/benefit the program,and how the percentage was determined. 52 53 A. Indirect Rate 14.20% 25,302 22,691 Fresno County Department of Public Health's indirect cost rate is 25.42%of the total personnel costs,prepared following OMB's 2 CFR Part 200 guidelines and Narrative/Justification— Narrative/Justification— approved by County of Fresno's Auditor-Controller/Treasure-Tax Collector Department.Lower rate applied to this budget to ensure sufficient funding for direct costs 54 and remaining within funding award amount. 55 Total Proposed Budget