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Home My WebLink AboutAgreement A-13-559-1 Health Linkages.pdfCounty of Fresno, Department of Public Health Child Care Health Linkages 1635964v1 / 16453.0001 1 First Amendment to Program Services Agreement FY 2015/2016 Parties Commission: Children and Families Commission of Fresno County, California Contractor: County of Fresno, Department of Public Health, 1221 Fulton Mall, Fresno, CA 93721 Administrative Original Contract Number: 2014-0957 Amendment 1 Contract Number: 2014-0957 Recitals A. Commission and Contractor are parties to that certain Program Services Agreement (the "Agreement"), dated October 3, 2013, the Term of which is from July 1, 2013 to June 30, 2015 (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 First Amendment to Program Services Agreement (this "First Amendment") shall have the meanings provided for in the Agreement unless otherwise specified in this First Amendment. Therefore, in consideration of the above recitals, which are incorporated into this First Amendment by reference, the Parties agree as follows: 1. Term. This First Amendment is made effective as of July 1, 2015 (the “Effective Date”). The Term of the Agreement is extended until June 30, 2016, unless terminated earlier under the Agreement (the “Term”) or as specified in this Amendment to the contrary. 2. Amendment to Section 2.1. Effective as of July 1, 2015, Exhibit A will be replaced with the Exhibit A, “Scope of Work (2015-16 Fiscal Year)” attached to this First Amendment and incorporated herein by this reference. As of July 1, 2015, 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: County of Fresno, Department of Public Health Child Care Health Linkages 1635964v1 / 16453.0001 2 4.1 Project Budget. Compensation for the Services provided from July 1, 2015 to June 30, 2016 is based upon actual costs as described in Exhibit B. Compensation for the Services will in no event exceed the total amount of two hundred ten thousand, $210,000 (the “Contract Amount”). The Contract Amount excludes Compensation for Services remaining under the Original Term of the Agreement. Rather, Compensation for Services provided prior to July 1, 2015 shall be in accordance with the original Agreement and not this Amendment. 4. Amendment to Section 4.2. The first sentence in Section 4.2 of the Agreement is deleted in its entirely and replaced with the following (the remainder of Section 4.2 is unaffected): Commission will reimburse Contractor for all necessary, reasonable, and justifiable expenses, as determined by Commission, incurred in accordance with the Project Budget for providing the Services on behalf of Commission in an amount not to exceed the Contract Amount. 5. Controlling Document; No Other Amendment. In the event of any conflict between the terms of this First Amendment and the Agreement, the terms of this First Amendment shall control. Except as amended by this First Amendment, all terms of the Agreement shall remain in full force and effect, including, without limitation, all monitoring, evaluation, data collection, contract review, auditing, inspection, and record retention obligations set forth in Article 9 of the Agreement. 6. Binding Effect. The Agreement, as amended by this First Amendment, is binding upon, and inures to the benefit of, the respective heirs, executors, administrators, successors, and assigns of the Parties. 7. Headings and Construction. The subject headings of the sections and paragraphs of this Amendment are included for purposes of convenience only and do not affect the construction or interpretation of any of its provisions. All words used in this Amendment include the plural as well as the singular number, and vice versa; words used in this Amendment in the present tense include the future as well as the present; and words used in this Amendment in the masculine gender include the feminine and neuter genders, whenever the context so requires. No provision of this Amendment will be interpreted for or against a Party because that Party or its legal representative drafted the provision, and this Amendment will be construed as if jointly prepared by the Parties. 8. Counterparts. This Amendment may be signed by the Parties in different counterparts and the signature pages combined to create one document binding on all Parties. 9. Signature Authority. Each Party represents that it has capacity, full power, and authority to enter into this Amendment 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. Contractor must sign the signatory authorization, attached as Exhibit C and incorporated into this Amendment. Contractor must complete and forward to Commission a new signatory authorization each time any name, title, or other information in the existing authorization is no longer current. /// 1635964v1 /16453 .0001 County of Fresno , Department of Public Health Child Care Health Linkages Signatures APPROVED AS TO LEGAL FORM: DAN IEL C. CEDERBORG , COUNTY COUNSEL APPROVED AS TO ACCOUNTING FORM: VICKI CROW, C.P.A., AUDITOR-CONTROLLER/ TREASURER-TAX COLLECTOR REVIEWED AND RECOMMENDED FOR APPROVAL: sy L 01/2.JI David Pomav ille , Director Department of Public Health Fund/Subclass: Organization: Account#: 0001 /1000 56201677 3530 County of Fresno, Department of Public Health Child Care Health Linkages 1635964v1 / 16453.0001 A-1 EXHIBIT A Scope of Work (2015-16 Fiscal Year) County of Fresno, Department of Public Health, Child Care Health Linkages, #2014-0957 0715(1&2) Page 1 of 8 Agency Name: County of Fresno, Department of Public Health Project Name: Child Care Health Linkages Contract Number: 2014-0957 Project ID Number: 0957-14 GL: 10-8513-00 Agency Address: 1221 Fulton Mall, Fresno CA 93721 Start date/End date: 07/01/2015-06/30/2016 Term from/to: 07/01/2015-06/30/2016 Contract amount: $210,000 FY 14-15: N/A FY 15-16: $210,000 Other Project Funding: $46,703 22 % BOS District: 3 Agency phone #: 559-600-3330 Mailing address if different than above: P.O. Box 11867 Fresno, CA 93775 Agency fax #: 559-600-7729 Website: www.fcdph.org Focus area: Early Learning F5FC Contract Manager: Hannah Norman F5FC Finance Manager: Erlan Zuniga Program Contact (Person who runs day to day operations/supervisor/coordinator/manager) Name: Margaret Morris Title: Supervising Public Health Nurse E-mail: mamorris@co.fresno.ca.us Phone #: 559-600-3330 Fax #: 559-600-7729 Prefix: Ms. Finance Contact (Person responsible for submitting budgets, financial reports and/or invoices) Name: Michael Chu Title: Accountant E-mail: mchu@co.fresno.ca.us Phone #: 559-600-6426 Fax #: 559-600-7692 Prefix: Mr. Notice Contact (Person who has legal authority to sign contract) Name: Dave Pomaville Title: Director E-mail: dpomaville@co.fresno.ca.us Phone #: 559-600-3200 Fax #: 559-600-7687 Prefix: Mr. Public Contact (Person responsible for general public calls requesting program information, how to access services, media, etc.) Name: Megan Gunn Title: Child Care Health Consultant (Public Health Nurse II) E-mail: mgunn@co.fresno.ca.us Phone #: 559-600-3330 Fax #: 559-600-7729 Prefix: Ms. Program Services Face Sheet & Scope of Work This document will be completed with First 5 Fresno County (F5FC) staff and Service Provider during a development meeting. A. Face Sheet Program Services Face Sheet & Scope of Work County of Fresno, Department of Public Health, Child Care Health Linkages, #2014-0957 0715(1&2) Page 2 of 8 Persimmony Contact (s) Program Module – PROGRAM DATA ENTRY (Person responsible for entering client level and/or aggregate data and funded through this contract) Name: Megan Gunn Title: Child Care Health Consultant (Public Health Nurse II) E-mail: mgunn@co.fresno.ca.us Phone #: 559-600-3330 Fax #: 559-600-7729 Training: Access and No Training Required Prefix: Ms. Persimmony Contact (s) Program Module – PROGRAM DATA ENTRY (Person responsible for entering client level and/or aggregate data and funded through this contract) Name: Margaret Morris Title: Supervising Public Health Nurse E-mail: mamorris@co.fresno.ca.us Phone #: 559-600-3330 Fax #: 559-600-7729 Training: Access and No Training Required Prefix: Ms. Persimmony Contact (s) Financial Module – FINANCIAL DATA ENTRY (Person responsible for entering financial information) Name: Michael Chu Title: Accountant E-mail: mchu@co.fresno.ca.us Phone #: 559-600-6426 Fax #: 559-600-7692 Training: Access and No Training Required Prefix: Mr. Persimmony Contact (s) Financial Module – FINANCIAL APPROVAL (Person responsible for approving financial information) Name: Aphivanh (Appy) Xayavath Title: Staff Analyst E-mail: axayavath@co.fresno.ca.us Phone #: 559-600-3330 Fax #: 559-600-7729 Training: Access and No Training Required Prefix: Ms. Persimmony Monitoring Module – ANNUAL CONTRACT REVIEW (ACR) ACCESS (Person responsible for responding to administrative and programmatic components of ACR) Name: Margaret Morris Title: Supervising Public Health Nurse E-mail: mamorris@co.fresno.ca.us Phone #: 559-600-3330 Fax #: 559-600-7729 Prefix: Ms. Persimmony Monitoring Module – ANNUAL CONTRACT REVIEW (ACR) ACCESS (Person responsible for responding to the financial component of ACR) Name: Michael Chu Title: Accountant E-mail: mchu@co.fresno.ca.us Phone #: 559-600-6426 Fax #: 559-600-7692 Prefix: Mr. Program Services Face Sheet & Scope of Work County of Fresno, Department of Public Health, Child Care Health Linkages, #2014-0957 0715(1&2) Page 3 of 8 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. Project Description: Briefly address what F5FC is funding and why. If applicable, describe the goals/outcomes. This will be placed on the F5FC website. The Child Care Health Linkages program provides health and safety technical assistance, consultation, and training to local child care providers to improve the quality of services for children in their care. The program is structured after an evidence-based model from University of California, San Francisco School of Nursing. The Public Health Nurses (PHNs) assist child care providers with incorporating best practices into their facilities and supporting efforts to implement Fresno County Early Stars, National Association for the Education of Young Children (NAEYC) and National Association for Family Child Care (NAFCC) health and safety standards. The PHNs also support child care providers by referring children with special needs and their families to nurse case management for assessment and linkage to needed services. Primary Strategy per F5FC Strategic Plan: State Reporting Result Area & Service Area: Refer to the Annual Report & School Readiness Appendices Fiscal Year Is this an evidence based or research based program? (Please check one) Evidence Based Research Based N/A Location(s) District(s) Location 1: 1221 Fulton Mall, Brix Building-4th Floor, Fresno, CA 93721 District 3 F5FC Strategy Percent of Funding Dollar Amount EC1 Early Care Quality Improvement 100 $210,000 State Result Area/Outcome State Service Area Percent of Clients (%) Percent of Funding (%) Improved Child Development Early Education Provider Program 100 95 Improved Child Health Tobacco Education Outreach 100 5 Program Services Face Sheet & Scope of Work County of Fresno, Department of Public Health, Child Care Health Linkages, #2014-0957 0715(1&2) Page 4 of 8 Please note that these fields reflect the client type options in Persimmony and not family relationships. Include all client level and aggregate clients included in sections C and D. Types of Providers/Professionals Served and Projected Numbers Provider Category Total # of Clients Center-based ECE Providers 115 Home/Family-based ECE Providers 45 Health Care Providers 0 Mental Health Providers 0 Internal Program Staff 0 Interns/Students/Volunteers 0 Other (specify: ) 0 TOTAL: 1601 Projected Numbers Served in Each Geographic Region: Geographical Location of Clients to be Served Total # of Clients Percent Urban (%) Percent Rural (%) Countywide 160 70% 30% B. Demographic and Geographic Client Served Details Program Services Face Sheet & Scope of Work County of Fresno, Department of Public Health, Child Care Health Linkages, #2014-0957 0715(1&2) Page 5 of 8 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. Data due Quarterly. Not Applicable - If your program does not provide aggregate services, please check this box. Service Type F5FC Strategy F5FC Indicators Core Client Type Core Client Target # (Expected # of clients receiving service) Frequency Verification Method Technical assistance 2 EC1 Early Care Quality Improvement SP accredited by NAEYC/NAFCC and/or QRIS Provider 65 Q1: 15 Q2: 15 Q3: 17 Q4: 18 Annually and as needed F5FC Provider Registration Form and internal Provider Technical Assistance Summary form 3 Provider workshop 4 EC1 Early Care Quality Improvement SP accredited by NAEYC/NAFCC and/or QRIS Provider 100 Q1: 25 Q2: 25 Q3: 25 Q4: 25 Annually and as needed F5FC Provider Registration Form 5 Upload to state report (not duplicated) Aggregate Service Types Client Type Aggregate Service Target (Expected # of service sessions or clients) Verification Method (How will you measure this service?) Evaluation Methods Information and referral6 Provider 60 Q1: 15 Q2: 15 Q3: 15 Q4: 15 Phone logs Persimmony data 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 through a contract amendment request. C. Outputs: Services and Contacts D. Aggregate Services and Narrative Program Services Face Sheet & Scope of Work County of Fresno, Department of Public Health, Child Care Health Linkages, #2014-0957 0715(1&2) Page 6 of 8 Service Provider Staff Confidentiality Agreement & Request for Persimmony User Logon All staff members of F5FC funded programs and projects (Service Providers) who are responsible for gathering or maintaining confidential information and records must adhere to this agreement. Responsibilities During the performance of Service Provider assigned duties related to the F5FC project, Service Provider might have access to confidential client information and records required for effective coordination and delivery of services to children and their families. All confidential discussions, deliberations, records, and information generated or maintained in connection with these activities shall be disclosed only to persons who have the need to know and authority to access confidential consumer information or records. This includes information obtained and conveyed through all media including the 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 F5FC will be confidential and will not be open to examination for any purpose not directly connected with the administration of local evaluation. • No person will publish, disclose, use, or permit the use of, or cause to be published, disclosed or used, any confidential information pertaining to any individual recipient of F5FC services. Prohibition of Re-Disclosing Confidential Client Information Employment Confidentiality Agreement This notice accompanies a disclosure of confidential information concerning a consumer of services funded by the F5FC. The above referenced agency is prohibited from making any further disclosure of this confidential information unless further disclosure is expressly permitted by the written authorization to release the information of the person to whom it pertains or as otherwise permitted by these regulations. A general authorization for the release of confidential information is NOT sufficient for this purpose. Acknowledgement of Confidentiality and Prohibition of Re-Disclosing Confidential Client Information Employment Confidentiality Agreement The Agency acknowledges responsibility not to divulge any confidential information or records concerning clients of F5FC funded services without proper written authorization. By signing the Program Services Agreement, the Agency accepts confidentiality and prohibition of re-disclosing confidential funding requirements. Program Services Face Sheet & Scope of Work County of Fresno, Department of Public Health, Child Care Health Linkages, #2014-0957 0715(1&2) Page 8 of 8 1 Client Totals: The client total of 160 providers assumes that some clients will receive multiple services through the Child Care Health Linkages contract. 2 Technical Assistance: Program will provide in-person technical assistance to providers to achieve best practice, accreditation and QRIS health and safety standards. Program staff will meet with center and home based programs individually for at least 30 minutes. Examples of technical assistance include: providing handouts and pamphlets, reviewing policies and procedures, and assisting providers with communicable disease control. 65 providers will receive technical assistance annually. TA will be available on a weekly basis. Dosage varies depending on provider needs. 3 Program uses their internal Provider Technical Assistance Summary form to document Technical Assistance activities. Program staff will also complete the F5FC Provider Registration Form with clients to document F5FC eligibility (self-verification box at bottom of the form). 4 Provider Workshop: Education on health and safety to help providers meet best practice, accreditation and QRIS health and safety standards. Workshops will be offered twice per quarter (English and Spanish separately, but typically on the same day) to a total of 100 providers per year. All providers (including accreditation and QRIS FCCH and center-based clients) will be invited. 5 For this service, program uses the F5FC Provider Registration Form to document attendance and F5FC eligibility (self-verification box at bottom of the form). 6 Information and Referral: Health and safety technical assistance via phone calls and e-mails for providers, community child care representatives, parents and community members. County of Fresno, Department of Public Health Child Care Health Linkages 1635964v1 / 16453.0001 B-1 EXHIBIT B Project Budget (2015-16 Fiscal Year) 1 2 3 4 5 6 7 8 9 Year 3 Revised Budget Year 3 10 7/1/15-6/30/16 7/1/15-6/30/16 11 12 13 98,617 0 98,617 14 67,221 0 67,221 15 7,544 0 7,544 16 173,382 0 173,382 17 18 4,461 0 4,461 19 1,077 0 1,077 20 6,157 0 6,157 21 0 0 0 22 11,695 0 11,695 23 24 1,340 0 1,340 25 1,340 0 1,340 26 4,492 0 4,492 27 0 0 0 28 19,091 0 19,091 29 30 210,000 0 210,000 31 32 33 A.Other Funding Source:46,703 34 B.Other Funding Source:0 35 C.Other Funding Source:0 36 46,703 Title: Prepared by: Date of Submission: Revised Budget: 2014-0957 03/20/15 Appy Xayavath Staff Anaylst Total Program Amount Total Other Funding IV. Professional Services V. Equipment VI. Indirect Costs VII. Other Funding I. Personnel A. Salaries B. Benefits C. Taxes Total Personnel II. Operating Expenses A. Facilities Costs B. Operational/Supplies Total Program C. Training/Travel D. Misc. Charges Total Operating Expenses III. Program Expenses A. Materials and Supplies Total Program Expenses FIRST 5 FRESNO COUNTY Category Agency Name: Project Name: Contract Term: Contract Number: Direct Service Budget 7/1/15-6/30/16 Child Care Health Linkages County of Fresno Department of Public Health No Yes Children Families Commission of Fresno County Service Provider Budget 7/30/2015 1 of 1 1 Agency Name:Contract Term: 2 Project Name:Contract Number:3 4 5 6 7 Title FTE Amount Title FTE Amount Title FTE Amount 8 Supervising Public Health Nurse 0.07 7,245 Supervising Public Health Nurse 0.04 4,268 - 9 Public Health Nurse II 0.85 70,680 Public Health Nurse II 0.15 12,963 10 Public Health Nurse I 0.36 20,692 Public Health Nurse I 0.09 5,442 11 12 13 14 15 1.28 98,617 0.28 22,673 - - 16 B. Benefits 68.164% 17 C. Taxes 7.650% 18 19 Justification of Benefits and Taxes: 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 43 44 45 46 48 49 50 Program Totals 51 52 53 A. Program Total @ %10.00% 54 55 Total Proposed Budget County of Fresno Department of Public Health 7/1/15-6/30/16 Child Care Health Linkages 2014-0957 A B C D Fiscal Period 1 (Insert Date Range) I. Personnel The "Amount" should be: Annual Salary X the FTE whenever possible A. Total Salaries & FTE First 5 Amounts Leveraged Select Other Funding Source: Fiscal Period 1 (07/01/15-06/30/16)Fiscal Period 1 (07/01/15-06/30/16) Personnel Subtotal 173,382 39,862 - 67,221 15,455 - 7,544 1,734 - A. Facilities Costs 4,461 990 - II. Operating Expenses Salaries and benefits reflect rates for FY 2015-16. Estimated benefits rates reflect Unemployment Insurance (.00122), Retirement (.4901- .6245), OASDI (.0765), Health Insurance ($6945 per FTE per year) and Benefits Administration ($144 per FTE per year). B. Operational/Supplies 1,077 239 - 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 the facilities, charges are determined by square footage allocation to the program. The details are: telephone/communication ($464), facility services rent which includes household & building maintenance services ($2,122), utilities ($1,901), household expenses ($387), and security/alarm ($577). These are all ISF (internal service funds) charges. General Services Administration provides the base amount for the department. Linkages staff use 370 sq ft. C. Training/Travel 6,157 1,366 - 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 ($1,016), postage ($50), and printing ($250). D. Misc Charges - - - 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 Local meetings, conferences, and training ($775). Private auto mileage reimbursement at a rate of $0.575 per mile ($3,260). County vehicle garage/maintenance/usage costs ($3,488), based on estimated Internal Service Fund allocation. ISF estimated allocation adjusted slightly for anticipated use. First 5 is billed actuals. Operating Expenses Subtotal 11,695 2,595 - 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 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). A. Materials and Supplies 1,340 - - 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. Narrative/Justification for Materials and Supplies Subtotal 1,340 - - Forms, pamphlets, educational materials to support and educate child care providers on health and safety issues in the child care setting. 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 exceeding $5,000 must have attached a narrative delineating services. Subtotal 4,492 - - Instructional Information In the Narrative/Justification box delineate and explain these costs and how they will support/benefit the program. Also, include the calculations where applicable. Equipment will be allowed on a case by case basis by the First 5 Contract Manager and Finance Staff. Please give name of employee receiving equipment and cost. Subtotal - - - Narrative/Justification – V. Equipment (Tangible assets that do not exceed $5,000 per unit or aggregation of same units) Estimated costs for interpreters/translators who provide services for various languages through a Countywide contract. 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. 19,091 4,246 - Narrative/Justification – Narrative/Justification – Narrative/Justification – 190,909 42,457 - Narrative/Justification – 210,000 46,703 - The actual County indirect cost rate is 14.676%, however, indirect costs were calculated at the allowable rate of 10% of program costs. County of Fresno, Department of Public Health Child Care Health Linkages 1635964v1 / 16453.0001 C-1 EXHIBIT C Signature Authorization County of Fresno, Department of Public Health Child Care Health Linkages Children and Families Commission of Fresno County Exhibit C-Signatory Authorization 1 CERTIFY THAT Deborah A. Poochigian, Chairman, Board of Supervisors (name & title) IS AUTHORIZED TO SIGN FOR, AND BY VIRTUE OF HIS/HER SIGNATURE, BIND County of Fresno Signature of Governing Body Official & ,~ I. _ I l a D~es~~d: ~ • Typed Name: Deborah A. Poochigian Title: Chairman, Board of Supervisors Signature of Official Authorized Above & I ~ l I . a Date Signed: ~ ~ Typed Name: Deborah A. Poochigian Title: Chairman, Board of Supervisors Note: Should circumstances require a change in the above, a new signatory authorization must be com leted and forwarded to Commission. ATTEST: BERNICE E. SEIDEL, Clerk Board f Supervisors By_"-=~-e:::..·=~----:--- 1635964v1/16453.0001 C-1