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Agreement A-23-581 Agreement Funding Application with CDPH.pdf
Agreement No. 23-581 CALIFORNIA DEPARTMENT OF PUBLIC HEALTH MATERNAL, CHILD AND ADOLESCENT HEALTH (MCAH) DIVISION FUNDING AGREEMENT PERIOD FY 2023-2024 AGENCY INFORMATION FORM Agencies are required to submit an electronic and signed copy(original signatures only) of this form along with their Annual AFA Package. Agencies are required to submit updated information when updates occur during the fiscal year. Updated submissions do not require certification signatures. AGENCY.IDENTIFICATION • . • Any program related information being sent from the CDPH MCAH Division will be directed to all Program Directors. Please enter the agreement or contract number for each of the applicable programs 202310 202310 MCAH BIH AFLP Update Effective Date(only required when submitting updates) Federal Employer ID#: Complete Official Agency Name: County of Fresno Business Office Address: 1221 Fulton Street, Fresno, CA 93721 Agency Phone: (559)600-3330 Agency Fax: (559)455-4705 Agency Website: www.fcdph.org Revised 2/7/2023 Page 1 of 5 AGREEMENT FUNDING APPLICATION POLICY COMPLIANCE AND CERTIFICATION Please enter the agreement or contract number for each of the applicable programs MCAH 2O2310 BIH 2O2310 AFLP The undersigned hereby affirms that the statements contained in the Agreement Funding Application (AFA)are true and complete to the best of the applicant's knowledge. I certify that these Maternal, Child and Adolescent Health (MCAH) programs will comply with all applicable provisions of Article 1, Chapter 1, Part 2, Division 106 of the Health and Safety code (commencing with section 123225), Chapters 7 and 8 of the Welfare and Institutions Code (commencing with Sections 14000 and 142), and any applicable rules or regulations promulgated by CDPH pursuant to this article and these Chapters. I further certify that all MCAH related programs will comply with the most current MCAH Policies and Procedures Manual, including but not limited to, Administration, Federal Financial Participation (FFP)Section. I further certify that the MCAH related programs will comply with all federal laws and regulations governing and regulating recipients of funds granted to states for medical assistance pursuant to Title XIX of the Social Security Act(42 U.S.C. section 1396 et seq.) and recipients of funds allotted to states for the Maternal and Child Health Service Block Grant pursuant to Title V of the Social Security Act(42 U.S.C. section 701 et seq.). I further agree that the MCAH related programs may be subject to all sanctions, or other remedies applicable, if the MCAH related programs violate any of the above laws, regulations and policies with which it has certified it will comply. Official authorized to commit the Agency to an MCAH Agreement Name(Print) Title Sal Quintero Chairman of the Board of Supervisors of the County of Fresno Original Signature Date OkA f o —1124 -aoa3 MCAH/AFLP Director Name (Print) Title Ge Vue MCAH Director Origin Signature Date ATTEST: BERNICE E.SEIDEL Revised 2/7/2023 Clerk of the Board of Supervisors Page 2 of 5 County of Fresno,State of California By_ _Deputy — - U) 0 2 S S S S S S 2 m U U U U U u U U p V) v LL N U i o > > o o c o > 0) o 0 > rn rn rn o > 0) o ea U N f0 (Op) U L) U U (p Z. 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MCAH/PROJECT DIRECTOR'S SIGNATURE DATE AGENCY FISCAL AGENT'S SIGNATURE DATE 'Th..-ntam local revenue submM for,formation and matching puryeses MCAH daes rxX reimburse Agency c Inbutions. STATE USE ONLY-TOTAL STATE AND FEDERAL REIMBURSEMENT MCAH-TV MCAH-SIDS AGENCY MCAH-Casty NE MCAH-Crdy E FUNDS PICA Codes 53107 53112 53118 53117 (1) PERSONNEL 422,226.00 7,372.00 0.00 1,121,715.05 0.00 934,273.81 (11) OPERATING EXPENSES 0.00 0.00 0.00 65,961.35 0.00 0.00 (111) CAPITAL EXPENSES 0.00 0.00 0.00 0.00 0.00 0.00 (IV) OTHER COSTS 0.00 0.00 0.00 338,927.56 0.00 0.00 (V) INDIRECT COSTS 0.00 0.00 0.00 319,443.89 0.00 0.00 Totals for PCA Codes 3,209,919.66 422,226.00 7,372.00 10.00 1,846,047.85 1 0.00 934,273.81 202310 MCAH 5 FY 2023-24 Budget Template 08.15.23.xlsx 1 of 5 Primed:9/1/2023 1:25 PM a ,o� ORIGINAL Public Heplth.coal Metemal,Child and AddesceM Heakh Didaicn Program: Matemal,Child and Adolescent Health MCAH NON-ENHANCED ENHANCED Agency: M2 310 Fresno UNMATCHED FUNDING MATCHING(50/50) MATCHING(75125) SubK: MCAH-TV MCAH-SIDS AGENCVFUNDS MCAH-Cory NE MCAH-CntyE (11 (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) Combinetl Combined Combinetl Combined TOTAL FUNDING % MCAH-N % MCAH-SIDS % Agency Funds* % Fed/State Fed/Aoenev % Fed/State Fed/Anencv %TRAVEL NON-ENHMATCH %TRAVELENHMATCH %PERSONNEL MATCH (II) OPERATING EXPENSES DETAIL 47.35% 18.93% 65.49% TOTAL OPERATING EXPENSES 231,795.00 0.00 0.00 99,872.30 0.00 131,922.70 0.00 0.00 Mann A.aiiaeie TRAVEL 65,218.00 0.00% 0.00 0.00 35.10% 22,891.52 0.00 64.90% 42,326.48 0.00 0.00 1.38% TRAINING 40,030.00 1 0.00% 0.00 0.00 34.51% 13,814.35 0.00 65.49% 26,215.65 0.00 0.00 0.00% 1 Communications 40,772.00 0.00% 0.00 0.00 34.51% 14,070.42 0.00 65.49% 26,701.58 0.00% 2 Office Supplies 49,080.00 0.00% 0.00 0.00 34.51% 16,937.51 0.00 65.49% 32,142.49 0.00% 3 Postage 1,757.00 0.00% 0.00 0.00 34.51% 606.34 0.00 65.49% 1,150.66 0.00% 4 Duplication 1,370.00 0.00% 0.00 0.00 34.51% 472.79 0.00 65.49% 897.21 0.00% 5 Maintenance Equipment 3,800.00 0.00% 0.00 0.00 34.51% 1,311.38 0.00 65.49% 2,488.62 0.00% 6 Medical Supplies 9,200.00 0.00% 0.00 0.00 100.00% 9,200.00 0.00 0.00 65.49% 7 Nurse-Family Partnership 20,568.00 0.00% 0.00 0.00 100.001 20,568.00 0.00 0.00 65.49% 8 0.00 0.00 0.00 0.00 0.00 9 0.00 0.00 0.00 0.00 0.00 10 0.00 0.00 0.00 0.00 0.00 11 0.00 0.00 0.00 0.00 0.00 12 0.00 0.00 0.00 0.00 0.00 13 0.00 0.00 0.00 0.00 0.00 14 0.00 0.00 0.00 0.00 0.00 15 0.00 0.00 0.00 0.00 0.00 Unmatched Oneraono Expenses are not enable for Federal matchlno funds(Title XIX) Expenses may only be charged to Unmatched Title V(Col 3).Stale General Funds(Col.5).and/or Anencv(Col 7)funds (III) CAPITAL EXPENDITURE DETAIL TOTAL CAPITAL EXPENDITURES 0.00 om 0.00 0.00 0.00 (IV) OTHER COSTS DETAIL %PERss5.4gy ATCH TOTAL OTHER COSTS 1,161,783.00 0.00 0.00 483,927.88 0.00 677,855.12 0.00 0.00 SUBCONTRACTS 1 Exceptional Parents Unlimited 275,000.00 0.00% 0.00 0.00 35.20% 96,800.00 0.00 64.80% 178,200.00 0.00 0.00 2 Centro La Familia Advocacy Services 261,229.00 0.00% 0.00 0.00 45.02% 117,616.18 0.00 54.98% 143,612.82 0.00 0.00 3 Central Valley Children's Services Network 274,448.00 0.00% 0.00 0.00 35.20% 96,605.70 0.00 64.80% 177,642.30 0.00 0.00 4 Fresno County Economic Opportunities Commission 275,000.00 0.00% 0.00 0.00 35.20% 96,800.00 0.00 64.80% 178,200.00 0.00 0.00 5 United Language Group 33,250.00 0.00% 0.00 0.00 100.00% 33,250.00 0.00 0.00 0.00 0.00 OTHER CHARGES Malin AveuaSla 1 Books B Publications 4,930.00 0.00% 0.00 0.00 100.00% 4,930.00 0.00 0.00 65.49% 2 Client Support Materials 37,926.00 0.00% 0.00 0.00 100.00% 37,926.00 0.00 0.00 65.49% 3 0.00 0.00 0.00 0.00 0.00 4 0.00 0.00 0.00 0.00 0.00 5 0.00 0.00 0.00 0.00 0.00 6 0.00 0.00 0.00 0.00 0.00 7 0.00 0.00 0.00 0.00 0.00 8 0.00 0.00 0.00 0.00 0.00 (V) INDIRECT COSTS DETAIL TOTAL INDIRECT COSTS 9831963.92 0.00 0.00 1 345,076.15 11 1 0.00 1 1 638,887.77 18.31% of Total Wages+Fringe Benefits 983,963.92 0.00% 0.00 10.00 1 35.07%1 345,076.15 11 10.00 1 64.93%1 638,887.77 202310 MCAH 5 FV 2023-24 Budget Template 08.15.23.xlsx 2 of 5 Primed:9/1/2023 1:25 PM w ,o� ORIGINAL Public Heplth.coprt Ma emal,Child and AddesceM H-Ilh Didaicn Program: Matertal,Child and Adolescent Health MCAH NON-ENHANCED ENHANCED Agency: M2 310 Fresno UNMATCHED FUNDING MATCHING(50/50) MATCHING(75125) SubK: MCAH-TV MCAHSIDS AGENCYFUNDS MCAH-Cary NE MCAH-CnyE (11 (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) Combinetl Combined Combinetl Combined TOTAL FUNDING % MCAH-N % MCAH-SIDS % AgencyFuntls' % Fed/State /o Fed/Aoencv` % Fed/State /o Fed/Anencv (I) PERSONNEL DETAIL TOTAL PERSONNEL COSTS 5,373,915.44 422,226.00 7,372.00 1,455,188.94 0.00 2,243,430.09 0.00 1,245,698.41 FRINGE BENEFIT RATE 71.14% 2,233,812.44 175,509.59 3,064.37 604,888.41 0.00 932,542.0i 0.00 517,808.03 TOTAL WAGES 3,140,103.00 246.716.41 4,307.63 850,300.53 0.00 1,310,888.06 0.00 727,890.37 fy % FULL NAME TITLE OR CLASSIFICATION ANNUAL 2 - (First Name Last Name) (No Acronyms) %FTE SALARY TOTAL WAGES 4 u 1 Ge Vue Division Manager 20.00% 145,782.00 29,156.00 0.00% (0,00) 0.00 57.64% 16,805.52 0.00 40.16% 11,709.05 0.00 2.20% 641.43 64.80% yx 2 Ge Vue MCAH Director/FIMR Director 50.00% 145,782.00 72,891.00 0.00% 0.00 38.129/. 27,786.05 0.00 53.17% 38,756.14 0.00 8.71% 6,348.81 64.80% x 3 Melinda Meza Administrative Assistant 70.00% 45,850.00 32,095.00 0.00% 0.00 0.00 36.00% 11,554.20 0.00 64.00% 20,540.80 0.00 0.00% 0.00 64.80% x 4 Chashua Lor Staff Analyst ll 100,00% 60,242.00 60,242.00 0.00% 0.00 0.00 45.38% 27,337.82 0.00 54.62% 32,904.18 0.00 0.00% 0.00 64.80% x 5 Dalgit Martinez Account Clark 30.00% 49,452.00 14,836.00 0.00% 0.00 0.00 36.00% 5,340.96 0.00 64.00% 9,495.04 0.00 0.00% 0.00 64.80% x 6 VACANT Public Health Nurse II-Pannalal Service 100,00% 116,685,00 116,685.00 0.00% 0.00 36.00% 42,006.60 0.00 58.00% 67,677.30 0.00 6.00% 7,001.10 64.80% x 7 Linda Hicks Public Health Nurse 11-Sudden Infant De 50,00% 114,115.00 57,058.00 0.00% 0.00 7,55% 4,307.63 92A5% 52,750.37 0.00 0.00% 0.00 0.00 0.00% 0.00 64.60% x 8 Jennifer Pino-Xiong Medical Social Worker 111 64.00% 83,122.00 53,197.00 0.00% 0.00 0.00 25.009/. 13,299.25 0.00 75.00% 39,897.75 0.00 0.00% 0.00 86.80% x 9 Bee Vang Epidemiologist 20.00% 90,870,00 18,174,00 0.00% 0.00 0.00 36.00% 6,542.64 0.00 64.00% 11,631.36 0.00 0.00% 0.00 64.80% x 10 Ana Carbajal Health Education Assistant 50.00% 48,646 24,323.00 0.00% 0.00 0.00 47.01% 11,434.24 0.00 52.99% 12,888.76 0.00 0.00% 0.00 64.80% x 11 Nang Thao Health Education Assistant 50.00% 48,646 24,323.00 0.00% 0.00 4L20% 10,021.08 0.00 58.80% 14,301.92 0.00 0.00% 0.00 64.80% x 12 Rebekah Kirkish Health Education Specialist 80.00% 53,622 42,898.00 0.00% 0.00 58A1% 25,056.72 0.00 41.59% 17,941.28 0.00 0.00% 0.00 64.80% x 13 Quentin Paramo Health Education Specialist 88.83% 53,622 47,631.00 0.00% 0.00 66.27% 31,565.06 0.00 33.73% 16,065.94 0.00 0.00% 0.00 84.60% x 14 Ah Vang Health Educator 75.00% 69,446 52,085.00 0.00% 0.00 0.00 46A7% 24,203.90 0.00 53.53% 27,881.10 0.00 0.00% 0.00 64.80% x 15 VACANT Program Technician l 100,00% 43,992 43,992.00 0.00% 0.00 0.00 36.00% 15,837.12 0.00 64.00% 28,154.88 0.00 0.00% 0.00 84.80% x 16 VACANT Program Technician l 100,00% 43,992 43,992.00 0.00% 0.00 0.00 36.005 15,837.12 0.00 64.00% 28,154.88 0.00 0.00% 0.00 64.80% x 17 Diana Colin Office Assistant ll 100,00% 44,694 44,694,00 0.00% 0.00 0.00 16.05% 7,173.39 0.00 83.95% 37,520.61 0.00 0.00% 0.00 86.80% x 18 Linda Willome Office Assistant ll 100,00% 44,694 44,694.00 0.00% 0.00 0.00 15A1% 6,887.35 0.00 84.59% 37,806.65 0.00 0.00% 0.00 86.80% x 19 Sophia Rodriguez Office Assistant ll 100,00% 44,694 44,694,00 0.00% 0,00 0.00 14.20% 6.346.55 0.00 85.80% 38,347.45 0.00 0.00% 0.00 86.80% x 20 Natalie Adolph Public Health Nurse ll 50.00% 114,115 57,058.00 100.00% 57,058.00 0.00 0.00% 0.00 0.00 0.00% 0.00 0.00 0.00% 0.00 64.80% x 21 Lynette Yamanaka Office Assistant ll 100.00% 44,694 44,694.00 0.00% 0.00 0.00 15.17% 6,780.08 0.00 I483% 37,913.92 0.00 0.00% 0.00 86.80% x 22 Christina Wyrick Program Technician ll 100.00% 54,236 54,236.00 0.00% 0.00 0.00 25.00% 13.559.00 0.00 75.00% 40,677.00 0.00 0.00% 0.00 86.80% x 23 Yvonne Lopez Public Health Nurse 11(1677) 100.00% 103,509 103,509.00 1 0.00% 0.00 84.11% 87,061.42 0.00 15.84% 16,395.83 0.00 0.05% 51.75 64.80% x 24 Fred Toshimitsu Public Health Nurse 11(1677) 100.00% 116,685 116,685.00 0.00% (0.00) 0.00 88.78% 103,592.94 0.00 11.03% 12,870.36 0.00 0.19% 221.70 64.80% x 25 Megan Gunn Supervising Public Health Nurse(1615) 70.00% 132,522 92,765.00 0.00% 0.00 0.00 10.50% 9,740.33 0.00 71.01% 65,872.43 0.00 18.49% 17,152.25 90.40% x 26 Gabriel Velazquez Public Health Nurse 1(1615) 100.00% 87,609 87,609.00 6.001 0.00 22.71% 19,896.00 0.00 48.69% 42,656.82 0.00 28.60% 25,056.17 90.40% x 27 Eileen Murry Public Health Nurse 11(1615) 100.00% 116,685 116,685.00 0.00% 0.00 13.16% 15.355.75 0.00 7.99% 9,323.13 0.00 78.85% 92,006.12 90.40% x 28 VACANT Public Health Nurse 1(1615) 100.00% 87,609 87,609.00 0.00% (0.00) 0.00 11.26% 9,864.77 0.00 17.28% 15,138.84 0.00 71.46% 62,605.39 90.40% x 29 VACANT Public Health Nurse 1(1615) 100.00% 85,680 85,680.00 0.00% 0.00 10.29% 8,816.47 0.00 18.10% 15,508.08 0.00 71.61% 61,355.45 90.40% x 30 Megan Gunn Supervising Public Health Nurse(1670) 30.00% 132,522 39,757.00 0.00% 0.00 0.00 17.67% 7,025.06 0.00 70.35% 27,969.05 0.00 11.98% 4,762.89 82.90% x 31 VACANT Public Health Nurse 1(1670) 100.00% 85,680 85,680.00 0.00% 0.00 35.00% 29,988.00 0.00 22.00% 18,849.60 0.00 43.00% 36,842.40 82.90% x 32 Pon Chin Public Health Nurse ll 100.00% 116,685 116,685.00 0.00% 0.00 21.41% 24.982.26 0.00 32.25% 37,630.91 0.00 46.34% 54,071.83 86.80% x 33 Lillarose Bangs Supervising Public Health Nurse-MCAH 85.00% 132,522 112,644.00 0.00% 0.00 0.00 15.17% 17,088.09 0.00 66.01% 74,356.30 0.00 18.82% 21,199.60 86.80% x 34 Deborah Omolayo Public Health Nurse ll 60.00% 116,685 70,011.00 0.00% 0.00 15.041/6 10,529.65 0.00 41.90% 29,334.61 0.00 43.06% 30,146.74 86.80% x 35 Erin An Public Health Nurse l 60.00% 91,996 55,198.00 0.00% 0.00 0.00 15.05% 8,307.30 0.00 51.41% 28,377.29 0.00 33.54% 18,513.41 86.80% x 36 VACANT Public Health Nurse l 60.00% 85,680 51,408.00 0.00% (0.00) 0.00 15.00% 7,711.20 0.00 65.00% 33,415.20 0.00 20.00% 10,281.60 86.80% x 37 Latoya Woods Public Health Nurse 1(1720) 100.00% 96,424 96,424.00 0.00% 0.00 0.00 30.001/6 28,927.20 0.00 60.00% 57,854.40 0.00 10.00% 9,642.40 86.80% x 38 VACANT Public Health Nurse 1(1720) 100.00% 85,680 85,680.00 0.00% (0.00) 0.00 30.00% 25,704.00 0.00 30.00% 25,704.00 0.00 40.00% 34,272.00 86.80% x 39 Brienna Harker Public Health Nurse 1(1720) 100.00% 110,310 110,310.00 0.001/6 (0.00) 0.00 33.04% 36,446.42 0.00 29.52% 32,563.51 0.00 37.44% 41,300.06 86.80% x 40 Lorraine Hardy Supervising Public Health Nurse 40.00% 132,522 53,009.00 0.00% (0.00) 0.00 13.30% 7,050.20 0.00 51.27% 27,177.71 0.00 35.43% 18,781.09 89.60% x 41 Lorraine Hardy Supervising Public Health Nurse(1719) 15.00% 132,522 19,878.00 0.001/6 0.00 0.00 11.98% 2,381.38 0.00 38.48% 7,649.05 0.00 49.54% 9,847.56 89.60% x 42 Kayla Marankevicz Public Health Nurse 1(1719) 100.00% 103,509 103,509.00 27.79% 28,768.26 0.00 1.10% 1,135.49 0.00 35.61% 36,859.55 0.00 35.50% 36,745.70 89.60% x 43 Jaynie Ortiz Public Health Nurse 1(1719) 100.00% 101,467 101,467.00 20.76% 21,064.55 0.00 0.00% 0.00 0.00 41.53% 42,139.25 0.00 37.71% 38,263.21 89.60% x 44 Melanie Deto Public Health Nurse ll 60.00% 116,685 70,011.00 20.90% 14,632.30 0.00 0.00% 0.00 0.00 34.55% 24,1118.80 0.00 Z5% 31,189.90 89.60% x 45 Mai Vang Public Health Nurse 11 0.00% 116,685 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 64.80% x 46 Bridget Ballast- Public Health Nurse 11 60.00% 116,685 70,011.00 27.16% 19,014.99 0.00 0.00% 0.00 0.00 36.19% 25,336.98 0.00 36.65% 25,659.03 89.60% x 47 Rachel Nevarez Public Health Nurse ll 60.00% 116,685 70,011.00 30.18% 21,129.32 0.00 0.00% 0.00 0.00 29.68% 20,779.26 0.00 40.14% 28,102.42 89.60% x 48 Lia Vangyi Public Health Nurse 11 25.00% 116,685 29,171.00 0.00% (0.00) 0.00 36.24% 10,571.57 0.00 43.78% 12,771.06 0.00 19.98% 5,828.37 64.80% x 49 Linda Hicks Public Health Nurse 11-Fetal Infant Mort: 50.00% 114,115 57,058.00 100.00% 57,058.00 0.00 0.00 0.00 0.00 0.00 0.00 64.80% 50 Jennifer Pino-Xiong Medical Social Worker III 21.00% 83,122 17,456.00 100.00% 17,456.00 0.00 0.00 0.00 0.00 0.00 0.00 64.80% 51 Bee Vang Epidemiologist 5.00% 90,870 4,544.00 100.00% 4,544.00 0.00 0.00 0.00 0.00 0.00 0.00 64.80% 52 Quentin Paramo Health Education Specialist 11.17% 53,622 5,991.00 100.00% 5,991.00 0.00 0.00 0.00 0.00 0.00 0.00 64.80% 53 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 54 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 55 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 56 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 57 0.00 0.00 0.00 0.00 F 0.00 0.00 0.00 0.00 0.00% 202310 MCAH 5 FY 2023-24 Budget Template 08.15.23.xlsx 3 of 5 Printed:9/1/2023 1:25 PM w �o� ORIGINAL Public Heplth.coat Ma emal,Child and AddesceM Hearth DiNsian Program: Matemal,Child and Adolescent Health MCAH NON-ENHANCED ENHANCED Agency: M2 310 Fresno UNMATCHED FUNDING MATCHING(50/50) MATCHING(75125) SubK: MCAH-TV MCAHSIDS AGENCVFUNDS MCAH-Cary NE MCAH-CntyE (11 (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) TOTAL FUNDING % MCAH-TV % MCAH-SIDS % Agency Funds* y, Combined % Combined % Combined Combined Fact State Fed/Amm.,1 Fed/State Fed/Aoencv 58 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 59 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 60 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 62 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 63 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 64 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 65 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 66 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 67 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 68 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 69 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 70 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 71 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 72 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 73 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 74 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 75 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 76 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 77 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 78 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 79 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 80 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 81 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 82 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 83 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 84 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 85 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 86 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 87 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 88 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 89 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 90 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 91 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 92 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 93 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 94 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 95 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 96 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 97 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 98 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 99 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 100 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 101 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 102 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 103 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 104 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 105 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 106 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 107 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 108 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 109 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 110 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 111 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 112 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 113 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 114 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 115 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 116 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 117 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 118 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 119 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 120 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 121 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 122 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 123 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 202310 MCAH 5 FY 2023-24 Budget Template 08.15.23.xlsx 4 of 5 Printed:9/1/2023 1:25 PM w �o� ORIGINAL Public Heplth.coat Malanrd,Child and Ad descent Health Didsian Program: Matemal,Child and Adolescent Health MCAH NON-ENHANCED ENHANCED Agency: M2 310 Fresno UNMATCHED FUNDING MATCHING(50/50) MATCHING(75125) SubK: MCAH-TV MCAHSIDS AGENCVFUNDS MCAH-Cary NE MCAH-CntyE (11 (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) TOTAL FUNDING % MCAH-TV % MCAH-SIDS % Agency Funtls' y, Combined % Combined % Combined Combined Fact State Fed/Amm.,l Fed/State Fed/Aoencv 124 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 125 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 126 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 127 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 128 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 129 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 130 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 131 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 132 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 133 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 134 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 135 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 136 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 137 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 138 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 139 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 140 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 141 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 142 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 143 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 144 0.00 0.110 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 145 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 146 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 147 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 148 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 149 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00 150 0.00 0.00 0.00 0.00 202310 MCAH 5 FY 2023-24 Budget Template 08.15.23.xlsx 5 of 5 Primed:9/1/2023 1:25 PM Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 California Department of Public Health (CDPH) Maternal, Child and Adolescent Health (MCAH) Division Local MCAH Scope of Work (SOW) The Local Health Jurisdiction (LHJ), in collaboration with the CDPH/MCAH Division, shall strive to develop systems that protect and improve the health of California's women of reproductive age, infants, children, adolescents and their families. The development of the Local MCAH SOW was guided by several public health frameworks including the ones listed below. Please consider integrating these approaches when conceptualizing and organizing local program, policy, and evaluation efforts. o The Ten Essential Services of Public Health and Toolkit o The Spectrum of Prevention o Life Course Perspective and Social Determinants of Health o The Social-Ecological Model All Title V programs must comply with the MCAH Fiscal Policy and Procedures Manual and the Local MCAH Program Policies and Procedures Manual. Certification by Name: Ge Vue MCAH Director: Title: MCAH Director/Division Manager Date: 7/25/2023 l certify that l have reviewed and approved this Scope of Work. Note: The Title V Maternal and Child Health Block Grant provides core funding to California to improve the health of mothers and children. The Title V Block Grant is federally administered by the Health Resources and Services Administration. CDPH/MCAH may post SOWS on the CDPH/MCAH website. 1 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 Section A: General requirements and activities for all LHJs Aligns With General Required Local Activities Time Frame Deliverable Description Requirement(s) CDPH/MCAH Local MCAH Al Annually, each fiscal year The Annual Report will report on progress of Requirement Annual Report Complete and submit an Annual Report each fiscal year to report on Scope of Work program activities and the extent to which activities. the LHJ met the SOW goals and deliverables and how funds were expended. Title V Toll-Free Line A2 Annually, each fiscal year Include on Local MCAH budget during the Requirement Provide a toll-free telephone number or"no cost to the calling party" number(and AFA cycle. other appropriate methods) which provides a current list of culturally and linguistically appropriate information and referrals to community health and human resources for Report in Annual Report: the public regarding access to prenatal care. • List toll-free telephone number Title V MCAH Website A3 Annually, each fiscal year Report in the Annual Report: Requirement Share link, if available,to the appropriate Local MCAH Title V Program website. • List the URL for the Local MCAH Title V program website Title V/ Workforce A4 Annually, each fiscal year Report attendance in Annual Report: CDPH/MCAH Development and Attend required trainings/meetings as outlined in the MCAH Program Policies and • MCAH Directors' meeting(s) Requirement Training Procedures. • SIDS Coordinators' meeting CDPH/MCAH MCAH Director AS Ongoing The LHJ must submit a Local MCAH Director Requirement Maintain required MCAH Director position and recruit and retain qualified Title V Verification form annually during the AFA program staff by as outlined in the MCAH Policies and Procedures. process and resubmit with any changes. CDPH/MCAH Community A6 By end of 2025 Report in Annual Report: Requirement Resource and Develop a comprehensive MCAH resource and referral guide of available health, • Submit/upload a copy or link to the Referral Guide mental health, emergency resources, and social services. existing resource and referral guide CDPH/MCAH Protocols A7 Annually, each fiscal year Report on protocols in the Annual Report. Requirement Develop and adopt protocols to ensure that MCAH clients are enrolled in health insurance, are linked to a provider and access preventive visits. Title V Conduct Local A8 Once in five-year cycle Complete Local Needs Assessment Requirement Needs Assessment Conduct a Local Needs Assessment to acquire an accurate,thorough picture of the deliverable documents provided by strengths and weaknesses of the local public health system. CDPH/MCAH. 2 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 Section B: Domain specific requirements and activities CDPH/MCAH Infant— 61 Annually, each fiscal year Report on SIDS/SUID services and supports in Requirement Sudden Infant Required for Infant Domain -all LHJs Death Provide SIDS/SUID grief and bereavement services and supports through home visits the Annual Report. Syndrome/Sudden and/or mail resource packets to families suffering an infant loss. Unexpected Infant Death (SIDS/SUID) CDPH/MCAH Infant— B2 Annually, each fiscal year Report on safe sleep activities in the Annual Requirement Safe Sleep Required for Infant Domain -all LHJs Promote the latest AAP Safe Sleep guidance and implement Infant Safe Sleep Report. Interventions to reduce the number of SUID related deaths. CDPH/MCAH Child Health - B3 Annually, each fiscal year Report on developmental screening activities Requirement Developmental Required for Child Domain-all LHJs Screening Partner with CDPH/MCAH to identify, review and monitor local developmental in the Annual Report. screening rates. CDPH/MCAH Child Health— B4 Annually, each fiscal year Report on famil economic su Requirement Family Economic Required for Child Domain-all LHJs Y pport activities Supports Link and refer families in MCAH programs to safety net and public health care in the Annual Report. programs such as Family Planning, Access, Care, and Treatment (PACT), Medi-Cal, and Denti-Cal. CDPH/MCAH Children and B5 Annually, each fiscal year Report on screening and referral activities in Requirement Youth with Special Required for CYSHCN Domain -all LHJs Health Care needs Link and refer children in families served by Local MCAH programs to services if results the Annual Report. (CYSHCN) of a developmental or trauma screening indicates that the child needs follow-up. CDPH/MCAH Children and B6 Requirement Youth with Special Required for CYSHCN Domain -all LHJs Annually, each fiscal year Report on outreach activities in the Annual Health Care needs Outreach to and connect with your local or regional family resource center to Report. (CYSHCN) understand needs of CYSHCN and their families and the resources available to them. Get Connected- Family Resource Centers Network of California (frcnca ors) CDPH/MCAH Infant— B7 Annually, each fiscal year Report on activities in the Annual Report. Requirement Infant Mortality Required for funded LHJs only Reviews LHJs funded for infant mortality reviews will implement activities in accordance with Local MCAH Program Policies and Procedures. 05/12/2023 3 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 CDPH/MCAH Black Infant B8 Annually, each fiscal year Report on BIH activities in the Annual Report. Requirement Health (BIH) Required for BIH funded LHJs only Program LHJs funded for BIH will implement the BIH Program in accordance with BIH Policies and Procedures. CDPH/MCAH Adolescent Family B9 Annually, each fiscal year Report on AFLP activities in the Annual Requirement Life Program Required for AFLP funded LHJs only Report. (AFLP) LHJs funded for AFLP will implement the AFLP Program in accordance with AFLP Policies and Procedures. Section C: Local Activities by Domain At least one activity must be selected or the LHJ must develop at least one activity of their own in the Women/Maternal Health Domain Women/Maternal Health Domain Women/Maternal Priority Need: Ensure women in California are healthy before,during and after pregnancy. Women/Maternal Focus Area 1:Reduce the impact of chronic conditions related to maternal mortality. Performance Measures NPM 1: Well-woman visit(Percent of women with a preventive medical visit in the past year). (National/State Performance Measures and Evidence-Based Strategy Measure) Women/Maternal State Objective 1: By 2025, reduce the rate of pregnancy-related deaths (up to 1 year after the end of pregnancy) from 12.8 deaths per 100,000 live births (2019 CA-PMSS)to 12.2 deaths per 100,000 live births. Women/Maternal State Objective 1:Strategy 1: Women/Maternal State Obiective 1: Strategy 2: Lead surveillance and investigations of pregnancy-related deaths(up to 1 year after the end of Partner to translate findings from pregnancy-related mortality investigations into recommendations for pregnancy) in California. action to improve maternal health and perinatal clinical practices. Local Activities for Women/Maternal Objective 1: Strategy 1: Local Activities for Women/Maternal Objective 1:Strategy 2: w 1.1.1 w 1.2.1 ❑Partner with CDPH/MCAH on dissemination and translation of recommendations to improve maternal El Partner with CDPH/MCAH on dissemination of data findings, guidance, and education to the health and perinatal clinical practices, including quality improvement toolkits to reduce disparities. public and local partners, including perinatal obstetric providers. What is your anticipated outcome? What is your anticipated outcome? 4 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 w 1.1.2 w 1.2.2 ❑Other local activity(Please Specify/Optional): ❑Other local activity (Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. Women/MaternalDomain Priority Need: Ensure women in California are healthy before,during and after pregnancy. Women/Maternal Focus Area 2: Reduce the impact of chronic conditions related to maternal morbidity. Performance Measures NPM 1: Well-woman visit(Percent of women with a preventive medical visit in the past year). (National/State Performance Measures and Evidence-Based Strategy Measure) Women/Maternal State Objective 2: By 2025, reduce the rate of severe maternal morbidity from 104.4 per 10,000 delivery hospitalizations (2020 PDD) to 88.8 per 10,000 delivery hospitalizations. Women/Maternal State Objective 2: Strategy 1: Women/Maternal State Objective 2: Strategy 2: Women/Maternal State Objective 2: Strategy 3: Lead surveillance and research related to maternal morbidity in Lead statewide regionalization of maternal care to ensure women Partner to strengthen knowledge and skill among health care California. receive appropriate care for childbirth. providers and individuals on chronic conditions exacerbated during pregnancy. Local Activities for Women/Maternal Objective 2: Strategy 1 Local Activities for Women/Maternal Objective 2: Strategy 2 Local Activities for Women/Maternal Objective 2: Strategy 3 w 2.1.1 w 2.2.1 w 2.3.1 ❑Partner with CDPH/MCAH on dissemination of data findings, ❑Partner with local Regional Perinatal Programs of California (RPPC) ❑Partner with CDPH/MCAH to pilot test educational materials guidance, and education to the public and local partners. Director to understand and promote efforts to establish Perinatal addressing chronic health conditions during pregnancy and Levels of Care and quality improvement efforts. disseminate to consumers and providers. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? 5 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 w 2.1.2 w 2.2.2 w 2.3.2 ❑Other local activity (Please Specify/Optional): ❑ Perinatal Service Coordinator (PSC) will partner with Women Infant ❑ For Black Infant Health (BIH) funded sites only, disseminate Children (WIC), RPPC, CDPH/MCAH, Medi-Cal, and other key culturally responsive materials to inform Black women on chronic stakeholders to ensure integration of resources and a coordinated health conditions. delivery system for women during and after pregnancy. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? w 2.1.3 w 2.2.3 w 2.3.3 ❑Other local activity (Please Specify/Optional): ❑Other local activity (Please Specify/Optional): ❑Other local activity (Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. Woman/Maternal Health Domain Priority Need: Ensure women in California are healthy before,during and after pregnancy. Women/Maternal Focus Area 3:Improve mental health for all mothers in California. Performance Measures (National/State Performance Measures and Evidence-Based Strategy NPM 1: Well-woman visit (Percent of women with a preventive medical visit in the past year). Measure) Women/Maternal State Objective 3: By 2025, increase the receipt of mental health services among women who reported needing help for emotional well-being or mental health concerns during the perinatal period from 49.0% (2020 MIHA) to 52.1%. 6 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 Women/Maternal State Objective 3: Strategy 1: Women/Maternal State Objective 3: Strategy 2: Women/Maternal State Objective 3: Strategy 3: Partner with state and local programs responsible for the Partner to strengthen knowledge and skill among health care Partner to ensure pregnant and parenting women are screened and provision of mental health services and early intervention providers, individuals, and families to identify signs of maternal referred to mental health services during the perinatal period. programs to reduce mental health conditions in the perinatal mental health-related needs. period. Local Activities for Women/Maternal Objective 3:Strategy 1 Local Activities for Women/Maternal Objective 3:Strategy 2 Local Activities for Women/Maternal Objective 3:Strategy 3 w 3.1.1 w 3.2.1 w 3.3.1 X Partner with local programs responsible for the provision of ❑Perinatal Service Coordinators (PSCs) will ensure providers, local ❑ Implement and utilize standardized and validated mental health mental health services and early intervention programs to health plans, and stakeholders in their communities are aware of screening tools for pregnant and parenting women in MCAH programs. promote mental health services in the perinatal period. mental health requirements at roundtable discussions or through other communications. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? Provide health education materials and resources during the perinatal period for better birth outcomes. w 3.1.2 w 3.2.2 w 3.3.2 ❑Partner with local mental health service providers to improve ❑Partner with local Mental Health Services Act (MHSA)/Prop. 63 ❑Lead the development of a county maternal mental health algorithm referral and linkages to mental health services. funded programs to increase available services to women during that outlines a referral system and the services available to address perinatal period. maternal mental health and identify systems gaps. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? w 3.1.3 w 3.2.3 w 3.3.3 ❑Other local activity(Please Specify/Optional): ❑Partner with CDPH/MCAH to disseminate mental health ❑ Other local activity (Please Specify/Optional): promotional messages that educate women and families to recognize early signs and symptoms of mental health disorders. What is your anticipated outcome? What is your anticipated outcome? 7 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 What is your anticipated outcome? w 3.1.4 w 3.2.4 w 3.3.4 ❑Other local activity (Please Specify/Optional): ❑Other local activity(Please Specify/Optional): ❑Other local activity(Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. Woman/Maternal Health Domain Priority Need: Ensure women in California are healthy before,during and after pregnancy. Women/Maternal Focus Area 4: Ensure optimal health before pregnancy and improve pregnancy planning and birth spacing. Performance Measures NPM 1:Well-woman visit (Percent of women with a preventive medical visit in the past year). (National/State Performance Measures and Evidence-Based Strategy ESM:The number of Local Health Jurisdictions (LHJs)that report developing or adopting a protocol to link clients (women 22-44)to a Measure) provider to access a preventive visit. Women/Maternal State Objective 4: By 2025, increase the percent of women who had an optimal interpregnancy interval of at least 18 months from 74.2% (2019 CCMBF) to 76.4%. Women/Maternal State Objective 4: Strategy 1: Women/Maternal State Objective 4: Strategy 2: Women/Maternal State Objective 4: Strategy 3: Women/Maternal State Objective 4: Strategy 4: Partner to increase provider and individual Lead a population-based assessment of mothers Lead efforts to improve local perinatal health Fund the DHCS Indian Health Program (IHP) to knowledge and skill to improve health and health in California,the Maternal and Infant Health systems utilizing morbidity and mortality data and administer the American Indian Maternal Support care before and between pregnancies. Assessment Survey(MIHA),to provide data to implement evidence-based interventions to Services (AIMSS)to provide case management and guide programs and services. improve the health of pregnant individuals and home visitation program services for American their infants. Indian women during and after pregnancy. Local Activities for Women/Maternal Objective Local Activities for Women/Maternal Objective Local Activities for Women/Maternal Objective 4: No Local Activities 4:Strategy 1 4:Strategy 2 Strategy 3 8 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 w 4.1.1 w 4.2.1 w 4.3.1 El Partner with CDPH/MCAH to disseminate and El Partner with CDPH/MCAH in the development El Partner with Perinatal Service Coordinators promote best practices and resources from key of the Maternal Infant Health Assessment (MIHA) (PSCs)to identify barriers in access to care in preconception initiatives. Survey. medically underserved areas and collaborate with local health plans to reduce barriers. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? w 4.1.2 w 4.2.2 w 4.3.2 ❑ Outreach coordination to underserved ❑Coordinate with CDPH/MCAH to identify ❑Partner with CDPH/MCAH to disseminate populations and provide information and uninsured populations and conduct outreach and MIHA data findings and guidance to the public education on topics to improve health outcomes awareness of health insurance options. and local partners. for parents, infants, and their families (e.g., social media, resource fairs). What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? w 4.1.3 w 4.2.3 w 4.3.3 ❑Partner with CDPH/MCAH to promote ❑Other local activity (Please Specify/Optional): ❑ Monitor the health status of the MCAH preconception/inter-conception health programs. population including disparities and social determinants of health and work with local leadership to address identified issues. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? w 4.1.4 w 4.2.4 w 4.3.4 9 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 ❑Other local activity(Please Specify/Optional): ❑Other local activity (Please Specify/Optional): ❑Other local activity(Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. Woman/Maternal Health Domain Priority Need: Ensure women in California are healthy before,during and after pregnancy. Women/Maternal Focus Area 5: Reduce maternal substance use. Performance Measures NPM 1:Well-woman visit(Percent of women with preventive medical visit in the a past year). (National/State Performance Measures and Evidence-Based Strategy Measure) Women/Maternal State Objective 5: By 2025, reduce the rate of maternal substance use from 21.1 per 1,000 delivery hospitalizations (2020 PDD) to 19.7 per 1,000 delivery hospitalizations. Women/Maternal State Objective 5: Strategy 1: Women/Maternal State Objective 5:Strategy 2: Lead research and surveillance on maternal substance use in California. Partner at the state and local level to increase prevention and treatment of maternal opioid and other substance use. Local Activities for Women/Maternal Objective 5:Strategy 1 Local Activities for Women/Maternal Objective 5:Strategy 2 w 5.1.1 w 5.2.1 ❑Coordinate with CDPH/MCAH to disseminate data findings, guidance, and education to the public and X Identify County specific resources on treatment and best practices to address substance use and local partners. collaborate to improve referral and linkages to services. Dr. Linscheid has connections with the CA Bridge Navigator Program.Two Substance Abuse Navigators (SAN) at Community Regional Medical Center(CRMC) emergency department are point What is your anticipated outcome? persons to assist patients in accessing medical assisted treatment and mental health services. Dr. Linscheid will assist in distributing the Perinatal Substance Use Disorder (SUD) brochures to OB and Family Practice colleagues. 10 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 What is your anticipated outcome? Every local hospital will encourage their perinatal staff to utilize California Maternal Quality Care Collaborative (CMQCC's) interactive online Mother& Baby Substance Exposure Initiative Toolkit to learn the best practices for improving outcomes for substance exposed mothers and babies. Regional Perinatal Programs of California (RPPC)will assist in distribution of the Perinatal SUD brochures to local hospitals and as needed, review the following information with staff: a) reporting guidelines, referral process, and plan of safe care; b) local treatment options; and c) linkage to community resources. w 5.1.2 w 5.2.2 ❑Other local activity(Please Specify/Optional): ❑Disseminate the Association of State and Territorial Health Officials (ASTHO) Public Health Perinatal Opioid Toolkit. What is your anticipated outcome? What is your anticipated outcome? w 5.1.3 w 5.2.3 ❑Other local activity (Please Specify/Optional): X Other local activity(Please Specify/Optional): Collaborate with Fresno County Jail and Jail Medical Services to allow Public Health Nurse to meet with pregnant inmates weekly to provide health information, resources, and linkage to MCAH. What is your anticipated outcome? Substance use programs and SUD services. What is your anticipated outcome? 75%of all pregnant women in Fresno County Jail will receive a visit by a Public Health Nurse 11 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 If you have additional local activities, please add a row. Section C: Local Activities by Domain At least one activity must be selected or the LHJ must develop at least one activity of their own in the Perinatal/Infant Health Domain Perinatal/infant Health Domain Perinatal/Infant Priority Need: Ensure all infants are born healthy and thrive in their first year of life. Perinatal/Infant Focus Area 1:Improve healthy infant development through breastfeeding. Perinatal/Infant Focus Area 2:Improve healthy infant development through caregiver/infant bonding. NPM 4a: Percent of infants who are ever breastfed. NPM 4b: Percent of infants breastfed exclusively through 6 months. Performance Measures ESM 4.1: Number of online views/hits to the "Lactation Support for Low-Wage Workers". (National/State Performance Measures and Evidence-Based Strategy Measure) SPM 1: Preterm birth rate among infants born to non-Hispanic Black women Perinatal/Infant State Objective 1: By 2025, increase the percent of women who report exclusive in-hospital breastfeeding from 69.7% (2020 GDSP) to 72.5%. Perinatal/Infant State Objective 1:Strategy 1: Perinatal/Infant State Obiective 1:Strategy 2: Perinatal/Infant State Objective 1:Strategy 3: Perinatal/Infant State Objective 1:Strategy 4: Lead surveillance of breastfeeding practices and Lead technical assistance and training to support Partner to develop and disseminate information and Partner with birthing hospitals to support assessment of initiation and duration trends. breastfeeding initiation, including the resources about policies and best practices to caregiver/infant bonding. implementation of the Model Hospital Policy or promote breastfeeding duration, including lactation Baby Friendly in all California birthing hospitals by accommodation within all MCAH programs. 2025. Local Activities for Perinatal/Infant Objective 1: Local Activities for Perinatal/Infant Objective 1: Local Activities for Perinatal/Infant Objective 1: Local Activities for Perinatal/Infant Objective 1: Strategy 1 Strategy 2 Strategy 3 Strategy 4 p 1.1.1 p 1.2.1 p 1.3.1 p 1.4.1 ❑ Monitor and track breastfeeding initiation El Promote breastfeeding education to prenatal X Partner to develop and disseminate information El Partner with Regional Perinatal Program of and duration rates and disseminate data to women in local MCAH programs. and resources about policies and best practices to California (RPPC) Directors to work with local community and local partners. promote extending breastfeeding duration, birthing hospitals on messaging related to infant including lactation accommodation within local bonding with an emphasis on a client-centered What is your anticipated outcome? What is your anticipated outcome? MCAH programs. approach. 12 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 Increase available breastfeeding information What is your anticipated outcome? Information will be shared with MCAH programs, participants, outreach events and on the program What is your anticipated outcome? website. p 1.1.2 p 1.2.2 p 1.3.2 p 1.4.2 ❑Other local activity (Please Specify/Optional): El Partner to disseminate information to the ❑Other local activity (Please Specify/Optional): El Partner with community leaders to promote community regarding evidence-based infant bonding, skin to skin training and outreach breastfeeding initiation guidance. activities to dads, partners, and caretakers. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? p 1.1.3 p 1.2.3 p 1.3.3 p 1.4.3 ❑Other local activity (Please Specify/Optional): El Partner with Regional Perinatal Programs of ❑Other local activity (Please Specify/Optional): ❑Other local activity (Please Specify/Optional): California (RPPC) Directors to track and assess implementation and technical assistance needs of birthing hospitals related to the implementation of What is your anticipated outcome? Model Hospital Policy or Baby Friendly. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? p 1.1.4 p 1.2.4 p 1.3.4 p 1.4.4 ❑Other local activity (Please Specify/Optional): ❑Other local activity (Please Specify/Optional): ❑Other local activity (Please Specify/Optional): ❑Other local activity (Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? 13 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 If you have additional local activities, please add a row. Perinatal/infant Health Domain Perinatal/Infant Priority Need: Reduce infant mortality with a focus on eliminating disparities. Perinatal/Infant Focus Area 3:Reduce Black Infant Mortality. Performance Measures (National/State Performance Measures and Evidence-Based Strategy EsPm : Preterm birth rate among infants born to non-Hispanic Black women. Measure) Perinatal/Infant State Objective 2: By 2025, reduce the rate of infant deaths from 3.9 per 1,000 live births (2020 BSMF/DSMF) to 4.0. *Note:Even though the objective has been surpassed, California has chosen to keep the target at the some level(4.0)for now because this might have been a statistical fluctuation and we want to ascertain if it is an actual stable trend. Perinatal/Infant State Objective 2:Strategy 1: Perinatal/Infant State Obiective 2:Strategy 2: Perinatal/Infant State Objective 2:Strategy 3: Lead research and surveillance related to fetal and infant mortality Lead planning and development of evidence-based practices and Lead the California SIDS Program to provide grief and bereavement in California. lesson learned for reducing infant mortality rates. support to parents,technical assistance, resources, and training on infant safe sleep to reduce infant mortality. Local Activities for Perinatal/Infant Objective 2:Strategy 1 No Local Activities Local Activities for Perinatal/Infant Objective 2:Strategy 3 p 2.1.1 p 2.2.1 p 2.3.1 X Monitor and track fetal and infant mortality utilizing the National El Other local activity(Please Specify/Optional): X Promote and disseminate information and resources related to Fatality Review-Case Reporting System (NFR-CRS) and disseminate SIDS/SUID risk factors and reduction strategies. data to community and local partners. Annual report published by DPH Epidemiologist on infant mortality rate by race and ethnicity What is your anticipated outcome? What is your anticipated outcome? New staff will receive training on safe sleep to increase understanding of SIDS and other sleep related infant deaths. Staff will use teaching materials to promote safe sleep and share resources to promote safer sleep in the community. 14 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 What is your anticipated outcome? Provide MCAH home visitors Safe Sleep flipbooks with updated 2022 Shared with community partners and stakeholders such as Babies AAP Guidelines. New MCAH home visiting staff will receive training First (Healthy Start) Community Advisory Network, County Medical on Cribette distribution and distribute cribettes to clients as needed. Providers, CPSP Providers, PEI/BIH Community Advisory Board, sub-contracted MCAH providers, Preconception to 5. p 2.1.2 p 2.3.2 ❑Other local activity (Please Specify/Optional): X Disseminate Safe to Sleep° campaign and Safe Sleep strategies that address SIDS and other sleep-related causes of infant death. What is your anticipated outcome? What is your anticipated outcome? Wide-spread community awareness and knowledge of safe sleep strategies and dissemination of safe sleep materials in the community Provide updated Safe Sleep flipbooks to CBO's who teach Safe Sleep. p 2.1.3 p 2.3.3 ❑Other local activity (Please Specify/Optional): X Partner with Regional Perinatal Programs of California (RPPC)to work with birthing hospitals to disseminate Sudden Infant Death Syndrome/Sudden Unexpected Infant Death (SIDS/SUID) risk What is your anticipated outcome? reduction information to parents or guardians of newborns upon discharge. What is your anticipated outcome? Provide posters to birthing hospitals to hang in Women's Health/NICU/Pediatric areas. 15 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 p 2.1.4 p 2.3.4 ❑Other local activity (Please Specify/Optional): X Partner with local childcare licensing, birthing facilities, clinics, Women Infant Children (WIC) sites, and medical providers to provide SIDS/SUID and Safe Sleep education. What is your anticipated outcome? What is your anticipated outcome? Promotion of best practices for Safe Sleep education beginning in the prenatal period. SIDS coordinator will participate in the Central Valley Safe Sleep Coalition meetings whose goal is to standardize and promote Safe Sleep education in the Central Valley. Continued collaboration with SIDS Coordinators throughout the valley to promote safe sleep. p 2.1.5 p 2.3.5 X Provide SIDS/SUID grief and bereavement services and supports ❑Other local activity (Please Specify/Optional): through home visits and/or mail resource packets to families suffering an infant loss. What is your anticipated outcome? What is your anticipated outcome? Families will report feeling supported and having a better understanding of their grief. p 2.3.6 X Other local activity(Please Specify/Optional): Improve Grief and Loss support for families who have experienced an infant loss by: 16 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 • Participate in trainings on Grief/Loss and support for families. • Attend CA SIDS council meetings and trainings, Northern Regional CA SIDS meetings and National SIDS meetings. • Work closely with Fresno Angel Babies to link families for grief support. What is your anticipated outcome? Collaboration with other state and national SIDS coordinators. Increased access to latest SIDS research and education materials. Improved grief support for parents. If you have additional local activities, please add a row. 17 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 DomainPerinatal/infant Health Perinatal/Infant Priority Need: Reduce infant mortality with a focus on eliminating disparities. Perinatal/Infant Focus Area 3:Reduce preterm births. Performance Measures SPM 1: Preterm birth rate among infants born to non-Hispanic Black women. (National/State Performance Measures and Evidence-Based Strategy Measure) Perinatal/Infant State Objective 3: By 2025, reduce the percentage of preterm births from 8.8% (2020 BSMF) to 8.4%. Perinatal/Infant State Objective 3: Strategy 1: Perinatal/Infant State Objective 3: Perinatal/Infant State Objective 3:Strategy 3: Perinatal/Infant State Objective 3: Lead research and surveillance on disparities Strategy 2: Lead the implementation of the state general Strategy 4: in preterm birth rates in California. Lead the implementation of the Black Infant fund effort, Perinatal Equity Initiative (PEI), to Lead the development and dissemination of preterm Health (BIH) Program to reduce the impact of support local initiatives to support birthing birth reduction strategies across California. stress due to structural racism to improve Black populations of color. birth outcomes. Local Activities for Perinatal/Infant Objective Local Activities for Perinatal/Infant Objective 3: Local Activities for Perinatal/Infant Objective 3: Local Activities for Perinatal/Infant Objective 3: 3:Strategy 1 Strategy 2 Strategy 3 Strategy 4 p 3.1.1 p 3.2.1 p 3.3.1 p 3.4.1 ❑Monitor and track local preterm birth rates ❑Other local activity(Please Specify/Optional): ❑Other local activity(Please Specify/Optional): ❑Partner with local birthing hospitals, and community and disseminate data to community and local stakeholders to disseminate social media campaigns partners. about preterm birth reduction strategies. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? 18 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 p 3.1.2 p 3.2.2 p 3.3.2 p 3.4.2 ❑Other local activity(Please ❑Other local activity (Please Specify/Optional): ❑Other local activity(Please Specify/Optional): Specify/Optional): X Develop a local public awareness campaign centered on preterm birth reduction, health education, and resources geared towards the Black community(moms, What is your anticipated outcome? What is your anticipated outcome? fathers, grandparents, community leaders, and What is your anticipated outcome? churches) and agencies providing services to Black moms and babies. (PEI/BIH Community Advisory Board (PEI/BIH CAB), First 5 Fresno County, UCSF Preterm Birth Initiative,African American Infant Mortality Council (AAIM), Faith Based Community, Medical Providers, and Medi-Cal Managed Care Plans. What is your anticipated outcome? Partner with leadership members in developing the campaign who work within the Black community to reach a potential 2,500 families. p 3.1.3 p 3.2.3 p 3.3.3 p 3.5.3 ❑Other local activity (Please ❑Other local activity (Please Specify/Optional): ❑Other local activity(Please Specify/Optional): ❑Other local activity(Please Specify/Optional): Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? Section C: Local Activities by Domain 19 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 At least one activity must be selected or the LHJ must develop at least one activity of their own in the Child Health Domain Child Priority Need: Optimize the healthy development of all children so they can flourish and reach their full potential. Child Focus Area 1:Expand and support developmental screening. (National/State Performance Measures and Evidence-Based NPM 6: Percentage of children, ages 9 through 35 months, who received a developmental screening using a parent-completed screening Strategy Measure) tool in the past year. ESM 6.1: Percent of children enrolled in CHVP with at least one developmental screen using a validated instrument within AAP-defined age range (10 months, 18 months, or 24 months'time points) during the reporting period. Child State Objective 1: By 2025, increase the percentage of children, ages 9 through 35 months, who received a developmental screening from a health care provider using a parent-completed screening tool in the past year from 25.9% (NSCH 2O17-18) to 32.4%. *Please note:We are waiting for the incoming NSCH oversample before updating this target. Child State Objective 1:Strategy 1: Child State Objective 1:Strategy 2: Child State Objective 1:Strategy 3: Child State Objective 1:Strategy 4: Partner to build data capacity for public health Partner to improve early childhood systems to Partner to educate and build capacity among Support implementation of Department of Health surveillance and program monitoring and support early developmental health and family providers and families to understand Care Services (DHCS) policies regarding child health evaluation related to developmental screening well-being. developmental milestones and implement best and well-being, including developmental screening. in California. practices in developmental screening and monitoring within MCAH programs. No Local Activities Local Activities for Child Objective 1:Strategy 2 Local Activities for Child Objective 1:Strategy 3 Local Activities for Child Objective 1:Strategy 4 ch 1.2.1 ch 1.3.1 ch 1.4.1 ❑ Partner with local stakeholders and partners, X Partner with early childhood and family-serving ❑ Build capacity by partnering with local Medi-Cal such as the local First 5 program, Help Me Grow programs (including CHVP,AFLP, BIH)to assess managed care health plans to educate and share system (if available in your jurisdiction), or current policies and practices on developmental information with providers about Medi-Cal Home Visiting Community Advisory Board to screening and monitoring developmental developmental screening reimbursement and identify key local resources for developmental milestones and determine whether additional quality measures. screening/linkage. monitoring or screening should be incorporated into the programs. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? 250 children ages 2 to 60 months of age will receive a developmental screening (ASQ 3 or ASQ SE 2). 20 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 Staff will attend collaborative meetings to discuss use of the ASO.and standardizing policies and procedures for administration to increase number of children screened ch 1.2.2 ch 1.3.2 ch 1.4.2 ❑Lead the development of a community ❑Partner with providers to educate families in resource map that links referrals to services. MCAH programs about specific milestones and ❑Track County Medi-Cal managed care health plan developmental screening needs. developmental screening data. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? ch 1.2.3 ch 1.3.3 ch 1.4.3 ❑ Implement a social media campaign or other ❑ Partner with Help Me Grow (HMG) and other ❑Other local activity(Please Specify/Optional): outreach to educate families on the importance key partners to educate providers and families of well-child and other preventive health visits. about developmental screening recommendations and tools. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? ch 1.2.4 ch 1.3.4 ch 1.4.4 ❑Other local activity(Please Specify/Optional): X Partner with Women Infant Children (WIC)to ❑Other local activity(Please Specify/Optional): disseminate developmental milestone information, educational resources, and tools. What is your anticipated outcome? What is your anticipated outcome? 21 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 What is your anticipated outcome? Increased educational resources will be distributed to MCAH clients ch 1.2.5 ch 1.3.5 ch 1.4.5 ❑Other local activity (Please Specify/Optional): ❑Other local activity(Please Specify/Optional): ❑Other local activity (Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. Child Health Domain Child Priority Need: Optimize the healthy development of all children so they can flourish and reach their full potential. Child Focus Area 2:Raise awareness of adverse childhood experiences and prevent toxic stress through building resilience. Performance Measures NPM 6: Percentage of children, ages 9 through 35 months, who received a developmental screening using a parent-completed screening tool in the past year. (National/State Performance Measures and Evidence-Based ESM 6.1: Percent of children enrolled in CHVP with at least one developmental screen using a validated instrument within AAP-defined age Strategy Measure) range (10 months, 18 months, or 24 months'time points) during the reporting period. Child State Objective 2: By 2025, increase the percentage of children (ages 0 - 17 years) who live in a home where the family demonstrated qualities of resilience (i.e., met all four resilience items as identified in the NSCH survey) during difficult times from 83.6% (NSCH 2O20-21) to 84.5%. Child State Objective 2:Strategy 1: Child State Objective 2:Strategy 2: Child State Objective 2:Strategy 3: Partner with CDPH Essentials for Childhood and other stakeholders Partner to build capacity and expand programs and practices to build Support the California Office of the Surgeon General and DHCS' to build data capacity to track and understand experiences of family resiliency by optimizing the parent-child relationship, ACES Aware initiative to build capacity among communities, adversity and resilience among children and families. enhancing parenting skills, and addressing child poverty through providers, and families to understand the impact of childhood increasing access to safety net programs within MCAH-funded adversity and the importance of trauma-informed care. programs. Local Activities for Child Objective 2: Strategy 1 Local Activities for Child Objective 2: Strategy 2 Local Activities for Child Objective 2:Strategy 3 22 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 ch2.1.1 ch2.2.1 ch2.3.1 ❑Identify and examine local county data sources for childhood ❑ Assess current MCAH program practices to promote healthy, safe, X Participate and promote within local county agencies the Surgeon adversity, childhood poverty, and social determinants of health stable, and nurturing parent-child relationships within MCAH General's ACES trainings. affecting child health and family resilience. programs. Trainers will train home visiting staff. Train new staff when onboarding to PHN Will follow up with Network of Care and Maternal Wellness What is your anticipated outcome? What is your anticipated outcome? Collision (MWC) or train the trainer course. What is your anticipated outcome? FCDPH MCAH program staff and Home Visitors will increase their knowledge of ACES and impacts on families being served by MCAH programs. Recertify home visiting staff to ACES. ch 2.1.2 ch 2.2.2 ch 2.3.2 ❑ Identify opportunities to expand data collection on key child ❑ Research and share information on statewide initiatives that ❑ Share information to support the Surgeon General and DHCS' adversity and family resilience measures. address social determinants of health and strengthen economic efforts on trauma screening and training for health care providers. supports for families. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? ch2.1.3 ch2.2.3 ch2.3.3 ❑Other local activity(Please Specify/Optional): ❑Incorporate policies and practices to strengthen economic ❑ Identify resources and training opportunities locally on ACES and supports, including improving access to safety net programs, for trauma-informed care for local programs. families within MCAH programs. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? 23 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 If you have additional local activities, please add a row. ild Health D. Child Priority Need:Optimize the healthy development of all children so they can flourish and reach their full potential. Child Focus Area 3:Support and build partnerships to improve the physical health of all children. Performance Measures NPM 6: Percentage of children, ages 9 through 35 months, who received a developmental screening using a parent-completed screening tool in the past year. (National/State Performance Measures and Evidence-Based ESM 6.1: Percent of children enrolled in CHVP with at least one developmental screen using a validated instrument within AAP-defined age Strategy Measure) range (10 months, 18 months, or 24 months'time points) during the reporting period. Child State Objective 3: By 2025,increase the percentage of children(ages 1-17 years)who had a preventive dental visit in the past year from 74.3%(NSCH 2O20-21)to 82.6%. Child State Objective 3:Strategy 1: Support the CDPH Office of Oral Health in their efforts to increase access to regular preventive dental visits for children by sharing information with MCAH programs. Local Activities for Child Objective 3:Strategy 1 ch 3.1.1 ❑Other local activity (Please Specify/Optional): What is your anticipated outcome? If you have additional local activities, please add a row. Child Priority Need:Optimize the healthy development of all children so they can flourish and reach their full potential. Child Focus Area 3:Support and build partnerships to improve the physical health of all children. Performance Measures NPM 6: Percentage of children, ages 9 through 35 months,who received a developmental screening using a parent-completed screening tool in the past year. 24 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 (National/State Performance Measures and Evidence-Based Strategy ESM 6.1: Percent of children enrolled in CHVP with at least one developmental screen using a validated instrument within AAP-defined age Measure) range (10 months, 18 months, or 24 months'time points) during the reporting period. Child State Objective 4: By 2025, decrease the percentage of fifth grade students who are overweight or obese from 41.3% (2019) to 39.3%. Child State Objective 4:Strategy 1: Child State Objective 4:Strategy 2: Partner to enable the reporting of data on childhood overweight and obesity in California. Partner with WIC and others to provide technical assistance to local MCAH programs to support healthy eating and physically active lifestyles for families. Local Activities for Child Objective 4:Strategy 1 Local Activities for Child Objective 4:Strategy 2 ch 4.1.1 ch 4.2.1 ❑ Contingent upon CDPH/MCAH procuring sub-State-level data on child overweight and obesity, ❑ Partner with local WIC, local Center for Healthy Communities Programs and Initiatives, local Education utilize guidance to inform local-level prevention initiatives. initiatives, and local CDPH/MCAH programs and initiatives, stakeholders, and partners to identify resources and best practices and tools on healthy eating and share with families in MCAH programs. What is your anticipated outcome? What is your anticipated outcome? ch 4.1.2 ch 4.2.2 ❑Other local activity (Please Specify/Optional): ❑Partner with Women Infant Children (WIC), and other local programs to refer and link eligible families to WIC and other healthy food resources. What is your anticipated outcome? What is your anticipated outcome? ch 4.1.3 ch 4.2.3 ❑Other local activity (Please Specify/Optional): ❑Partner with CDPH/MCAH to utilize the Policies, Systems, and Environmental Change Toolkit to improve physical activity, nutrition, and breastfeeding within the local health jurisdiction. 25 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 What is your anticipated outcome? What is your anticipated outcome? ch 4.1.4 ch 4.2.4 ❑Other local activity (Please Specify/Optional): ❑ Share the child MyPlates and related messaging with families and providers to promote healthy eating in children. What is your anticipated outcome? What is your anticipated outcome? ch 4.1.5 ch 4.2.5 ❑Other local activity (Please Specify/Optional): ❑Other local activity(Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. Section C: Local Activities by Domain At least one activity must be selected or the LHJ must develop at least one activity of their own in the CYSHCN Health Domain Children and Youth with Special - • Domain CYSHCN Priority Need 1: Make systems of care easier to navigate for CYSHCN and their families. CYSHCN Focus Area 1:Build capacity at the state and local levels to improve systems that serve CYSHCN and their families. 26 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 NPM 12: Percent of adolescents with and without special health care needs who receive services necessary to make transitions Performance Measures to adult health care. (National/State Performance Measures and Evidence-Based Strategy Measure) ESM 12.1: Number of Local MCAH programs that implement a Scope of Work objective focused on CYSHCN public health systems. CYSHCN State Objective 1: By 2025, maintain the number of Local MCAH programs (44) that chose to implement a Scope of Work objective focused on CYSHCN public health systems and services. CYSHCN State Obiective 1:Strategy 1: CYSHCN State Obiective 1:Strategy 2: CYSHCN State Obiective 1:Strategy 3: Lead state and local MCAH capacity-building efforts to improve Lead program outreach and assessment within State MCAH to ensure Partner to build data capacity to understand needs and health and expand public health systems and services for CYSHCN. best practices for serving CYSHCN are integrated into all MCAH disparities in the CYSHCN population. programs. Local Activities for CYSHCN Objective 1:Strategy 1 Local Activities for CYSHCN Objective 1:Strategy 2 No Local Activities cy 1.1.1 cy 1.2.1 ❑ Conduct an environmental scan focused on CYSHCN and their ❑ Create or update a resource guide or diagram to help families, families, which could include strengths, opportunities, needs, gaps, providers, and organizations understand the landscape of available and resources available in your county or region. local resources for CYSHCN. What is your anticipated outcome? What is your anticipated outcome? cy 1.1.2 cy 1.2.2 X Improve coordination of emergency preparedness and disaster relief support for CYSHCN and their families (COVID-19, wildfires, X Other local activity for the CCS nurse consultant: earthquakes, etc.) Collaborate with FCDPH CCS division on mutual clients to improve quality of case management services and care coordination. What is your anticipated outcome? What is your anticipated outcome? Improved Coordination with Emergency Preparedness, MCAH, Increased number of children in MCAH FCDPH children's home CMS and CH(CDI)to provide support and relief for CYSHCN and visitation programs who are enrolled in CCS will receive a joint families impacted by an emergency. consultation with CCS staff and MCAH PHN case manager. 27 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 cy 1.1.3 cy 1.2.3 ❑Conduct a local data/evaluation project focused on CYSHCN. ❑Other local activity (Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? cy 1.1.4 cy 1.2.4 El Create or join a public health taskforce focused on the needs of ❑Other local activity (Please Specify/Optional): CYSHCN in your county or region. What is your anticipated outcome? What is your anticipated outcome? cy 1.1.5 cy 1.2.5 El Partner with your county CCS program to improve connections ❑Other local activity (Please Specify/Optional): and referrals between CCS and Local MCAH. What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. Children and Youth with Special Health Care Needs (CYSHCN) Domain CYSHCN Priority Need 1: Make systems of care easier to navigate for CYSHCN and their families. CYSHCN Focus Area 2: Increase access to coordinated primary and specialty care for CYSHCN. 28 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 Performance Measures NPM 12: Percent of adolescents with and without special health care needs who receive services necessary to make transitions to adult (National/State Performance Measures and Evidence-Based health care Strategy Measure) ESM 12.1: Number of Local MCAH programs that implement a Scope of Work objective focused on CYSHCN public health systems CYSHCN State Objective 2: By 2025, increase the percent of adolescents with special health care needs (ages 12 — 17) who received services necessary to make transitions to adult health care from 18.4%to 20.2%. (NSCH 2016-20) CYSHCN State Objective 2: Strategy 1: CYSHCN State Obiective 2: Strategy 2: CYSHCN State Obiective 2: Strategy 3: Partner on identifying and incorporating best practices to ensure Fund DHCS/ISCD to assist CCS counties in providing necessary care Fund DHCS/ISCD to increase timely access to qualified providers for that CYSHCN and their families receive support for a successful coordination and case management to CCS clients to facilitate timely CCS clients to facilitate coordinated care. transition to adult health care. and effective access to care and appropriate community resources. Local Activities for CYSHCN Objective 2: Strategy 1 No Local Activities No Local Activities cy 2.1.1 ❑Conduct an environmental scan in your county and/or region to understand needs, strengths, barriers, and opportunities in the transition to adult health care, supports, and services for youth with special health care needs. What is your anticipated outcome? cy 2.1.2 ❑Develop a communication and/or outreach campaign focused on transition from pediatric care to adult health care, including supports and services for youth with special health care needs. What is your anticipated outcome? 29 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 cy 2.1.3 ❑Create/join a local learning collaborative or workgroup focused on the transition to adult health care and supports and services for youth with special health care needs. What is your anticipated outcome? cy 2.1.4 ❑Other local activity(Please Specify/Optional): What is your anticipated outcome? If you have additional local activities, please add a row. 30 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 �hilclren and Youth with Special Health Care Needs (CYSHCN) Dornairij .1111111110 CYSHCN Priority Need 2: Increase engagement and build resilience among CYSHCN and their families. CYSHCN Focus Area 3:Empower and support CYSHCN,families, and family-serving organizations to participate in health program planning and implementation. NPM 12: Percent of adolescents with and without special health care needs who receive services necessary to Performance Measures make transitions to adult health care. (National/State Performance Measures and Evidence-Based Strategy Measure) ESM 12.1: Number of Local MCAH programs that implement a Scope of Work objective focused on CYSHCN public health systems. CYSHCN State Objective 3: By 2025, maintain the number of local MCAH programs (17) that chose to implement a Scope of Work objective focused on family engagement, social/community inclusion, and/or family strengthening for CYSHCN. CYSHCN State Objective 3:Strategy 1: CYSHCN State Objective 3:Strategy 2: CYSHCN State Oblective 3:Strategy 3: Partner to train and engage CYSHCN and families to improve CYSHCN- Fund DHCS/ISCD to support continued family engagement in CCS Support statewide and local efforts to increase resilience among serving systems through input and involvement in state and local MCAH program improvement, including the Whole Child Model,to assist CYSHCN and their families. program design, implementation, and evaluation. families of CYSHCN in navigating services. Local Activities for CYSHCN Objective 3:Strategy 1 No Local Activities Local Activities for CYSHCN Objective 3: Strategy 3 cy 3.1.1 cy 3.3.1 ❑ Collaborate with a local Family Resource Center or other CYSHCN- serving community organization to develop a training for LHJ staff on ❑ Implement a project focused on mental health for best practices for working with families of CYSHCN. parents/caregivers of CYSHCN (examples: connecting families in the NICU to home visiting or other Local MCAH programs, What is your anticipated outcome? provider outreach to integrate maternal mental health screening into NICU follow-up visits or other pediatric specialty visits). JAL What is your anticipated outcome? pe 31 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 cy 3.1.2 cy 3.3.2 ❑ Provide training to a local Family Resource Center or other CYSHCN- ❑ Implement a project focused on social and community serving community organization on how to access Local MCAH inclusion for CYSHCN and their families (examples: creating a programs and resources. youth with special health care needs advisory group to improve community inclusion, partner with Parks and Rec or other non- What is your anticipated outcome? traditional partners to make public spaces and events more inclusive). What is your anticipated outcome? cy 3.1.3 cy 3.3.3 ❑Other local activity (Please Specify/Optional): ❑ Partner with child welfare to address health needs (including mental health) of children and youth in foster care. What is your anticipated outcome? What is your anticipated outcome? cy 3.1.4 cy 3.3.4 ❑Other local activity (Please Specify/Optional): ❑ Integrate trauma-informed and resilience-building practices specific to CYSHCN and their families into local MCAH programs. What is your anticipated outcome? What is your anticipated outcome? 32 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 cy 3.1.5 cy 3.3.5 ❑Other(Please Specify/Optional): ❑Other(Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. Section C: Local Activities by Domain At least one activity must be selected or the LHJ must develop at least one activity of their own in the Adolescent Health Domain Adolescent Domain Adolescent Priority Need 1: Enhance strengths,skills and supports to promote positive development and ensure youth are healthy and thrive. Adolescent Focus Area 1:Improve sexual and reproductive health and well-being for all adolescents in California. Performance Measures NPM 10: Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year. (National/State Performance Measures and Evidence-Based ESM 10.1: Percent of AFLP participants who received a referral for preventive services. Strategy Measure) Adolescent State Objective 1: By 2025, increase the proportion of sexually active adolescents who use condoms and/or hormonal or intrauterine contraception to prevent pregnancy and provide barrier protection against sexually transmitted diseases as measured by: • percent of sexually active adolescents who used a condom at last sexual intercourse from 55%to 58% • percent of sexually active adolescents who used the most effective or moderately effective methods of FDA-approved contraception from 23%to 25%. Adolescent State Objective 1:Strategy 1: Adolescent State Objective 1:Strategy 2: Adolescent State Objective 1:Strategy 3: Lead surveillance and program monitoring and evaluation related to Lead to strengthen knowledge and skills to increase use of protective Partner across state and local health and education systems to adolescent sexual and reproductive health. sexual health practices within CDPH/MCAH-funded programs. implement effective comprehensive sexual health education in California. Local Activities for Adolescent Objective 1: Strategy 1 Local Activities for Adolescent Objective 1: Strategy 2 Local Activities for Adolescent Objective 1: Strategy 3 33 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 a 1.1.1 a 1.2.1 a 1.3.1 ❑Utilize California Adolescent Sexual Health Needs Index (CASHNI) ❑For non-AFLP funded county agencies, partner with local AFLP ❑ For non-ASH Ed funded county agencies, partner with local ASH to target adolescent sexual health programs and efforts to youth agencies and/or other community partners to promote healthy sexual Ed funded agencies and/or other community partners to ensure facing the greatest inequities in health and social outcomes. behaviors and healthy relationships among expectant and parenting local implementation of sexual health education that is aligned youth. with the California Healthy Youth Act (CHYA)to young people facing the greatest inequities in health and social outcomes. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? a 1.1.2 a 1.2.2 a 1.3.2 ❑Utilize and disseminate California's Adolescent Birth Rate (ABR) X Build capacity of local MCAH workforce to promote protective ❑Other local activity (Please Specify/Optional): data report to the public and local partners. adolescent sexual health practices by disseminating information, resources, and training opportunities. Collaborate with Local Health Department STD program. What is your anticipated outcome? (Vending machine project) What is your anticipated outcome? What is your anticipated outcome? Trained MCAH Work force in protective adolescent and sexual health practices. Increased understanding of protective sexual and reproductive health for adolescents Utilization of appropriate teaching materials that promote protective sexual and reproductive health in the community MCAH staff to attend adolescent and sexual health training. 34 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 a 1.1.3 a 1.2.3 a 1.3.3 ❑Other (Please Specify/Optional): ❑Other local activity (Please Specify/Optional): ❑Other (Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. p . Adolescent Priority Need: Enhance strengths,skills and supports to promote positive development and ensure youth are healthy and thrive. Adolescent Focus Area 2: Improve awareness of and access to youth friendly services for all adolescents in California. Performance Measures NPM 10: Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year. (National/State Performance Measures and Evidence-Based Strategy ESM 10.1: Percent of AFLP participants who received a referral for preventive services. Measure) Adolescent State Objective 2: By 2025, increase the percent of adolescents 12 -17 with a preventive medical visit in the past year from 59.8% (NSCH 2O20-2021)to 83.8%. Adolescent State Obiective 2:Strategy 1: Adolescent State Obiective 2:Strategy 2: Lead to develop and implement best practices in CDPH/MCAH funded programs to support youth with Partner to increase the quality of preventive care for adolescents in California. accessing youth-friendly preventative care, sexual and reproductive health care, and mental health care. Local Activities for Adolescent Objective 2:Strategy 1 Local Activities for Adolescent Objective 2:Strategy 2 a 2.1.1 a 2.2.1 ❑Implement evidence-based screening tools or evidence-informed assessments to connect ❑ Partner with CDPH/MCAH to disseminate tools and resources to improve the quality and accessibility of adolescents in Local MCAH programs to needed services. adolescent health care in their communities. 35 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 What is your anticipated outcome? What is your anticipated outcome? a 2.1.2 a 2.2.2 ❑Lead the development of a community resources map that links referrals to services for young ❑Other(Please Specify/Optional): people. What is your anticipated outcome? What is your anticipated outcome? a 2.1.3 a 2.2.3 ❑Partner to disseminate adolescent preventive care recommendations to improve the quality of ❑Other local activity (Please Specify/Optional): adolescent health services. What is your anticipated outcome? What is your anticipated outcome? a 2.1.4 a 2.2.4 ❑Implement referrals to youth-friendly preventive care, mental health care, and sexual and ❑Other local activity (Please Specify/Optional): reproductive health care, including the California's Family Planning,Access, Care and Treatment program. What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. 36 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 Adolescent D• Priority Need: Enhance strengths,skills and supports to promote positive development and ensure youth are healthy and thrive. Adolescent Focus Area 3: Improve social, emotional, and mental health and build resilience among all adolescents in California. Performance Measures NPM 10: Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year. (National/State Performance Measures and Evidence-Based ESM 10.1: Percent of AFLP participants who received a referral for preventive services. Strategy Measure) Adolescent State Objective 3: By 2025, increase the percent of adolescents aged 12-17 who have an adult in their lives with whom they can talk to about serious problems from 76.7% (NSDUH 2O18-2019)to 79.7%. Adolescent State Objective 3: Strategy 1: Adolescent State Objective 3:Strategy 2: Adolescent State Objective 3:Strategy 3: Lead to strengthen resilience among expectant and parenting adolescents Partner to identify opportunities to build protective factors for adolescents at Partner to strengthen knowledge and skills among providers, to improve health,social,and educational outcomes. the individual,community,and systems levels. individuals, and families to identify signs of distress and mental health related needs among adolescents. Local Activities for Adolescent Objective 3:Strategy 1 Local Activities for Adolescent Objective 3:Strategy 2 Local Activities for Adolescent Objective 3:Strategy 3 a 3.1.1 a 3.2.1 a 3.3.1 El Partner with CDPH/MCAH to utilize evidence-based tools and resources, ❑ Conduct a Positive Youth Development(PYD) Organizational ❑Identify local needs and assets relating to adolescent mental such as the Positive Youth Development(PYD)Model,to build youth Assessment to build agency capacity to engage and promote youth health. resiliency to improve health,social,and educational outcomes among leadership and youth development. expectant and parenting youth. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? 37 05/12/2023 Local Health Jurisdiction: Fresno Fiscal Year: SFY 2023-24 Agreement Number: 202310 a 3.1.2 a 3.2.2 a 3.3.2 ❑Lead or participate on an Adolescent Family Life Program's(AFLP)Local ❑Establish or join a local youth advisory board to incorporate youth ❑Partner with or join local adolescent health coalitions and co- Stakeholder Coalition(if AFLP exists in the county). voice and feedback into local MCAH health programs and initiatives. develop a plan to improve adolescent mental health and well- being. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? a 3.1.3 a 3.2.3 a 3.3.3 ❑Other local activity (Please Specify/Optional): ❑Partner with local community agencies to understand and promote ❑ Partner to disseminate training opportunities and resources efforts to improve youth engagement and leadership opportunities. related to adolescent mental health and well-being. What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? a 3.1.4 a 3.2.4 a 3.3.4 ❑Other(Please Specify/Optional): ❑Other(Please Specify/Optional): ❑Other (Please Specify/Optional): What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome? If you have additional local activities, please add a row. 38 05/12/2023 Public Health (.DP• H Matemal,ChlMand Adolescent Heal#,Dmon ORIGINALsi BUDGET SUMMARY FISCAL YEAR LO UD IGIN GET BUDGET STATUS BUDGET BALANCE 2023-24 AL ACTIVE 0.00 Version 7.0-150 Ouadedv 4 20.20 Program: Black Infant Health(BIH) NON-ENHANCED ENHANCED Age^or 202310 Fresno UNMATCHED FUNDING MATCHING(50150) MATCHING(75125) SUbK: BIH-TV BIH-SGF AGENCYFUNDS BIH-SGF-NE BIH-Cnty NE BIH-SGF-E BIH-CntyE (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) TOTAL FUNDING % BIH-N % BIHSGF % Agency Funds` Combined % Combined Combinetl Combined Fed/State Fed/AaenGM* Fed/State Fed/Aaen.,* ALLOCATION(S) - 259,379.00 1,144,621.00 #VALUE! EXPENSE CATEGORY (1) PERSONNEL 888,662.62 195,106.86 190,252.12 0.00 399,803.80 0.00 103,499.85 0.00 (11)OPERATING EXPENSES 561,604.54 13,643.61 547,960.93 0.00 0.00 0.00 0.00 0.00 (111)CAPITAL EXPENDITURES 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 (IV) OTHER COSTS 101,088.33 9,950.00 91,138.33 0.00 0.00 0.00 0.00 0.00 (V) INDIRECT COSTS 162,714.13 40,678.53 56,949.94 0.00 65,085.65 0.00 0.00 0.00 BUDGET TOTALS" 1,714,069.62 15.13% 259,379.00 5171% 886,301.32 000% 0.00 27.12% 464,889.45 000% 0.00 604% 103,499.85 000% 0.00 BALANCE(S) o.00 0.00 TOTAL BIH-TV 259,379.00 zss,37s.00 TOTAL BIH-SGF 1,144,621.00 886,301.32 [50%] 232,444.72 [25%] 25,874.96 TOTAL TITLE XIX 310,069.62 [50%11 232,444.73 [5o%] 0.00 n5%1 77,624.89 [75%] 0.00 TOTAL AGENCY FUNDS 0.00 o.o0 150%11 0.00 [25%11 0.00 $ 1,714,069.62 Maximum Amount Payable from State and Federal resources WE CERTIFYTHAT THIS BUDGET HAS BEEN CONSTRUCTED IN COMPLIANCE WITH ALL MCAH ADMINISTRATIVE AND PROGRAM POLICIES. MCAN/PROJECT DIRECTOR'S SIGNATURE DATE AGENCY FISCAL AGENT'S SIGNATURE DATE These amounts contain local revenue submided fa infarmatien and matching purposes.MCAH does nol reimburse Agency oontdbutiens. STATE USE ONLY-TOTAL STATE AND FEDERAL REIMBURSEMENT BIH-TV BIH-SGF AGENCY BIH-SGF-NE BIH-Cnty NE BIH-SGF-E BIH-Cnty E FUNDS PCA Codes 53113 53127 53124 53100 53125 53102 (1) PERSONNEL 195,106.86 190,252.12 399,803.80 0.00 103,499.85 0.00 (11) OPERATING EXPENSES 13,643.61 547,960.93 0.00 0.00 0.00 0.00 (111) CAPITAL EXPENSES 0.00 0.00 0.00 0.00 0.00 0.00 (IV) OTHER COSTS 9,950.00 91,138.33 0.00 0.00 0.00 0.00 IV) INDIRECTCOSTS 40,678.53 56,949.94 65,085.65 0.00 0.00 0.00 Totals for PCA Codes 1,714,069.62 259,379.00 886,301.32 464,889.45 0.00 1 103,499.85 0.00 202310 BIH 5 FY 2023-24 Budget Template 08.25.23.xlsx 1 of 5 Printed:9/1/2023 1:25 PM P.-9(1C HBOrth wl• Matemal,Child and Adolescent Health Drvis,m ORIGINAL Program: Black Infant Health BIH NON-ENHANCED ENHANCED Agency: 202310 Fresno UNMATCHED FUNDING MATCHING(50/50) MATCHING(75125) SubK: BIH-TV BIHSGF AGENCYFUNDS BIH-SGF-NE BIH-Cnty NE BIH-SGF-E BIH-CntyE (1) (2) (3) (4) (5) (S) (7) (8) (9) (1O) (11) (12) (13) (1<) (15) TOTAL FUNDING % BIH-N % BIHSGF % Agency Funds' % COmbinan Combined % Combinetl % Combined Fed/State Fed/Acenar Fed/State Fad/Acen-A II OPERATING EXPENSES DETAIL %TRAVEL NON-ENH MATCH %TRAVEL ENH MATCH %PERSONNEL MATCH ( ) 0.00% 0.00% 56.25% TOTAL OPERATING EXPENSES 561,604.54 13,643.61 547,960.93 0.00 0.00 0.00 0.00 0.00 Mel--- TRAVEL 17,500.00 32,03% 5,604.57 67.979/6 11,895.43 0.00 0.00 0.00 0.00 0.00 0.00% TRAINING 5,500,00 19,09% 1,050.00 80.91% 4,450.00 0.00 0.00 0.00 0.00 0.00 56.25% 1 Office Supplies 7,500.00 29,65% 2,223.73 70.35% 5,276.27 0.00 0.00 0.00 56.25% 2 Postage 500.00 30.007 150.00 70.00% 350.00 0.00 0.00 0.00 56.25% 3 Duplication 5,500.00 3.00% 165.00 97.00% 5,335.00 0.00 0.00 0.00 56.25% 4 Public Awareness Campaign 500,000.00 0.00% 0.00 100.00% 500,000.00 0.00 0.00 0.00 56.25% 5 Communications 6,200.00 26.62% 1,650.30 73.38% 4,549.70 0.00 0.00 0.00 56.25% 6 Facilities,Utilities,Securities 13,404.54 20.89% 2,800.00 79.11% 10,604.54 0.00 0.00 0.00 56.25% 7 Small Tools&Instruments 5,500.00 0.00% 0.00 100.00% 5,500.00 0.00 0.00 0.00 56.25% 8 0.00 0.00 0.00 0.00 0.00 9 0.00 0.00 0.00 0.00 0.00 10 0.00 0.00 0.00 0.00 0.00 11 0.00 0.00 0.00 0.00 0.00 12 0.00 0.00 0.00 0.00 0.00 13 0.00 0.00 0.00 0.00 0.00 14 0.00 0.00 0.00 0.00 0.00 15 0.00 0.00 0.00 0.00 0.00 "Unmatched ODeralinq Expenses are not eligible for Federal matchinq funds(Title XIX).Expenses may only be charged to Unmatched Title V(Col.3),State General Funds(Col.5),and/or Agency(Col.7)funds. (III) CAPITAL EXPENDITURE DETAIL TOTAL CAPITAL EXPENDITURES 0.00 0.00 0.00 0.00 0.00 (IV) OTHER COSTS DETAIL %PERS56.2E5/ATCH TOTAL OTHER COSTS 101,088.33 9,950.00 91,138.33 0.00 0.00 0.00 0.00 0.00 SUBCONTRACTS 1 BLACK Wellness and Prosperity Center 56,500.00 1 0.00% 1 0.001 100.00%1 56,500.00 11 10.00 1 10.00 1 10.00 1 10.00 1 10.00 2 Reading and Beyond 6,000.00 50.00% 3,000.00 50.00% 3,000.00 0.00 0.00 0.00 0.00 0.00 3 BabySafe-Kim Wilson 700.00 1 100.00% 700.00 0.00 0.00 0.00 0.00 0.00 0.00 4 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 0.00 0.00 0.00 0.00 0.00 0.00 0.00 OTHER CHARGES 1 Client Support Materials 30,138.33 0.00% 0.00 100.00% 30,138.33 0.00 0.00 0.00 56.25%e 2 Participant Transportation 1,500.00 0.00% 0.00 100.00% 1,500.00 0.00 0.00 0.00 56.25% 3 Client Refreshments 6,250.00 100.00% 6,250.00 0.00 0.00 0.00 0.00 56.25% 4 0.00 0.00 0.00 0.00 0.00 5 0.00 0.00 0.00 0.00 0.00 6 0.00 0.00 0.00 0.00 0.00 7 0.00 0.00 0.00 0.00 0.00 8 0.00 0.00 0.00 0.00 0.00 (V) INDIRECT COSTS DETAIL TOTAL INDIRECT COSTS 162,714.13 1 40,678.53 56,949.94 11 0.00 1 65,085.65 1 0.00 18.31% of Total Wages+Fringe Benefits 162,714.13 25.00%1 40,678.53 1 35.00%1 56,949.94 11 10.00 1 40.00% 1 65,085.65 1 10.00 202310 BIH 5 FY 2023-24 Budget Template 08.25.23.xlsx 2 of 5 Printed:9/1/2023 1:25 PM PU-9IIQ HeOrth wl a Matemal,Chid and Adolescent Health D,-- ORIGINAL Program: I Black Infant Health BIH NON-ENHANCED ENHANCED Agency: 1202310 Fresno UNMATCHED FUNDING MATCHING(50/50) MATCHING(75125) SubK: BIH-TV BIHSGF AGENCYFUNDS BIH-SGF-NE BIH-Cnty NE BIH-SGF-E BIH-CmyE (i) (2) (3) (<) (5) (6) (7) (8) (9) (i D) (i t) (12) (13) (14) (15) TOTAL FUNDING % BIH-TV % BIHSGF % Agency Funds* % COmbinan % Combined % Coramnetl Combined Fed/State Fed/Aaencv` Fed/State I Fed/Aaencv* (I) PERSONNEL DETAIL TOTAL PERSONNEL COSTS 888,662.62 195,106.86 1 190,252.12 1 0.00 1 1 399,803.80 1 0.00 1 1 103,499.85 1 0.00 FRINGE BENEFIT RATE 77.40% 387,726.62 85.125.81 83,007.67 0.00 174,435.80 0.00 45,157.35 0.00 TOTAL WAGES 500,936.00 109,981.05 107,244.45 0.00 225,368.00 0.00 58,342.50 0.00 FULL NAME TITLE OR CLASSIFICATION ANNUAL C (First Name Last Name) (No Acronyms) A FTE SALARY TOTAL WAGES P 1 Janel Claybon Public Health Nurse II 100.00% 116,685.00 116,685.00 25.009/6 29,171.25 15.00% 17,502.75 0.00 10.00% 11,668.50 0.00 50.00% 58,342.50 0.00 84.70% 2 Sabrina Beavers BIH Coordinator-Health Educator 100.00% 66,027.00 66,027.00 30.00% 19,808.10 20.000% 13,205.40 0.00 50.00% 33,013.50 0.00 0.00 0.00 84.70% 3 Denise Simon Family Health Advocate Group Facilitato 100.00% 59,748.00 59,748.00 15.009/6 8,962.20 25.00% 14,937.00 0.00 60.00% 35,848.80 0.00 0.00 0.00 84.70% 4 Arturo Perez Community Outreach Liaison-Health Ec 100.00% 57,790.00 57,790.00 30.009/6 17,337.00 20.00% 11,558.00 0.00 50.00% 28,895.00 0.00 0.00 0.00 84.70% 5 Kimberly Murphy Family Health Advocate Group Facilitato 100.00% 48,646.00 48,646.00 10.009/6 4,864.60 30.009% 14,593.80 0.00 60.00% 29,187.60 0.00 0.00 0.00 84.70% 6 Martha Garcia Data Entry-Office Assistant 11 100.00% 44,694.00 44,694.00 30.00% 13,408.20 20.00% 8,938.80 0.00 50.00% 22,347.00 0.00 0.00 0.00 84.70% 7 VACANT Mental Health Professional-Medical So, 100.00% 56,951.00 56,951.00 20.009/6 11,390.20 20.009% 11,390.20 0.00 60.00% 34,170.60 0.00 0.00 0.00 84.70% 8 VACANT Family Health Advocate Community Out 100.00% 50,395.00 50,395.00 10.00% 5,039.50 30.00% 15,118.50 0.00 60.00% 30,237.00 0.00 0.00 0.00 84.70% 9 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 10 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 11 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 12 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 13 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 14 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 15 0.00 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 16 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 17 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 18 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 19 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 20 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 21 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 22 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 23 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 24 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 25 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 26 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 27 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 28 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 29 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 30 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 31 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 32 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 33 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 34 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 35 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 36 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 37 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 38 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 39 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 40 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 41 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 42 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 43 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 44 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 45 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 46 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 47 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 48 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 49 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 50 0.00 0.00 0.00 0.00 0.00H 0.00 0.00 0.00 0.00% 51 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 52 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 53 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 54 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 55 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 202310 BIH 5 FY 2023-24 Budget Template 08.25.23.xlsx 3 of 5 Printed:9/1/2023 1:25 PM PU-VIIQ HeOrth (:.• ,, Matamal,ChiM esaeo andAdoltHealthDrvis,m ORIGINAL Program: Black Infant Health BIH NON-ENHANCED ENHANCED Agency: 202310 Fresno UNMATCHED FUNDING MATCHING(50/50) MATCHING(75125) SubK: BIH-TV BIHSGF AGENCYFUNDS BIH-SGF-NE BIH-Cnty NE BIH-SGF-E BIH-CntyE (1) (2) (3) (4) (5) (6) (7) (8) (B) (10) (11) (12) (13) (14) (15) TOTAL FUNDING % BIH-TV % BIHSGF % Agency Funds* % Combinetl % Combined T Combined Combined Fed/State Fed/Aaencv* Fed/State Fed/Aaencv* 56 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 57 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 58 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 59 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 60 0.00 0.00 0.00 1 0.00 0.00 0.00 0.00 0.00 0.00% 61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 62 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 63 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 64 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 65 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 66 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 67 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 68 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 69 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 70 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 71 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 72 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 73 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 74 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 75 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 76 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 77 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 78 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 79 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 80 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 81 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 82 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 83 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 84 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 85 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 86 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 87 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 88 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 89 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 90 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 91 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 92 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 93 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 94 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 95 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 96 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 97 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 98 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 99 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 100 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 101 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 102 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 103 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 104 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 105 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 106 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 107 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 108 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 109 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 110 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 111 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 112 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 113 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 114 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 115 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 116 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 117 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 118 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 119 0.00 0.00 0.00 1 0.00 0.00 0.00 0.00 0.00 0.00% 202310 BIH 5 FY 2023-24 Budget Template 08.25.23.xlsx 4 of 5 Printed:9/1/2023 1:25 PM PU-VIIQ HeOrth (:.• ,, Matamal,ChiM esaeo andAdoltHealthDrvis,m ORIGINAL Program: Black Infant Health BIH NON-ENHANCED ENHANCED Agency: 202310 Fresno UNMATCHED FUNDING MATCHING(50/50) MATCHING(75125) SubK: BIH-TV BIHSGF AGENCYFUNDS BIH-SGF-NE BIH-Cnty NE BIH-SGF-E BIH-CntyE (1) (2) (3) (4) (5) (6) (7) (8) (B) (10) (11) (12) (13) (14) (15) TOTAL FUNDING % BIH-TV % BIHSGF % Agency Funds* % Combinetl % Combined T Combined Combined Fed/State Fed/Aaencv* Fed/State Fed/Aaencv* 120 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 121 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 122 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 123 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 124 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 125 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 126 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 127 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 128 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 129 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 130 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 131 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 132 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 133 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 134 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 135 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 136 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 137 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 138 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 139 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 140 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 141 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 142 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 143 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 144 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 145 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 146 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 147 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00% 1411 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 149 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 150 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 202310 BIH 5 FY 2023-24 Budget Template 08.25.23.xlsx 5 of 5 Printed:9/1/2023 1:25 PM Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. California Department of Public Health (CDPH) Maternal, Child and Adolescent Health (MCAH) Black Infant Health (BIH)Scope of Work(SOW) Black Infant Health Program The BIH Program is a specialized CDPH MCAH program under the local MCAH system and helps to address MCAH SOW-Women/Maternal Domain: Focus Areas 1-5: Ensure women in California are healthy before, during and after pregnancy. Perinatal/Infant Domain: Ensure all infants are born healthy and thrive in their first year of life. Focus Area 2: Reduce infant mortality with a focus on reducing disparities. The goals in this SOW incorporate local problems identified by the Local Health Jurisdiction's (LHJs') 5-Year Needs Assessments and reflect the Title V priorities of the MCAH Division. All BIH sites are required to comply with BIH Policy and Procedures (P&P) and the MCAH Fiscal Policy and Procedures Manual https://www.cdph.ca.gov/Programs/CFH/DMCAH/Pages/Fiscal-Documents.aspx in their entirety. In addition, all BIH Sites shall work towards maintaining group model fidelity by adhering to the policies and procedures, delivering services as intended, implementing strategies to maximize participant retention, fulfilling all deliverables, attending required meetings and trainings, and completing other MCAH-BIH reports as required. The CDPH Maternal, Child and Adolescent Health (MCAH) Division places a high priority on outcomes that disproportionately impact the Black Birthing community in California due to systemic racism.The BIH site agrees to implement all activities in this Scope of Work(SOW). Central to the efforts in reducing these disparities, listed below are the goals that are the hallmark of the program: 1. Improve infant and maternal health of Black Birthing People by promoting health knowledge and healthy behaviors 2. Increase the ability of Black Birthing People to develop effective stress reduction strategies 3. Decrease Black-White health disparities and social inequities for Black Birthing People and infants 4. Empower Black Birthing People and build resiliency 5. Promote social support and healthy relationships 6. Connect Black Birthing People with services 7. Engage the community to support Black Birthing families' health and well-being with education and outreach efforts To achieve these goals,the BIH Program is a client-centered, strength-based group intervention with complementary life planning and case management that embraces the life course perspective and promotes social support, empowerment, skill building, stress reduction and goal setting. Each BIH Site shall also make all efforts to implement the program with fidelity, collect, and enter participant and program data into the electronic Efforts to Outcomes(ETO) data system and engage community partner agencies. Page 1 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. All BIH LHJS are required to comply with staffing and participants served targets as outlined in the per the BIH 2O23 Request for Supplemental Information (RSI)to ensure fidelity and standardization across all sites. All funding is contingent on approval of FY 23-24 Governor's Budget. Per the BIH P&P,the following criteria applies to participants enrolled in the Case Management-Only intervention: Eligibility: • African-American • 16 years of age or older • Pregnant through 6 months postpartum Services: • For those 18 years of age and older,they are offered BIH Group model services before consenting to the BIH CM Only Intervention. • Has been provided with her rights and responsibilities for program participation, completed Assessment 1 or postpartum entry assessment, documentation of a case management interaction, received 1 referral for services. • May receive services until infant is 1 year of age. Contained within the BIH SOW, under the Measures (Process and Outcome) cells,there are Source Keys that are designed to provide a reference for reporting purposes. The "E" Source Key refers to information that is based on participant-level program data included and maintained in ETO.The "N" "Source Key refers to narrative information provided in quarterly reports or site surveys. It is the responsibility of the LHJ to meet the goals and objectives of this SOW. Agencies that enter into agreement with the division to provide MCAH-related services, and accept the division funding, are legally required to provide the full level of services, outlined in the program SOW, regardless of the proportion of funding provided by the division.The LHJ shall strive to develop systems that protect and improve the health of California's women of reproductive age, infants, children, adolescents, and their families. All sites should have policies that facilitate the promotion of health equity. It is the responsibility of an LHJ to solicit technical assistance and guidance from MCAH if performance issues arise. If a program does not meet the goals and objectives outlined in this SOW and the implementation measures for accountability,and if the tier compliance standards are not met in a timely manner, the LHJ may be placed on a Corrective Action Plan (CAP). After implementation of the CAP, if the LHJ does not demonstrate substantial growth,or fails to successfully meet the goals and objectives of this SOW, MCAH may temporarily withhold cash payment pending correction of the deficiency; disallowing all or part of the cost of the activity or action out of compliance;wholly or partly suspending or terminating the award; or withholding further awards." Continued participation in the BIH program beyond the current fiscal year is also subject to successful performance in meeting caseload requirements and implementing the agreed upon activities. The development of this SOW is a collaborative process with BIH Program Coordinators and was guided by several public health frameworks including the Ten Essential Services of Public Health and the three (3) core functions of assessment, policy development, and assurance;the Spectrum of Prevention; the Life Page 2 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Course Perspective; the Social-Ecological Model, and the Social Determinants of Health. Please consider integrating these approaches when conceptualizing and organizing local program, policy, and evaluation efforts. o The Ten Essential Services of Public Health and Toolkit o The Spectrum of Prevention o Life Course Perspective AMCHP o Social Determinants of Health o The Social-Ecological Model o Strengthening Families All activities in this SOW shall take place within the fiscal year. For each fiscal year of the contract period, the LHJ shall submit the deliverables identified below. All deliverables shall be submitted to the MCAH Division to your designated Program Consultant in accordance with the BIH P&P Manual and postmarked or emailed no later than the due date. Deliverables for each FY Due Date for each FY Annual Progress Report August 15 Coordinator Quarterly Report: Reporting Period From To Due Date First Report July 1, 2023 September 30, 2023 October 15, 2023 Second Report October 1, 2023 December 31, 2023 January 15, 2024 Third Report January 1, 2024 March 31, 2024 April 15, 2024 Fourth Report(WAIVED) April 1, 2024 June 30, 2024 August 15, 2024 Information during this reporting period will be included in the Annual Progress Report See the following pages for a detailed description of the services to be performed. Page 3 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Part II: Black Infant Health (BIH) Program Goal 1: BIH local staff will assure program implementation, staff competency,data management, and maintain program fidelity and fiscal management to administer the program as required by the Program's Policy and Procedures (P&P's)and Scope of Work(SOW)guidelines. Local staff will also support,as their capacity allows, activities related to the revisions of the BIH model. Evaluation/Performance Measures Intervention Activities to Meet Process, Short and/or Intermediate Measures Short and/or Intermediate Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) IMPLEMENTATION 1.1 1.1 1.1 1.1 BIH Coordinator, under the • Implement the program • Define and describe MCAH • Submit BIH Annual report by guidance and leadership of the activities as defined in the Director and BIH Coordinator August 15. MCAH Director will provide SOW. responsibilities as they relate • Submit BIH Quarterly Reports oversight, maintain program • Annually review and revise to BIH. (N) as directed by MCAH. (See fidelity, fiscal management and internal local policies and • Provide organization chart page 4) demonstrate that BIH activities procedures for delivering that designates the are conducted as required in the services to eligible BIH delineation of responsibilities BIH P&Ps, SOW, Data Collection participants. of MCAH Director and BIH Manual, BIH data collection forms, . BIH Coordinator will Coordinator from MCAH to Group Curriculum, and MCAH coordinate and collaborate the BIH Program in AFA Fiscal P&Ps. with MCAH Director to packet. complete, review, and • Describe collaborative approve the BIH budget process between MCAH prior to submission. Director and BIH Coordinator • Submit Agreement Funding related to BIH budget prior to Application (AFA)timely. AFA submission. (N) • Submit BIH Annual report by August 15. • Submit BIH Quarterly Reports as directed by MCAH. 1.2 1.2 1.2 1.2 Recruit, hire and maintain staff • Maintain culturally • Describe process of recruiting • Percent of key staffing roles at that reflect the community being competent staff to perform and hiring staff at each site that site filled by personnel who meet served to implement a BIH program services that are filled by personnel reflective qualifications in the P&P. (N) Page 4 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) Program that is relevant to the honors the unique of the community being served . Percent of direct contact roles cultural heritage of Black history/traditions of Black that meet qualifications in the that reflect the population being Birthing People, and the Birthing People as outlined P&P. served. (N) community. in the P& P. • Include duty statements of all • At a minimum,the following staff with submission of AFA key staffing roles are packet. required: • Submission of all staff changes • 1.0 FTE BIH Coordinator per guidelines outlined in BIH • Family Health Advocates P&P. (FHA)/Group Facilitators (GF) based on MCAH-BIH designated tier level. • 1.0 FTE Community Outreach Liaison (COL) • 1.0 FTE Data Entry • 1.0 FTE Mental Health Professional (MHP) • 1.0 FTE Public Health Nurse (PHN) • 1.0 FTE Child Watch • Utilization of a staff-hiring plan. TRAINING 1.3 1.3 1.3 1.3 All BIH staff will maintain and • Develop a plan to assess the • List new staff training • Maintain records of staff increase staff competency. ability of staff to effectively activities in quarterly report. attendance at trainings. (N) perform their assigned (N) • Number of trainings and tasks, including regular • Describe improved staff conferences(both state and observations of group performance and confidence local) attended by staff during facilitators. in implementing the program FY 2023-24. (N) • Identify staff training needs model due to participating in • Completion of at least two (2) and ensure those needs are staff development activities group observation feedback and/or trainings. (N) forms by the BIH Coordinator Page 5 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) met, notifying MCAH of any • List gaps in staff for every pair of group training needs. development and training in facilitators during FY 2023-24. • Ensure that all key BIH staff quarterly report. (N) (E) participates in on-going • Describe plan to ensure that training or educational staff development needs are opportunities designed to met in quarterly report. (N) enhance cultural sensitivity • Describe how cultural and responsiveness through sensitivity training has webinars, trainings and/or enhanced LHJ staff conferences. knowledge and how that • Ensure that all new and key knowledge is applied. (N) BIH staff attend the Annual • Describe how staff utilized MCAH Sudden Infant Death information from the MCAH Syndrome (SIDS) Conference SIDS conference with to receive the latest AAP participants. guidelines on infant safe • Document strategies and sleep practices and SIDS risk action plans related to SIDS reduction strategies. risk reduction strategies • Establish local SIDS developed from SIDS collaborative workgroups collaborative workgroup with community partners to meetings. enhance awareness of Black • Recommend training topic SIDS rates and to develop suggestions for statewide SIDS risk reduction meetings. (N) strategies. • Require that all key BIH staff (i.e., BIH Coordinator, and ALL direct service staff) attend mandatory MCAH Division-sponsored in- person or virtual trainings, conference calls, meetings and/or conferences as Page 6 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) scheduled by MCAH Division. • Ensure that the BIH Coordinator and all direct service staff attend mandatory MCAH Division- sponsored training(s) prior to implementing the BIH Program. • Ensure that the BIH Coordinator and/or MCAH Director perform regular observations of GFs and assessments of FHAs, MHPs and/or PHNs case management activities. DATA COLLECTION AND ENTRY 1.4 1.4 1.4 1.4 All BIH participant program • Ensure that all direct service • Review ETO and other data • Number and percent of information and outcome data staff participate in data reports, discuss during calls required forms that were will be collected and entered collection, data entry, data with BIH State Team. entered within ten (10) days timely and accurately using BIH quality improvement, and • Enter all data into ETO within of collection. (E) BIH PA: required forms at required use of data collection ten (10) working days of Timeliness of data entry report intervals. software determined by collection. • Maintain records of the four MCAH. • Review of the BIH Data chart audits conducted in FY • Ensure that all Collection Manual by all staff. (N). subcontractor agencies • Completion of ETO training providing direct service by all staff. enter data in the ETO as • Participation in periodic determined by MCAH. MCAH-Data calls. Page 7 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) • Ensure accuracy and Read data alerts or other completeness of data input data guidance sent via email into ETO system. or posted on SharePoint. • Ensure that all staff receives • Participation in role-specific updates about changes in trainings for the Data Entry ETO and forms. Lead. • Ensure that a selected staff • Review of MCAH and ETO member with advanced data quality reports by the knowledge of the BIH BIH Coordinator and Data Program, data collection, Entry staff on a regular basis. and ETO is selected as the • The Coordinator and Data BIH Site's Data Entry lead Entry lead conduct and and participates in all data report on audits of and evaluation calls. recruitment, enrollment, and • Accurately and completely service delivery paper forms collect required participant against ETO reports once information as outlined in every quarter.Audit sample the data collection manual, must include at least 10%of with timely data input into recruitment records and 10% the appropriate data of enrollment records and system(s). should include all staff • Work with MCAH to ensure collecting data.The audits proper and continuous should verify that the data in operation of the MCAH-BIH- the paper forms matches the ETO. information in ETO for that • Store Participant level Data sample. forms on paper or scanned copies per security guidelines in P&P for a minimum of four years (prior three years plus current FY). Page 8 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) • Define a data entry schedule for staff and monitor for adherence. • Ensure that all staff that collect data and enter data into the BIH data system have completed the ETO training video series available in the BIH SharePoint site. • Ensure that all staff that have ETO access are currently in the SharePoint roster by completing the Quarterly Roster Assessment. OUTREACH 1.5 1.5 1.5 1.5 All BIH LHJs will increase and • All BIH LHJs will conduct • Describe the types of • Total number(overall and by expand community awareness of outreach activities and build community partner agencies type) of outreach activities BIH by collaborating with other collaborative relationships contacted by LHJ staff. (N) completed by all staff during BIH counties and individually as a with local Women, Infants, • Describe outreach activities FY 2023-24. (N) county on communication and Children (WIC) performed to reach target outreach activities, including the providers, Comprehensive population. (N) use of social media. Perinatal Services Program • Describe deviations in (CPSP) Perinatal Service outreach activities, noting Coordinators, social service changes from local providers, health care recruitment plan. (N) providers, the Faith-based • Document type, frequency community, and other and number of social media community-based partners activities conducted on the and individuals to increase BIH Primary Contact Table Page 9 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) and maximize awareness and submit with Quarterly opportunities to ensure that and Annual Report. (N) eligible women are referred to BIH. • All BIH LHJs will establish referral mechanisms that will facilitate reciprocity with partner agencies as appropriate. • At a minimum, all BIH LHJs will utilize social media campaigns developed by MCAH to increase community awareness while conducting outreach activities. PARTICIPANT RECRUITMENT 1.6a 1.6a 1.6a 1.6a For BIH Group Sessions, all BIH • Develop and implement a • Submit participant triage • Number and percent of LHJs will recruit African-American Participant Recruitment Plan algorithm with submission of recruited and referred women women 18 years of age and older, (standardized intake AFA packet. that were eligible for Group and less than 30 weeks pregnant process) according to the • Track and document progress (based on age and pregnancy for prenatal group services, or up target population and in meeting goals of the status) based on their to six months postpartum for eligibility guidelines in Participant Recruitment Plan, recruitment date, in FY 2023- postpartum group services. MCAH-BIH P&P and submit review annually and update 24. (E) BIH PA:Recruitment upon request. as needed. during a specified time period • Review Recruitment plan report annually and update as • List social media addresses. needed. (N) • Site uses social media strategies (Facebook, Page 10 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) Twitter, Instagram)for distribution of BIH materials, community events, engagement of former and current participants. • Staff will complete a recruitment for all people recruited and referred to the Program. 1.6b 1.6b 1.6b 1.6b For Case Management Only, all • Develop and implement a • Track and document progress • Number and percent of BIH LHJs will recruit African- Participant Recruitment Plan in meeting goals of the recruited and referred women American teens at least 16 years (standardized intake Participant Recruitment Plan, that were eligible for Case of age and adult women, process) according to the review annually and update Management(based on age pregnant or up to 6 months target population and as needed. and pregnancy status) based postpartum. eligibility guidelines in on their recruitment date, in MCAH-BIH P&P and submit FY 2023-24. (E) BIH PA: upon request. Recruitment during a specified • Site uses social media time period report. strategies (Facebook, Twitter, Instagram)for distribution of BIH materials, community events, engagement of former and current participants. • Staff will complete a recruitment for all people recruited and referred to the Program. Page 11 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) PARTICIPANT REFERRAL 1.7 1.7 1.7 1.7 All BIH LHJs will establish a . Develop collaborative • Describe process for ensuring • Total number of service network of referral partners. relationships with local that referral partner agencies providers that made referrals Medi-Cal Managed Care, are referring eligible women to the BIH Program in FY Commercial Health Plans, to BIH in quarterly reports 2023-24. (E) BIH PA: WIC, and local agencies in and during technical Recruitment during a specified the community that provide assistance calls. (N) time period report. services to Black Birthing People and children,to establish strong resource linkages for recruitment of potential participants and for referrals of active participants. • Provide referrals to other MCAH programs for women who cannot participate in group intervention sessions. PARTICIPANT ENROLLMENT 1.8a BIH Coordinator, under the 1.8a 1.8a 1.8a guidance and leadership of the • Enroll women that are • Visual inspection of all • Number and percent of MCAH Director will ensure the African-American. recruitment eligibility fields participants that agree to following: • Enroll women that will on incoming referral forms enroll among those recruited • All participants enrolled in participate in the group for completeness. and eligible in FY 2023-24. BIH the BIH group model will intervention. • Inclusion of eligibility criteria PP: Recruitment and be African-American. with materials used for enrollment report • All participants will be referral and recruitment. • Number and percent that has enrolled during pregnancy a recruitment and a rights and or postpartum. responsibilities (consent) touchpoint in ETO in FY 2023- Page 12 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) • All participants will receive 24. (E) BIH PP:Recruitment a rights and and enrollment report responsibilities ()form and provide signed or verbal acknowledgement. • All women will participate in virtual or in-person prenatal and/or postpartum group intervention. • Participants may receive services until infant is 1 year of age. 1.8b 1.8b 1.8b 1.8b BIH Coordinator, under the • Enroll women that are • Visual inspection of all • Number and percent of guidance and leadership of the African-American. recruitment eligibility fields participants that agree to enroll MCAH Director will ensure the • Enroll women during on incoming referral forms among those recruited and eligible following: pregnancy through 6 for completeness. in FY 2023-24. BIH PP: • All participants enrolled in months postpartum. • Inclusion of eligibility criteria Recruitment and enrollment report Case Management-Only . Enroll women to participate with materials used for • Number and percent that has a intervention will be African- in the Case Management- referral and recruitment. recruitment and a rights and American. Only intervention. responsibilities (consent) • Participants will be enrolled in touchpoint in ETO in FY 2023-24. virtual or in-person Case (E) BIH PP: Recruitment and Management-Only during enrollment report pregnancy through 6 months postpartum. • Participants enrolled in Case Management-Only intervention are not required to attend BIH Group sessions. Page 13 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) • Participants may receive services until infant is 1 year of age. PROGRAM PARTICIPATION 1.9.1 1.9.1 1.9.1 1.9.1 BIH Coordinator, under the • Assign participants to a • Describe barriers, challenges • Number and percent of guidance and leadership of the prenatal or postpartum and successes of enrolling enrolled women who MCAH Director will ensure the group as part of enrollment women in a group within 30- attended a prenatal group following: process. 45 days of first successful session within 30-45 days of • All women will participate in a • Schedule groups to allow contact during technical enrollment. (E)—BIH PP: prenatal or postpartum group. participants to attend within assistance calls. (N) Group Dose Report • All women will participate in a 30-45 days of enrollment. • Describe barriers, challenges • Percent of prenatal group group within 30-45 days of • Enroll participants in a and successes of beginning sessions in a series that were enrollment. group within 45 days of groups with the minimum attended by at least 5 • All groups will be enrollment required number of participants. (E) -BIH PP: implemented according to the • Begin groups with the participants during technical Group Attendance by Session 10-group intervention model minimum required number assistance calls. (N) as specified in the P&P. (see of participants per the BIH 1.9.3) P&P. 1.9.2a 1.9.2a 1.9.2a 1.9.2a BIH Coordinator, under the • Assign participants to an • Collect and record service • Number and percent of active guidance and leadership of the FHA as part of enrollment delivery activities for enrolled participants that are served MCAH Director will ensure the process. women into ETO. during the FY 22-23(E). BIH following: • Conduct services that align • Describe successes and/or PP:Served during a specified • All BIH participants (enrolled with Life Plan activities (goal challenges in assisting time period—Group NEW in BIH Group) will receive an setting). participants with setting Note: If not all active appear assessment#1 or postpartum . Collect completed self- short and long-term goals as served provide a narrative entry assessment and will assessment administered during Life Planning of why this is the case is attend at least one group to scaled questions as meetings. (N) needed. be considered active and will described in P&P. • Describe program • Number and percent of receive other services to be improvements resulting from enrolled women who received considered served: participant satisfaction at least one case conference Page 14 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) subsequent group sessions, • Collect the required number survey findings at least at any point in their life planning, referrals, birth of assessments per quarterly. (N) participation-(E) BIH PA Case plan, EPDS, or safety checklist timeframe outlined in P&P. Conferences during the FY. • Develop and implement a • Number and percent of • All BIH participants (enrolled Life Plan based on goal enrolled women who have a in BIH Group)will receive at setting during Life Planning known referral status for least one case conference. meetings for each BIH every documented referral at • All BIH participants (enrolled participant; complete all time of exit from the program in BIH Group)will receive prenatal and postpartum (among women dismissed door-to-door transportation assessments; provide from BIH). (E) BIH PA:Referral assistance as needed to ongoing identification of her Status Report NEW attend group sessions and Life specific concerns/needs and • Number and percent of Planning meetings. referral to services outside enrolled women who have • All BIH locations will include a of BIH as needed based on been dismissed from BIH with space dedicated for Child Life Planning meetings. a completed participant Watch during group sessions. • Ensure participant referrals satisfaction survey during the • All group sessions will include are generated and FY. (E) BIH PP:Participant full meals for participants. completed for all services Satisfaction Report • All BIH active participants will identified. be provided with necessary • Ensure participants have tools for participation in access to transportation virtual services as necessary. assistance via Uber/Lyft or other door-to-door services in order to attend group sessions and Life Planning meetings. • Ensure location of group services have dedicated child watch staff and space when group sessions are conducted. • Ensure participants have access to necessary tools to Page 15 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) participate in virtual services. • Conduct participant dismissal activities. • Conduct participant satisfaction surveys. • Submit complete and accurate reports in the timeframe specified by MCAH. 1.9.2b 1.9.2b 1.9.2b 1.9.2b BIH Coordinator, under the guidance • Assign participants to an • Collect and record service • Number and percent of active and leadership of the MCAH Director FHA, MHP and/or PHN as delivery activities for enrolled participants that are served will ensure the following: part of enrollment process. women into ETO. during the FY(E). BIH PP: • Case Management • Conduct case management • Describe program Served during a specified time participants will receive BIH services that align with improvements resulting from period—CM Note: If not all Case Management support as identified needs of each participant satisfaction active appear as served defined in the P&P. participant. survey findings at least provide a narrative of why this • All BIH participants (enrolled • Collect required quarterly. (N) is the case is needed. in BIH Case Management) will assessments per timeframe • Number and percent of receive an assessment#1 or outlined in P&P. enrolled women who received postpartum entry assessment • Develop and implement a at least one case conference - to be considered active and Care Plan based on (E) BIH PA Case Conferences will receive at least one other participant needs during service to be considered case management meetings served: case management for each BIH participant; meetings, referrals, birth plan, complete all prenatal and EPDS, or safety checklist postpartum assessments; during the FY. provide ongoing identification of her specific concerns/needs and referral to services outside of BIH as Page 16 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) needed based on case management meetings. • Ensure participant referrals are generated and completed for all services identified. • Conduct participant dismissal activities. • Conduct participant satisfaction surveys. • Submit complete and accurate reports in the timeframe specified by MCAH. • BIH Case Management support will be provided until the child turns one year of age. 1.9.3a 1.9.3a 1.9.3a 1.9.3a BIH Coordinator, under the • Schedule Group • Collect and record Group • Number of Group Intervention guidance and leadership of the Intervention Sessions with Intervention Session Sessions entered in ETO that MCAH Director will ensure that guidance from State BIH attendance records for all began during FY 2023-24. (E) all BIH participants will Team. enrolled women into ETO. BIH PP: Group Attendance by participate in virtual or in-person • All participants will have the • Submit FY 2023-24 Group Session Group Intervention Sessions. opportunity to enroll in Intervention Sessions • Number and percent of Group Intervention Sessions Calendar to MCAH-BIH enrolled women who attend within 30-45 days of the first Program with submission of at least one prenatal or successful contact. AFA and upon request. postpartum Group • Conduct and adhere to the • Describe participant Intervention Session. (E) BIH 10-group intervention successes or challenges with PP:Group Attendance by model as specified in the completing seven (7) of ten Session P&P. (10) prenatal and/or Page 17 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) • Participants enrolled in the postpartum Group • Number and percent of BIH Group model may Intervention Sessions. (N) enrolled women who switch to the BIH Case attended the expected Management-Only number of Prenatal or intervention on a case-by- postpartum Group case basis. Intervention Sessions based upon the number of days in program (E)—BIH PP Group Dose Report • Number and percent of enrolled women who attended the expected number of life planning meetings based upon the number of days in program (E) —BIH PA Life Planning Report 1.9.3b 1.9.3b 1.9.3b 1.9.3b BIH Participants enrolled in • Schedule case management • Describe participant successes or • Number and percent of enrolled the Case Management only meetings per guidance in the challenges with completing case women who complete case intervention are not required BIH P&P. management services. management meetings at the to attend BIH group sessions. . Participants enrolled in the BIH P&P-designated time intervals. (E) Case Management only intervention may switch to the BIH Group model on a case-by- case basis. PARTICIPANT RETENTION 1.9.4 1.9.4 1.9.4 1.9.4 BIH Coordinator, under the • Discuss and develop • Discuss participant retention • Submit Participant Retention guidance and leadership of the participant retention strategies during technical Strategies with Quarterly and MCAH Director will ensure that strategies during team assistance calls. (N) Annual Report. (N) participant retention strategies meetings. • Review participant retention are in place. • Plan participant retention strategies quarterly and strategies as they relate to update as needed. (N) Page 18 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) program implementation • Document participant components retention strategies in ETO (outreach/recruitment, and in Quarterly Reports. enrollment, Life Planning, (E/N) group sessions, program • Submit participant retention completion). strategy successes and • Ensure participants have challenges with Annual access to transportation Report. (N) assistance via Uber/Lyft or other door-to-door services in order to attend group sessions and Life Planning meetings. • Ensure location of group services is accessible, culturally affirming, and have dedicated child watch staff and space when group sessions are conducted. • Ensure participants have access to necessary tools to participate in virtual services. • Designated staff will conduct participant satisfaction surveys after group sessions and at program completion to obtain feedback related to improvement of retention strategies. • Ensure group motivators including but not limited to Page 19 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process, Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) gift cards, pack and plays, items to support fitness, infant feeding supplies, breastfeeding supplies, diapers, etc. are provided to program participants. • Ensure full meals are provided at each group session. Page 20 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Goal 2: Engage the African American community to support Black Birthing families' health and well-being with education and outreach efforts. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objective(s) Objectives (Describe the steps of the (Report on these measures in the Annual Report) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) 2.1 2.1 2.1 2.1 BIH Coordinator under the • Implementation of a Convene and document efforts of • Submit CAB meeting guidance and leadership of the Community Advisory Board Community Advisory Board, materials (roster, stakeholder MCAH Director will increase and (CAB) to: collaborations or other similar types, attendance, agenda, expand community awareness of . Inform the community about formal or informal partnerships minutes) with BIH quarterly Black Birthing outcomes and the disparate birth outcomes to address maternal and infant report. (N) role of the Black Infant Health among Black Birthing People health disparities, social • Number, format, and Program. by delivering standardized determinants of health, well- outcomes associated with messages describing how the woman visits and postpartum community outreach BIH Program addresses these visits at least once per quarter. activities conducted by issues. (N) BIH Coordinator and/or • Create partnerships with • Submit quarterly reports that MCAH Director during FY community and referral describe outreach activities 2023-24. (E/N) agencies that support the electronically using ETO in a BIH PA Community Contacts broad goals of the BIH timely manner. (N) report. Program,through formal and • Document the local plan for informal agreements. community linkages, including an • Ensure that efforts are effective referral process that will focused on Black birthing be reviewed on an annual basis people and families in the and updated as needed. (N) community who are in need • Document successes and barriers of services and are to community education confronting disparities activities or events at least once caused by systematic per quarter through quarterly oppression and reporting. (N) marginalization, implicit bias, • List and maintain current and discrimination. documentation on the nature of • Develop and implement a formal and informal partnerships community awareness plan with community and referral that outlines how community agencies at least once a quarter; record referral relationships in Page 21 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) engagement activities will be the ETO service provider details conducted. form. (E/N) • Develop and implement • Document inclusion of BIH activities related to multi- participant (past or current) level community engagement participation on CAB roster to and awareness with referral provide the lived experience of partners to identify service Black birthing people and the role gaps in the LHJ target area. of the BIH program in addressing • Develop performance maternal and infant health strategies with local outcomes. organizations that provide • Enter all outreach activities in the services to Black birthing Community Contacts Log in ETO. people and infants to • Document collaborative efforts improve referrals and linkage with local MCAH programs and to BIH services. Regional Perinatal Programs • Collaborate with local MCAH describing strategies to improve programs and other partners maternal and perinatal systems such as Medi-Cal to identify of care at least quarterly. (N) strategies, activities and • Maintain current lists of provide technical assistance community providers and Service to: Provider details in ETO. o Improve access to health care services o Increase utilization of well- woman and postpartum visits o Identify Preterm Birth (PTB) reduction strategies o Increase the utilization of preconception health services. • Collaborate with local MCAH programs and Regional Perinatal Programs to Page 22 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) improve maternal and perinatal systems of care. • Participate in collaboratives with community partners to review data and develop strategies and policies to address social determinants of health and disparities. • Collaborate with agencies providing services to Black Birthing People to develop and disseminate tangible Reproductive Life Planning training materials (e.g., power point presentation, webinars,toolkits, etc.)to focus on Before, During, and Beyond Pregnancy for dissemination and integration in their service delivery protocols. 2.2 2.2 2.2 2.2 BIH COL will increase information • Develop a clear point(s) of • Enter all outreach activities in • Number of agencies where sharing with other local agencies contact with collaborating the Community Contacts Log the COL has a documented providing services to Black Birthing community agencies on a in ETO. point(s) of contact and with People and children in the regular basis as it relates to • Maintain current lists of whom information is community and establish a clear outreach, enrollment, community providers and regularly exchanged. (N) point of contact. referrals, care coordination, Service Provider details in • Total number of agencies etc. ETO. with outreach records during • Assess referrals from partner • Describe materials used to FY 2023-24. (N) agencies to determine inform community partners enrollment points of entry about BIH. (N) quarterly. Page 23 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) • List and describe barriers, challenges and/or successes related to establishing community partnerships and point(s) of contact at least quarterly. (N) Page 24 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Goal 3: Provide strategies and resources to assist Black Birthing People to manage chronic stress. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objective(s) Objectives (Describe the steps of the (Report on these measures in the Annual Report) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) 3.1 3.1 3.1 3.1 BIH Coordinator under the • Implement the prenatal and • Provide FY 2023-24 group • Number and percent of guidance and leadership of the postpartum group intervention schedules upon active participants with a MCAH Director will ensure that intervention with fidelity to request. (N) baseline and follow-up all BIH participants will have their the P&P. • Document results from group assessment(relative to social support measured at • Encourage participants to session information form, number of days enrolled in baseline and after attending the attend and participate in including description of the program). (E) prenatal and/or postpartum group sessions. participant engagement in • Number and percent of group intervention and • Support clients in fostering group activities for each enrolled women who completing Life Planning activities healthy interpersonal and group session. attended the expected using the Social Provisions Scale— familial relationships. number of Prenatal Group Short (SPS-S). Intervention Sessions based upon the number of days in program (E)—BIH PP Group Dose Report • Number and percent of enrolled women who attended the expected number of prenatal life planning meetings based upon the number of days in program (E)—BIH PA Life Planning Report 3.2 3.2 3.2 3.2 BIH Coordinator under the • LHJ staff will facilitate the • Summarize participant • Number and percent of guidance and leadership of the administration of the stress successes and challenges in active participants with a MCAH Director will ensure that scale and ask questions utilizing stress reduction baseline and follow-up all BIH participants will have their about stress management as techniques. (N) assessment(relative to perceived stress and use of stress outlined in the P&P, focused number of days enrolled in management techniques(yoga, on the participant's ability to the program). (E) deep breathing, or meditation) be resilient and manage Page 25 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) measured at baseline and after chronic stressors presenting attending prenatal and/or during pregnancy. postpartum group intervention • All activities are delivered and completing Life Planning with an understanding of the activities. Black Birthing culture and history. • Assist participants in identifying and utilizing their personal strengths. • Develop and implement a Life Plan with each participant. • Teach and provide support to participants as they develop goal-setting skills and create their Life Plans. • Teach participants about the importance of stress reduction and guide them in applying stress reduction techniques. • Support participants as they become empowered to take actions toward meeting their needs. • Teach participants how to express their feelings in constructive ways. • Help participants to understand societal influences and their impact on Black Birthing Peoples' health and wellness. Page 26 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Goal 4: Provide resources to assist with improving the health of pregnant and parenting African American women and their infants. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objective(s) Objectives (Describe the steps of the (Report on these measures in the Annual Report) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) 4.1 4.1 4.1 4.1 BIH Coordinator under the • Assist participants in • List and document additional • Number and percent of guidance and leadership of the understanding behaviors that activities (e.g., Champions for enrolled women who have a MCAH Director will ensure that all contribute to overall good Change cooking known referral status for BIH participants will be linked to health, including: demonstrations) conducted every documented referral at services that support health and Stress management that promote health and time of exit from the wellness while enrolled in the BIH Sexual health wellness of BIH participants program (among women Program. Healthy relationships and their infants at least once dismissed from BIH). (E) BIH Nutrition per quarter. (N/E) PA:Referral Status Report Physical activity • Describe collaborative efforts NEW • Ensure that participants are with March of Dimes, • Number and percent of enrolled in health insurance MotherToBaby and other enrolled participants that and are receiving risk- agencies that provide health have received a referral for appropriate perinatal care. education, preterm birth health insurance. (E) • Ensure that a healthy reduction materials and nutritious full meal is resources. (N) available during group sessions. • Provide participants with health information that supports a healthy pregnancy. • Provide participants with health education materials that address preterm birth reduction strategies, such as the MCAH-BIH prematurity awareness and Provider sheet tip sheet. • Identify participants' health, dental and psychosocial Page 27 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) needs and provide referrals and follow-up as needed to health and community services. • Provide information and health education to participants who report drug, alcohol and/or tobacco use. • Assist participants with completion of the birth plan that outlines specific labor/delivery and birthing requests to be conveyed to their prenatal care provider. • Provide information on the benefits and importance of delivering a full-term baby. • Provide information related to the risks associated with delivering via cesarean section in order to make an informed decision related to their delivery. 4.2 4.2 4.2 4.2 BIH LHJ staff will coordinate with • Promote and support family • Summarize • Number and percent of State MCAH and BIH staff to assist planning by providing challenges/barriers of birth enrolled participants that BIH Participants with increased information and education control usage among have discussed reproductive knowledge and understanding of a on birth spacing and enrolled women who have life planning during life Reproductive Life Plan and Family interconception health delivered. (N) planning or case Planning services by providing during group sessions and • Document collaborative management meetings. (E) culturally and linguistically Life Planning Meetings. activities with local MCAH appropriate tools for integration • Help participants understand programs and other partners into existing program materials. and value the concept of such as Medi-Cal Managed Page 28 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) reproductive life planning as Care and CPSP Provider Life Plans are completed and networks to identify discussed with Family Health strategies, activities and Advocates during Life provide technical assistance Planning Meetings and Group to improve access to health Facilitators during group care services and increase sessions. utilization of the postpartum • Provide referrals and visit. (N) promote linkages to family • Describe collaborative efforts planning providers including with Violence Prevention Family Planning, Access, Organizations such as Futures Care, and Treatment(Family without Violence to PACT). determine service capacity to • Help participants understand adequately meet needs the characteristics of healthy identified by participants and relationships and provide LHJ staff providing case resources that can help management services. (N) participants deal with abuse, reproductive coercion, or birth control sabotage. 4.3 4.3 4.3 4.3 BIH Coordinator under the • Local staff will work with or • Summarize successes and • Number and percent of guidance and leadership of the support participants to: challenges in addressing active participants with an MCAH Director will ensure that all o Understand how mental mental health issues, EPDS(relative to number of BIH participants will be screened health contributes to overall including mental health days enrolled in the for Perinatal Mood and Anxiety health and wellness, referrals at least once per program). (E) Disorders (PMAD) and those with o Recognize the connection quarter. (N) • Number and percent of positive screens will be given a between stress and mental enrolled participants that referral to mental health services. health and practice stress have received a referral for reduction techniques, mental, behavioral health, or o Help participants understand substance use treatment. (E) the connection between Page 29 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) physical activity and mental health, o Understand the symptoms of postpartum depression. • Local staff will administer the Edinburgh Postpartum Depression Screen (EPDS)to every participant 6-8 weeks after she gives birth; and • Provide referrals and follow- up to mental health services when appropriate. 4.4 4.4 4.4 4.4 All BIH participants will report an • Assist participants in • List and describe additional • Number and percent of increase in parenting skills and understanding and applying activities that enhance active participants with a bonding with their infants and effective parenting parenting and bonding. (N) birth plan (relative to number other family members. techniques. • Provide of days enrolled in the • Assist participants with anecdotes/participant program). (E) completing home safety success stories about • Number and percent of checklist. improved parenting/bonding active participants with a • Assist participants with with submission of BIH safety checklist(relative to increasing knowledge of Quarterly Reports. number of days enrolled in infant safe sleep practices, • Provide participants with the program). (E) SIDS, Sudden Unexplained health education materials • Number and percent of Infant Death (SUID) risk related to safe sleep enrolled participants that reduction. practices and SIDS reduction. have discussed • Assist participants with • List and describe additional breastfeeding/infant feeding completion of the birth plan activities on infant safe sleep during life planning or case that outlines specific practices/SIDS/SUID risk management meetings. (E) labor/delivery and birthing reduction. (N) • Number and percent of requests to be conveyed to • Provide enrolled participants that their prenatal care provider. anecdotes/participant have received a referral for success stories about infant breastfeeding or lactation. (E) Page 30 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) • Provide participants with safe sleep practices and health education materials SIDS/SUID risk reduction with addressing the benefits of submission of BIH Quarterly breastfeeding. Reports. (N) • Assist participants with • Document collaborative identifying and using bonding activities with State MCAH strategies, including Programs used to identify breastfeeding,with their strategies, provide technical newborns. assistance, and disseminate resource materials that address the benefits of breastfeeding. (N) • Provide anecdotes/participant success stories about breastfeeding practices with submission of BIH Quarterly Reports. (N) Page 31 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Goal 5: Provide interconception health resources intended to decrease risk factors for adverse life course events among Black Birthing people of reproductive age. Evaluation/Performance Measures Intervention Activities to Meet Process,Short and/or Intermediate Measures Short and/or Intermediate Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) 5.1 5.1 5.1 5.1 BIH Coordinator under the • Ensure that participants are • Describe collaborative • Number and percent of guidance and leadership of the enrolled in prenatal care and activities with Text 4 Baby to participants who attend a 4-6 MCAH Director will ensure that all are receiving risk-appropriate deliver health education week postpartum checkup BIH participants are linked to perinatal care. messages to pregnant with a medical provider. (E) services that support timely • Provide participants with women about the prenatal care, postpartum visits health education materials importance of postpartum and well-woman check-ups while and messages including but visits. (N/E) enrolled in the BIH Program. not limited to the importance • Document collaborative of attending prenatal care activities with March of visits; recognizing the signs Dimes (MOD), MotherToBaby and symptoms of preterm and other agencies that labor; safe sleeping practices. provide preterm birth • Provide participants with reduction and health health information that education resources and supports a healthy messaging. (N) pregnancy. • Describe collaborative efforts • Ensure that participants are with local MCAH programs attending postpartum visits and other partners such as and well-woman check-ups Medi-Cal Managed Care and as scheduled. CPSP to identify strategies, • Increase knowledge of and activities and provide facilitate collaboration with technical assistance to local MCAH programs to improve access to health care improve perinatal and post- services and increase partum referral systems for utilization of the postpartum high-risk participants. visit. (N) Page 32 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Goal 6:Assist in reducing Infant morbidity and mortality by decreasing the percentage of preterm births. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objective(s) Objectives (Describe the steps of the (Report on these measures in the Annual Report) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) 6.1 6.1 6.1 6.1 BIH Participants will be provided • Provide participants with • Participate in MOD webinars • Maintain records of staff with strategies and interventions health education materials and trainings that provide attendance at trainings. (N) they can utilize to reduce the that address preterm birth LHJ staff with opportunities • Maintain attendee records of occurrence of preterm births. reduction strategies and to increase their knowledge trainings/Webinars hosted by breastfeeding including those of preterm birth reduction LHJ. (N) from MCAH-BIH and MOD. strategies and other • Maintain a list of local • LHJ staff will distribute any approaches for having a medical providers LHJ staff customized preterm birth healthy pregnancy. (N) distribute preterm birth resources to local medical • Distribute and encourage resources to. (N) providers. MCAH programs to integrate • LHJ staff will support, the following preterm birth promote, and attend preterm resources to educate women birth educational webinars and providers on preventing for medical providers. preterm births: (N) • Increase knowledge of infant o Reducing Preterm Birth: safe sleep practices, SIDS, What Black Women Need to SUID risk reduction by Know Tip Sheet participating in local SIDS o Reducing Premature Birth: collaborative meetings and What Providers Need to trainings. Know Tip Sheet • o Reducing Premature Birth Discussion Points—guidance to encourage conversation with women about preterm birth reduction strategies • Provide participants with health education materials related to safe sleep practices and SIDS reduction. (N) Page 33 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Evaluation/Performance Measures Short and/or Intermediate Intervention Activities to Meet Process,Short and/or Intermediate Measures Objectives (Describe the steps of the (Report on these measures in the Annual Report) Objective(s) intervention) Process Description and Measures Short and/or Intermediate Outcome Measure(s) • Conduct and document collaborative activities with State MCAH Programs used to identify strategies, provide technical assistance, and disseminate resource materials that address the benefits of breastfeeding. (N) Page 34 of 35 Effective 07/01/2022 Agency: Click or tap here to enter text. Fiscal Year: 2023-24 Agreement Number: Click or tap here to enter text. Goal 7:To educate the public about the factors leading to the disparities in Black maternal and infant birth outcomes by providing consistent and culturally responsive information. and promoting enrollment in the California Department of Public Health- Black Infant Health Program (CDPH-BIH). Objectives Activity Evaluation/Deliverables 7.1 7.1 7.1 Create and/or maintain a statewide public Develop public awareness materials that are • Provide a report that describes outreach awareness campaign to inform the State about focus tested with targeted community. engagement plan in the community. African American birth outcome inequities • Share ongoing progress in and/or the root causes of these inequities. developing/maintaining the campaign during quarterly BIH Statewide Media Campaign meetings/reports. • LHJ Program Coordinator to review all staff/contractor/subcontractor deliverables and methodologies to ensure materials: o honor the unique history/traditions of people of African American descent o reflect/include the targeted community o are culturally responsive and engaging o applicable to all Black birthing people, regardless of enrollment status in the CDPH- BIH program • LHJ to share final campaign deliverables and methodologies with the State for final review and approval. 7.2 7.2 7.2 Hire and maintain culturally competent • Maintain culturally competent • Describe process of recruiting and hiring staff/contractors/subcontractors to develop staff/contractors/subcontractors to staff/contractors/subcontractors. campaign materials that are relevant and perform media campaign services that • Include resumes of respectful to the cultural heritage of African honors the unique history/traditions of staff/contractors/subcontractors with American women and the community. people of African American descent submission of AFA packet. • Submit all staff/contractor/subcontractor changes to the State for review Page 35 of 35 Effective 07/01/2022 Agreement Between the County of Fresno and the California Department of Public Health Name/No.: CDPH Maternal, Child and Adolescent Health (MCAH) Division Agreement Funding Application (AFA). Agreement — Agreement No. 202310 MCAH and Agreement No. 202310 Black Infant Health (BIH) Fund/Subclass: 0001/10000 Organization #: 56201700, 56201706 Revenue Account #: 4382, 3530