HomeMy WebLinkAboutAgreement A-22-550 Amendment A2 with CDPH.pdf Agreement No. 22-550
STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES SCO ID:4265-2010704-A2
STANDARD AGREEMENT-AMENDMENT
STD 213A(Rev.4/2020) AGREEMENT NUMBER AMENDMENT NUMBER Purchasing Authority Number
❑ CHECK HERE IF ADDITIONAL PAGES ARE ATTACHED PAGESF 20-10704 A2
1.This Agreement is entered into between the Contracting Agency and the Contractor named below:
CONTRACTING AGENCY NAME
California Department of Public Health
CONTRACTOR NAME
County of Fresno
2.The term of this Agreement is:
START DATE
April 22,2021
THROUGH END DATE
June 29,2023
3.The maximum amount of this Agreement after this Amendment is:
$156,042.00 One Hundred Fifty-Six Thousand Forty-Two Dollars and Zero Cents
4.The parties mutually agree to this amendment as follows.All actions noted below are by this reference made a part of the Agreement and
incorporated herein:
I.Purpose of amendment: This amendment reduced funds from Budget Year 2-A,in the amount of$355.00,thereby decreasing the maximum contract
amount to$156,042.00.Shifts Budget Year 2-A remaining balance of unspent funds in the amount of S43,052.67 to Year 3,as identified in Exhibit 8,
Attachment III,Budget Year 3. Shifts Budget Year 2 unspent funds in the amount of $26,601.44 to Year 3,as identified in Exhibit B,Attachment III,
Budget Year 3. Amends the Scope of Work by extending Timeline/Deliverables dates.
II.Certain changes made in this amendment are shown as: Text additions are displayed in bold and underline. Text deletions are displayed as strike
through text(i.e.,Strike).
111.Exhibit A,Scope of Work,20-10704 Al is hereby replaced in its entirety and shall now read Exhibit A,A2,Scope of Work,20-10704 A2.
IV.Exhibit A,Attachment I,20-10704 Al is hereby replaced in its entirety and shall now read Exhibit A,Attachment I,20-10704 A2
V.Exhibit B,Budget Detail and Payment Provisions,20-10704 Al is hereby replaced in its entirety and shall now read Exhibit 8,A2,Budget Detail and
Payment Provisions,20-10704 A2.
VI. Exhibit 6,Attachment III,Budget Year 3,replaced in its entirety,and shall now read Exhibit B,Attachment III,Budget Year 3,20-10704 A2.
All other terms and conditions shall remain the same.
IN WITNESS WHEREOF,THIS AGREEMENT HAS BEEN EXECUTED BY THE PARTIES HERETO.
CONTRACTOR
CONTRACTOR NAME(if other than an individual,state whether a corporation,partnership,etc.)
County of Fresno
CONTRACTOR BUSINESS ADDRESS CITY STATE [ZIP
1221 Fulton Street Fresno CA 93721
PRINTED NAME OF PERSON SIGNING TITLE
Brian Pacheco- Chairman of Board of Supervisors of the County
Cg�R TOR AUTHORIZED SIGNATURE DATE SIGNED
1L I I lz�r/ZZ
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
Coun of Fr sno,State of California
BY Deputy
Page 1 of 2
STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES SCO ID:4265-2010704-A2
STANDARD AGREEMENT-AMENDMENT -[STD 213A(Rev.4/2020) AGREEMENT NUMBER AMENDMENT NUMBER Purchasing Authority Number
CHECK HERE IF ADDITIONAL PAGES ARE ATTACHED PAGES 20-1 0704 A2
STATE OF CALIFORNIA
CONTRACTING AGENCY NAME
California Department of Public Health
CONTRACTING AGENCY ADDRESS CITY STATE ZIP
1616 Capitol Avenue,Suite 74.262,MS 1802,PO Box 997377 Sacramento CA 95899
PRINTED NAME OF PERSON SIGNING TITLE
Jeannie Galarpie Chief,Contracts Management Unit
CONTRACTING AGENCY AUTHORIZED SIGNATURE DATE SIGNED
12/09/2022
CALIFORNIA DEPARTMENT OF GENERAL SERVICES APPROVAL APPROVE® } EXEMPTION(If Applicable)
DEC 22 2022
EE:abs
OFFICE OF LEGAL SERVICES
DEPT.OF GENERAL SERVICES
Page 2 of 2
County of Fresno
20-10704 A4A2
Page 1 of 18
Exhibit A
Scope of Work
1. Service Overview
Pursuant to California Health and Safety Code Sections 131058 and 131085 the County of
Fresno, Department of Public Health (Contractor) will provide prevention and self-management
support to high burden/underserved adult populations diagnosed or at risk for Type 2 Diabetes
(diabetes).
Contractor services will increase chronic disease support services to target population health
status and improve patient intervention management systems through Health Information
Technology (HIT), Health Information Exchange (HIE), and Electronic Health Records (EHR).
Increase and improve referrals for nationally recognized lifestyle change and chronic disease self-
management programs. Service coordination, such as, meetings, consultations and reporting
scope of work activities will be conducted with public health and safety priorities. Service
coordination will be conducted using social distancing measures throughout the duration of the
Coronavirus pandemic, such as, virtual online platforms, telehealth, conference phone calls,
computer assisted coordination and emails.
The Centers for Disease Control and Prevention (CDC), CFDA number 93.426, Grant Number
NU58DP006540, funding awarded to the CDPH for Contractor Local Assistance provides
California Prevention Forward (PF) interventions; including required objectives and strategies as
described in the Scope of Work and in compliance with the CDC Grant.
2. Service Location
The services shall be performed at applicable facilities and/or remotely in the County of Fresno
as prescribed in the Scope of Work.
3. Service Hours
The services shall be provided during normal Contractor workdays, 8 am — 5 pm, Monday
through Friday, except official holidays.
4. Project Representatives
A. The project representatives during the term of this agreement will be:
California Department of Public Health Fresno County Department of Public
Lisa Pulido Health
Telephone: (916) 552-9948 Melanie Ruvalcaba, Program Manager
Fax: (916) 552-9729 Telephone: (559) 600-6449
E-mail: Lisa.Pulido@cdph.ca.gov Fax: (559) 600-7687
E-mail: mruvalcaba(a-),fresnocountyca.gov
County of Fresno
20-10704 A4A2
Page 2 of 18
Exhibit A
Scope of Work
B. Direct all inquiries to:
California Department of Public Health Fresno County Department of Public
Chronic Disease Control Branch Health
Attention: Lisa Rawson Office of Health Policy and Wellness
essoGa "'Rez do Ybarra Attention: Melanie Ruvalcaba, Program
P.O. Box 997377, MS 7208 Manager
Sacramento, CA 95899-7377 1221 Fulton Street
Fresno, CA 93721
Telephone: (916) 522-98779900
Fax: (916) 552-9729 Telephone: (559) 600-6449
E-mail: lisa.rawsonCa-)_cdph.ca.gov Fax: (559) 600-7687
esso a N Rez deYbarra265)Grdph , ryG" E-mail: mruvalcaba@fresnocountyca.gov
C. All payments from CDPH to the Contractor shall be sent to the following address:
Remittance Address
[Contractor: [County of Fresno
Attention Bruna Chavez, DPH Business Manager
�PO Box 11800
Fresno, CA, 93775
559-600-6438
559-600-7687
�dphboap@fresnocountyca.gov
D. Either party may make changes to the information above by giving written notice to the other
party. Said changes shall not require an amendment to this agreement.
5. Services to be Performed are in the Exhibit A, Attachment I, Scope of Work Below:
County of Fresno
20-10704 A4A2
Page 3 of 18
Exhibit A
Scope of Work
Year 1 — 3
March 1, 2021 — June 29, 2023
Category A — Pre-Diabetes and Diabetes Prevention and Control
Goal 1: Increase utilization of a health systems' reporting infrastructure to identify, treat, and manage patients with at least one of the
following six chronic conditions: prediabetes, type 2 diabetes, high blood pressure, undiagnosed high blood pressure, stroke, or high
blood cholesterol.
Subgoal 1.1. Coordinate with a Health System Champion (HSC) to increase Health Information Technology (HIT)/Electronic Health
Record (EHR) systems utilization to improve identification of individuals with prediabetes and type 2 diabetes. The HSC is required to
monitor, track, and complete California Department of Public Health (CDPH) quarterly reports on individuals with the identified chronic
conditions and report those individuals referred to the National Diabetes Prevention Program (National DPP) or Diabetes Self-
Management Education and Support (DSMES) services.
Objective(s) Activities Responsible Timeline Deliverables
Party
1. Partnership with 1.1 Contractor will serve as a liaison to Program March 1 , 2021- 1.1 Submit via email to
Community provide resources to CRMC and Manager June 29, 2023 CDPH a list of
Regional Medical two (2) HSC's to assess, plan, and (PM), Health Quarterly materials distributed
Center (CRMC) and implement HIT systems to improve Education to CRMC and new
two (2) HSC's patient referrals to community Specialist HSC who received
implement systems prevention and management (HES) the materials,
to identify programs such as attending quarterly.
individuals with quarterly California Prevention
prediabetes or type Diabetes: Screen, Test, Act,
2 diabetes and refer TodayTM (CA PDSTAT) webinars
them to National and coordinating with Intrepid
DPP or DSMES. Ascent (IA) for HIT support.
County of Fresno
20-10704 A4A2
Page 4 of 18
Exhibit A
Scope of Work
1.2 Contractor will complete PM, HES March 1, 2021- 1.2 Submit via email to
Prevention Forward (PF) Local June 29, 2023 CDPH the LHD
Health Department (LHD) quarterly Quarterly survey, quarterly.
surveys to provide information on
progress, accomplishments,
challenges, and technical
assistance needs in addressing
objective 1.
1.3 Contractor will meet with CRMC PM, HES March 1, 2021- 1.3 Submit via email to
and two (2) HSC's to assess, plan, June 29, 2023 CDPH CRMC and
and implement policies/procedures Annually HSC's
to identify individuals within the policies/procedures
clinical service area diagnosed with utilized, annually, to
prediabetes or type 2 diabetes. identify individuals
within their clinical
service area
diagnosed with
prediabetes or type
2 diabetes.
County of Fresno
20-10704 A4A2
Page 5 of 18
Exhibit A
Scope of Work
Category A — Pre-Diabetes and Diabetes Prevention and Control
Goal 2: Increase patient utilization and adherence to evidenced-based strategies for monitoring referrals to community self-
management programs; such as: lifestyle change, nutrition improvement, and physical activity.
Subgoal 2.1 - Improve access to and participation in American Diabetes Association (ADA)-recognized/Association of Diabetes Care
and Education Specialists (ADCES)-accredited DSMES services in the Contractor's service area. Assist the HSC's to recruit and
expand organization(s) to obtain or renew ADA-recognition/ADCES-accreditation. Share DSMES best practice resources to increase
referral and enrollment.
Objective(s) Activities Responsible Timeline Deliverables
Party
2. Improve access to and 2.1 Recruit the Community Diabetes PM, March 1, 2021- 2.1 Submit via email to
participation in, at Education Program at Community June 29, 2023 CDPH a list of
minimum five (5) DSMES Regional Medical Center as the Quarterly recruited or
programs in underserved HSC's. expansion agencies
areas where the for ADA-
prevalence of chronic recognition/ADCES
disease is above the State -accreditation,
average or national quarterly.
average, low income, and
residents who have limited 2.2 Assist HSC's and up to five (5) PM, HES March 1, 2021- 2.2 Submit via email to
access to healthcare local providers seeking to become June 29, 2023 CDPH a list of
services and trainings in ADA-recognized/ ADCES Quarterly DSMES
Fresno County. accredited DSMES programs to stakeholders that
increase referral and enrollment received a DSMES
into DSMES program. application,
quarterly.
County of Fresno
20-10704 A4A2
Page 6 of 18
Exhibit A
Scope of Work
2.3 Provide at least two (2) PM, HES March 1, 2021- 2.3 Submit via email to
educational Continuing Education June 29, 2023 CDPH a list of
Units/Continuing Medical Units Quarterly Training and
opportunities to providers Technical
regarding DSMES program and Assistance (TTA)
opportunities during the contract provided to DSMES
period. organizations to
establish, retain,
and will expand
DSMES; and will
provide a list of
materials
distributed and
organizations who
received the
materials, quarterly.
3. Provide monthly technical 3.1 Collaborate with Fresno Diabetes PM, HES March 1, 2021- 3.1 Submit via email to
assistance to the Fresno Collaborative to update and June 29, 2023 CDPH the LHD
Diabetes Collaborative in maintain web site Quarterly survey to update
efforts to educate and (www.fresnodiabetes.com) the website
inform the community and monthly to include current progress, quarterly.
providers about lifestyle programs, such as DSMES and
change programs in National DPP, and methods of
Fresno County. referrals to diabetes programs
posted on the website.
3.2Update website with learning PM, HES March 1, 2021- 3.2 Submit via email to
opportunities for diabetes June 29, 2023 CDPH the LHD
providers (physicians, nurses, and Quarterly survey to update
Community Health Workers the learning
(CHW): webinars, seminars, opportunities listed
symposiums, and trainings. on the website,
qua rterl .
County of Fresno
20-10704 A4A2
Page 7 of 18
Exhibit A
Scope of Work
4. Provide per organization 4.1 Assist one (1) HSC, certified as a PM, HES March 1, 2021- 4.1a Submit via email to
support to one (1) DSMES DSMES provider, with adding a JLRe 30,2 CDPH a list of
program for Centers for telehealth option, using an online June 29, 2023 DSMES
Medicare and Medicaid platform to deliver services. stakeholders that
Services (CMS)/Medi-Cal received telehealth
telehealth billing codes for support by july 30,
providers and patients; 2022 June 29,
telehealth capacity 2023.
building in patient/provider
technology; and/or, patient 4.1 b Submit via email
engagement options to to CDPH a list of
improve patient/provider telehealth TTA
and patient/diabetes provided to DSMES
learning through virtual organizations; and
platforms. provide a list of
materials
distributed and
organizations who
received the
materials by Jt-y
30, 2 June 29,
2023.
County of Fresno
20-10704 A4A2
Page 8 of 18
Exhibit A
Scope of Work
Subgoal 2.2 - Improve access to and participation in CDC-recognized National DPP lifestyle change programs in the Contractor's
service area. Assist the HSC to recruit new and expand organization(s) to obtain or renew CDC recognition. Share National DPP best
practice resources to increase referral and enrollment.
Objective(s) Activities Responsible Timeline Deliverables
Party
5. Improve access to and 5.1 Assist and provide one (1) hour PM, HES March 1, 2021- 5.1 Submit via email to
participation in, at quarterly Technical Assistance June 29, 2023 CDPH, progress in
minimum, one (1) CDC- (TA) to the California Health Quarterly the LHD survey,
recognized National DPP Collaborative (CHC) Partner with quarterly.
program in underserved recruitment efforts to increase
areas where the referrals to and participation in
prevalence of chronic National DPP.
disease is above the 5.2Provide TA to at minimum one (1) PM, HES March 1, 2021- 5.2a Submit via email to
State average or national additional organization seeking to June 29, 2023 CDPH a list of
average, low income, and achieve recognition for National Quarterly recruited or
residents whon4 have DPP during the contract period. expansion
limited access to agencies for
healthcare services and CDC-recognition
trainings in Fresno of National DPP.
County.
5.2b Submit via email
to CDPH a list of
National DPP
stakeholders for
CDC application,
quarterly.
County of Fresno
20-10704 AIA2
Page 9 of 18
Exhibit A
Scope of Work
5.2c Submit via email to
CDPH a list of TTA
that was provided
to National DPP
organizations to
establish, retain,
and will expand
National DPP; and
provide a list of
materials
distributed and
organizations who
received the
materials,
quarterly.
6. Provide per organization 6.1 Assist the CHC, a National DPP PM, HES March 1, 2021- 6.1a Submit via email to
support to one (1) local provider in Fresno County to offer do„30, 2 CDPH a list of
National DPP for telehealth service coordination and National DPP June 29, 2023 National DPP
CMS/Medi-Cal telehealth access to online virtual platforms Subcontractor stakeholders that
billing codes for providers for lifestyle change programs. received telehealth
and patients; telehealth support by -may
capacity building in
2 June 29,
patient/provider 2023.
technology; and/or, 6.1 b Submit via email
patient engagement to CDPH a list of
options to improve telehealth TTA,
patient/provider and provided to
patient/diabetes learning National DPP
through virtual platforms. organizations; and,
provide a list of
materials
distributed and
County of Fresno
20-10704 A4A2
Page 10 of 18
Exhibit A
Scope of Work
organizations who
received the
materials by -duly
0,2 June 29,
2023.
Category A — Pre-Diabetes and Diabetes Prevention and Control
GOAL 3 Increase patient coordination with non-physician care team members to monitor and manage patient condition(s) and
refer individuals to lifestyle change programs.
Subgoal 3.1 - Coordinate recruitment and engagement of a pharmacist(s) within the Contractor's service area to increase the provision
of DSMES patient coordination.
Objective(s) Activities Responsible Timeline Deliverables
Party
7. Engage a minimum of 7.1 Attend and participate in, at PM, HES March 1, 2021- 7.1 Submit via email to
three (3) local pharmacists minimum, two (2) Central Valley June 29, 2023 CDPH the meeting
to promote DSMES and Pharmacy Association meetings Quarterly attendance,
National DPPs. annually to update members on quarterly.
lifestyle change programs.
7.2 Collaborate with, at minimum, HES March 1, 2021- 7.2 Submit via email to
three (3) local pharmacists to June 29, 2023 CDPH a list of
distribute educational and materials
promotional materials and Fresno distributed to
Diabetes Collaborative web site pharmacist(s) and
at least one (1) time per quarter. who received the
materials, quarterly.
County of Fresno
20-10704 A4A2
Page 11 of 18
Exhibit A
Scope of Work
Subgoal 3.2 - Identify and report on service area agencies with a CHW program curriculum or training process.
Objective(s) Activities Responsible Timeline Deliverables
Party
8. In partnership with 8.1 Schedule, at minimum, one (1) PM, HES March 1 , 2021- 8.1 Share the progress
"Collaborating for annual meeting with community June 29, 2023 of CHW activities
Wellness" program partners to discuss training and Quarterly within the local
identify and engage with utilization of CHWs in Fresno jurisdiction to CDPH
partner agencies that County. via email, quarterly.
provide resources for
CHWs. 8.2 Schedule, at minimum, two (2) HES March 1, 2021- 8.2 Share the progress
trainings for CHWs in Fresno May 15, 2023 of CHW activities
County for prediabetes and type 2 Quarterly within the local
diabetes during the contract period. jurisdiction to CDPH
via email, quarterly.
8.3 Contractor will attend and invite PM, HES March 1 , 2021- 8.3a Submit, via email,
CRMC and HSCs to participate in June 29, 2023 to CDPH the
webinars conducted by Vision y Quarterly meeting
Compromiso (VyC) about CHW attendance.
program curriculum or training
delivery process during the 8.3b Share the
contract period. progress of CHW
activities within the
local jurisdiction to
CDPH, via email,
quarterly.
County of Fresno
20-10704 A4A2
Page 12 of 18
Exhibit A
Scope of Work
Subgoal 3.3 - Recruit and engage a pharmacist(s) and provide TTA on DSMES ADA-recognition/ADCES-accreditation.
Objective(s) Activities Responsible Timeline Deliverables
Party
9. Minimum of one (1) local 9.1 Collaborate with the Central Valley HES March 1, 2021- 9.1 Submit, via email, to
pharmacist will receive Pharmacy Association to identify, at Ju„30,2 CDPH, a list of
ADA-recognition/ADCES- minimum, one (1) pharmacist June 29, 2023 pharmacist(s) that
accreditation for their committed to offering DSMES Quarterly are interested in
DSMES services that services. Partner with local programs becoming a
connect to a local clinic recognition/accreditation. DSMES program,
patient referral process. quarterly.
9.2 Contractor will share information and HES 9.2a Submit via email,
provide assistance to eligible March 1, 2021- to CDPH, a list of
pharmacists to register as ADA- Jun e 30, `' materials
recognized/ADCES-accredited June 29, 2023 distributed to
DSMES programs. Quarterly pharmacist(s) and
who received the
materials, quarterly.
9.2b Submit via email,
to CDPH, a list of
pharmacist(s) that
received
recognition for
DSMES, quarterly.
9.2c Submit, via email,
to CDPH, a list of
the pharmacist(s)
that received
County of Fresno
20-10704 A4A2
Page 13 of 18
Exhibit A
Scope of Work
recognition for
DSMES-related
TTA; and, submit a
list of materials
distributed and
who received the
materials,
qua rterl .
Subgoal 3.4 - Contractor and HSC will recruit a pharmacist or CHW in the service area to increase the patient Comprehensive
Medication Management CMM team-based care process.
Objective(s) Activities Responsible Timeline Deliverables
Party
10. Engage a minimum of 10.1 Disseminate information about the HES March 1, 10.1 Submit, via email,
one (1) local pharmacist patient care process to local 2021-June 29, to CDPH, a list of
to collaborate with an pharmacist(s) at least once 2023 materials
attending physician to annually. Quarterly distributed to
increase the provision of pharmacist(s) and
DSMES patient who received the
coordination. 10.2 Coordinate with a minimum of one materials,
(1) local pharmacist to complete a HES, March 1, quarterly.
*Collaborative Practice Agreement Pharmacist 2021-June 29,
(CPA), with an attending physician Subcontractor 2023 10.2 Submit, via
to increase the provision of Quarterly email, to CDPH, a
DSMES patient coordination. contact list which
will identify
* Collaborative Practice Agreement(CPA)is a legal pharmacist(s)
document in the United States that establishes a interested in
legal relationship between clinical pharmacists and
collaborating physicians that allows for pharmacists completing a CPA,
to participate in collaborative drug therapy quarterly.
management(CDTM). The CPA is a tool(not a
subcontract)to improve coordination for the benefit
of the patient.
County of Fresno
20-10704 A4A2
Page 14 of 18
Exhibit A
Scope of Work
Objective(s) Activities Responsible Timeline Deliverables
Party
10.3 Contractor will support pharmacy July 1, 2021- 10.3a Share the
subcontractor to provide CMM and HES, HSC, june 30,2 progress of CMM
refer 50 patients to National DPP or Pharmacist June 29, 2023 activities to CDPH
DSMES programs. Each patient Subcontractor via email, quarterly
receives three encounters with a
pharmacist for CMM, followed by a 10.3b Submit a process
referral to National DPP or DSMES map of the referral
programs with HSC. process to CDPH
via email, quarterly.
GOAL 4 - Coordinate with CDPH on a required schedule to increase participation, coordination, management, and delivery to
improve data collection, information exchange, and resource development and distribution.
Objective(s) Activities Responsible Timeline Deliverables
Party
11.1 Attend and actively 11.1 Contractor staff will participate in HE, HES March 1, 2021- 11.1 Provide via email,
participate in PF quarterly CDPH webinars, conference calls, June 29, 2023 to CDPH, a list of
webinars, conference and meetings to share successes, Quarterly all PF Contractor
calls, and meetings. challenges, and progress on key Public Health Staff
Participate by sharing contract deliverables. participation,
successes, challenges, quarterly.
and progress on key
contracted deliverables.
11.2 Contractors, and a 11.2 Contractor and HSC(s) will attend HE, HES March 1, 2021- 11.2 Provide via email,
minimum of one (1) key CDPH convening in a virtual setting jURe 29, 2 to CDPH, a list of
stakeholder, will June 29, 2023 the PF
participate in a PF convening(s)
sponsored convening. attended via email
by July 30, 2022
2023.
County of Fresno
20-10704 A4A2
Page 15 of 18
Exhibit A
Scope of Work
11.3 Participate in a limited 11.3 Contractor staff will participate in HE, HES March 1, 2021- 11.3 Briefly describe
amount (4-6 hours, PF-sponsored cultural humility or June 29, 2023 efforts in the LHD
annually) of accredited health equity training. Quarterly quarterly survey
online cultural humility or and provide a list
health equity trainings of training(s)
facilitated health equity attended, to
consulting agency to CDPH, via email.
support coordination with
underserved minority
populations facing
multiple social
determinant issues.
11.4 Submit Progress 11.4 Contractor will submit online HE, HES March 1, 2021- 11.4 Submit via Survey
Report(s) (e.g., quarterly progress reports at quarterly fiscal June 29, 2023 Monkey or
LHD compiled file) year (FY) intervals to provide health Quarterly hardcopy version,
according to a PF system performance measure data to CDPH, a copy
schedule and format for PF services delivered to local of quarterly
describing key progress populations. progress reports.
and deliverable status for
the reporting period. The
report shall detail activity
achievements and
summarize work
underway. The report
shall list successes and
provide information on
barriers to activity
completion and
recommendations for
future best practices.
County of Fresno
20-10704 A4A2
Page 16 of 18
Exhibit A
Scope of Work
11.5 Participate in the PF 11.5 Contractor will update the HE, HES September 30, 11.5 Provide via email,
biennial pharmacist pharmacists/pharmacy locations list 2021 to CDPH, updated
practice survey. in Fresno County, provide the list of
updated list to PF for the biennial pharmacists/phar
pharmacist practice survey and macy locations in
share the biennial pharmacy survey Fresno County
link with all pharmacists/pharmacy and share the PF
locations in Fresno. biennial pharmacy
survey links with
the
pharmacists/phar
macy locations by
September 30,
2021.
11.6 Participate in the PF 11.6 Collaborate with HSC to submit a HE, HES March 1, 2021- 11.6 HSC shall submit
biennial pharmacist list of pharmacy/pharmacist June 29, 2023 via email, to
practice survey. location(s) that have established a Quarterly CDPH, updated
CPA with HSC. list of
pharmacists/phar
macy locations in
collaborative
practice, quarterly.
11.7 Respond to all PF 11.7 Contractor will coordinate with clinic HE, HES March 1, 2021- 11.7 Submit via email,
survey(s) (e.g., quarterly partnerships and local public health June 29, 2023 to CDPH, LHD
LHD surveys and health stakeholders to complete and Quarterly surveys and share
system capacity surveys) respond quarterly during the FY to HSC and biennial
according to a required all PF surveys. surveys as
schedule and process. needed.
County of Fresno
20-10704 A4A2
Page 17 of 18
Exhibit A
Scope of Work
11.8 Partners without a 11.8 Contractor will identify an HSC to HE, HES March 1, 2021- 11.8 Report via email,
connected health system; participate in PF Activities. Create June 29, 2023 to CDPH, the
identify an HSC to an engagement method with the Quarterly resource sharing
engage patients with PF HSC that will require coordinated method.
chronic disease service service delivery, performance
delivery and establish an measure data collection and
agreed-upon resource appropriate consideration for local
sharing method participation.
conducted by the HSC
and upon specific PF
performance approved by
CDPH.
11.9 Partners without a 11.9 Contractor will develop a one (1) HE, HES March 1, 2021- 11.9 Provide via email,
connected health page evidence report that describes June 29, 2023 to CDPH,
system; provide a one- the method of engagement PF evidence of a one-
page evidence of the services provided and amount of page method of
method provided to an compensation with the HSC. agreement
HSC for specific between
performance to support Contractor and
the PF program. HSC.
11.10 Contractor will submit a 11.10 Contractor staff will develop and HE, HES April 1, 2023- 11.10 Provide via email,
final Project Summary submit a final Project Summary June 29, 2023 to CDPH, a copy
Report to CDPH in a Report by March 31, 2023 for of final Project
prescribed form and review and comment. The report Summary Report.
format. will summarize PF services
delivered, local coordination and
The report must include: performance measure completion.
a. Narrative discussion of
key Category A
quantitative and
County of Fresno
20-10704 A4A2
Page 18 of 18
Exhibit A
Scope of Work
qualitative process or
outcome measures;
b. Narrative discussion of
program successes or
barriers significant to the
population burden for
Category A interventions;
c. Brief purpose and
approach statement for
key Category A
interventions;
d. Narrative statement on
the linkages between
Category A interventions
and overall population
health impact;
e. Brief summary of the
intervention process or
outcome, including
lessons learned;
f. Brief summary of positive
improvements to health
processes or outcomes
and impact on high
burden/underserved
populations; and,
g. Sustainability paragraph
identifying options for
continuing or impact of
not continuing the
program.
County of Fresno
20-10704 A4A2
Exhibit B
Budget Detail and Payment Provisions
1. Invoicing and Payment
A. In no event shall the Contractor request reimbursement from the State for obligations entered into
or for costs incurred prior to the commencement date or after the expiration of this Agreement.
B. For services satisfactorily rendered, and upon receipt and approval of the invoices, CDPH agrees to
compensate the Contractor for actual expenditures incurred in accordance with the Budget Line
Item amounts specified in Attachment I, II, II-A and III of this Exhibit.
C. Invoices shall include the Agreement Number, CDCB Address, and shall be submitted
electronically, not more frequently than quarterly, in arrears to:
CDCBlnvoices(a)_cdph.ca.gov
California Department of Public Health
Chronic Disease Control Branch
P.O. Box 997377, MS 7208
Sacramento, CA 95899-7377
The State, at its discretion, may designate an alternate invoice submission address. A change in
the invoice address shall be accomplished via a written notice to the Contractor by the State and
shall not require an amendment to this agreement.
D. Invoices shall:
1) Be prepared using the CDPHC/CDCB approved template, which will be provided by the
CDPH/CDCB Contract Manager. Invoices must include contractor letterhead and be signed by
an authorized official, employee or agent certifying that the expenditures claimed represent
activities performed and are in accordance with Exhibit A.
2) Invoices must be submitted to CDPH electronically only, according to naming convention (refer
to 9., C. below) Hard copies are not required and will not be accepted.
3) Identify the billing and/or performance period covered by the invoice.
4) Itemize costs for the billing period in the same or greater level of detail as indicated in this
agreement. Subject to the terms of this agreement, reimbursement may only be sought for
those costs and/or cost categories expressly identified as allowable in this agreement and
approved by CDPH.
5) Bear the Contractor's name, as shown on the Agreement.
6) Show an invoice date reflecting when the invoice was prepared.
7) Submitted electronically, no later than five (5) days after the invoice date.
8) Show the Agreement number assigned by CDPH.
9) Show the Contractor's remittance address.
10)Electronic invoices must be submitted to read on the subject line as follows: Contract Number,
Vendor Name, State Fiscal Year, Invoice Number
E. Amounts Payable
The amounts payable under this agreement shall not exceed $156,397.00 $156,042.00, as
indicated in Attachment 1,11, II-A and III of this Exhibit.
Page 1 of 43
County of Fresno
20-10704 A4A2
Exhibit B
Budget Detail and Payment Provisions
2. Budget Contingency Clause
A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered
under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be
of no further force and effect. In this event, the State shall have no liability to pay any funds
whatsoever to Contractor or to furnish any other considerations under this Agreement and
Contractor shall not be obligated to perform any provisions of this Agreement.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program,
the State shall have the option to either cancel this Agreement with no liability occurring to the State
or offer an agreement amendment to Contractor to reflect the reduced amount.
3. Prompt Payment Clause
Payment will be made in accordance with, and within the time specified in, Government Code Chapter
4.5, commencing with Section 927.
4. Timely Submission of Final Invoice
A. Final undisputed invoice shall be submitted for payment no more than sixty (60) calendar days
following the expiration or termination date of this agreement, unless a later or alternate deadline is
agreed to in writing by the program contract manager. Said invoice should be clearly marked "Final
Invoice", indicating that all payment obligations of the State under this agreement have ceased and
that no further payments are due or outstanding. The State may, at its discretion, choose not to
honor any delinquent final invoice if the Contractor fails to obtain prior written State approval of an
alternate final invoice submission deadline.
B. The Contractor is hereby advised of its obligation to submit to the state, with the final invoice, a
completed copy of the "Contractor's Release (Exhibit H)".
5. Expense Allowability/ Fiscal Documentation
A. Invoices, received from the Contractor and accepted for payment by the State, shall not be deemed
evidence of allowable agreement costs.
B. Contractor shall maintain for review and audit and supply to CDPH upon request, adequate
documentation of all expenses claimed pursuant to this agreement to permit a determination of
expense allowability.
C. If the allowability of an expense cannot be determined by the State because invoice detail, fiscal
records, or backup documentation is nonexistent or inadequate according to generally accepted
accounting principles or practices, all questionable costs may be disallowed, and payment may be
withheld by the State. Upon receipt of adequate documentation supporting a disallowed or
questionable expense, reimbursement may resume for the amount substantiated and deemed
allowable.
6. Recovery of Overpayments
A. Contractor agrees that claims based upon the terms of this agreement or an audit finding and/or an
audit finding that is appealed and upheld, will be recovered by the State by one of the following
options:
Page 2 of 43
County of Fresno
20-10704 A4A2
Exhibit B
Budget Detail and Payment Provisions
1) Contractor's remittance to the State of the full amount of the audit exception within 30 days
following the State's request for repayment;
2) A repayment schedule which is agreeable to both the State and the Contractor.
B. The State reserves the right to select which option as indicated above in paragraph A will be
employed and the Contractor will be notified by the State in writing of the claim procedure to be
utilized.
C. Interest on the unpaid balance of the audit finding or debt will accrue at a rate equal to the monthly
average of the rate received on investments in the Pooled Money Investment Fund commencing on
the date that an audit or examination finding is mailed to the Contractor, beginning 30 days after
Contractor's receipt of the State's demand for repayment.
D. If the Contractor has filed a valid appeal regarding the report of audit findings, recovery of the
overpayments will be deferred until a final administrative decision on the appeal has been reached.
If the Contractor loses the final administrative appeal, Contractor shall repay, to the State, the over-
claimed or disallowed expenses, plus accrued interest. Interest accrues from the Contractor's first
receipt of State's notice requesting reimbursement of questioned audit costs or disallowed
expenses.
7. Advance Payments
No advance payment is allowed under this Contract.
8. Travel and Per Diem Reimbursement
Any reimbursement for necessary travel and per diem shall, unless otherwise specified in this
Agreement, be at the rates currently in effect, as established by the California Department of Human
Resources (Cal HR). If the Cal HR rates change during the term of the Agreement, the new rates shall
apply upon their effective date and no amendment to this Agreement shall be necessary. No travel
outside the state of California shall be reimbursed without prior authorization from the CDPH. Verbal
authorization should be confirmed in writing. Written authorization may be in a form including fax or
email confirmation. Refer to CaIHR website.
9. Invoice Reporting Requirements and Billing Instructions
A. Quarterly Invoice Schedule - Contractor shall submit electronic quarterly invoice in accordance with
the following schedule:
Quarter Dates Due
1 07/01 thru 09/30 11/1
2 10/01 thru 12/31 2/1
3 01/01 thru 03/31 5/1
4 04/01 thru 6/30 8/30
B. Contractor shall have the right to issue a supplemental invoice for expenditures incurred after
quarter four (4)final invoice has been submitted to recover in full all actual costs, as specified in the
executed Exhibit B, Budget Attachment(s) for this agreement.
Page 3 of 43
Exhibit B, Attachment III County of Fresno
Budget Year 3 20-10704 A2
(7101122 - 6/29/23) —
Category A
Diabetes Total
A. PERSONNEL
Position Title % FTE Total Annual Salary Months Monthly Salary % of Subtotal Total Cost
Fund
Program Manager 3% 5% $104,583.00 $115,232.00 12 $ '� $9,602.67 100% Qa� $5,761.60 Q�� $5,761.60
Health Education Specialist I 4 -o/, 15% �5« $48,205.00 12 1 $-480,2-6 $4,017.08 100% $ ,7� $7,230.75 $5,'� $7,230.75
Total Salaries* $g,400.61- $12,992.35 $8408.6- $12,992.35
FRINGE BENEFITS* 67% Q� aa� �� $8,704.87 Q� a63 A4 $8,704.87'
Wes; &1_4 $5;�o�
Total Personnel Costsl Q�^�-,T� $21,697.22 Q�W_,T o6T o= $21,697.22
Category A
Total
Diabetes
B. OPERATING EXPENSES DETAIL % of Subtotal Total Cost
Fund
Travel: 100% $7&-.00 $328.80 $7g:gg $328.80
General Expense (office supplies): 100% $500.00 $500.00
Communication/Software: phones, network, computers, support($666/month/FTE x 0.2 FTE x 100% $1,599.00 $1,599.00
12 months)
Space/Rent: rent, utilities, security, maintenance ($1500/month/FTE x 0.2 FTE x 12 months) 100% $3,600.00 $3,600.00
Total Operating $78 0g $6,027.80 $7&00 $6,027.80
Category A
Total
Diabetes
C. SUBCONTRACTORS % of Subtotal Total Cost
Fund
National DPP Subcontractor Obi. 6.1 100% $2,675.001 $ 2,675.00
Total Other Costs $2,675.00 $2,675.00
Page 1 of 2
Exhibit B, Attachment III County of Fresno
Budget Year 3 20-10704 A2
(7101122 - 6/29/23) —
Category A
Total
Diabetes
D. OTHER COSTS % of Subtotal Total Cost
Fund
DSMES/NDPP certification fees and materials for Health System Champion(s): Obj. 2, 2.1, &4.1; 100% $19 999.98 $31,477.78 $1Q�Q98 $31,477.78
Obj. 10.1 & 10.2; Obj. 11.2, 11.10 & 11.8
Education and training materials and fees: Obi. 2.1, 2.2, 2.3, 3.1, 3.2, 4.1, 5.2, 7.2, 8.1, 100% $2,340.89 $2,340.89
9.1, 9.2
Pharmacist Mini grants Obl. 10.2 100% $40,000.001 $40,000.00
Total Other Costs Q� aaa oQ $73,818.67 Q1 o aaa oQ $73,818.67
� �
Category A
Total
Diabetes
E. INDIRECT % of Subtotal Total Cost
Fund
Total Personnel Cost* I L8.82%61 25-90% 100% 44,— � $4,083.421 $ 3,71 .00 $ 4,083.42
Total Indirect Cost $ 3,7-16. $4,083.42 -$_�0� $ 4,083.42
Category A
Total
Diabetes
TOTAL EXPENSES $38,658.00 $108,302.11 $38_,658.00 $108,302.11
*Rounding may occur
Page 2 of 2
Amendment II to Agreement Between the County of Fresno and the
California Department of Public Health
Amendment Name: CDPH Prevention Forward for Type 2 Diabetes (State Agreement
No. 20-10704-A2)
Fund/Subclass: 0001/10000
Organization #: 56201556
Revenue Account #: 4380