HomeMy WebLinkAboutAgreement A-16-238 with RDA.pdf
COUNTY OF FRESNO
Fresno, CA
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AGREEMENT
THIS AGREEMENT is made and entered into this _______ day of ________________, 2016,
by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California,
hereinafter referred to as "COUNTY", and RESOURCE DEVELOPMENT ASSOCIATES, a
California For-Profit Corporation, whose address is 230 4th Street, Oakland, California, 94607,
hereinafter referred to as "CONTRACTOR".
W I T N E S S E T H:
WHEREAS, COUNTY, through its Department of Public Health (DPH), is in need of an
independent contractor to provide technical assistance and expertise in comprehensive evaluation and
data analysis regarding infant mortality and morbidity issues for its Public Health Nursing (PHN)
Division; and
WHEREAS, CONTRACTOR, is qualified and is willing to provide such services, pursuant to
the terms and conditions of this Agreement.
NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
hereto agree as follows:
1. RESPONSIBILITIES
A. CONTRACTOR shall perform all services and fulfill all responsibilities as
identified in COUNTY’s Request for Proposal (RFP) No. 918-5350 dated May 7, 2015, Addendum
One (1) to RFP No. 918-5350 dated June 9, 2015, and CONTRACTOR’s Response to said RFP and
Addendum dated June 18, 2015 all incorporated herein by reference and made part of this Agreement.
In the event of any inconsistency among these documents, the inconsistency shall be resolved by
giving precedence in the following order of priority: 1) to this Agreement 2) to the RFP and
Addendum 3) to CONTRACTOR’s Response to RFP. A copy of COUNTY’s RFP No. 918-5350,
Addendum One (1) to RFP No. 918-5350, and CONTRACTOR’s Response shall be retained and
made available during the term of this Agreement by COUNTY’s General Services Department,
Purchasing Division.
B. CONTRACTOR shall perform all services and fulfill all responsibilities
identified in Exhibit A, attached hereto and incorporated herein by this reference.
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C. CONTRACTOR shall assist with monitoring progress toward achieving
performance outcomes, and help to revise outcome measures, as needed by the COUNTY.
D. CONTRACTOR shall be available for conference calls and shall attend meetings
on-site, as needed.
E. CONTRACTOR shall provide technical assistance and consultation to the PHN
Division.
F. CONTRACTOR shall attend the annual Healthy Start grantee meeting, as well as
other federal meetings, if required. These expenses will be paid by the federal Healthy Start grant.
G. CONTRACTOR shall use its own computer equipment to extract data regarding
PHN services from the databases that are maintained on the COUNTY’s server via a virtual private
network connection. COUNTY’s information technology staff will assist the CONTRACTOR to
acquire access.
2. TERM
The term of this Agreement shall be for the period commencing on the 1st day of March
2016 through and including the 31st day of March 2017. This Agreement may be extended for two (2)
additional consecutive twelve (12) month periods upon written approval of both parties no later than
thirty (30) days prior to the first day of the next twelve (12) month extension period. The DPH
Director or his or her designee is authorized to execute such written approval on behalf of COUNTY
based on CONTRACTOR’s satisfactory performance.
3. TERMINATION
A. Non-Allocation of Funds - The terms of this Agreement, and the services to be
provided thereunder, are contingent on the approval of funds by the appropriating government agency.
Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
terminated at any time by giving CONTRACTOR thirty (30) days advance written notice.
B. Breach of Contract - COUNTY may immediately suspend or terminate this
Agreement in whole or in part, where in the determination of COUNTY there is:
1) An illegal or improper use of funds;
2) A failure to comply with any term of this Agreement;
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3) A substantially incorrect or incomplete report submitted to COUNTY;
4) Improperly performed service.
In no event shall any payment by COUNTY constitute a waiver by COUNTY of any
breach of this Agreement or any default which may then exist on the part of CONTRACTOR. Neither
shall such payment impair or prejudice any remedy available to COUNTY with respect to the breach
or default. COUNTY shall have the right to demand of CONTRACTOR the repayment to COUNTY
of any funds disbursed to CONTRACTOR under this Agreement, which in the judgment of COUNTY
were not expended in accordance with the terms of this Agreement. CONTRACTOR shall promptly
refund any such funds upon demand or, at COUNTY’s option, such repayment shall be deducted from
future payments owing to CONTRACTOR under this Agreement.
C. Without Cause - Under circumstances other than those set forth above, this
Agreement may be terminated by COUNTY upon the giving of thirty (30) days advance written notice
of an intention to terminate to CONTRACTOR.
4. COMPENSATION
COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive
compensation for actual hours worked at the hourly rates identified in Exhibit B, attached hereto and
incorporated herein by this reference. In no event shall actual services performed under this
Agreement be in excess of Eighty-Five Thousand and No/100 Dollars ($85,000) during the initial term
of this Agreement; and Thirty Thousand and No/100 Dollars ($30,000) for each subsequent twelve
(12) month extension period of this Agreement.
In no event shall the total maximum compensation for the full term of the Agreement
exceed One Hundred Forty-Five Thousand and No/100 Dollars ($145,000). It is understood that all
expenses incidental to CONTRACTOR's performance of actual services under this Agreement shall be
borne by CONTRACTOR.
Payments by COUNTY shall be in arrears, for services provided during the preceding
month, within forty-five (45) days after receipt and verification of CONTRACTOR's invoices by
COUNTY's DPH. If CONTRACTOR should fail to comply with any provision of this Agreement,
COUNTY shall be relieved of its obligation for further compensation.
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5. INVOICING
CONTRACTOR shall invoice COUNTY monthly, in duplicate, addressed to the County
of Fresno, Department of Public Health, Public Health Nursing, P.O. Box. 11867, Fresno, CA 93775,
Attention: PHN Division Manager. Invoices must include an itemization of services and deliverables
provided during the preceding month, including hours and the cost for each item.
6. INDEPENDENT CONTRACTOR
In performance of the work, duties, and obligations assumed by CONTRACTOR under
this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of
CONTRACTOR's officers, agents, and employees will at all times be acting and performing as an
independent contractor, and shall act in an independent capacity and not as an officer, agent, servant,
employee, joint venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have
no right to control or supervise or direct the manner or method by which CONTRACTOR shall
perform its work and function. However, COUNTY shall retain the right to administer this
Agreement so as to verify that CONTRACTOR is performing its obligations in accordance with the
terms and conditions thereof. CONTRACTOR and COUNTY shall comply with all applicable
provisions of law and the rules and regulations, if any, of governmental authorities having jurisdiction
over matters which are directly or indirectly the subject of this Agreement.
Because of its status as an independent contractor, CONTRACTOR shall have
absolutely no right to employment rights and benefits available to COUNTY employees.
CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its employees
all legally-required employee benefits. In addition, CONTRACTOR shall be solely responsible and
save COUNTY harmless from all matters relating to payment of CONTRACTOR's employees,
including compliance with Social Security, withholding, and all other regulations governing such
matters. It is acknowledged that during the term of this Agreement, CONTRACTOR may be
providing services to others unrelated to the COUNTY or to this Agreement.
7. MODIFICATION
Any matters of this Agreement may be modified from time to time by the written
consent of all the parties without, in any way, affecting the remainder.
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Notwithstanding the above, changes to line items in the budget, attached hereto as
Exhibit B, that do not exceed ten percent (10%) of the maximum compensation payable to the
CONTRACTOR, may be made with the written approval of COUNTY’s DPH Director, or designee.
Said budget line item changes shall not result in any change to the maximum compensation amount
payable to CONTRACTOR, as stated herein.
8. NON-ASSIGNMENT
Neither party shall assign, transfer or subcontract this Agreement nor their rights or
duties under this Agreement without the prior written consent of the other party.
9. HOLD-HARMLESS
CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request,
defend the COUNTY, its officers, agents and employees from any and all costs and expenses,
including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to
COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers,
agents or employees under this Agreement, and from any and all costs and expenses, including
attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to any
person, firm or corporation who may be injured or damaged by the performance, or failure to perform,
of CONTRACTOR, its officers, agents or employees under this Agreement.
10. INSURANCE
Without limiting the COUNTY's right to obtain indemnification from CONTRACTOR
or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect the
following insurance policies throughout the term of this Agreement:
A. Commercial General Liability
Commercial General Liability Insurance with limits of not less than One Million
Dollars ($1,000,000) per occurrence and an annual aggregate of Two Million
Dollars ($2,000,000). This policy shall be issued on a per occurrence basis.
COUNTY may require specific coverage including completed operations,
product liability, contractual liability, Explosion, Collapse, and Underground
(XCU), fire legal liability or any other liability insurance deemed necessary
because of the nature of the Agreement.
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B. Automobile Liability
Comprehensive Automobile Liability Insurance with limits for bodily injury of
not less than Two Hundred Fifty Thousand Dollars ($250,000) per person, Five
Hundred Thousand Dollars ($500,000) per accident and for property damages of
not less than Fifty Thousand Dollars ($50,000), or such coverage with a
combined single limit of Five Hundred Thousand Dollars ($500,000). Coverage
should include owned and non-owned vehicles used in connection with this
Agreement.
C. Professional Liability
If CONTRACTOR employs licensed professional staff (e.g. Ph.D., R.N.,
L.C.S.W., M.F.C.C.) in providing services, Professional Liability Insurance with
limits of not less than One Million Dollars ($1,000,000) per occurrence, Three
Million Dollars ($3,000,000) annual aggregate.
D. Worker's Compensation
A policy of Worker's Compensation Insurance as may be required by the
California Labor Code.
CONTRACTOR shall obtain endorsements to the Commercial General Liability
insurance naming the County of Fresno, its officers, agents, and employees, individually and
collectively, as additional insured, but only insofar as the operations under this Agreement are
concerned. Such coverage for additional insured shall apply as primary insurance and any other
insurance, or self-insurance, maintained by the COUNTY, its officers, agents and employees shall be
excess only and not contributing with insurance provided under the CONTRACTOR's policies herein.
This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance
written notice given to COUNTY.
Within thirty (30) days from the date CONTRACTOR executes this Agreement,
CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of the
foregoing policies, as required herein, to the County of Fresno, Department of Public Health, P.O. Box
11867, Fresno, California, 93775, Attention: Contracts Section – 6th Floor, stating that such insurance
coverage have been obtained and are in full force; that the County of Fresno, its officers, agents and
employees will not be responsible for any premiums on the policies; that such Commercial General
Liability insurance names the County of Fresno, its officers, agents and employees, individually and
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collectively, as additional insured, but only insofar as the operations under this Agreement are
concerned; that such coverage for additional insured shall apply as primary insurance and any other
insurance, or self-insurance, maintained by the COUNTY, its officers, agents and employees, shall be
excess only and not contributing with insurance provided under the CONTRACTOR’s policies herein;
and that this insurance shall not be cancelled or changed without a minimum of thirty (30) days
advance, written notice given to COUNTY.
In the event CONTRACTOR fails to keep in effect at all times insurance coverage as
herein provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate
this Agreement upon the occurrence of such event.
All policies shall be with admitted insurers licensed to do business in the State of
California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating
of A FSC VII or better.
11. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
A. The parties to this Agreement shall be in strict conformance with all applicable
Federal and State of California laws and regulations, including but not limited to Sections 5328,
10850, and 14100.2 et seq. of the Welfare and Institutions Code, Sections 2.1 and 431.300 et seq. of
Title 42, Code of Federal Regulations (CFR), Section 56 et seq. of the California Civil Code, and the
Health Insurance Portability and Accountability Act (HIPAA), including but not limited to Section
1320 D et seq. of Title 42, United States Code (USC) and its implementing regulations, including, but
not limited to Title 45, CFR, Sections 142, 160, 162, and 164, The Health Information Technology for
Economic and Clinical Health Act (HITECH) regarding the confidentiality and security of patient
information, and the Genetic Information Nondiscrimination Act (GINA) of 2008 regarding the
confidentiality of genetic information.
Except as otherwise provided in this Agreement, CONTRACTOR, as a Business
Associate of COUNTY, may use or disclose Protected Health Information (PHI) to perform functions,
activities or services for or on behalf of COUNTY, as specified in this Agreement, provided that such
use or disclosure shall not violate the Health Insurance Portability and Accountability Act (HIPAA),
USC 1320d et seq. The uses and disclosures of PHI may not be more expansive than those applicable
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to COUNTY, as the “Covered Entity” under the HIPAA Privacy Rule (45 CFR 164.500 et seq.),
except as authorized for management, administrative or legal responsibilities of the Business
Associate.
B. CONTRACTOR, including its subcontractors and employees, shall protect, from
unauthorized access, use, or disclosure of names and other identifying information, including genetic
information, concerning persons receiving services pursuant to this Agreement, except where
permitted in order to carry out data aggregation purposes for health care operations [45 CFR Sections
164.504 (e)(2)(i), 164.504 (3)(2)(ii)(A), and 164.504 (e)(4)(i)] This pertains to any and all persons
receiving services pursuant to a COUNTY funded program. This requirement applies to electronic
PHI. CONTRACTOR shall not use such identifying information or genetic information for any
purpose other than carrying out CONTRACTOR’s obligations under this Agreement.
C. CONTRACTOR, including its subcontractors and employees, shall not disclose
any such identifying information or genetic information to any person or entity, except as otherwise
specifically permitted by this Agreement, authorized by Subpart E of 45 CFR Part 164 or other law,
required by the Secretary, or authorized by the client/patient in writing. In using or disclosing PHI that
is permitted by this Agreement or authorized by law, CONTRACTOR shall make reasonable efforts
to limit PHI to the minimum necessary to accomplish intended purpose of use, disclosure or request.
D. For purposes of the above sections, identifying information shall include, but not
be limited to name, identifying number, symbol, or other identifying particular assigned to the
individual, such as finger or voice print, or photograph.
E. For purposes of the above sections, genetic information shall include genetic
tests of family members of an individual or individual, manifestation of disease or disorder of family
members of an individual, or any request for or receipt of, genetic services by individual or family
members. Family member means a dependent or any person who is first, second, third, or fourth
degree relative.
F. CONTRACTOR shall provide access, at the request of COUNTY, and in the
time and manner designated by COUNTY, to PHI in a designated record set (as defined in 45 CFR
Section 164.501), to an individual or to COUNTY in order to meet the requirements of 45 CFR
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Section 164.524 regarding access by individuals to their PHI. With respect to individual requests,
access shall be provided within thirty (30) days from request. Access may be extended if
CONTRACTOR cannot provide access and provides individual with the reasons for the delay and the
date when access may be granted. PHI shall be provided in the form and format requested by the
individual or COUNTY.
CONTRACTOR shall make any amendment(s) to PHI in a designated record set
at the request of COUNTY or individual, and in the time and manner designated by COUNTY in
accordance with 45 CFR Section 164.526.
CONTRACTOR shall provide to COUNTY or to an individual, in a time and
manner designated by COUNTY, information collected in accordance with 45 CFR Section 164.528,
to permit COUNTY to respond to a request by the individual for an accounting of disclosures of PHI
in accordance with 45 CFR Section 164.528.
G. CONTRACTOR shall report to COUNTY, in writing, any knowledge or
reasonable belief that there has been unauthorized access, viewing, use, disclosure, security incident,
or breach of unsecured PHI not permitted by this Agreement of which it becomes aware, immediately
and without reasonable delay and in no case later than two (2) business days of discovery. Immediate
notification shall be made to COUNTY’s Information Security Officer and Privacy Officer and
COUNTY’s DPH HIPAA Representative, within two (2) business days of discovery. The notification
shall include, to the extent possible, the identification of each individual whose unsecured PHI has
been, or is reasonably believed to have been, accessed, acquired, used, disclosed, or breached.
CONTRACTOR shall take prompt corrective action to cure any deficiencies and any action pertaining
to such unauthorized disclosure required by applicable Federal and State Laws and regulations.
CONTRACTOR shall investigate such breach and is responsible for all notifications required by law
and regulation or deemed necessary by COUNTY and shall provide a written report of the
investigation and reporting required to COUNTY’s Information Security Officer and Privacy Officer
and COUNTY’s DPH HIPAA Representative. This written investigation and description of any
reporting necessary shall be postmarked within the thirty (30) working days of the discovery of the
breach to the addresses below:
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County of Fresno County of Fresno County of Fresno
Dept. of Public Health Dept. of Public Health Information Technology Services
HIPAA Representative Privacy Officer Information Security Officer
(559) 600-6439 (559) 600-6405 (559) 600-5800
P.O. Box 11867 P.O. Box 11867 2048 N. Fine Street
Fresno, CA 93775 Fresno, CA 93775 Fresno, CA 93727
H. CONTRACTOR shall make its internal practices, books, and records relating to
the use and disclosure of PHI received from COUNTY, or created or received by the CONTRACTOR
on behalf of COUNTY, in compliance with HIPAA’s Privacy Rule, including, but not limited to the
requirements set forth in Title 45, CFR, Sections 160 and 164. CONTRACTOR shall make its internal
practices, books, and records relating to the use and disclosure of PHI received from COUNTY, or
created or received by the CONTRACTOR on behalf of COUNTY, available to the United States
Department of Health and Human Services (Secretary) upon demand.
CONTRACTOR shall cooperate with the compliance and investigation reviews
conducted by the Secretary. PHI access to the Secretary must be provided during the
CONTRACTOR’s normal business hours, however, upon exigent circumstances access at any time
must be granted. Upon the Secretary’s compliance or investigation review, if PHI is unavailable to
CONTRACTOR and in possession of a Subcontractor, it must certify efforts to obtain the information
to the Secretary.
I. Safeguards
CONTRACTOR shall implement administrative, physical, and technical
safeguards as required by the HIPAA Security Rule, Subpart C of 45 CFR 164, that reasonably and
appropriately protect the confidentiality, integrity, and availability of PHI, including electronic PHI,
that it creates, receives, maintains or transmits on behalf of COUNTY and to prevent unauthorized
access, viewing, use, disclosure, or breach of PHI other than as provided for by this Agreement.
CONTRACTOR shall conduct an accurate and thorough assessment of the potential risks and
vulnerabilities to the confidential, integrity and availability of electronic PHI. CONTRACTOR shall
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develop and maintain a written information privacy and security program that includes administrative,
technical and physical safeguards appropriate to the size and complexity of CONTRACTOR’s
operations and the nature and scope of its activities. Upon COUNTY’s request, CONTRACTOR shall
provide COUNTY with information concerning such safeguards.
CONTRACTOR shall implement strong access controls and other security
safeguards and precautions in order to restrict logical and physical access to confidential, personal
(e.g., PHI) or sensitive data to authorized users only. Said safeguards and precautions shall include the
following administrative and technical password controls for all systems used to process or store
confidential, personal, or sensitive data:
1. Passwords must not be:
a. Shared or written down where they are accessible or recognizable
by anyone else; such as taped to computer screens, stored under keyboards, or visible in a work area;
b. A dictionary word; or
c. Stored in clear text
2. Passwords must be:
a. Eight (8) characters or more in length;
b. Changed every ninety (90) days;
c. Changed immediately if revealed or compromised; and
d. Composed of characters from at least three (3) of the following
four (4) groups from the standard keyboard:
1) Upper case letters (A-Z);
2) Lowercase letters (a-z);
3) Arabic numerals (0 through 9); and
4) Non-alphanumeric characters (punctuation symbols).
CONTRACTOR shall implement the following security controls on each
workstation or portable computing device (e.g., laptop computer) containing confidential, personal, or
sensitive data:
1. Network-based firewall and/or personal firewall;
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2. Continuously updated anti-virus software; and
3. Patch management process including installation of all operating
system/software vendor security patches.
CONTRACTOR shall utilize a commercial encryption solution that has received
FIPS 140-2 validation to encrypt all confidential, personal, or sensitive data stored on portable
electronic media (including, but not limited to, compact disks and thumb drives) and on portable
computing devices (including, but not limited to, laptop and notebook computers).
CONTRACTOR shall not transmit confidential, personal, or sensitive data via e-
mail or other internet transport protocol unless the data is encrypted by a solution that has been
validated by the National Institute of Standards and Technology (NIST) as conforming to the
Advanced Encryption Standard (AES) Algorithm. CONTRACTOR must apply appropriate sanctions
against its employees who fail to comply with these safeguards. CONTRACTOR must adopt
procedures for terminating access to PHI when employment of employee ends.
J. Mitigation of Harmful Effects
CONTRACTOR shall mitigate, to the extent practicable, any harmful effect that
is suspected or known to CONTRACTOR of an unauthorized access, viewing, use, disclosure, or
breach of PHI by CONTRACTOR or its subcontractors in violation of the requirements of these
provisions. CONTRACTOR must document suspected or known harmful effects and the outcome.
K. CONTRACTOR’s Subcontractors
CONTRACTOR shall ensure that any of its contractors, including
subcontractors, if applicable, to whom CONTRACTOR provides PHI received from or created or
received by CONTRACTOR on behalf of COUNTY, agree to the same restrictions, safeguards, and
conditions that apply to CONTRACTOR with respect to such PHI and to incorporate, when
applicable, the relevant provisions of these provisions into each subcontract or sub-award to such
agents or subcontractors.
L. Employee Training and Discipline
CONTRACTOR shall train and use reasonable measures to ensure compliance
with the requirements of these provisions by employees who assist in the performance of functions or
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activities on behalf of COUNTY under this Agreement and use or disclose PHI and discipline such
employees who intentionally violate any provisions of these provisions, including termination of
employment.
M. Termination for Cause
Upon COUNTY’s knowledge of a material breach of these provisions by
CONTRACTOR, COUNTY shall either:
1. Provide an opportunity for CONTRACTOR to cure the breach or end the
violation and terminate this Agreement if CONTRACTOR does not cure the breach or end the
violation within the time specified by COUNTY; or
2. Immediately terminate this Agreement if CONTRACTOR has breached a
material term of these provisions and cure is not possible.
3. If neither cure nor termination is feasible, the COUNTY’s Privacy
Officer shall report the violation to the Secretary of the U.S. Department of Health and Human
Services.
N. Judicial or Administrative Proceedings
COUNTY may terminate this Agreement in accordance with the terms and
conditions of this Agreement as written hereinabove, if: (1) CONTRACTOR is found guilty in a
criminal proceeding for a violation of the HIPAA Privacy or Security Laws or the HITECH Act; or (2)
there is a finding or stipulation that the CONTRACTOR has violated a privacy or security standard or
requirement of the HITECH Act, HIPAA or other security or privacy laws in an administrative or civil
proceeding in which the CONTRACTOR is a party.
O. Effect of Termination
Upon termination or expiration of this Agreement for any reason,
CONTRACTOR shall return or destroy all PHI received from COUNTY (or created or received by
CONTRACTOR on behalf of COUNTY) that CONTRACTOR still maintains in any form, and shall
retain no copies of such PHI. If return or destruction of PHI is not feasible, it shall continue to extend
the protections of these provisions to such information, and limit further use of such PHI to those
purposes that make the return or destruction of such PHI infeasible. This provision shall apply to PHI
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that is in the possession of subcontractors or agents, if applicable, of CONTRACTOR. If
CONTRACTOR destroys the PHI data, a certification of date and time of destruction shall be
provided to the COUNTY by CONTRACTOR.
P. Disclaimer
COUNTY makes no warranty or representation that compliance by
CONTRACTOR with these provisions, the HITECH Act, HIPAA or the HIPAA regulations will be
adequate or satisfactory for CONTRACTOR’s own purposes or that any information in
CONTRACTOR’s possession or control, or transmitted or received by CONTRACTOR, is or will be
secure from unauthorized access, viewing, use, disclosure, or breach. CONTRACTOR is solely
responsible for all decisions made by CONTRACTOR regarding the safeguarding of PHI.
Q. Amendment
The parties acknowledge that Federal and State laws relating to electronic data security
and privacy are rapidly evolving and that amendment of these provisions may be required to provide
for procedures to ensure compliance with such developments. The parties specifically agree to take
such action as is necessary to amend this agreement in order to implement the standards and
requirements of HIPAA, the HIPAA regulations, the HITECH Act and other applicable laws relating
to the security or privacy of PHI. COUNTY may terminate this Agreement upon thirty (30) days
written notice in the event that CONTRACTOR does not enter into an amendment providing
assurances regarding the safeguarding of PHI that COUNTY in its sole discretion, deems sufficient to
satisfy the standards and requirements of HIPAA, the HIPAA regulations and the HITECH Act.
R. No Third-Party Beneficiaries
Nothing express or implied in the terms and conditions of these provisions is
intended to confer, nor shall anything herein confer, upon any person other than COUNTY or
CONTRACTOR and their respective successors or assignees, any rights, remedies, obligations or
liabilities whatsoever.
S. Interpretation
The terms and conditions in these provisions shall be interpreted as broadly as
necessary to implement and comply with HIPAA, the HIPAA regulations and applicable State laws.
COUNTY OF FRESNO
Fresno, CA
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The parties agree that any ambiguity in the terms and conditions of these provisions shall be resolved
in favor of a meaning that complies and is consistent with HlPAA and the HIPAA regulations.
T. Regulatory References
A reference in the terms and conditions of these provisions to a section in the
HIPAA regulations means the section as in effect or as amended.
U. Survival
The respective rights and obligations of CONTRACTOR as stated in this Section
shall survive the termination or expiration of this Agreement.
V. No Waiver of Obligations
No change, waiver or discharge of any liability or obligation hereunder on any one or more occasions
shall be deemed a waiver of performance of any continuing or other obligation, or shall prohibit
enforcement of any obligation on any other occasion.
12. NON-DISCRIMINATION
During the performance of this Agreement, CONTRACTOR shall not unlawfully
discriminate against any employee or applicant for employment, or recipient of services, because of
race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical
condition, genetic information, marital status, sex, gender, gender identity, gender expression, age,
sexual orientation, or military and veteran status, pursuant to all applicable State of California and
Federal statutes and regulations.
13. REPORTS
CONTRACTOR shall prepare and submit to COUNTY reports as required to fulfill the
services described in Paragraph One (1) of this Agreement. Said reports, as specified in the Scope of
Work – Exhibit A, shall include data related to performance outcome measures, activities, and services
performed toward meeting the evaluation component of the COUNTY’s Babies First program, a PHN
Division program. All said reports/documents shall become the property of the COUNTY.
14. PROPERTY OF COUNTY
COUNTY shall makes available (in a timely manner) to CONTRACTOR records by
CONTRACTOR to fulfill CONTRACTOR’s obligations, pursuant to the terms and conditions of the
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Fresno, CA
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Agreement. Said records are to be inspected/used by CONTRACTOR at COUNTY’s facilities and
shall be maintained in a confidential and locked manner. Said records shall remain the property of the
COUNTY.
Any documents provided by the COUNTY to the CONTRACTOR during performance
of this Agreement shall be returned to the COUNTY by the CONTRACTOR upon the expiration or
termination of this Agreement.
15. COMPLIANCE WITH FEDERAL REQUIREMENTS
CONTRACTOR recognizes that COUNTY operates its DPH Babies First program
under an Agreement with the United States Health Resources and Services Administration, U.S.
Department of Health and Human Services, Maternal and Child Health Bureau, Grant No.
H49MC00150, incorporated herein by reference; and that under said Agreement the Federal
government imposes certain requirements on COUNTY and its subcontractors. Therefore,
CONTRACTOR shall adhere to the Federal requirements identified in said Agreement. COUNTY
shall make available to CONTRACTOR a copy of said Agreement upon request.
16. AUDITS AND INSPECTIONS
CONTRACTOR shall at any time during business hours, and as often as the COUNTY
may deem necessary, make available to the COUNTY for examination all of its records and data with
respect to the matters covered by this Agreement. CONTRACTOR shall, upon request by the
COUNTY, permit the COUNTY to audit and inspect all such records and data necessary to ensure
CONTRACTOR's compliance with the terms of this Agreement.
If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00),
CONTRACTOR shall be subject to the examination and audit of the State Auditor for a period of
three (3) years after final payment under contract (Government Code Section 8546.7).
17. NOTICES
The persons and their addresses having authority to give and receive notices under this
Agreement include the following:
///
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COUNTY OF FRESNO
Fresno, CA
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COUNTY CONTRACTOR
Director, County of Fresno Patricia Marrone Bennet, Ph. D., CEO
Department of Public Health Resource Development Associates
P.O. Box 11867 230 4th Street
Fresno, CA 93775 Oakland, CA 94607
Any and all notices between the COUNTY and the CONTRACTOR provided for or
permitted under this Agreement or by law shall be in writing and shall be deemed duly served when
personally delivered to one of the parties, or in lieu of such personal service, when deposited in the
United States Mail, postage prepaid, addressed to such party.
18. GOVERNING LAW
The parties agree, that for the purposes of venue, performance under this Agreement is
to be in Fresno County, California.
The rights and obligations of the parties and all interpretation and performance of this
Agreement shall be governed in all respects by the laws of the State of California.
19. SEVERABILITY
The provisions of this Agreement are severable. The invalidity or unenforceability of
any one provision in the Agreement shall not affect the other provisions.
20. ENTIRE AGREEMENT
This Agreement, including all Exhibits, COUNTY’s RFP No. 918-5350, Addendum
One (1) to RFP No. 918-5350, and CONTRACTOR’s Response thereto, constitutes the entire
Agreement between the CONTRACTOR and COUNTY with respect to the subject matter hereof and
supersedes all previous Agreement negotiations, proposals, commitments, writings, advertisements,
publications, and understanding of any nature whatsoever unless expressly included in this
Agreement.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
year first hereinabove written.
CONTRACTOR:
RESOURCE DEVELOPMENT ASSOCIATES
By 7t£:
PatriciaMarrone Bennet, Ph. D.
President and CEO
Date: '3/2 312o I&
Print Name: L-1S f1 fO~-M V\ vvcN
Title: OVD
Secretary (of Corporation), or
any Assistant Secretary, or
Chief Financial Officer, or
any Assistant Treasurer
Date: 3 {2 3\t ~
I
Mailing Address:
230 4th Street
Oakland, CA 94607
Phone#: (510) 488-4345
Fax#: (510) 444-1434
Contact: Patricia Marrone Bennet, Ph.D., CEO
-18 -
COUNTY OF FRESNO:
Date: ('{\ <2vu 8-L\ 1 d-.0 I U>
I
BERNICE E. SEIDEL, Clerk
Board of Supervisors
By ~SOvn fusb ~ , fu e p~
Date : (Y\ ~ d-. L\ ., ~D llo
PLEASE SEE ADDITIONAL
SIGNATURE PAGE ATTACHED
COUN1Y OF FRESNO
Fresno, CA
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APPROVED AS TO LEGAL FORM:
DAN,IEL C. CEDERBORG, COUNTY COUNSEL
APPROVED AS TO ACCOUNTING FORM:
VICKI CROW, C.P.A., AUDITOR-CONTROLLER/
TREASURER-TAX COLLECTOR
REVIEWED AND RECOMMENDED FOR APPROVAL:
By J);tg(!
David Pomav ille, Director
Department of Public Health
Fund/Subclass:
Organization:
Account #:
ax
0001 /10000
56201748 ($85,000 .00)
56201 706 ($60,000.00)
7295
-19 -COUNTY OF FRESNO
F res no, CA
County of Fresno
RFP 918-5350 – PHN Division Program Evaluator
Prepared by RESOURCE DEVELOPMENT ASSOCIATES March 18, 2016 | 1
Scope of Work
Evaluation Approach
The Fresno County Public Health Department’s Public Health Nursing Division (PHN) administers the
Fresno Babies First program to prevent infant mortality and eliminate disparities in perinatal health by
funding local programs in high-needs communities. The program, funded by the Health Resources and
Services Administration’s (HRSA) Healthy Start initiative, works in target neighborhoods to provide direct
client services to expecting mothers and families. To support this effort, RDA will design and implement a
quality improvement (QI) plan and outcomes evaluation to demonstrate and document measurable
progress toward achieving program goals, which are mapped to local needs and national performance
objectives. The evaluation findings and QI efforts will serve to inform potential program improvements
throughout the three-year project period. Outlined below, RDA’s approach to delivering these services
centers on the provision of support through evaluation and QI plan development, tool refinement,
training and TA, data analysis and reporting.
At RDA, we believe that the function of evaluation is to strengthen the abilities of public agencies and
service providers to fulfill their missions and serve their communities. RDA believes that evaluation and
assessment are powerful tools that help public agencies offer better services with increased efficiency.
We collect, analyze, and report both qualitative and quantitative data in order to provide a comprehensive
and comprehensible picture of the impact programs and services are having on different constituencies
and goals. As such, we will implement a mixed methods approach to evaluation that integrates
stakeholder perspectives with quantitative rigor as a way of maximizing validity, triangulating findings,
and providing different perspectives on complex, multi-dimensional issues.
Based on our experience with providing evaluation services to Fresno’s Babies First and MCAH programs,
RDA brings knowledge of existing data sources, organizational resources, as well as an understanding of
current and past challenges to this effort. The evaluation strategies adopt and build on evaluation
activities that are currently in process. With these objectives in mind, and by drawing from the lessons
learned from our past evaluation efforts, the RDA team will:
Develop a work plan that builds on existing evaluation activities.
Provide planning services related to existing data collection and evaluation strategies.
Streamline and adapt developed tools as appropriate to support evaluation efforts.
Support program monitoring and data collection through TA and training.
Provide analysis of data for the purposes of reporting.
Provide required reports according to defined timelines and federal requirements.
Communicate with program staff at regular intervals.
Exhibit ARDA
County of Fresno
RFP 918-5350 – PHN Division Program Evaluator
Prepared by RESOURCE DEVELOPMENT ASSOCIATES March 18, 2016 | 2
Work Plan
Identification of Key Personnel. RDA’s collaborative approach ensures that individuals with the greatest
knowledge and skills are selected to benefit the project. The proposed project team brings significant
experience planning and conducting public health evaluations and previously worked together on the
most recent Fresno Babies First evaluation project. Dr. Banthia will serve as project manager for this
evaluation and be responsible for implementation and all deliverables. She will oversee day-to-day project
activities, tasks, and team and client communications. The evaluation will be supported by a Research
Associate who will provide quantitative and qualitative data analysis, report writing, and TA support to
program staff. Mr. Ennis, who has extensive experience working with the County’s MIS system, will
provide technical support regarding MIS database development and maintenance and work with Fresno
County’s Information Technology staff to ensure access to necessary databases is obtained. The project
team will be supported by Nishi Moonka, Managing Director, who will provide oversight to the project.
Communication Plan. RDA is committed to consistent communication with program staff. As such, our
communication practices maximize efficiency by leveraging state of the art communications tools such as
Web X and videoconference technology as a means of closing the distance between the Bay Area and
Fresno. In addition to the proposed activities below, the project manager will participate in ongoing
phone/email communications to discuss progress and problem solve any technical issues that arise. RDA
will engage in the following communication activities:
Project Kickoff Meeting: Within the first month of the project, RDA will facilitate an evaluation
kickoff meeting with key division staff. The objectives of this meeting will be to: 1) make
introductions; 2) refine the evaluation’s goals and objectives; 3) review the proposed work plan
and timeline for key activities; and 4) establish communication protocols for the project.
o Output 1: After the initial kickoff meeting, RDA will provide Fresno PHN with meeting
notes and debrief to ensure project understanding. RDA will also finalize the proposed
work plan and timelines for key activities, deliverables, and reporting.
Annual Site Visit: RDA proposes one annual site visit. In addition to serving as an opportunity for
the project team and key program staff to meet in person, the site visit will include one program
participant focus group and a training session to fit TA needs as identified in each project year.
o Output 2: After the site visit, RDA will synthesize what was learned and share notes and
action items with Fresno PHN.
Conference Calls: Our extensive experience working remotely with clients informs our ability to
effectively connect with clients. We will facilitate monthly conference calls as well as participate
in quarterly Healthy Start technical assistance calls.
o Output 3: RDA will send agendas and share meeting minutes to synthesize the
meetings/calls.
Exhibit ARD A
Identification of Key Personnel and Communication Plan
County of Fresno
RFP 918-5350 – PHN Division Program Evaluator
Prepared by RESOURCE DEVELOPMENT ASSOCIATES March 18, 2016 | 3
RDA will support the PHN division in developing and implementing a comprehensive quality improvement
plan that supports the County’s capacity to continually enhance their programs. Our aim is to support
Fresno Babies First in developing processes and practices that will mitigate potential data and reporting
issues. The QI Plan will leverage the County’s current MIS data system to collect and use data for quality
improvement purposes. RDA will work collaboratively with the County to identify specific QI aims,
measures, and activities that ensure compliance with federal Healthy Start performance indicators and
reporting requirements. RDA will assist the County in defining goals and objectives for QI activities, as well
as provide TA on how to best enhance existing program capacity to measure program progress through
data analysis and reporting. RDA will also assist Fresno PHN as they migrate to the new electronic health
record and help with testing the new system. The kick-off meeting will initiate the QI planning process,
and provide an opportunity for RDA to seek answers to a set of questions related to development of the
QI plan. Based on our familiarity with both personnel and data sources, RDA will seek to answer questions
essential to program continuation.
Output 4: Once these questions are answered, RDA will provide TA and support to the program to create
and implement a QI plan that builds on current data collection and reporting capacity. Specifically, RDA
will provide TA and training to support the program to engage in activities such as: 1) refining the data
entry process flow and associated roles and responsibilities, including protocols with timeframes for
nurses to use in accurately gathering data, administering tools, and submitting data for entry; 2) revising
or amending reporting templates based on current needs or changes in reporting requirements; and 3)
implementing data cleaning procedures and quality assurance measures. The QI plan will be revisited as
needed during the project period.
RDA recognizes that Babies First seeks to further develop internal capacity to efficiently report on the
measurable progress made in relation to national performance indicators and the program’s goals and
objectives. As such, we will work with Babies First and MCAH program leadership and staff to confirm the
previously defined performance measures. We will refine evaluation goals and objectives to ensure that
performance and outcome measures are in line with current program goals and benchmarks.
Furthermore, RDA will work with program staff to confirm the key questions and hypotheses related to
this evaluation effort. To support PHN in developing appropriate and targeted evaluation strategies, RDA
will review data collection tools, work to enhance existing tools, and support data input and collection
processes. Additionally, RDA will review and confirm reporting requirements and deliverable timelines
based on funders’ requirements. The proposed comprehensive evaluation of outcomes will serve to
inform the understanding of how implemented program strategies contributed to the achievement of the
stated goals and objectives of the Babies First program. RDA will complete required reporting based on
the following three primary data collection and analysis strategies:
Participant Survey: The collection of essential information regarding participant satisfaction and
program effectiveness will be supported through the implementation of a streamlined survey
Exhibit ARDA
Quality Improvement Plan
Evaluation Activities and Outputs
County of Fresno
RFP 918-5350 – PHN Division Program Evaluator
Prepared by RESOURCE DEVELOPMENT ASSOCIATES March 18, 2016 | 4
tool. The survey, to be designed based on previous evaluation tools, will be administered by
program staff during home visits. Surveys will take no longer than 15 minutes to complete to
minimize participant and staff burden. Surveys will be administered at regular intervals for every
program participant and provide key information on participant behavior changes and
perceptions of program effectiveness.
o Output 5: RDA will develop a streamlined evaluation tool based on review of previous
tools such as the Interconception Care tool and PHFQ. This new tool will ensure that RDA
and PHN has the information needed to meet evaluation and reporting requirements.
RDA will also provide training to nurses on the new tool to help ensure effective
implementation.
Participant Focus Group: To gather in-depth qualitative data about attitudes, beliefs, and
behaviors related to program interventions, RDA will conduct one participant focus group during
the annual site visit for each year of the project. The focus group protocol, based on a previously
implemented tool, will include questions geared towards understanding participants’ program
experience. Trained RDA staff will moderate the focus group. Each group will include no more
than 10 participants and be audio-recorded pending permission
o Output 6: RDA will develop a focus group tool that aims to improve our understanding of
women’s attitudes, beliefs, and behaviors about the PHN programs. RDA will use this
information to supplement the information gathered from the above survey.
Management Information System (MIS): Thorough analysis of participant data collected using
MIS is essential to understanding program impact and outcomes. RDA will support the Division to
ensure that data collected in MIS is in alignment with evaluation objectives and mapped to
national performance and outcome measures.
o Output 7: RDA will provide TA to the program to support the incorporation of the
participant survey into the MIS data collection system to ensure all necessary data are
captured and incorporated into annual Healthy Start monitoring as appropriate. In
addition, RDA will analyze data from MIS to meet evaluation and reporting requirements.
RDA understands that successful program evaluations hinge on the commitment to both meaningful and
consistent data collection and rigorous data analysis to ensure that programs are meeting their objectives
and providing meaningful services that increase positive outcomes for their target populations. RDA brings
significant experience conducting thorough analyses using multiple data sources to support meaningful
reporting on program performance on specified benchmarks and outcome goals. RDA will engage in a
number of analysis activities using information collected by program staff during evaluation activities,
including data from the streamlined survey tool, MIS, and participant focus group. Specific data analysis
activities to support program reporting include:
Survey and MIS data analysis: RDA will analyze survey and MIS data provided by Babies First
program staff to determine both short- and long-term program benefits, including impact on
family functioning, infant mortality, client’s access to preventative care services, birth weight, and
Exhibit ARDA
Healthy Start Evaluation Report
County of Fresno
RFP 918-5350 – PHN Division Program Evaluator
Prepared by RESOURCE DEVELOPMENT ASSOCIATES March 18, 2016 | 5
other performance measures that are included in Healthy Start program requirements. Analyses
of quantitative survey and MIS data will be conducted using SPSS.
Qualitative data analysis: RDA will use data gathered during the client focus group to enhance
the findings gleaned through quantitative analysis of program and survey data. Qualitative data
from the focus group will be analyzed using the notes taken by moderators. RDA will conduct a
conceptual analyses of qualitative data to determine the presence of salient concepts for each
question. RDA will triangulate findings from the quantitative and qualitative data analyses to
highlight and synthesize results.
Output 8: The data analysis activities will contribute to the development of the Healthy Start Annual
Evaluation Report, which will be completed to the specifications and requirements of federal reporting
guidelines and using the Healthy Start evaluation report template. In addition to reporting on the
indicators described above, the evaluation report will examine promising and best practices in
implementation, the obstacles encountered by the Babies First project during implementation, and the
factors associated with program fidelity. The report will provide policy, program, practice, and other
pertinent recommendations as appropriate and necessary to promote continuous program improvement
and systemic change.
Output 9: In addition to the annual evaluation report, RDA will prepare an annual summary of evaluation
activities. The evaluation summary will include a brief description of evaluation strategies and activities
undertaken to address the identified program needs and achieve national and local performance
objectives. The summary will also describe ongoing evaluation activities to gather information from
participants and to evaluate program implementation. The summary will detail any recommended
changes to evaluation tools, as well as the results of any modifications that have been implemented,
including a description of the streamlined data collection tool, ongoing training and TA to support
successful data collection, and implementation of the QI plan and quality assurance process.
RDA will provide TA to the program in regards to additional data and reporting requests by the Federal or
State government, County, PHN Division, and other programs as permitted by the project budget. We will
also participate in the following additional activities.
A. Healthy Start Grantee Meeting: RDA will support the Fresno Babies First program administrator
by attending annual healthy start grantee conferences for each year of the project period.
B. Coordination with Healthy Start National Evaluator: RDA will consult and coordinate evaluation
activities with the Healthy Start national evaluator as appropriate.
C. Healthy Start TA Calls/Webinars: RDA will participate in Healthy Start related TA calls and/or
webinars during each year of the project period as directed by program administrators.
Exhibit ARDA
Additional Data and Reporting Support
County of Fresno
Scope of Work
Prepared by RESOURCE DEVELOPMENT ASSOCIATES February 2016 | 6
PHN Division Evaluation Scope of Work
Year 1: March 1, 2016 to March 31, 2017
Resource Development Associates (RDA) will provide the following services according to the schedule provided below while allowing for flexibility to adapt to
emerging needs.
Project Activities Managing
Director
($200/ hr)
Project
Manager
($175/ hr)
IT
Director
($150/ hr)
Program
Associate
($150/ hr)
Total
Cost
Communications Activities
Project kickoff meetings (2 days for work planning with staff and data leads) 16 24 $7,400
Client communications, preparation, and follow-up (phone, videoconference, and email as
needed to monitor progress) 10 10 $3,250
Federal grantee meeting (travel paid by Fresno County; Fall 2016) 34 $5,950
Healthy Start technical assistance calls (quarterly) 4 $600
Site visits (2 days total for staff meetings, focus group, technical assistance, and training) 18 30 $7,650
Evaluation Activities
Review of program documents, data processes, and new evaluation/ reporting requirements 2 4 14 $3,050
Evaluation planning/refinement of goals and objectives (includes review of pertinent
assessment processes, evaluation opportunities, and benchmark data progress) 4 16 $3,100
Development/implementation of new evaluation activities 4 16 $3,100
Revision of report templates/forms to reflect new requirements and expand reporting
capacity 4 4 $1,300
Technical assistance 10 2 10 $3,550
Protocol revision (participant survey, focus group tool, MIS) to ensure alignment with
program outcomes and quality improvement efforts 3 6 $1,425
Focus group preparation/data analysis (1) 1 8 $1,375
Analysis of MIS, survey, and case review form data 4 50 $8,200
Annual report 8 32 $6,200
Annual evaluation summary 1 4 $775
Support for publication development 3 7 $1,575
Quality Improvement Activities
Exhibit ARDA
County of Fresno
Scope of Work
Prepared by RESOURCE DEVELOPMENT ASSOCIATES February 2016 | 7
Quality improvement planning (including establishment of PDSA cycles, monitoring of
benchmark data progress, and identification of opportunities) 4 16 $3,100
System updates (e.g. addition of quality assurance queries) 2 8 $1,550
Staff training webinar/video on data collection requirements 3 7 $1,575
Revision of standardized and performance report templates/ forms to reflect new
requirements and expand reporting capacity 4 4 $1,300
Technical assistance 10 2 10 $3,550
Other Direct Costs
Project management/internal meetings 10 60 2 10 $14,300
Travel (2 staff) $1,125
Grand Total 26 213 18 258 $85,000
Years 2-3: April 1, 2017 to March 31, 2019 (Annual Cost)
Project Activities Project
Manager
($175/ hr)
IT
Director
($150/ hr)
Program
Associate
($150/ hr)
Total
Cost
Communications Activities
Client communications, preparation, and follow-up (phone, videoconference, and email as needed to
monitor progress) 12 12 $3,900
Federal grantee meeting (travel paid by Fresno County) 32 $4,800
Site visit (including staff meetings, focus group, technical assistance, and training) 11 16 $4,325
Evaluation Activities
Focus group preparation/data analysis (1) 1 8 $1,375
Data analysis 1 10 $1,675
Annual report 4 20 $3,700
Annual evaluation summary 1 2 $475
Other Direct Costs
IT support 5 $750
Project management/internal meetings 12 46 $9,000
Grand Total 42 5 146 $30,000
Exhibit ARDA
Exhibit B
PHN Division Evaluation Budget
March 01, 2016 through March 31, 2017
RDA Personnel Cost Distribution PHN Programs Evaluation
Resource Development Associates Staff Hours Hourly Rate Total
Managing Director 26 $200 $5,200
Project Manager 213 $175 $37,275
IT Director 18 $150 $2,700
Program Associate 258 $150 $38,700
Total Personnel Costs $83,875
Total Non-Personnel Costs (Travel) $1,125
Total Costs $85,000
April 1, 2017 through March 31, 2019
Annual Costs
RDA Personnel Cost Distribution PHN Programs Evaluation
Resource Development Associates Staff Hours Hourly Rate Total
Managing Director 0 $200 $0
Project Manager 42 $175 $7,350
IT Director 5 $150 $750
Program Associate 146 $150 $21,900
Total Personnel Costs $30,000
Total Non-Personnel Costs (Travel) $0
Total Costs $30,000