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HomeMy WebLinkAboutAgreement A-15-397-1 with California Dept. of Public Health.pdfCounty of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 1 of 55 57 1. Service Overview Pursuant to California Health and Safety Code Sections 131050-131135 and 104100-104140 respectively, Contractor will provide services to local communities with populations at high risk for diabetes and cardiovascular disease (CVD) who are 18 years and older. The services provided will result in increasing knowledge, skills and opportunities to improve diet, physical activity, and other life habits to prevent, delay or control diabetes, CVD and other chronic diseases Centers for Disease Control and Prevention (CDC) funding awarded to the California Department of Public Health (CDPH) for Contractor Local Assistance is for Lifetime of Wellness: Communities in Action interventions and include required strategies as described in the Scope of Work. 2. CDPH Responsibilities CDPH will be responsible for overall programmatic oversight for implementation of the activities designed to address the risk of diabetes and CVD. 3. Service Location The services shall be performed in the County of Fresno as prescribed in the Scope of Work. 4. Service Hours The services shall be provided during normal Contractor working days and hours, excluding national and state holidays. 5. Project Representatives A. The project representatives during the term of this agreement will be: California Department of Public Health Majel Arnold, Janet Bates, Acting Chief, Programs and Policy Section Chronic Disease Control Branch Telephone: (916) 322-5336 552-9900 Fax: (916) 552-9729 Email: Majel.Arnold cdcb@cdph.ca.gov County of Fresno Sara Bosse, Program Manager Office of Policy, Planning and Communication Department of Public Health Telephone: (559) 600-6449 Fax: (559) 600-7687 Email: sbosse@co.fresno.ca.us County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 2 of 55 57 B. Direct all inquiries to: California Department of Public Health Chronic Disease Control Branch Attention: Lisa Pulido 1616 Capitol Avenue P.O. Box 997377, MS 7208 Sacramento, CA 95899-7377 Telephone: (916) 552-9948 Fax: (916) 552-9927 Email: lisa.pulido@cdph.ca.gov County of Fresno Sara Bosse, Program Manager Office of Policy, Planning and Communication Department of Public Health Telephone: (559) 600-6449 Fax: (559) 600-7687 Email: sbosse@co.fresno.ca.us C. Either party may make changes to the information above by giving written notice to the other party. Said changes shall not require an amendment to this agreement. 6. Reporting A. The Contractor shall submit one original Performance Report semi-annually to CDPH in the format prescribed by the State. The Performance Reports shall describe advancement made in completing agreement deliverables. B. Per the Consolidated Appropriations Act of 2014, Prevention and Public Health Fund (PPHF) summary reporting is required semiannually. The Contractor shall submit one original PPHF Summary Report semi-annually to CDPH in the format prescribed by the State. The PPHF Summary Reports shall provide a brief summary of reporting period activities, including subsections for all subcontractor activities, and an estimated percentage of total goals reached. C. Contractor shall submit one original Comprehensive Final report within 30 days after the end of the contract. The final report shall include, at a minimum: 1) lessons learned on implementing action items; 2) main challenges and how the challenges were addressed; 3) key partners and their roles; 4) if activities related to the implementation of deliverables will continue and if so, what activities are planned. D. Report periods and due dates: Report Report Period Due Date Year 1: Performance Report 03/01/15-07/31/15 07/06/15 PPHF Summary 03/01/15-06/30/15 07/06/15 Year 2: Performance Report I 08/01/15-01/31/16 01/15/16 PPHF Summary I 07/01/15-12/31/15 11/15/15 Performance Report II 02/01/16-07/31/16 07/15/16 PPHF Summary II 01/01/16-06/30/16 05/15/16 County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 3 of 55 57 Report Report Period Due Date Year 3: Performance Report I 08/01/16-01/31/17 01/15/17 PPHF Summary I 07/01/16-12/31/16 11/15/16 Performance Report II 02/01/17-07/31/17 07/15/17 PPHF Summary II 01/01/17-06/30/17 05/15/17 Year 4: Performance Report I 08/01/17-01/31/18 01/15/18 PPHF Summary I 07/01/17-12/31/17 11/15/17 Performance Report II 02/01/18-07/31/18 07/15/18 PPHF Summary II 01/01/18-06/30/18 05/15/18 Comprehensive Final 09/30/14-09/30/18 10/30/18 09/29/18 E. Copies of items specified in the scope of work as a Deliverable must be submitted to CDPH concurrently with the semiannual Performance Reports. F. If the State does not receive complete and accurate reports by the required dates, further payments to the Contractor may be suspended until complete and accurate reports are received. Contractor’s last monthly and/or final invoice will not be processed until an acceptable Comprehensive Final Report has been received and approved by the State., due no later than 30 days after contract end. G. Upon the evaluation of the contractor’s performance, the State may at its discretion terminate this Agreement or decrease the funding allocation to Contractor if insufficient screening volume and/or delivery of program services are not met as outlined in the Exhibit A, Scope of Work. 7. Subcontractor Requirements Contractor will implement a competitive bid process for subcontracts $2,500 and over. All subcontracting must comply with the requirements of the State Contracting Manual, Sections 3.06.D and 3.17.2.D, as applicable. 8. Services to be Performed The Contractor will provide specific services, deliverables, and tasks specified in the Scope of Work to address strategies required by CDC funding. Any subsequent formal amendments will be approved in writing as required pursuant to this agreement. The Contractor will collaborate with the University of California, Davis (UCD) to collect data from publically available sources to track and monitor progress in meeting required performance measures. The required performance measures include: A. Increased community and large city environments that promote and reinforce healthful behaviors and practices related to obesity, diabetes prevention, cardiovascular health, including key settings that support physical activity and healthful foods and beverages B. Increased use and reach of strategies to build support of lifestyle change County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 4 of 55 57 C. Improved quality, effective delivery and use of clinical and other preventive services D. Increased management of hypertension (HTN) and prevention of type 2 diabetes. E. Increased community clinical linkages to support self-management and control of hypertension and prevention of type 2 diabetes F. Increased consumption of nutritious food and beverages and increased physical activity G. Increased engagement in lifestyle change H. Improved medication adherence for adults with high blood pressure (HBP) I. Increased self-monitoring of HBP tied to clinical support J. Increased referrals to and enrollments in lifestyle change programs (LCPs) K. Reduced death and disability due to diabetes, heart disease and stroke by 3% in the implementation area L. Reduced prevalence of obesity by 3% in the implementation area. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 5 of 55 57 YEAR 1 Component 1a: Environmental Strategies to Promote Health and Support and Reinforce Healthful Behaviors Strategy 1.1: Implement nutrition and beverage standards including sodium standards in public institutions, worksites and other key locations such as hospitals # Activity Timeline Responsible Deliverables 1 Contractor will work with UCD to conduct an environmental scan to: • Identify food/beverages sold in the cafeterias, snack shops/bars, and/or vending machines of the four largest hospitals and large county buildings (potential reach of over 10,000 employees combined) to determine baseline and target numbers. • Review existing food procurement guidelines for the target venues. • Review model food procurement guidelines from other counties. March 1 2015- September 30, 2015 2016 Health Educator (HE) and Health Education Specialists (HES1, HES2) Submit to CDPH: • a copy of the scan tool obtained from UCD, • a copy of the developed plan for conducting the scan using the scan tool, • a list of agencies who participated in the environmental scan, and • a copy of the scan results. 2 Contractor will develop educational materials on the need for food/beverage guidelines. Include public data on blood pressure, diabetes, and obesity in the local jurisdiction. Distribute to government facilities/worksites/hospitals, stakeholders, policymakers; and post on the County Health Department website. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a copy of developed educational materials, and • a screen shot of posted web materials. 3 Contractor will identify and participate in national and state meetings, webinars and conferences as appropriate to increase local knowledge and capacity. Suggestions include American Heart Association (AHA), Association of State and Territorial Health Officials (ASTHO), National Salt Reduction Initiative (NSRI), CDC Healthy Food Service Guidelines, CDPH Sodium Awareness Leadership Team (SALT), and the Million Hearts Initiative (MHI) March 1 2015 - September 30, 2015 2016 Principle Investigator (PI), HE, HES1, HES2 Submit to CDPH: • a copy of the agenda from each event attended County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 6 of 55 57 Strategy 1.1: Implement nutrition and beverage standards including sodium standards in public institutions, worksites and other key locations such as hospitals # Activity Timeline Responsible Deliverables 4 Using environmental scans, contractor will work with the Health Clinic Subcontractor to identify target worksites and assess the trainings needs and provide customized technical assistance* (TA) and training to local government officials and key stakeholders on the need for food procurement guidelines that include sodium reduction. *TA conveys information for the express purpose of achieving increased capacity for project implementation and meeting required performance measures. March 1 2015- September 30, 2015 2016 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of training materials, and • meeting agendas/minutes. 5 Contractor and Health Clinic Subcontractor, will work with identified target worksites to develop, adopt, and implement food procurement guidelines that include sodium reduction to increase availability of healthy foods and beverages. March 1 2015- September 30, 2015 2016 PI, HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the training materials, • the meeting agendas/minutes, • the target worksite procurement guidelines, and • resulting implementation plan(s). 6 Contractor will conduct an assessment of the Contractor’s internal wellness policy. Identify areas for strengthening and update the policy. Distribute the policy and provide training to Contractor supervisors regarding successful implementation. Continue to monitor progress. March 1 2015- September 30, 2015 2016 PI, HE, HES1, HES2 Submit to CDPH: • a copy of the assessment results, • the training materials, and • the meeting agendas/minutes. 7 Contractor will work with UCD to identify and collect public data for required performance measures within strategy 1.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 7 of 55 57 Strategy 1.2: Strengthen healthier food access and sales in retail venues and community venues through increased availability, improved pricing, placement, and promotion # Activity Timeline Responsible Deliverables 1 Contractor will participate in quarterly 1-2 hour meetings of the Fresno County Healthy Stores for a Healthy Community Workgroup (FCHSHC) to add capacity and implement additional interventions that encourage healthy retail environments with the goal to promote healthier food access. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. 2 Contractor will use FCHSHC assessment public data and store public data from CDPH Environmental Health Division to identify stores for intervention. Work with FCHSHC and CDPH Nutrition, Education, and Obesity Prevention Branch (NEOP) to identify specific activities needed to promote healthier food access in retail stores. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a copy of FCHSHC assessment results and • retail promotion activities plan. 3 As part of FCHSHC, Contractor will provide input and TA to the “Healthy Stores for a Healthy Community Campaign” to reinforce campaign messages at the local level. If possible, utilize the CDPH Chronic Disease Prevention Messaging Toolkit to develop culturally and linguistically appropriate campaign messages and educational materials. Utilize Public Relations Services (PRS) to promote selected campaign messages. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes, and • campaign messages and educational materials. 4 Contractor will participate in a Statewide Nutrition-Specific Retail Workgroup facilitated by CDPH to support the FCHSHC campaign. The workgroup will define and prioritize strategies for local level environmental and system change interventions as related to healthier food access. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a copy of workgroup meeting agenda/minutes. 5 Contractor will work with UCD to identify and collect public data for required performance measures within strategy 1.2. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 8 of 55 57 Strategy 1.3: Strengthen community promotion of physical activity through signage, worksite policies, social support, and joint use agreements in communities and jurisdictions # Activity Timeline Responsible Deliverables 1 Contractor will participate in quarterly 1-2 hour Healthy Lifestyle Partnership (HLP) meetings (county coalition facilitated by NEOP) to plan and implement community initiatives that promote physical activity. March 1 - September 30, 2015 PI, HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. 2 Contractor will use the local Physical Activity (PA) directory to determine low and no cost PA opportunities in the county. Work with the HLP and Partner in Community Health (PICH) to assess community readiness, resources (including funding and local individual/agency champions), target audience, potential reach, barriers, and sustainability of potential PA initiatives including joint use and structured adult physical activity programs at schools, worksites, and other community sites. Utilize this assessment to select 1-2 physical activity initiatives that do not duplicate efforts of other programs. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes, and • assessment. 3 Contractor will collect or develop materials to educate stakeholders and key opinion leaders on the selected physical activity initiatives and engage them in the promotion of the initiatives. Provide technical assistance as necessary. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a copy of the training materials. 4 Contractor will work with HLP and PICH to assess the effectiveness of potential promotional/marketing approaches for the PA initiatives and target audiences selected. Develop culturally and linguistically appropriate campaign messages, including educational materials, for activities within strategy 1.3. Implement selected communication strategies to support physical activity initiatives including PRS to promote selected campaign messages. March 1 2015 - September 30, 2015 2016 PI, HE, HES1, HES2 Submit to CDPH: • a copy of communications/ promotion items and educational materials. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 9 of 55 57 Strategy 1.3: Strengthen community promotion of physical activity through signage, worksite policies, social support, and joint use agreements in communities and jurisdictions # Activity Timeline Responsible Deliverables 5 Contractor will work with UCD to identify and collect public data for required performance measure 1.3. Contractor will attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected as well as a copy of event agendas. Strategy 1.4: Develop and or implement transportation and community plans that promote walking # Activity Timeline Responsible Deliverables 1 As part of the Fresno County Transportation Needs Assessment already underway, Contractor will work with the Fresno Council of Governments (Fresno COG) and the Transportation Community Coalition (TCC) and participate in conducting an environmental community scan for the county to identify gaps in transportation infrastructure to support safe and active communities, existing city/county transportation plans that promote walking and readiness to implement walking/biking plans, as well as city/county planning departments that are open to enhancing plans to promote more walking/biking. March 1 2015 - September 30, 2015 2016 PI, HE, HES1, HES2 Submit to CDPH: • a copy of the scan results and • a walking promotion plan. 2 Based on assessment results collaborate with Fresno COG and TCC, Contractor will identify 1-2 target communities (city or unincorporated community) and provide input to city or county general, transportation bicycle master plans and community transportation plans to increase number of communities that promote walking and active transportation, and use of public transportation. Work with target communities to promote the plan through public relations services. March 1 2015- September 30, 2015 2016 PI and HE Submit to CDPH: • a copy of meeting agendas/minutes and • copies of target communities’ plan(s). • copy of promotional items County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 10 of 55 57 Strategy 1.4: Develop and or implement transportation and community plans that promote walking # Activity Timeline Responsible Deliverables 3 Contractor will work with UCD to identify and collect public data for required performance measure 1.4. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • compilation of public data collected, and • event agendas. Component 1b: Strategies to build support for healthy lifestyles, particularity for those at high risk, to support diabetes and heart disease and stroke prevention efforts Program Strategy 1.5: Plan and execute strategic public data-driven actions through a network of partners and local organizations to build support for lifestyle change # Activity Timeline Responsible Deliverables 1 Contractor will identify a Health Clinic Subcontractor and assist them to develop partnerships with organizations (employer groups, insurers, health systems, community-based organizations (CBOs), diabetes health educators, coalitions, etc.) to promote the goals of the National Diabetes Prevention Program (NDPP) and Take off Pounds Sensibly (TOPS). March 1 2015- September 30, 2015 2016 PI, HE, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of meeting agendas/minutes, and • list of identified partners. 2 Contractor will conduct NDPP capacity/readiness assessment utilizing an evaluation tool created by UCD with network partners to determine if resources are available within community to deliver the program. March 1 2015- September 30, 2015 2016 PI, HE, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of the assessment results. 3 Based on results of assessment, Contractor will identify readiness of Health Clinic System to implement and sustain an NDPP. Contractor will then develop a strategic plan to build capacity and implement a NDPP program in conjunction with Health Clinic Subcontractor. March 1 2015- September 30, 2015 2016 PI, HE, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of NDPP strategic plan. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 11 of 55 57 Program Strategy 1.5: Plan and execute strategic public data-driven actions through a network of partners and local organizations to build support for lifestyle change # Activity Timeline Responsible Deliverables 4 Contractor will work with Health Clinic Subcontractor to conduct a scan to identify any existing TOPS chapters as well as CBOs within the service area which may be interested in starting chapters. March 1 2015- September 30, 2015 2016 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of scan results. 5 Contractor will work with Health Clinic Subcontractor to implement capacity building efforts to expand TOPS to include Spanish- language materials and resources. March 1 2015- September 30, 2015 2016 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of meeting agendas/minutes, and • a copy of developed Spanish language materials. 6 Contractor will work with UCD to identify and collect public data for required performance measure 1.5. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2, Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 1.6: Implement evidence-based engagement strategies to build support for lifestyle change # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to conduct a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis regarding lifestyle change with identified priority population(s) in the clinic system (i.e., high burden populations, whose with pre-diabetes or uncontrolled HBP who experience racial/ethnic or socioeconomic health disparities including inadequate access to care, poor quality of care, or low income), and/or organizations that serve identified priority population(s). In year 2, implement community engagement principles within identified communities. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2, Epidemiologist, Health Clinic Subcontractor (TBD) Submit to CDPH: • SWOT analysis, and • SWOT analysis results. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 12 of 55 57 Program Strategy 1.6: Implement evidence-based engagement strategies to build support for lifestyle change # Activity Timeline Responsible Deliverables 2 Based on the SWOT analysis, Contractor will develop a marketing plan, including educational materials, using the CDC template. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a copy of Contractor marketing plan and educational materials. 3 Contractor will work with UCD to identify and collect public data for required performance measure 1.6. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 1.7: Increase coverage for evidence-based supports for lifestyle change by working with network partners # Activity Timeline Responsible Deliverables 1 Contractor will work with network partners to conduct an assessment utilizing an evaluation tool created by UCD to identify what health insurance plans are offered to employees and essential benefits included for prediabetes and prevention of type 2 diabetes. Contractor will identify challenges and barriers to coverage for LCPs. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a copy of the assessment results. 2 Contractor will adapt CDC communication and marketing materials designed for various audiences to educate about prediabetes and promote LCPs as a means to prevent or delay the onset of type 2 diabetes in high risk populations. Leverage other resources as applicable, such as the recommendation to cover LCPs that accompanied the report released by the University of California at Los Angeles Center of Health Policy Research and California Center for Public Health Advocacy. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a copy of CDC adapted marketing materials. 3 Contractor will work with UCD to identify and collect public data for required performance measure 1.7. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 13 of 55 57 Component 2a: Health System Interventions to Improve the Quality of Health Care Delivery to Populations with the Highest Hypertension and Prediabetes Disparities Program Strategy 2.1: Increase electronic health records (EHR) adoption and the use of health information technology (HIT) to improve performance (pursuant to federal and state guidelines) # Activity Timeline Responsible Deliverables 1 Contractor will conduct an environmental scan utilizing an evaluation tool created by UCD to assess EHR/Meaningful Use of select providers/health systems regarding implementation, related policies and procedures, and capacity of Health Clinic Subcontractor, focusing on achievement of blood pressure control initiatives to identify gaps and opportunities for collaboration. Engage with Health Clinic Subcontractor to maximize understanding of EHR policy and practice landscape within the local area. March 1 2015- September 30, 2015 2016 HE, Epidemiologist, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the scan results. 2 Contractor will work with UCD to identify and collect public data. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.2: Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider level # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to identify and provide web links for TA and training to Health Center Controlled networks in the area (or similar health systems) in order to develop and implement toolsets (e.g., clinical quality dashboards) to provide clinicians with public performance data. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the training materials. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 14 of 55 57 Program Strategy 2.3: Increase engagement of non-physician team members in hypertension management in community health care systems # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to conduct environmental scan of providers and hospital/clinic systems and health insurance plans, utilizing an evaluation tool created by UCD, to determine which clinic systems are currently engaging in hypertension management. Results will be used to determine baseline in county. March 1 2015- September 30, 2015 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Subcontractor (TBD) will submit to Contractor: • a list of proposed and interviewed clinic systems. Contractor will submit to CDPH: • a copy of the scan results. 2 Based on scan results, Health Clinic Subcontractor will promote adoption by clinic systems of procedures/protocols that support the implementation of comprehensive health care teams. Contractor will monitor, provide TA, and track providers that adopt procedures/protocols. March 1 2015- September 30, 2015 2016 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Subcontractor (TBD) will submit to Contractor: • a list of clinic systems that adopted the recommended procedures/protocols. Contractor will submit to CDPH: • a copy of adopted procedures/protocols. 3 Contractor will work with UCD to identify and collect public data for required performance measure 2.3. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 15 of 55 57 Program Strategy 2.4: Increase use of self-measured blood pressure monitoring tied with clinical support # Activity Timeline Responsible Deliverables 1 Conduct asset mapping/environmental scans, utilizing an evaluation tool created by UCD, to determine the CBOs or health systems that are currently providing blood pressure and or diabetes screening/monitoring and who they serve (demographics) for baseline and target. Identify blood pressure/diabetes champions from within the community. March 1 2015 - September 30, 2015 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the scan results. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.4. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.5: Implement systems to facilitate identification of patients with undiagnosed hypertension and people with prediabetes # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to conduct asset mapping/environmental scans that determine the CBOs in Health Clinic Subcontractor service areas which are currently providing blood pressure and or diabetes screening/monitoring and who they serve (demographics) for baseline and target. Identify blood pressure/diabetes champions from within the community. March 1 2015- September 30, 2015 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a written summary of the scan, and • list of community Champions. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.5. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 16 of 55 57 Component 2b: Community Clinical Linkage Strategies to Support Heart Disease and Stroke and Diabetes Prevention Efforts Program Strategy 2.6: Increase engagement of CHWs to promote linkages between health systems and community resources for adults with high blood pressure and adults with prediabetes or at high risk for type 2 diabetes # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to conduct an environmental scan utilizing an evaluation tool created by UCD, to assess existing programs that target adults with HBP and adults with prediabetes or at high risk for type 2 diabetes. Begin with Fresno Metro Ministry’s Community Resource Directory. March 1 2015- September 30, 2015 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the scan results. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.6. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.7: Increase engagement of community pharmacists in the provision of medication-/self-management for adults with high blood pressure # Activity Timeline Responsible Deliverables 1 Contractor will conduct environmental scan/assessment utilizing an evaluation tool created by UCD to determine which providers, health insurance plans etc. are using pharmacists as part of the team for medication/self-management. Based on the results of the community scan, Contractor will build relationships with health systems to promote inclusion of community pharmacists as part of the health care team. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a copy of the scan results. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.7. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 17 of 55 57 Program Strategy 2.8: Implement systems and increase partnerships to facilitate bi-directional referral between community resources and health systems, including lifestyle change programs # Activity Timeline Responsible Deliverables 1 Contractor will conduct environmental scan utilizing an evaluation tool created by UCD of existing 211 services within Fresno County. Identify current and potential 211 service availability and/or identify other entities that could serve as a source for community referrals to LCPs. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a copy of the scan results. 2 Contractor will work with Health Clinic Subcontractor to conduct assessment of Subcontractor referral practices for patients with a diagnosis of HBP and prediabetes, and viability of utilizing 211 for referral to LCPs. March 1 2015- September 30, 2015 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Contractor will submit to CDPH: • a copy of assessment results. 3 Contractor will work with UCD to identify and collect public data for required performance measure 2.8. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. March 1 - September 30, 2015 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 18 of 55 57 Cross-cutting (applies to all components) Cross-Cut Strategy: Build local capacity and document lessons learned of implementing local health departments and partners. # Activity Timeline Responsible Deliverables 1 Contractor will attend training sessions, conferences, and webinars on specific content areas to augment the internal team’s skills and program effectiveness (topics could include, public data mining health records, increasing community-clinical linkages, etc.). March 1 2015- September 30, 2015 2016 PI, HE, HES1, HES2, Staff Analyst (SA) I, and Epidemiologist Submit to CDPH: • copies of training agendas. 2 Contractor will send at least 2 staff to attend CDPH required annual meeting (1) and trainings (1-2 per year) in Sacramento. Meetings may include: “Program Kick Off”, SALT, and NDPP. March 1 2015- September 30, 2015 2016 PI, HE, HES1, HES2 Submit to CDPH: • copies of confirmed travel arrangements. 3 Contractor will provide a description of best practice, noting whether it refers to innovative educational materials/presentations, policies, success stories, or other. March 1 2015- September 30, 2015 2016 HE Submit to CDPH: • a copy of best practices summary report. 4 Contractor will participate in focus groups and planning workgroups. Focus groups may include TA, educational materials, and/or review of evaluation tools. Workgroups may include sodium taskforce and NDPP. March 1 2015- September 30, 2015 2016 HE Submit to CDPH: • copies of meeting agendas/minutes. 5 Contractor will provide internal support including logistics and paperwork for orders, mailing, travel, meetings, technical support, training, etc. March 1 2015- September 30, 2015 2016 Office Assistant (OA) III Submit to CDPH: • timesheets, and • documentation of logistical processes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 19 of 55 57 YEAR 2 Component 1a: Environmental Strategies to Promote Health and Support and Reinforce Healthful Behaviors Strategy 1.1: Implement nutrition and beverage standards including sodium standards in public institutions, worksites and other key locations such as hospitals # Activity Timeline Responsible Deliverables 1 Contractor will develop educational materials on the need for food/beverage guidelines. Include public data on blood pressure, diabetes, and obesity in the local jurisdiction. Distribute to government facilities/worksites/hospitals, stakeholders, policymakers. Post on the Fresno County Health Department website. October 1 2015 - September 30, 2016 HE, HES1, HES2, Submit to CDPH: • a copy of developed educational materials and a screen shot of posted materials. 2 Contractor will identify and participate in national and state meetings, webinars and conferences as appropriate to increase local knowledge and capacity. Suggestions include AHA, ASTHO, NSRI, CDC Healthy Food Service Guidelines, SALT, and MHI. October 1 2015 - September 30, 2016 PI, HE, HES1, HES2 Submit to CDPH: • a copy of event agendas. 3 Contractor will use existing environmental scans identify target worksites, assess their training needs and provide customized training/TA to local government officials and key stakeholders on the need for food procurement guidelines that include sodium reduction. October 1 2015 - September 30, 2016 HE, HES1, HES2, Submit to CDPH: • a copy of training materials, and • meeting agendas/minutes. 4 Contractor will work with identified target worksites to develop, adopt, and implement food procurement guidelines that include sodium reduction to increase availability of healthy foods and beverages.Use public relations services to promote new guidelines and/or policies. October 1 2015 - September 30, 2016 PI, HE, HES1, HES2 Submit to CDPH: • a copy of training materials, • meeting agendas/minutes, • target worksite procurement guidelines, and • implementation plan(s). 5 Contractor will conduct an assessment of the internal wellness policy for the Fresno County Department of Public Health (FCDPH). Identify areas for strengthening and update the policy. Distribute the policy and provide training/TA to FCDPH supervisors regarding successful implementation. Monitor progress. October 1 2015 - September 30, 2016 PI, HE, HES1, HES2 Submit to CDPH: • a copy of the assessment results, • training materials, and • meeting agendas/minutes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 20 of 55 57 Strategy 1.1: Implement nutrition and beverage standards including sodium standards in public institutions, worksites and other key locations such as hospitals # Activity Timeline Responsible Deliverables 6 Contractor will work with UCD to identify and collect public data for required performance measures within strategy 1.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Strategy 1.2: Strengthen healthier food access and sales in retail venues and community venues through increased availability, improved pricing, placement, and promotion # Activity Timeline Responsible Deliverables 1 Contractor will participate in quarterly 1-2 hour meetings of the FCHSHC to add capacity and implement additional interventions that encourage healthy retail environments with the goal to promote healthier food access. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. 2 Contractor will use FCHSHC assessment public data and store public data from CDPH Environmental Health Division to identify stores for intervention. Work with FCHSHC and NEOP to identify specific activities needed to promote healthier food access in retail stores. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of FCHSHC assessment results and • retail promotion activities plan. 3 As part of FCHSHC, Contractor will provide input to the “Healthy Stores for a Healthy Community Campaign” to reinforce campaign messages at the local level. If possible, utilize the CDPH Chronic Disease Prevention Messaging Toolkit to develop culturally and linguistically appropriate campaign and educational messages. Utilize PRS to promote selected campaign messages. October 1 2015 - September 30, 2016 HE, HES1, HES2, Submit to CDPH: • a copy of meeting agendas/minutes, and • campaign messages. 4 In collaboration with the FCHSHC subcommittee, Contractor will participate in the California Tobacco Control Program (CTCP) retail public data collection training to prepare for public data collection. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 21 of 55 57 Strategy 1.2: Strengthen healthier food access and sales in retail venues and community venues through increased availability, improved pricing, placement, and promotion # Activity Timeline Responsible Deliverables 5 As part of the FCHSHC, Contractor will participate in an event to train data collectors for the retail survey. October 1, 2015- September 30, 2016 HE, HES1, HES2 Submit to CDPH: • Copy of training agenda and materials 56 Contractor will recruit, determine specific training/resources needs, and provide TA to at least 1-2 new owner/operator representatives of grocery/specialty food retailers including farmers’ market operators to participate in the FCHSHC campaign to improve healthy options in their stores. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agenda/minutes, • training materials, and • photos of the campaign materials in the retailer venue. 67 In collaboration with the FCHSHC, Contractor will participate in the CTCP retail public data collection nutrition specific module. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH • a list of retail venues where public data was collected. 7 8 Contractor will work with UCD to identify and collect public data for required performance measures within strategy 1.2. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Strategy 1.3: Strengthen community promotion of physical activity through signage, worksite policies, social support, and joint use agreements in communities and jurisdictions # Activity Timeline Responsible Deliverables 1 Contractor will participate in quarterly 1-2 hour Healthy Lifestyle Partnership (HLP) meetings (county coalition facilitated by NEOP) to plan and implement community initiatives that promote physical activity. October 1 2015 - September 30, 2016 PI, HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 22 of 55 57 Strategy 1.3: Strengthen community promotion of physical activity through signage, worksite policies, social support, and joint use agreements in communities and jurisdictions # Activity Timeline Responsible Deliverables 2 Contractor will use the local PA directory to determine low and no cost PA opportunities in the county, work with the HLP and Partner in Community Health (PICH) to assess community readiness, resources (including funding and local individual/agency champions), target audience, potential reach, barriers, and sustainability of potential PA initiatives including joint use and structured adult physical activity programs at schools, worksites, and other community sites. Contractor will utilize this assessment to select 1-2 physical activity initiatives that do not duplicate efforts of other programs. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes, and • copy of assessment. 3 2 Contractor will collect or develop materials to educate stakeholders and key opinion leaders on the selected physical activity initiatives and engage them in the promotion of the initiatives. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of training materials. 4 3 Contractor will provide training and TA to facilitate the development and implementation of the selected physical activity initiatives. October 1 2015 - September 30, 2016 HE, HES1, HES2, Submit to CDPH: • a copy of meeting agenda/minutes and photos. • Additional specific deliverables will be identified after the initiatives are selected. 5 4 Contractor will work with HLP and PICH to assess the effectiveness of potential promotional/marketing approaches for the PA initiatives and target audiences selected. Develop culturally and linguistically appropriate education and campaign messages for activities within strategy 1.3. Implement selected communication strategies to support physical activity initiatives including PRS to promote selected campaign messages. October 1 2015 - September 30, 2016 PI, HE, HES1, HES2, Submit to CDPH: • a copy of communications/promotion items. 6 5 Contractor will work with UCD to identify and collect public data for required performance measure 1.3. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 23 of 55 57 Strategy 1.4: Develop and or implement transportation and community plans that promote walking # Activity Timeline Responsible Deliverables 1 As part of the Fresno County Transportation Needs Assessment already underway, Contractor will work with the Fresno Council of Governments (Fresno COG) and the Transportation Community Coalition (TCC) and participate in conducting an environmental community scan for the county to identify gaps in transportation infrastructure to support safe and active communities, existing city/county transportation plans that promote walking and readiness to implement walking/biking plans, as well as city/county planning departments that are open to enhancing plans to promote more walking/biking. October 1 2015 - September 30, 2016 PI, HE, HES1, HES2 Submit to CDPH: • a copy of scan results and • walking promotion plan. 2 Based on assessment results, Contractor will continue to collaborate with Fresno COG and TCC, identify 1-2 to work with target communities (city or unincorporated community) and provide input to city or county general, transportation bicycle master plans, and community transportation plans to increase number of communities that promote walking and active transportation, and use of public transportation. Work with target communities to promote the plans through public relations services. October 1 2015 - September 30, 2016 PI, HE Submit to CDPH: • a copy of meeting agendas/minutes and • copies of target communities’ plan(s). 3 Contractor will educate community leaders from 1-2 target communities on conducting walkability assessment to determine scope of problem and highlight changes needed to create safe environments for active transportation October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes, and • training materials. 4 Contractor will coordinate with TCC, target city/county officials including law enforcement, and community members to conduct 1-2 walkability assessments in target communities to determine scope of problem and highlight changes needed to create safe environments for active transportation. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of the walkability assessment(s). 5 Contractor will work with UCD to identify and collect public data for required performance measure 1.4. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 24 of 55 57 Component 1b: Strategies to build support for healthy lifestyles, particularity for those at high risk, to support diabetes and heart disease and stroke prevention efforts Program Strategy 1.5: Plan and execute strategic public data-driven actions through a network of partners and local organizations to build support for lifestyle change # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to provide NDPP training and certification to at least four identified Health Clinic System staff. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of certifications, and • training materials. • 2 Contractor will provide technical assistance to Health Clinic Subcontractor to complete the NDPP Capacity Assessment and will initiate the CDC recognition process. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • Copy of DPRP Capacity Assessment. 2 Contractor will work with Health Clinic Subcontractor to provide TOPS training to Health Clinic System staff on how to initiate and lead TOPS chapters. Offer and promote the training to other interested CBOs serving Health Clinic System target population. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of promotional and training materials. 3 Contractor will work with Health Clinic Subcontractor to participate in planning for a statewide NDPP summit led by CDPH staff. Planning will include participation in planning meetings, developing summit materials, identifying appropriate key partners/stakeholders to identify the strategic direction and priorities for increasing referrals, utilization, and reimbursement of NDPP. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of planning meeting agendas/minutes. 4 Contractor will work with Health Clinic Subcontractor to refer patients and interested community members to scheduled NDPP classes at Health Clinic System health centers. Promote classes through public relations services. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a listing of classes scheduled, • referral and attendance logs (summary numbers only). County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 25 of 55 57 Program Strategy 1.5: Plan and execute strategic public data-driven actions through a network of partners and local organizations to build support for lifestyle change # Activity Timeline Responsible Deliverables 5 Contractor will work with Health Clinic Subcontractor to refer patients and interested community members to chapters of TOPS at Health Clinic System health centers and nearby CBOs with weekly meetings for members. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a listing of classes scheduled, • referral and attendance logs (summary numbers only). 6 5 Contractor will work with Health Clinic Subcontractor and UCD to identify and collect public data for required performance measure 1.5. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 1.6: Implement evidence-based engagement strategies to build support for lifestyle change # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to conduct a strengths, weaknesses, opportunities, and threats (SWOT) analysis regarding lifestyle change with identified priority population(s), and/or organizations that serve them. In year 2, based on SWOT analysis results, implement community engagement principles within identified communities. October 1 2015 - September 30, 2016 HE, HES1, HES2, Epidemiologist, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of SWOT analysis results. • List of potential community engagement activities. 2 Utilizing the Chronic Disease Prevention Messaging Toolkit, Contractor will work with Health Clinic Subcontractor to develop a plan, including educational materials, for how partners (CBOs, Fresno County Department of Public Health, Health Clinic Systems, community champions) will work together to conduct outreach, promote the programs through public relations services, build support for and increase referrals to NDPP and TOPS. Review and update annually. October 1 2015 - September 30, 2016 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of planning meeting agendas/minutes, and • the outreach plan. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 26 of 55 57 Program Strategy 1.6: Implement evidence-based engagement strategies to build support for lifestyle change # Activity Timeline Responsible Deliverables 3 In collaboration with CDPH, Contractor will adapt CDC NDPP communications, educational, and public relations services for marketing materials and work with Health Clinic Subcontractor to mobilize champions to disseminate in target communities as a means to increase reach to and engagement of priority populations. Assess reach and outcomes of lifestyle change strategies and marketing efforts and refine as necessary. October 1 2015 - September 30, 2016 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of promotional materials developed, • distribution and reach log. 4 Contractor will work with Health Clinic Subcontractor and UCD to identify and collect public data for required performance measure 1.6. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 1.7: Increase coverage for evidence-based supports for lifestyle change by working with network partners # Activity Timeline Responsible Deliverables 1 Contractor will work with network partners to conduct an assessment utilizing an evaluation tool created by UCD to identify what health insurance plans are offered to employees and essential benefits included for prediabetes and prevention of type 2 diabetes. Identify challenge and barriers to coverage for LCPs. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of the assessment results. 2 Based on assessment results, Contractor will develop and implement an action plan to establish or increase insurance coverage of LCPs within county. October 1 2015 - September 30, 2016 PI, HE, HES1, HES2 Submit to CDPH: • action plan timeline. 3 Contractor will work with UCD to identify and collect public data for required performance measure 1.7. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 27 of 55 57 Component 2a: Health System Interventions to Improve the Quality of Health Care Delivery to Populations with the Highest Hypertension and Pre-diabetes Disparities Program Strategy 2.1: Increase electronic health records (EHR) adoption and the use of health information technology (HIT) to improve performance (pursuant to federal and state guidelines) # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to conduct a community scan within Health Clinic System of blood pressure control initiatives to identify gaps and opportunities for collaboration and improve performance. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of scan. 2 Contractor will recruit providers/health systems to participate in Central Valley Health Information Exchange (CVHIE) to promote reporting on National Quality Forum (NQF) 18 and 59 and standardized clinical quality measures for management and treatment of patients with HBP. October 1 2015 - September 30, 2016 PI, HE, and Epidemiologist Submit to CDPH: • a copy of meeting agendas/minutes. 3 Contractor will work with Health Clinic Subcontractor and UCD to identify and collect public data for required performance measure 2.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.2: Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider level # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to assess capacity for providers and/or health systems, utilizing an evaluation tool created by UCD, to electronically track, monitor and report aggregated/standardized quality measures to the Centers for Medicare and Medicaid Services, CDPH, and others. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • an assessment report of the environmental scan. 2 Contractor will work with Health Clinic Subcontractor to convene representatives from county Federally Qualified Health Centers (FQHCs) and CVHIE to develop protocols and processes for monitoring and sharing standardized quality measures at the provider level. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of meeting agendas/ minutes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 28 of 55 57 Program Strategy 2.2: Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider level # Activity Timeline Responsible Deliverables 3 Contractor will work with Health Clinic Subcontractor to expand health system EHR analytics or participation in clinical quality dashboards for Health Clinic System patients with hypertension, prediabetes, and diabetes. Promote quality improvement through the implementation of systems that provide relevant and timely patient public data to providers and health systems. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a summary of systems in use. 4 Contractor will work with Health Clinic Subcontractor and UCD to identify and collect public data for required performance measure 2.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.3: Increase engagement of non-physician team members in hypertension management in community health care systems # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to conduct environmental scan of providers and hospital/clinic systems and health insurance plans, utilizing an evaluation tool created by UCD, to determine which team members are currently engaging in hypertension management. Results will be used to determine baseline in county. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the scan results. 2 Based on scan results, Contractor will work with Health Clinic Subcontractor to promote adoption by Health Clinic System providers of procedures/protocols that support the implementation of comprehensive health care teams. Monitor and track providers that adopt procedures/protocols. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of adopted procedures/ protocols. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 29 of 55 57 Program Strategy 2.3: Increase engagement of non-physician team members in hypertension management in community health care systems # Activity Timeline Responsible Deliverables 3 Contractor will work with Health Clinic Subcontractor to utilize scan results to identify evidence and practice tools to share with the provider community that support the implementation of evidence-based guidelines for HBP, such as the MHI hypertension protocols i.e., through local medical society. Identify training and TA needs to facilitate adoption/implementation of tools by Health Clinic Subcontractor. October 1 2015 - September 30, 2016 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of training materials, and • meeting agendas/minutes. 4 Contractor will work with Health Clinic Subcontractor to develop a workgroup and project workplan to fill 1-2 of the evidence gaps specified in The Community Guide at http://www.thecommunityguide.org/cvd/RGteambasedcare.html . October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a summary of the evidence gathered and gap(s) identified. 5 Contractor will work with Health Clinic Subcontractor and UCD to identify and collect public data for required performance measure 2.3. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.4: Increase use of self-measured blood pressure monitoring tied with clinical support # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to provide assessment or analysis results to augment and enhance Health Clinic System provider’s capacity and reach. Analysis should include feasibility and compatibility of self-management programs for HBP (e.g., Check. Change. Control) with existing community health care programs. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of analysis report. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 30 of 55 57 Program Strategy 2.4: Increase use of self-measured blood pressure monitoring tied with clinical support # Activity Timeline Responsible Deliverables 2 Contractor will work with Health Clinic Subcontractor to research model practices, outcomes, and benefits to promote the adoption and EHR use with Health Clinic Systems that include integrated HBP algorithms and supports for provider prompts/feedback, patient communication, and public data tracking, monitoring, and reporting. Promote new practices to community partners. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of sample adopted EHR systems. 3 Contractor will work with Health Clinic Subcontractor and UCD to identify and collect public data for required performance measure 2.4. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.5: Implement systems to facilitate identification of patients with undiagnosed hypertension and people with pre- diabetes # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to complete an assessment of Health Clinic System to identify patients with undiagnosed hypertension and/or pre-diabetes, provide referral for education and provider feedback about home blood pressure/blood sugar monitoring, and provider prompts and patient contact system for managing patients with HBP/blood sugar. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the assessment. 2 Contractor will work with Health Clinic Subcontractor to Develop and implement a plan for improving the system for identifying and monitoring patients with HBP in Health Clinic System. Promote new system to community partners. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the plan. 3 Contractor will work with Health Clinic Subcontractor and UCD to identify and collect public data for required performance measure 2.5. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 31 of 55 57 Component 2b: Community Clinical Linkage Strategies to Support Heart Disease and Stroke and Diabetes Prevention Efforts Program Strategy 2.6: Increase engagement of CHWs to promote linkages between health systems and community resources for adults with high blood pressure and adults with pre-diabetes or at high risk for type 2 diabetes # Activity Timeline Responsible Deliverables 1 Contractor will assess where CDPH, PHI and other partners currently are with fiscal reimbursement strategies for Community Health Workers (CHW s) within health plans. Contractor will work with Health Clinic Subcontractor to conduct an environmental scan, utilizing an evaluation tool created by UCD of existing clinics, the California Health Workforce Alliance report, and local health care systems to identify which have CHWs or similar staff. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the scan results. 2 As a result of the health system scan, Contractor will work with Health Clinic Subcontractor by providing TA to develop a plan to promote systematic change to involve Health Clinic System CHWs to promote linkages between health systems and community resources to improve outcomes for heart disease and diabetes. Coordinate with others working on CHW initiatives for awareness, input, and support. Work with CHWs for their input and guidance on promotional strategies between health systems and community resources. Monitor change. Promote new guidelines or policies through public relations services. October 1 2015 - September 30, 2016 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of the plan and • a summary of changes made. 3 Contractor will work with Health Clinic Subcontractor and UCD to identify and collect public data for required performance measure 2.6. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 32 of 55 57 Program Strategy 2.7: Increase engagement of community pharmacists in the provision of medication-/self-management for adults with high blood pressure # Activity Timeline Responsible Deliverables 1 Contractor will conduct environmental scan/assessment utilizing an evaluation tool created by UCD to determine which providers, health insurance plans etc. are using pharmacists as part of the team for medication/self-management. Based on the results of the community scan build relationships with health systems to promote inclusion of community pharmacists as part of the health care team. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of the scan results. 2 Contractor will work with Health Clinic Subcontractor to identify and convene appropriate partners to identify and share best practices, including training of pharmacists and mechanism of payment; promoting inclusion of pharmacists in the team for community-based medication reconciliation/reporting to providers and hypertension self- management. Promote new guidelines or policies through public relations services. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of meeting agendas/minutes. 3 Contractor will work with UCD to identify and collect public data for required performance measure 2.7. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.8: Implement systems and increase partnerships to facilitate bi-directional referral between community resources and health systems, including lifestyle change programs # Activity Timeline Responsible Deliverables 1 Contractor will institute 211 service LCPs for HBP and pre-diabetes, and/or identify other entities that could serve as a source for community referrals to LCPs. Develop tracking/monitoring system for referrals. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes, • 211/referral system service promotion materials, and • a summary of the tracking/monitoring system. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 33 of 55 57 Program Strategy 2.8: Implement systems and increase partnerships to facilitate bi-directional referral between community resources and health systems, including lifestyle change programs # Activity Timeline Responsible Deliverables 2 Contractor will develop and implement a communications plan to provide TA and assist with communication, awareness, and outreach strategy to maximize reach and impact of 211. October 1 2015 - September 30, 2016 HE, HES1, HES2 Submit to CDPH: • a copy of 211 communication plan. 3 Contractor will work with Health Clinic Subcontractor to educate Health Clinic System providers about community resources available for patients with HBP and pre-diabetes, and the benefits of using a community referral system, such as 211, within their organization (e.g. utilizing EHR to refer patients to community resources). Determine what resources/systems are needed to ensure bi-directional referrals are made. October 1 2015 - September 30, 2016 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of training materials, and • 211/referral system service promotion materials. 4 Contractor will work with Health Clinic Subcontractor and UCD to identify and collect public data for required performance measure 2.8. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2015 - September 30, 2016 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Cross-cutting (applies to all components) Cross-Cut Strategy: Build local capacity and document lessons learned of implementing local health departments and partners. # Activity Timeline Responsible Deliverables 1 Contractor will attend training sessions, conferences, and webinars on specific content areas to augment the internal team’s skills and program effectiveness (topics could include, public data mining health records, increasing community-clinical linkages, etc.). October 1 2015 - September 30, 2016 PI, HE, HES1, HES2, SA I, and Epidemiologist Submit to CDPH: • copies of training agendas. 2 Contractor will send at least 2 staff to attend CDPH required annual meeting (1) and trainings (1-2 per year) in Sacramento. Meetings may include: “Program Kick Off”, SALT, and NDPP. March 1 - September 30, 2015 PI, HE, HES1, HES2 Submit to CDPH: • copies of confirmed travel arrangements. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 34 of 55 57 Cross-Cut Strategy: Build local capacity and document lessons learned of implementing local health departments and partners. # Activity Timeline Responsible Deliverables 3 Contractor will provide a description of best practice, noting whether it refers to innovative educational materials/presentations, policies, success stories, or other. October 1 2015 - September 30, 2016 Health Educator Submit to CDPH: • a best practices summary report. 4 Contractor will participate in focus groups and planning workgroups. Focus groups may include TA, educational materials, and/or review of evaluation tools. Workgroups may include sodium taskforce, and NDPP. October 1 2015 - September 30, 2016 Health Educator Submit to CDPH: • copies of meeting agendas/minutes. 5 Contractor will provide internal support including logistics and paperwork for orders, mailing, travel, meetings, technical support, training, etc. March 1 - September 30, 2015 OA III Submit to CDPH: • timesheets, and • documentation of logistical processes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 35 of 55 57 YEAR 3 Component 1a: Environmental Strategies to Promote Health and Support and Reinforce Healthful Behaviors Strategy 1.1: Implement nutrition and beverage standards including sodium standards in public institutions, worksites and other key locations such as hospitals # Activity Timeline Responsible Deliverables 1 Contractor will identify and participate in national and state meetings, webinars and conferences as appropriate to increase local knowledge and capacity. Suggestions include AHA, ASTHO, NSRI, CDC Healthy Food Service Guidelines, SALT, and MHI. October 1 2016 - September 30, 2017 PI, HE, HES1, HES2 Submit to CDPH: • a copy of event agendas. 2 Contractor will work with identified target worksites to develop, adopt, and implement food procurement guidelines that include sodium reduction to increase availability of healthy foods and beverages. October 1 2016 - September 30, 2017 PI, HE, HES1, HES2 Submit to CDPH: • a copy of training materials, • meeting agendas/minutes, • target worksite procurement guidelines, and • implementation plan(s). 3 Contractor will conduct an assessment of the internal wellness policy for the Fresno County Department of Public Health (FCDPH). Identify areas for strengthening and update the policy. Distribute the policy and provide training to FCDPH supervisors regarding successful implementation. Monitor progress. October 1 2016 - September 30, 2017 PI, HE, HES1, HES2 Submit to CDPH: • a copy of the assessment results, • training materials, and • meeting agendas/minutes. 4 Contractor will meet with directors of other county departments and share the FCDPH wellness policy. Through discussion, assess the viability of implementing a similar or modified version of the FCDPH wellness policy in the other departments. October 1 2016 - September 30, 2017 PI, HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. 5 Contractor will work with UCD to identify and collect public data for required performance measures within strategy 1.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 36 of 55 57 Strategy 1.2: Strengthen healthier food access and sales in retail venues and community venues through increased availability, improved pricing, placement, and promotion. # Activity Timeline Responsible Deliverables 1 Contractor will participate in quarterly 1-2 hour meetings of the FCHSHC to add capacity and implement additional interventions that encourage healthy retail environments with the goal to promote healthier food access. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. 2 Contractor will use FCHSHC assessment public data and store public data from CDPH Environmental Health Division to identify stores for intervention. Work with FCHSHC and NEOP to identify specific activities needed to promote healthier food access in retail stores. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a copy of FCHSHC assessment results and • retail promotion activities plan. 3 As part FCHSHC, Contractor will provide input to the “Healthy Stores for a Healthy Community Campaign” to reinforce campaign messages at the local level. If possible, utilize the CDPH Chronic Disease Prevention Messaging Toolkit to develop culturally and linguistically appropriate campaign messages. October 1 2016 - September 30, 2017 HE, HES1, HES2, Submit to CDPH: • a copy of meeting agendas/minutes, and • campaign messages. 4 Contractor will recruit, determine specific training/resources needs, and provide TA to at least 1-2 new owner/operator representatives’ grocery/specialty food retailers including farmers’ market operators to participate in the FCHSHC campaign to improve healthy options in their stores. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agenda/minutes, • training materials, and • photos of the campaign materials in the retailer venue. 5 In collaboration with the FCHSHC, Contractor will participate in the CTCP retail public data collection nutrition specific module. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a list of retail venues where public data was collected. 6 5 In collaboration with the FCHSHC subcommittee, Contractor will participate in the CTCP spokesperson training to prepare for a FCHSHC press event. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a copy of the spokesperson training agenda. 7 6 In collaboration with the FCHSHC subcommittee and CDPH, Contractor will plan and participate in the CTCP retail public data collection press event. October 1 2016 - September 30, 2017 HE, HES1, HES2, Submit to CDPH: • a copy of the press event packet. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 37 of 55 57 Strategy 1.2: Strengthen healthier food access and sales in retail venues and community venues through increased availability, improved pricing, placement, and promotion. # Activity Timeline Responsible Deliverables 8 7 In collaboration with the FCHSHC subcommittee, Contractor will assist with the dissemination of Fresno County retail public data collection results. Results will be provided by CTCP in the form of a factsheet that will be adapted to meet the needs of Solano Fresno County. October 1 2016 - September 30, 2017 HE, HES1, HES2, Submit to CDPH: • a copy of the adapted factsheet. 9 8 Contractor will work with UCD to identify and collect public data for required performance measures within strategy 1.2. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Strategy 1.3: Strengthen community promotion of physical activity through signage, worksite policies, social support, and joint use agreements in communities and jurisdictions # Activity Timeline Responsible Deliverables 1 Contractor will participate in quarterly 1-2 hour Healthy Lifestyle Partnership (HLP) meetings (county coalition facilitated by NEOP) to plan and implement community initiatives that promote physical activity. October 1 2016 - September 30, 2017 PI, HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. 2 Contractor will provide training and TA to facilitate the development and implementation of the selected physical activity initiatives. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agenda/minutes and photos. • Additional specific deliverables will be identified after the initiatives are selected. 3 Contractor will work with HLP and PICH to assess the effectiveness of potential promotional/marketing approaches for the PA initiatives and target audiences selected. Develop culturally and linguistically appropriate campaign messages. Implement selected communication strategies to support physical activity initiatives including PRS to promote selected campaign messages. October 1 2016 - September 30, 2017 PI, HE, HES1, HES2, Submit to CDPH: • a copy of communications/ promotion items. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 38 of 55 57 Strategy 1.3: Strengthen community promotion of physical activity through signage, worksite policies, social support, and joint use agreements in communities and jurisdictions # Activity Timeline Responsible Deliverables 4 Contractor will work with UCD to identify and collect public data for required performance measure 1.3. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2, Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Strategy 1.4: Develop and or implement transportation and community plans that promote walking # Activity Timeline Responsible Deliverables 1 Based on assessment results, Contractor will continue to collaborate with Fresno COG and TCC, identify 1-2to work in target communities (city or unincorporated community) and provide input to city or county general, transportation bicycle master plans and community transportation plans to increase number of communities that promote walking and active transportation, and use of public transportation. October 1 2016 - September 30, 2017 PI, HE, Submit to CDPH: • a copy of meeting agendas/minutes and • copies of target communities’ plan(s). 2 Contractor will coordinate with TCC, target city/county officials including law enforcement, and community members to conduct 1-2 walkability assessments in target communities to determine scope of problem and highlight changes needed to create safe environments for active transportation. October 1 2016 - September 30, 2017 HE, HES1, HES2, Submit to CDPH: • a copy of the walkability assessment(s). 3 2 Contractor will coordinate with TCC, target city/county officials including law enforcement, and community members to utilize the completed walkability assessment(s) to identify potential local active transportation project(s) for funding from CalTrans and other funding sources. October 1 2016 - September 30, 2017 PI, HE, Submit to CDPH: • a copy of meeting agendas/minutes and • list of the potential projects identified. 4 3 Contractor will work with UCD to identify and collect public data for required performance measure 1.4. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2, Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 39 of 55 57 Component 1b: Strategies to build support for healthy lifestyles, particularity for those at high risk, to support diabetes, heart disease and stroke prevention efforts Program Strategy 1.5: Plan and execute strategic data-driven actions through a network of partners and local organizations to build support for lifestyle change # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to refer patients and interested community members to scheduled NDPP classes at health centers. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of classes scheduled, • referral and attendance logs (summary numbers only). 2 Contractor will work with Health Clinic Subcontractor to submit evaluation data to CDC in order to achieve NDPP recognition status. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • Copy of evaluation data. 2 3 Contractor will work with Health Clinic Subcontractor to refer patients and interested community members to chapters of TOPS at health centers and nearby CBOs with weekly meetings for members. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of classes scheduled, • referral and attendance logs (summary numbers only). 3 4 Contractor will work with UCD to identify and collect public data for required performance measure 1.5. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 40 of 55 57 Program Strategy 1.6: Implement evidence-based engagement strategies to build support for lifestyle change # Activity Timeline Responsible Deliverables 1 Utilizing the Chronic Disease Prevention Messaging Toolkit, Contractor will work with Health Clinic Subcontractor to develop a plan for how partners (CBOs, Fresno County Department of Public Health, Health Clinic Subcontractor, community champions) will work together to conduct outreach/marketing, build support for and increase referrals to NDPP and TOPS. Review and update annually. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of planning meeting agendas/minutes, and • the outreach/marketing plan. 2 In collaboration with CDPH, Contractor will adapt CDC NDPP communications and marketing materials and mobilize champions to disseminate in target communities as a means to increase reach to and engagement of priority populations. Assess reach and outcomes of lifestyle change strategies and marketing efforts and refine as necessary. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of promotional materials developed, and • distribution and reach log. 3 Contractor will work with UCD to identify and collect public data for required performance measure 1.6. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 1.7: Increase coverage for evidence-based supports for lifestyle change by working with network partners # Activity Timeline Responsible Deliverables 1 Based on assessment results, Contractor will develop and implement an action plan to establish or increase insurance coverage of LCPs within county. October 1 2016 - September 30, 2017 PI, HE, HES1, HES2 Submit to CDPH: • action plan timeline. 2 Contractor will work with UCD to identify and collect public data for required performance measure 1.7. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 41 of 55 57 Component 2a: Health System Interventions to Improve the Quality of Health Care Delivery to Populations with the Highest Hypertension and Pre-diabetes Disparities Program Strategy 2.1: Increase electronic health records (EHR) adoption and the use of health information technology (HIT) to improve performance (pursuant to federal and state guidelines) # Activity Timeline Responsible Deliverables 1 Contractor will recruit providers/health systems to participate in CVHIE to promote reporting on NQF 18 and 59 and standardized clinical quality measures for management and treatment of patients with HBP. October 1 2016 - September 30, 2017 PI, HE, Epidemiologist Submit to CDPH: • a copy of meeting agendas/minutes. 2 Contractor will work with Health Clinic Subcontractor to create and/or adapt existing Patient-centered Medical Home (PCMH) certification materials for use with partners of the California Primary Care Association or the County Medical Society. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of promotional materials, • materials distribution log, and • meeting agendas/minutes. 3 Contractor will work with UCD to identify and collect public data for required performance measure 2.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.2: Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider level # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to convene representatives from FQHCs and CVHIE in the county to develop protocols and processes for monitoring and sharing standardized quality measures at the provider level. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of meeting agendas/ minutes. 2 Contractor will work with Health Clinic Subcontractor to expand health system EHR analytics or participation in clinical quality dashboards for Health Clinic System patients with hypertension, pre-diabetes, and diabetes. Promote quality improvement through the implementation of systems that provide relevant and timely patient public data to providers and health systems. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a summary of systems in use. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 42 of 55 57 Program Strategy 2.2: Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider level # Activity Timeline Responsible Deliverables 3 Contractor will work with UCD to identify and collect public data for required performance measure 2.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.3: Increase engagement of non-physician team members in hypertension management in community health care systems # Activity Timeline Responsible Deliverables 1 Based on scan results, Contractor will work with Health Clinic Subcontractor to promote adoption by Health Clinic System providers of procedures/protocols that support the implementation of comprehensive health care teams. Contractor will monitor and track procedures/protocols adopted by providers. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of adopted procedures/ protocols. 2 Contractor will work with Health Clinic Subcontractor to Utilize scan results to identify evidence and practice tools to share with the provider community that support the implementation of evidence-based guidelines for HBP, such as the MHI hypertension protocols i.e., through local medical society. Identify training and TA needs to facilitate adoption/implementation of tools with Health Clinic Systems. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of training materials, and • meeting agendas/minutes. 3 Contractor will work with Health Clinic Subcontractor to develop a workgroup and project work plan to fill 1-2 of the evidence gaps specified in The Community Guide at http://www.thecommunityguide.org/cvd/RGteambasedcare.html October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a summary of the evidence gathered and • a summary of gap(s) identified. 4 Contractor will work with UCD to identify and collect public data for required performance measure 2.3. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 43 of 55 57 Program Strategy 2.4: Increase use of self-measured blood pressure monitoring tied with clinical support # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to research model practices, outcomes, and benefits to promote the adoption and EHR use by Health Clinic System that include integrated HBP algorithms and supports for provider prompts/feedback, patient communication, and public data tracking, monitoring, and reporting. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of sample adopted EHR systems. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.4. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.5: Implement systems to facilitate identification of patients with undiagnosed hypertension and people with prediabetes # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to develop and implement a plan for improving the system for identifying and monitoring patients with HBP in Health Clinic System. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the implementation plan. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.5. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 44 of 55 57 Component 2b: Community Clinical Linkage Strategies to Support Heart Disease and Stroke and Diabetes Prevention Efforts Program Strategy 2.6: Increase engagement of CHWs to promote linkages between health systems and community resources for adults with high blood pressure and adults with pre-diabetes or at high risk for type 2 diabetes # Activity Timeline Responsible Deliverables 1 As a result of the health system scan, Contractor will develop a plan to promote systematic change to involve Health Clinic System CHWs to promote linkages between health systems and community resources to improve outcomes for heart disease and diabetes. Contractor will work with Health Clinic Subcontractor to coordinate with others working on CHW initiatives for awareness, input, and support. Contractor will work with CHWs for their input and guidance on promotional strategies between health systems and community resources and monitor change. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the plan and • a summary of changes made. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.6. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.7: Increase engagement of community pharmacists in the provision of medication-/self-management for adults with high blood pressure # Activity Timeline Responsible Deliverables 1 Contractor will identify and convene appropriate partners to identify and share best practices, including training of pharmacists and mechanism of payment; promoting inclusion of pharmacists in the team for community-based medication reconciliation/reporting to providers and hypertension self-management. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/ minutes. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.7. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 45 of 55 57 Program Strategy 2.8: Implement systems and increase partnerships to facilitate bi-directional referral between community resources and health systems, including lifestyle change programs # Activity Timeline Responsible Deliverables 1 Contractor will institute 211 service LCPs for HBP and prediabetes, and/or identify other entities that could serve as a source for community referrals to LCPs. Develop tracking/monitoring system for referrals. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/ minutes, • 211/referral system service promotion materials, and • summary of the tracking/monitoring system. 2 Contractor will work with Health Clinic Subcontractor to educate Health Clinic Systems about community resources available for patients with HBP and pre-diabetes, and the benefits of using a community referral system, such as 211, within their organization (e.g. utilizing EHR to refer patients to community resources). Determine what resources/systems are needed to ensure bi-directional referrals are made. October 1 2016 - September 30, 2017 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of training materials, and • 211/referral system service promotion materials. 3 Contractor will work with UCD to identify and collect public data for required performance measure 2.8. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2016 - September 30, 2017 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 46 of 55 57 Cross-cutting (applies to all components) Cross-Cut Strategy: Build local capacity and document lessons learned of implementing local health departments and partners. # Activity Timeline Responsible Deliverables 1 Contractor will attend training sessions, conferences, and webinars on specific content areas to augment the internal team’s skills and program effectiveness (topics could include, public data mining health records, increasing community-clinical linkages, etc.). October 1 2016 - September 30, 2017 PI, HE, HES1, HES2, SA I, Epidemiologist Submit to CDPH: • copies of training agendas. 2 Contractor will send at least 2 staff to attend CDPH required annual meeting (1) and trainings (1-2 per year) in Sacramento. Meetings may include: “Program Kick Off”, SALT, and NDPP. March 1 - September 30, 2015 PI, HE, HES1, HES2 Submit to CDPH: • copies of confirmed travel arrangements. 3 Contractor will provide a description of best practice, noting whether it refers to innovative educational materials/presentations, policies, success stories, or other. October 1 2016 - September 30, 2017 HE Submit to CDPH: • a copy of best practices summary report. 4 Contractor will participate in focus groups and planning workgroups. Focus groups may include TA, educational materials, and/or review of evaluation tools. Workgroups may include sodium taskforce, and NDPP. October 1 2016 - September 30, 2017 HE Submit to CDPH: • copies of meeting agendas/minutes. 5 Contractor will provide internal support including logistics and paperwork for orders, mailing, travel, meetings, technical support, training, etc. March 1 - September 30, 2015 OA III Submit to CDPH: • timesheets, and • documentation of logistical processes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 47 of 55 57 YEAR 4 Component 1a: Environmental Strategies to Promote Health and Support and Reinforce Healthful Behaviors Strategy 1.1: Implement nutrition and beverage standards including sodium standards in public institutions, worksites and other key locations such as hospitals # Activity Timeline Responsible Deliverables 1 Contractor will identify and participate in national and state meetings, webinars and conferences as appropriate to increase local knowledge and capacity. Suggestions include AHA, ASTHO, NSRI, CDC Healthy Food Service Guidelines, SALT, and MHI. October 1 2017 - September 29, 2018 PI, HE, HES1, HES2 Submit to CDPH: • a copy of event agendas. 2 Contractor will work with identified target worksites to develop, adopt, and implement food procurement guidelines that include sodium reduction to increase availability of healthy foods and beverages. October 1 2017 - September 29, 2018 PI, HE, HES1, HES2 Submit to CDPH: • a copy of training materials, • meeting agendas/minutes, • target worksite procurement guidelines, and • implementation plan(s). 3 Contractor will meet with directors of other county departments and share the FCDPH wellness policy. Through discussion, assess the viability of implementing a similar or modified version of the FCDPH wellness policy in the other departments. October 1 2017 - September 29, 2018 PI, HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. 4 Contractor will work with UCD to identify and collect public data for required performance measures within strategy 1.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2, Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Strategy 1.2: Strengthen healthier food access and sales in retail venues and community venues through increased availability, improved pricing, placement, and promotion # Activity Timeline Responsible Deliverables 1 Contractor will participate in quarterly 1-2 hour meetings of the FCHSHC to add capacity and implement additional interventions that encourage healthy retail environments with the goal to promote healthier food access. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 48 of 55 57 Strategy 1.2: Strengthen healthier food access and sales in retail venues and community venues through increased availability, improved pricing, placement, and promotion # Activity Timeline Responsible Deliverables 2 Contractor will use FCHSHC assessment public data and store public data from CDPH Environmental Health Division to identify stores for intervention. Work with FCHSHC and NEOP to identify specific activities needed to promote healthier food access in retail stores. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a copy of FCHSHC assessment results and • retail promotion activities plan. 3 As part FCHSHC, Contractor will provide input to the “Healthy Stores for a Healthy Community Campaign” to reinforce campaign messages at the local level. If possible, utilize the CDPH Chronic Disease Prevention Messaging Toolkit to develop culturally and linguistically appropriate campaign messages. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes, and • campaign messages. 4 Contractor will recruit, determine specific training/resources needs, and provide TA to at least 1-2 new owner/operator representatives’ grocery/specialty food retailers including farmers’ market operators to participate in the FCHSHC campaign to improve healthy options in their stores. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agenda/minutes, • training materials, and • photos of the campaign materials in the retailer venue. 5 Contractor will work with UCD to identify and collect public data for required performance measures within strategy 1.2. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Strategy 1.3: Strengthen community promotion of physical activity through signage, worksite policies, social support, and joint use agreements in communities and jurisdictions # Activity Timeline Responsible Deliverables 1 Contractor will participate in quarterly 1-2 hour Healthy Lifestyle Partnership (HLP) meetings (county coalition facilitated by NEOP) to plan and implement community initiatives that promote physical activity. October 1 2017 - September 29, 2018 PI, HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 49 of 55 57 Strategy 1.3: Strengthen community promotion of physical activity through signage, worksite policies, social support, and joint use agreements in communities and jurisdictions # Activity Timeline Responsible Deliverables 2 Contractor will provide training and TA to facilitate the development and implementation of the selected physical activity initiatives. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agenda/minutes and photos. • Additional specific deliverables will be identified after the initiatives are selected. 3 Contractor will work with HLP and PICH to assess the effectiveness of potential promotional/marketing approaches for the PA initiatives and target audiences selected. Develop culturally and linguistically appropriate campaign messages for activities within strategy 1.3. Implement selected communication strategies to support physical activity initiatives including PRS to promote selected campaign messages. October 1 2017 - September 29, 2018 PI, HE, HES1, HES2 Submit to CDPH: • a copy of communications/ promotion items. 4 Contractor will work with UCD to identify and collect public data for required performance measure 1.3. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Strategy 1.4: Develop and or implement transportation and community plans that promote walking # Activity Timeline Responsible Deliverables 1 Based on assessment results, Contractor will collaborate with Fresno COG and TCC, identify 1-2 target communities (city or unincorporated community) and Contractor will continue to provide input to city or county general, transportation bicycle master plans and community transportation plans to increase number of communities that promote walking and active transportation, and use of public transportation. October 1 2017 - September 29, 2018 PI, HE, Submit to CDPH: • a copy of meeting agendas/minutes and • copies of target communities’ plan(s). County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 50 of 55 57 Strategy 1.4: Develop and or implement transportation and community plans that promote walking # Activity Timeline Responsible Deliverables 2 Contractor will coordinate with TCC, target city/county officials including law enforcement, and community members to utilize the completed walkability assessment(s) to identify potential local active transportation project(s) for funding from CalTrans and other funding sources. October 1 2017 - September 29, 2018 PI, HE, Submit to CDPH: • a copy of meeting agendas/minutes and • list of the potential projects identified. 3 Contractor will work with UCD to identify and collect public data for required performance measure 1.4. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Component 1b: Strategies to build support for healthy lifestyles, particularity for those at high risk, to support diabetes and heart disease and stroke prevention efforts Program Strategy 1.5: Plan and execute strategic data-driven actions through a network of partners and local organizations to build support for lifestyle change # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to refer patients and interested community members to scheduled NDPP classes at Health Clinic System health centers. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of classes scheduled, • referral and attendance logs (summary numbers only). 2 Contractor will work with Health Clinic Subcontractor to refer patients and interested community members to chapters of TOPS at Health Clinic System health centers and nearby CBOs with weekly meetings for members. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of classes scheduled, • referral and attendance logs (summary numbers only). 3 2 Contractor will work with UCD to identify and collect public data for required performance measure 1.5. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 51 of 55 57 Program Strategy 1.5: Plan and execute strategic data-driven actions through a network of partners and local organizations to build support for lifestyle change # Activity Timeline Responsible Deliverables 3 Contractor will work with Health Clinic Subcontractor to submit evaluation data to CDC in order to achieve NDPP recognition status. October 1 2017 - September 29, 2018 HE, HES1, HES2, and Health Clinic Subcontractor (TBD) Submit to CDPH: • Copy of evaluation data. Program Strategy 1.6: Implement evidence-based engagement strategies to build support for lifestyle change # Activity Timeline Responsible Deliverables 1 Utilizing the Chronic Disease Prevention Messaging Toolkit, Contractor will work with Health Clinic Subcontractor to develop a plan for how partners (CBOs, Fresno County Department of Public Health, Health Clinic System, community champions) will work together to conduct outreach/marketing, build support for and increase referrals to NDPP and TOPS. Review and update annually. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of planning meeting agendas/minutes, • the outreach/marketing plan. 2 In collaboration with CDPH and Health Clinic Subcontractor, Contractor will adapt CDC NDPP communications and marketing materials and mobilize champions to disseminate in target communities as a means to increase reach to and engagement of priority populations. Assess reach and outcomes of lifestyle change strategies and marketing efforts and refine as necessary. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of promotional materials developed, • distribution and reach log. 3 Contractor will work with UCD to identify and collect public data for required performance measure 1.6. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 52 of 55 57 Program Strategy 1.7: Increase coverage for evidence-based supports for lifestyle change by working with network partners # Activity Timeline Responsible Deliverables 1 Based on assessment results, Contractor will develop and implement an action plan to establish or increase insurance coverage of LCPs within county. October 1 2017 - September 29, 2018 PI, HE, HES1, HES2 Submit to CDPH: • action plan timeline. 2 Contractor will work with UCD to identify and collect public data for required performance measure 1.7. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Component 2a: Health System Interventions to Improve the Quality of Health Care Delivery to Populations with the Highest Hypertension and Prediabetes Disparities Program Strategy 2.1: Increase electronic health records (EHR) adoption and the use of health information technology (HIT) to improve performance (pursuant to federal and state guidelines) # Activity Timeline Responsible Deliverables 1 Contractor will recruit providers/health systems to participate in CVHIE to promote reporting on NQF 18 and 59 and standardized clinical quality measures for management and treatment of patients with HBP. October 1 2017 - September 29, 2018 PI, HE, Epidemiologist Submit to CDPH: • a copy of meeting agendas/minutes. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.2: Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider level # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to convene representatives from FQHCs and CVHIE in the county to develop protocols and processes for monitoring and sharing standardized quality measures at the provider level. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of meeting agendas/minutes. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 53 of 55 57 Program Strategy 2.2: Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider level # Activity Timeline Responsible Deliverables 2 Contractor will work with Health Clinic Subcontractor to expand health system EHR analytics or participation in clinical quality dashboards for Health Clinic System patients with hypertension, pre-diabetes, and diabetes. Promote quality improvement through the implementation of systems that provide relevant and timely patient public data to providers and health systems. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a summary of systems in use. 3 Contractor will work with UCD to identify and collect public data for required performance measure 2.1. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.3: Increase engagement of non-physician team members in hypertension management in community health care systems # Activity Timeline Responsible Deliverables 1 Based on scan results, Contractor will work with Health Clinic Subcontractor to promote adoption by Health Clinic System providers of procedures/protocols that support the implementation of comprehensive health care teams. Monitor and track providers who adopt procedures/protocols. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of adopted procedures/protocols. 2 Contractor will work with Health Clinic Subcontractor to utilize scan results to identify evidence and practice tools to share with the provider community that support the implementation of evidence-based guidelines for HBP, such as the MHI hypertension protocols i.e., through local medical society. Identify training and TA needs to facilitate adoption/implementation of tools with Health Clinic Subcontractor. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of training materials, and • meeting agendas/minutes. 3 Contractor will work with Health Clinic Subcontractor to develop a workgroup and project work plan to fill 1-2 of the evidence gaps specified in The Community Guide at http://www.thecommunityguide.org/cvd/RGteambasedcare.html October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a summary of the evidence gathered and • gap(s) identified. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 54 of 55 57 Program Strategy 2.3: Increase engagement of non-physician team members in hypertension management in community health care systems # Activity Timeline Responsible Deliverables 4 Contractor will work with UCD to identify and collect public data for required performance measure 2.3. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.4: Increase use of self-measured blood pressure monitoring tied with clinical support # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to research model practices, outcomes, and benefits to promote the adoption and EHR use with Health Clinic System health centers that include integrated HBP algorithms and supports for provider prompts/feedback, patient communication, and public data tracking, monitoring, and reporting. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of sample adopted EHR systems. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.4. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.5: Implement systems to facilitate identification of patients with undiagnosed hypertension and people with prediabetes # Activity Timeline Responsible Deliverables 1 Contractor will work with Health Clinic Subcontractor to develop and implement a plan for improving the system for identifying and monitoring patients with HBP in Health Clinic System. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the plan. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.5. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 55 of 55 57 Component 2b: Community Clinical Linkage Strategies to Support Heart Disease and Stroke and Diabetes Prevention Efforts Program Strategy 2.6: Increase engagement of CHWs to promote linkages between health systems and community resources for adults with high blood pressure and adults with pre-diabetes or at high risk for type 2 diabetes # Activity Timeline Responsible Deliverables 1 As a result of the health system scan, Contractor will work with Health Clinic Subcontractor to develop a plan to promote systematic change to involve Health Clinic System CHWs to promote linkages between health systems and community resources to improve outcomes for heart disease and diabetes. Coordinate with others working on CHW initiatives for awareness, input, and support. Work with CHWs for their input and guidance on promotional strategies between health systems and community resources. Monitor change. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD) Submit to CDPH: • a copy of the plan and • a summary of changes made. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.6. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. Program Strategy 2.7: Increase engagement of community pharmacists in the provision of medication-/self-management for adults with high blood pressure # Activity Timeline Responsible Deliverables 1 Identify and convene appropriate partners to identify and share best practices, including training of pharmacists and mechanism of payment; promoting inclusion of pharmacists in the team for community-based medication reconciliation/reporting to providers and hypertension self-management. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/ minutes. 2 Contractor will work with UCD to identify and collect public data for required performance measure 2.7. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 56 of 55 57 Program Strategy 2.8: Implement systems and increase partnerships to facilitate bi-directional referral between community resources and health systems, including lifestyle change programs # Activity Timeline Responsible Deliverables 1 Contractor will institute 211 services LCPs for HBP and pre-diabetes, and/or identify other entities that could serve as a source for community referrals to LCPs. Develop tracking/monitoring system for referrals. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a copy of meeting agendas/minutes, • 211/referral system service promotion materials, and • a summary of the tracking/monitoring system. 2 Contractor will work with Health Clinic Subcontractor to educate Health Clinic System providers about community resources available for patients with HBP and pre-diabetes, and the benefits of using a community referral system, such as 211, within their organization (e.g. utilizing EHR to refer patients to community resources). Determine what resources/systems are needed to ensure bi-directional referrals are made. October 1 2017 - September 29, 2018 HE, HES1, HES2, Health Clinic Subcontractor (TBD), Submit to CDPH: • a copy of training materials, and • 211/referral system service promotion materials. 3 Contractor will work with UCD to identify and collect public data for required performance measure 2.8. Attend required webinars and trainings on public data collection and performance measures sponsored by CDPH. October 1 2017 - September 29, 2018 HE, HES1, HES2 Submit to CDPH: • a compilation of public data collected, and • a copy of event agendas. County of Fresno Department of Public Health 14-10712 A01 Exhibit A Scope of Work Page 57 of 55 57 Cross-cutting (applies to all components) Cross-Cut Strategy: Build local capacity and document lessons learned of implementing local health departments and partners. # Activity Timeline Responsible Deliverables 1 Contractor will attend training sessions, conferences, and webinars on specific content areas to augment the internal team’s skills and program effectiveness (topics could include, public data mining health records, increasing community-clinical linkages, etc.). October 1 2017 - September 29, 2018 PI, HE, HES1, HES2, SA I, Epidemiologist Submit to CDPH: • copies of training agendas. 2 Contractor will send at least 2 staff to attend CDPH required annual meeting (1) and trainings (1-2 per year) in Sacramento. Meetings may include: “Program Kick Off”, SALT, and NDPP. March 1 - September 30, 2015 PI, HE, HES1, HES2 Submit to CDPH: • copies of confirmed travel arrangements. 3 Contractor will provide a description of best practice, noting whether it refers to innovative educational materials/presentations, policies, success stories, or other. October 1 2017 - September 29, 2018 HE Submit to CDPH: • a copy of best practices summary report. 4 Contractor will participate in focus groups and planning workgroups. Focus groups may include TA, educational materials, and/or review of evaluation tools. Workgroups may include sodium taskforce, and NDPP. October 1 2017 - September 29, 2018 HE Submit to CDPH: • copies of meeting agendas/minutes. 5 Contractor will provide internal support including logistics and paperwork for orders, mailing, travel, meetings, technical support, training, etc. March 1 - September 30, 2015 OA III Submit to CDPH: • timesheets, and • documentation of logistical processes. County of Fresno Department of Public Health 14-10712 A01 Exhibit B Budget Detail and Payment Provisions Page 1 of 4 1. Invoicing and Payment A. In no event shall the County request reimbursement from the State for obligations entered into or for costs incurred prior to the commencement date or after the expiration of this Agreement. B. For services satisfactorily rendered and upon receipt and approval of the invoices, California Department of Public Health (CDPH) agrees to compensate the County for actual expenditures incurred in accordance with the rates specified herein or attached hereto. C. The County shall submit, in arrears, not more frequently than once a month, and no less than quarterly, an invoice to CDPH for costs incurred pursuant to this agreement. In Addition, each invoice shall contain the following: 14-10712 Lisa Pulido California Department of Public Health Chronic Disease Control Branch MS 7208 P.O. Box 997377 Sacramento, CA 95899-7377 D. Invoices shall: 1) Be prepared on County letterhead and bear the County name as shown on the agreement. If invoices are not on produced letterhead invoices must be signed by an authorized official, employee or agents certifying that the expenditures claimed represent actual expenses for the service performed under this contract. 2) Invoices must be submitted to CDPH electronically only. Hard copies are not required. 3) Identify the billing and/or performance period covered by the invoice. 4) Itemize costs for the billing period in the same or greater level of detail as indicated in this agreement. Subject to the terms of this agreement, reimbursement may only be sought for those costs and /or cost categories expressly identified as allowable in this agreement may be reimbursed. 5) Be submitted to CDPH within 60 days of invoice period end. E. Timely Submission of Final Invoice 1) A final undisputed invoice shall be submitted for payment no more than sixty (60) calendar days following the expiration or termination date of this agreement, unless a later or alternate deadline is agreed to in writing by the program project representative, as shown in Exhibit A, provision 5A. Said invoice should be clearly marked “Final Invoice”, indicating that all payment obligations of CDPH under this agreement have ceased and that no further payments are due or outstanding. CDPH may, at its discretion, choose not to honor any delinquent final invoice if the County fails to obtain prior written CDPH approval of an alternate final invoice submission deadline. 2) The Contractor is hereby advised of its obligation to submit to the state, with the final invoice, a completed copy of the “Contractor’s Release (Exhibit F)”. County of Fresno Department of Public Health 14-10712 A01 Exhibit B Budget Detail and Payment Provisions Page 2 of 4 2. Budget Contingency Clause A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of no further force and effect. In this event, the State shall have no liability to pay any funds whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be obligated to perform any provisions of this Agreement. B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State shall have the option to either cancel this Agreement with no liability occurring to the State, or offer an agreement amendment to Contractor to reflect the reduced amount. 3. Payment A. Costs for this Agreement shall be computed in accordance with State Administrative Manual Sections 8752 and 8752.1. B. Nothing herein contained shall preclude advance payments pursuant to Article 1, Chapter 3, Part 1, Division 3, Title 2 of the Government Code of the State of California. 4. Advance Payments No advance payment is allowed under this agreement. 5. Amounts Payable A. The amounts payable under this agreement shall not exceed: 1) $638,429 60,591 for the budget period of 03/01/2015 through 09/30 29/2015. 2) $638,429 1,216,267 for the budget period of 10/01 09/30/2015 through 09/30 29/2016, this includes $577,838 of unspent funds being shifted from Year 1 to Year 2 to complete Year 1 services. 3) $638,429 for the budget period of 10/01 09/30/2016 through 09/30 29/2017. 4) $638,429 for the budget period of 10/01 09/30//2017 through 09/29/2018. B. Reimbursement shall be made for allowable expenses up to the amount annually encumbered commensurate with the state fiscal year in which services are performed and/or goods are received. 6. Expense Allowability / Fiscal Documentations A. Invoices, received from the County and accepted for payment by CDPH, shall not be deemed evidence of allowable agreement costs. B. The County shall maintain for review and audit and supply to CDPH upon request, adequate documentation of all expenses claimed pursuant to this agreement to permit a determination of expense allowability. County of Fresno Department of Public Health 14-10712 A01 Exhibit B Budget Detail and Payment Provisions Page 3 of 4 C. If the allowability of an expense cannot be determined by CDPH because invoice detail, fiscal records, or backup documentation is nonexistent or inadequate according to generally accepted accounting principles or practices, all questionable costs may be disallowed and payment may be withheld by CDPH. Upon receipt of adequate documentation supporting a disallowed or questionable expense, reimbursement may resume for the amount substantiated and deemed allowable. D. If travel is a reimbursable expense, receipts must be maintained to support the claimed expenditures. E. Invoices must be clearly labeled to differentiate Budgets and Tasks as per the incorporated Budget Attachments. 7. Travel and Per Diem Reimbursement Travel and per diem reimbursement shall be in accordance with State travel regulations and rates. Reimbursement for out-of-state travel requires prior written authorization by the CDPH program Contract Manager who may either approve said travel in a budget exhibit or issue a letter of approval if such travel was not previously specified in an approved budget. A copy of the Contractor’s approved travel rates shall be provided to CDPH upon request. 8. Federal Contract Funds A. It is mutually understood between the parties that this contract may have been written for the mutual benefit of both parties before ascertaining the availability of congressional appropriation of funds to avoid program and fiscal delays that would occur if the contract were executed after that determination was made. B. This contract is valid and enforceable only if sufficient funds are made available to the State by the United States Government for the fiscal year(s) 2014-2018 for the purpose of this program. In addition, this contract is subject to any additional restrictions, limitations, or conditions enacted by the Congress or to any statute enacted by the Congress that may affect the provisions, terms or funding of this agreement in any manner. C. The parties mutually agree that if the Congress does not appropriate sufficient funds for the program, this agreement shall be amended to reflect any reduction in funds. D. The department has the option to invalidate the contract under the 30-day cancellation clause or to amend the contract to reflect any reduction in funds. 9. Recovery of Overpayments A. Contractor agrees that claims based upon the terms of this agreement or an audit finding, and/or an audit finding that is appealed and upheld, will be recovered by the State by one of the following options: 1) Contractor‘s remittance to the State of the full amount of the audit exception within 30 days following the State’s request for repayment; 2) A repayment schedule which is agreeable to both the State and the Contractor. County of Fresno Department of Public Health 14-10712 A01 Exhibit B Budget Detail and Payment Provisions Page 4 of 4 B. The State reserves the right to select which option as indicated above in paragraph A will be employed and the Contractor will be notified by the State in writing of the claim procedure to be utilized. C. Interest on the unpaid balance of the audit finding or debt will accrue at a rate equal to the monthly average of the rate received on investments in the Pooled Money Investment Fund commencing on the date that an audit or examination finding is mailed to the Contractor, beginning 30 days after Contractor‘s receipt of the State’s demand for repayment. D. If the Contractor has filed a valid appeal regarding the report of audit findings, recovery of the overpayments will be deferred until a final administrative decision on the appeal has been reached. If the Contractor loses the final administrative appeal, Contractor shall repay, to the State, the over-claimed or disallowed expenses, plus accrued interest. Interest accrues from the Contractor’s first receipt of State’s notice requesting reimbursement of questioned audit costs or disallowed expenses. Exhibit B, Attachment I Budget Year 1 (03/01/2015 through 09/3029/2015) County of Fresno Department of Public Health 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 1 Position Title Base Salary Months Benefit %Cost Cost Cost Cost Total % FTE Total Costs 77,792 7 64.74% $ 681 $ 1,588 $ 681 $ 1,588 10% $ 4,538 $ 283 $ 660 $ 283 $ 660 $ 1,886 Health Educator 45,058 3 70.76% $ 1,183 $ 2,760 $ 1,183 $ 2,760 70%$ 7,885 7,886 Health Education Specialist 38,740 3 73.23% $ 1,307 $ 3,051 $ 1,307 $ 3,051 90%$ 8,717 8,716 Health Education Specialist 38,740 3 73.23% $ 872 $ 2,034 $ 872 $ 2,034 60%$ 5,811 5,812 Staff Analyst I 42,354 4 86.01% $ 424 $ 988 $ 424 $ 988 20% $ 2,824 $ 198 $ 462 $ 198 $ 462 $ 1,320 Office Assistant III 32,812 7 90.02% $ 718 $ 1,675 $ 718 $ 1,675 25% $ 4,785 $ 355 $ 828 $ 355 $ 828 $ 2,366 Epidemiologist 61,672 3 80.25% $ 231 $ 540 $ 231 $ 540 10% $ 1,542 $0 $0 $0 $0 $0 Total Salaries 337,169$ 76.89% $ 5,415 $ 12,635 $ 5,415 $ 12,635 $ 4,198 $ 9,795 $ 4,198 $ 9,795 $ 3,092 $ 7,216 $ 3,092 $ 7,216 $ 7,290 $ 17,011 $ 7,290 $ 17,011 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $ 223 $ 520 $ 223 $ 520 $ 223 $ 520 $ 223 $ 520 $ 49 $0 $0 $0 Principal Principle Investigator Printing ♦C1,all Strategies; ♦C2, all Strategies $ 49 $ 1,486 CD. TRAVEL $ 104 $ 242 $ 104 $ 242 $ 690 Local travel to complete SOW deliverables (1200 miles at $.575/mile) ♦C1,all Strategies; ♦C2, all Strategies $ 1,486 Total Operating $ 3,900 $ 9,100 $ 3,900 $ 9,100 $ 26,000 $0 Tech Support $ 750 $ 1,750 $ 750 $ 1,750 $ 5,000 $ 1,500 $ 3,500 $ 1,500 $ 3,500 $ 10,000 $0 Meeting room rentals ♦C1,all Strategies; ♦C2, all Strategies Communications $ 375 $ 875 $ 375 $ 875 $ 2,500 $0 $ 150 $ 350 $ 150 $ 350 $ 1,000 BC. OPERATING EXPENSES General Office Supplies $ 1,125 $ 2,625 $ 1,125 $ 2,625 $ 7,500 $0 $ 9,716 $ 4,164 $ 9,716 $ 27,759 $ 27,986 $ 48,602 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes Task 2b Heart 70% $ 20,616 **Fresno County employees receive benefits based upon their date of hire, retirement tier level, and job classification. Benefit rates vary based upon the length of time in a position and changes yearly with merit adjustments. Total Personnel Costs $ 9,579 $ 22,351 $ 9,579 $ 22,351 $ 63,860 A. PERSONNEL $ 36,101 B. FRINGE BENEFITS Average 76.89% of Personnel** $ 4,164 Exhibit B, Attachment I Budget Year 1 (03/01/2015 through 09/3029/2015) County of Fresno Department of Public Health 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 2 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes Task 2b Heart 70% $ 454 $ 945 $ 405 $ 945 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $ 7,967 $ 18,476 $ 7,918 $ 18,476 $ 19,787 $ 51,171 $ 23,821 $ 44,471 $ 7,967 $ 18,476 $ 7,918 $ 18,476 $ 1,170 $ 2,711 $ 1,162 $ 2,711 $ 9,137 $ 21,187 $ 9,080 $ 21,187 $ - Health Clinic Subcontractor (TBD) ♦C1b,S1.5,A1-A6; S1.6,A1-A4; ♦C2a,S2.1,A1,A3; S2.2,A1-A4; S2.3,A1-A5; S2.4,A1-A3; S2.5,A1-A3; ♦C2b,S2.6,A1-A3; S2.8,A3-A4 $0 $0 $0 $0 $ - $ 503,737 Total Subcontracts $ 125,934 $ 251,869 $ 125,934 $ 503,737 $ 2,749 DE. SUBCONTRACTS $ 125,934 $ 251,869 $ 125,934 Total Travel $ 7,512 $ 3,497 $ 6,528 $ 20,442 FG. INDIRECT COSTS TOTAL EXPENSES $ 22,692 $ 176,284 $ 270,853 $0 TOTAL DIRECT COSTS $ 19,787 $ 168,772 $ 267,356 $ 162,072 $ 617,987 $ 168,600 $ 638,429 $ 52,837 Total Allowable Direct Costs $ 139,250 *Only the first $25,000 of each subcontract may be used in the calculation $ 7,754 Calculated at 14.68% of Total Allowable* Direct Costs $ 2,905 $0 Total Other Costs $ 5,800 $ 10,200 $ 1,500 $ 3,500 $ 21,000 $0 $0Education/Training Materials (including related translation of materials) ♦C1a,S1.1,A1,A3-A4; S1.4,A3; ♦C1b,S1.5,A1- $ 1,750 $ 750 $ 2,500 $ 375 $ 875 $ 375 $ 875 $ 2,500 Meeting supplies, interpretation, and child care for all sessions and kick-off meetings. ♦C1,all Strategies; ♦C2, all Strategies $0 $ 1,125 $ 2,625 $ 1,125 $ 2,625 $ 7,500 $0 $0 EF. OTHER COSTS $ 2,550 $ 5,950 $ 8,500 Technical Assistance (Provider Support - TBD. Based on available funding) ♦C1a,S1.1,A3,A5; S1.2,A5; ♦C1b,S1.3,A4; ♦C2a,S2.3,A3; ♦Cross-CutA4 $0 $0Public Relations Services (Media, Press release, Campaign) ♦C1a,S1.2,A3,A5; S1.2,A1-A6; S1.3,A1-A6; S1.4,A1-A4 $0 $ 509 $ 1,187 $ 509 $ 1,187 $ 3,390 Conferences/Trainings (hotel, per diem, parking, and mileage) ♦C1,all Strategies; ♦C2, all Strategies $ 405 $ 945 $ 405 $ 945 $ 2,700 $ 60,591 $ 52,837 Exhibit B, Attachment II Budget Year 2 (09/3010/01/2015 through 09/3029/2016) County of Fresno Department of Public Health 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 1 Position Title Base Salary Months Benefit %Cost Cost Cost Cost Total % FTE Total Costs 77,792$ 12 64.74% $ 1,167 $ 2,723 $ 1,167 $ 2,723 10% $ 7,779 79,021$ $ 3,161 $ 1,976 $ 790 $ 1,976 $ 7,903 Health Educator 47,918$ 12 69.85% $ 5,031 $ 11,740 $ 5,031 $ 11,740 70% $ 33,543 49,426$ $ 13,839 $ 8,650 $ 3,460 $ 8,650 $ 34,599 Health Education Specialist 41,210$ 12 72.18% $ 5,563 $ 12,981 $ 5,563 $ 12,981 90% $ 37,089 42,510$ $ 17,003 $ 10,628 $ 4,251 $ 10,628 100% $ 42,510 Health Education Specialist 41,210$ 12 72.18% $ 3,709 $ 8,654 $ 3,709 $ 8,654 60% $ 24,726 42,510$ $ 10,202 $ 6,377 $ 2,551 $ 6,377 $ 25,507 Staff Analyst I 45,032$ 12 82.20% $ 1,351 $ 3,152 $ 1,351 $ 3,152 20% $ 9,006 $ 3,603 $ 2,252 $ 901 $ 2,252 $ 9,008 Office Assistant III 34,892$ 12 85.97% $ 1,308 $ 3,053 $ 1,308 $ 3,053 25% $ 8,723 35,490$ $ 3,549 $ 2,218 $ 887 $ 2,218 $ 8,872 Epidemiologist 63,596$ 12 77.12% $ 954 $ 2,226 $ 954 $ 2,226 10% $ 6,360 64,402$ $ 2,576 $ 1,610 $ 644 $ 1,610 $ 6,440 Total Salaries 351,651$ 74.89% $ 19,084 $ 44,529 $ 19,084 $ 44,529 $ 127,226 358,392$ $ 53,933 $ 33,711 $ 13,484 $ 33,711 $ 134,839 $ 152 $ 350 $ 1,314 $ 333 $ 333 2,244$ 6,382$ $ 143 $ 950 $ 2,577 $ 6,008 $ 2,546 $ 6,008 $ 17,139 $ 1,003 Printing ♦C1,all Strategies; ♦C2, all Strategies $ 3,024 $ 7,055 $ 3,024 $ 7,055 $ 20,159 Meeting room rentals ♦C1,all Strategies; ♦C2, all Strategies $ 150 $ 350 $ 1,000 962$ 2,244$ 932$ $ 150 $ 563 $ 143 $ 150 $ 563 Communications Security and Utilities Tech Support Total Operating $ 1,000 $ 3,754 $ 2,131 $ 750 $ 77,877 $ 33,376 $ 77,877 $ 222,507 BC. OPERATING EXPENSES $ 4,973 $ 2,131 $ 4,973 $ 14,209 $ 350 $ 1,314 $ 150 $ 350 General Office Supplies $ 450 $ 350 $ 151 $ 1,750 $ 750 $ 1,750 $ 5,000 $ 14,785 $ 34,498 A. PERSONNEL TOTAL PERSONNEL COSTS $ 33,376 **Fresno County employees receive benefits based upon their date of hire, retirement tier level, and job classification. Benefit rates vary based upon the length of time in a position and changes yearly with merit adjustments. $ 14,785 $ 34,498 $ 98,566 $ 68,718 $ 68,209 $ 28,269 $ 68,209 $ 233,405 B. FRINGE BENEFITS Average 74.89% 73.10% of Personnel** $ 350 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes 30% Task 2b Heart 70% $ 14,292 $ 33,348 $ 14,292 $ 33,348 $ 95,281 Principal Principle Investigator $ 1,050 $ 450 $ 1,050 $ 3,000 Exhibit B, Attachment II Budget Year 2 (09/3010/01/2015 through 09/3029/2016) County of Fresno Department of Public Health 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 2 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes 30% Task 2b Heart 70% $ 150 $ 15,647 $ 36,510 $ 647 $ 225 $ 175 $ 500 $ 1,400 Calculated at 14.68% 15.0% of Total Allowable* Direct Costs $ 509 $ 75 $ 175 $ 75 $ 600 $ 675 $ 405 $0 $0 Meeting supplies, interpretation, and child care for all sessions and kick-off meetings. ♦C1,all Strategies; ♦C2, all Strategies $ 197 $ 460 $ 197 $ 145,174 DE. SUBCONTRACTS $ 150 $ 350 Local travel to complete SOW deliverables (1200926 miles at $.575.54/mile) ♦C1,all Strategies; ♦C2, all Strategies Total Travel Conferences/Trainings (hotel, per diem, parking, and mileage) ♦C1,all Strategies; ♦C2, all Strategies Total Subcontracts Health Clinic Subcontractor (TBD) ♦C1b,S1.5,A1-A2,A4-A5; S1.6,A1-A3; ♦C2a,S2.1,A1; S2.2,A1-A3 4; S2.3,A1-A4; S2.4,A1- A2 3; S2.5,A1-A23; ♦C2b,S2.6,A1-A23; S2.7,A2; S2.8,A3-A4 Public Relations Services (Media, Press release, Campaign) ♦C1a,1.3,A5 S1.1,A4; S1.2,A3,A7; S1.3,A4; S1.4,A2 ♦C1b,S1.5,A4; S1.6,A2-A3; S1.7,A2 ♦C2aS2.4,A2; S2.5,A2, ♦C2b,S2.6,A2; S2.7,A2, S2.8,A3 CD. Travel $ 675 $ 1,575 $ 72,574 $ 1,575 $ 4,500 $ 145,174 $ 72,574 $ 104 $ 242 $ 104 $ 242 $ 690 $ 600 $ 945 $ 2,700 $ 1,187 $ 3,390 $ 72,574 $ 290,294 $ 116,583 $ 55,485 $ 288,651 *Only the first $25,000 of each subcontract may be used in the calculation $ 638,429 $ 290,294 $ 12,491 $ 15,025 $ 6,340 $ 15,025 $ 48,881 $ 47,764 FG. INDIRECT COSTS $ 589,548 $ 116,583 Total Other Costs Education/Training Materials (including related translation of materials) ♦C1a,S1.1,A1,A3-A54; S1.2,A3,A5; S1.3,A2,A4; S1.4,A3 ♦C1b,S1.5,A1-A2; S1.6,A2-A3; ♦C2a,S2.3,A3 ♦C2b,S2.7,A2; S2.8,A3 $ 72,574 $ 460 $ 1,315 $1,000 $ 405 $ 945 $ 1,400 $ 4,000 $ 509 $ 1,187 $ 225 $ 525 $ 1,500 $1,000 $ 150 TOTAL DIRECT COSTS $ 52,556 $ 195,203 $ 182,703 $ 160,203 $ 590,664 $ 11,303 $ 16,050 $ 2,450 $ 16,050 $ 10,853 $ 15,000 $ 2,000 $ 15,000 $ 150 $ 350 $ 150 $ 350 $ 525 $ 116,583 $ 55,485 $ 116,583 $ 288,651 EF. OTHER COSTS $ 15,000 $ 35,000 $ - $ - $ 50,000 Technical Assistance (Provider Support - TBD. Based on available funding) ♦C1a,S1.1,A3,A5; S1.2,A56; ♦C1b S1.3,A3- 4 ♦C1b, S1.5,A2; ♦C2a,S2.3,A3; ♦C2b,S2.6,A2; S2.8,A2 ♦Cross- CutA4 $ 225 $ 525 $ 95,764 $ 223,450 $ 95,764 $ 223,450 $ 130,963 $ 45,889 $ 95,963 $ 83,273 $ 100,167 $ 42,265 $ 100,167 Total Allowable Direct Costs $ 52,556 $ 174,290 $ 7,715 Total Expenses $ 1,500 $1,000 $42,853 $ 350 $ 150 $ 350 $ 60,271 $ 214,428 $ 189,439 $ 19,225 $ 6,736 $ 14,087 $ 325,872 $ 83,273 $ 208,425 $ 89,425 $ 208,425 $ 325,370 $ 1,510 $ 54,315 $45,853 $ 350 $ 225 $ 525 Exhibit B, Attachment II-A Budget, Year II-A (Unspent balance from Budget Year I) 09/30/15 - 09/29/16 County of Fresno Department of Public Health 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 1 Position Title Base Salary Month s Benefit %Cost Cost Cost Cost Total % FTE Total Costs Health Educator 45,058.00 3 70.76% $ 1,428 $0.00 $0.00 $0.00 70% $ 1,428 Health Education Specialist 38,740.00 3 73.23% $ 782 $0.00 $0.00 $0.00 90% $ 782 Health Education Specialist 38,740.00 3 73.23% $ 1,026 $0.00 $0.00 $0.00 60% $ 1,026 Total Salaries 337,169$ 76.89% $ 3,236 $0.00 $0.00 $0.00 $ 3,000 $0.00 $0.00 $0.00 Technical Assistance (Provider Support - TBD. Based on available funding) ♦C1a,S1.1,A4; S1.2, A3; S1.3,A3 ♦Cross- CutA4 $ 7,500 $0.00 $0.00 $0.00 Total Subcontracts $ 15,693 $ 7,500 $ 200,959 $ 86,126 $ 200,959 $ 503,737 Total Travel $ 2,000 $0.00 $0.00 $0.00 $ 2,000 E. SUBCONTRACTS Health Clinic Subcontractor (TBD) ♦C1a,S1.1,A4-A5 ♦C1b,S1.5,A1-A5; S1.6,A1; ♦C2a,S2.1,A1; S2.2,A1; S2.3,A1-A2; S2.4,A1; S2.5,A1; ♦C2b,S2.6,A1; S2.8,A2 $ 15,693 $ 200,959 $ 86,126 $ 200,959 $ 503,737 Total Operating $ 29,690 Equipment (3 b&w printers to complete SOW activities) $ 3,000 Meeting room rentals ♦ C1a, all Strategies $ 1,190 $0.00 $0.00 $0.00 $ 1,190 $0.00 $0.00 $ 2,488 Printing ♦ C1a, all Strategies $ 15,000 $0.00 $0.00 $0.00 $ 15,000 C. OPERATING EXPENSES General Office Supplies $ 10,500 $0.00 $0.00 $0.00 $ 10,500 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes 30% Task 2b Heart 70% $ 29,690 $0.00 $0.00 $0.00 **Fresno County employees receive benefits based upon their date of hire, retirement tier level, and job classification. Benefit rates vary based upon the length of time in a position and changes yearly with merit adjustments. Total Personnel Costs $ 5,724 $0.00 $0.00 $0.00 $ 5,724 A. PERSONNEL $ 3,236 B. FRINGE BENEFITS Average 76.89% of Personnel** $ 2,488 $0.00 D. TRAVEL Conferences/Trainings (hotel, per diem, parking, and mileage) ♦ C1a, all Strategies $ 2,000 $0.00 $0.00 $0.00 $ 2,000 F. OTHER COSTS Meeting supplies, interpretation, and child care for all sessions and kick-off meetings. ♦ C1a, all Strategies $ 3,500 $0.00 $0.00 $0.00 $ 3,500 Public Relations Services (Media, Press release, Campaign) ♦C1a,S1.2,A3; S1.3,A4; S1.4,A2 $ 8,500 $0.00 $0.00 $0.00 $ 8,500 Exhibit B, Attachment II-A Budget, Year II-A (Unspent balance from Budget Year I) 09/30/15 - 09/29/16 County of Fresno Department of Public Health 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 2 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes 30% Task 2b Heart 70% $ 65,164 $ 8,750 $ 3,750 $ 8,750 $ 86,414 Calculated at 14.68% of Total Allowable* Direct Costs $ 9,566 $ 1,285 $ 551 $ 1,285 $ 12,686 Total Allowable Direct Costs G. INDIRECT COSTS TOTAL DIRECT COSTS $ 77,107 $ 200,959 $ 86,126 $ 200,959 $ 565,151 $ 4,500 $0.00 $0.00 $0.00 $ 24,000 $0.00 $0.00 $0.00 Education/Training Materials (including related translation of materials) ♦C1a,S1.1,A2; S1.2,A3; S1.3,A3-A4 $ 4,500 Total Other Costs $ 24,000 *Only the first $25,000 of each subcontract may be used in the calculation TOTAL EXPENSES $ 86,673 $ 202,244 $ 86,676 $ 202,244 $ 577,837 Exhibit B, Attachment lll Budget Year 3 (10/0109/30/2016 through 09/3029/2017) County of Fresno Department of Public Health 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 1 Position Title Base Salary Months Benefit %Cost Cost Cost Cost Total % FTE Total Costs Principal Investigator 77,792.00 12 64.74% $ 1,167 $ 2,723 $ 1,167 $ 2,723 10% $ 7,779 Health Educator 49,426.00 12 69.41% $ 5,190 $ 12,109 $ 5,190 $ 12,109 70% $ 34,598 Health Education Specialist 42,510.00 12 71.67% $ 5,739 $ 13,391 $ 5,739 $ 13,391 90% $ 38,259 Health Education Specialist 42,510.00 12 71.67% $ 3,826 $ 8,927 $ 3,826 $ 8,927 60% $ 25,506 Staff Analyst I 46,436.00 12 80.79% $ 1,393 $ 3,251 $ 1,393 $ 3,251 20% $ 9,287 Office Assistant III 35,984.00 12 84.44% $ 1,349 $ 3,149 $ 1,349 $ 3,149 25% $ 8,996 Epidemiologist 65,572.00 12 75.85% $ 984 $ 2,295 $ 984 $ 2,295 10% $ 6,557 Total Salaries 360,231$ 74.08% $ 19,647 $ 45,844 $ 19,647 $ 45,844 Technical Assistance (Provider Support - TBD. Based on available funding) ♦C1a,S1.2,A4; ♦C1b,S1.3,A2; ♦C2a,S2.3,A2; ♦Cross-CutA4 $ 225 $ 525 $ 225 $ 525 $ 1,500 E. OTHER COSTS Public Relations Services (Media, Press release, Campaign) ♦C1a,1.3,A3 ♦C1b,S1.6,A1,A2 $ 7,500 $ 17,500 $ - $ - $ 25,000 Total Subcontracts $ - $ 79,368 $ 158,736 $ 79,368 $ 317,472 D. SUBCONTRACTS Health Clinic Subcontractor (TBD) ♦C1b,S1.5,A1-A2; S1.6,A1-A2; ♦C2a,S2.1,A2; S2.2,A1-A2; S2.3,A1-A3; S2.4,A1; S2.5,A1; ♦C2b,S2.6,A1; S2.8,A2 $ - $ 79,368 $ 158,736 $ 79,368 $ 317,472 Total Travel $ 509 $ 1,187 $ 509 $ 1,187 $ 3,390 Conferences/Trainings (hotel, per diem, parking, and mileage) ♦C1,all Strategies; ♦C2, all Strategies $ 405 $ 945 $ 405 $ 945 $ 2,700 C. TRAVEL Local travel to complete SOW deliverables (1200 miles at $.575/mile) ♦C1,all Strategies; ♦C2, all Strategies $ 104 $ 242 $ 104 $ 242 $ 690 Total Operating $ 2,393 $ 5,583 $ 2,393 $ 5,583 $ 15,950 Tech Support $ 143 $ 333 $ 143 $ 333 $ 950 Communications $ 150 $ 350 $ 150 $ 350 $ 1,000 Meeting room rentals ♦C1,all Strategies; ♦C2, all Strategies $ 150 $ 350 $ 150 $ 350 $ 1,000 Printing ♦C1,all Strategies; ♦C2, all Strategies $ 1,500 $ 3,500 $ 1,500 $ 3,500 $ 10,000 B. OPERATING EXPENSES General Office Supplies $ 450 $ 1,050 $ 450 $ 1,050 $ 3,000 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes Task 2b Heart 70% **Fresno County employees receive benefits based upon their date of hire, retirement tier level, and job classification. Benefit rates vary based upon the length of time in a position and changes yearly with merit adjustments. Total Personnel Costs $ 34,202 $ 79,806 $ 34,202 $ 79,806 $ 228,016 A. PERSONNEL $ 130,983 B. FRINGE BENEFITS Average 74.08% of Personnel** $ 14,555 $ 33,962 $ 14,555 $ 33,962 $ 97,034 Exhibit B, Attachment lll Budget Year 3 (10/0109/30/2016 through 09/3029/2017) County of Fresno Department of Public Health 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 2 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes Task 2b Heart 70% $ 45,251 $ 113,918 $ 46,084 $ 96,418 *Only the first $25,000 of each subcontract may be used in the calculation TOTAL EXPENSES $ 51,894 $ 201,676 $ 203,252 $ 181,607 $ 638,429 F. INDIRECT COSTS Calculated at 14.68% of Total Allowable* Direct Costs $ 6,643 $ 16,723 $ 6,765 $ 14,154 $ 44,285 Total Allowable Direct Costs $ 301,671 TOTAL DIRECT COSTS $ 45,251 $ 184,953 $ 196,487 $ 167,453 $ 594,143 Total Other Costs $ 8,147 $ 19,010 $ 647 $ 1,510 $ 29,315 Education/Training Materials (including related translation of materials) $ 225 $ 525 $ 225 $ 525 $ 1,500 Meeting supplies, interpretation, and child care for all sessions and kick-off meetings. ♦C1,all Strategies; ♦C2, all Strategies $ 197 $ 460 $ 197 $ 460 $ 1,315 Exhibit B, Attachment IV Budget Year 4 (10/01 09/30/2017 through 09/29/2018) County of Fresno 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 1 Position Title Base Salary Months Benefit %Cost Cost Cost Cost Total % FTE Total Costs Principal Investigator 77,792.00 12 64.74% $ 1,167 $ 2,723 $ 1,167 $ 2,723 10% $ 7,779 Health Educator 50,960.00 12 69.00% $ 5,351 $ 12,485 $ 5,351 $ 12,485 70% $ 35,672 Health Education Specialist 43,836.00 12 71.18% $ 5,918 $ 13,808 $ 5,918 $ 13,808 90% $ 39,452 Health Education Specialist 43,836.00 12 71.18% $ 3,945 $ 9,206 $ 3,945 $ 9,206 60% $ 26,302 Staff Analyst I 47,892.00 12 71.16% $ 1,437 $ 3,352 $ 1,437 $ 3,352 20% $ 9,578 Office Assistant III 37,102.00 12 74.70% $ 1,391 $ 3,246 $ 1,391 $ 3,246 25% $ 9,276 Epidemiologist 67,626.00 12 66.38% $ 1,014 $ 2,367 $ 1,014 $ 2,367 10% $ 6,763 Total Salaries 369,045$ 69.76% $ 20,223 $ 47,188 $ 20,223 $ 47,188 Meeting supplies, interpretation, and child care for all sessions and kick-off meetings. ♦C1,all Strategies; ♦C2, all Strategies $ 135 $ 315 $ 135 $ 315 $ 900 Technical Assistance (Provider Support - TBD. Based on available funding) ♦C1a,S1.2,A4; ♦C1b,S1.3,A2; ♦C2a,S2.3,A2; ♦Cross- CutA4 $ 225 $ 525 $ 225 $ 525 $ 1,500 E. OTHER COSTS Public Relations Services (Media, Press release, Campaign) ♦C1a,1.3,A3 ♦C1b,S1.6,A1,A2 $ 3,000 $ 7,000 $ - $ - $ 10,000 Total Subcontracts $ - $ 85,204 $ 170,408 $ 85,204 $ 340,815 D. SUBCONTRACTS Health Clinic Subcontractor (TBD) ♦C1b,S1.5,A1-A2; S1.6,A1-A2; ♦C2a, S2.2,A1-A2; S2.3,A1-A3; S2.4,A1; S2.5,A1; ♦C2b,S2.6,A1; S2.8,A2 $ - $ 85,204 $ 170,408 $ 85,204 $ 340,815 Total Travel $ 509 $ 1,187 $ 509 $ 1,187 $ 3,390 Conferences/Trainings (hotel, per diem, parking, and mileage) ♦C1,all Strategies; ♦C2, all Strategies $ 405 $ 945 $ 405 $ 945 $ 2,700 C. TRAVEL Local travel to complete SOW deliverables (1200 miles at $.575/mile) ♦C1,all Strategies; ♦C2, all Strategies $ 104 $ 242 $ 104 $ 242 $ 690 Total Operating $ 1,643 $ 3,833 $ 1,643 $ 3,833 $ 10,950 Tech Support $ 143 $ 333 $ 143 $ 333 $ 950 Communications $ 150 $ 350 $ 150 $ 350 $ 1,000 Meeting room rentals ♦C1,all Strategies; ♦C2, all Strategies $ 150 $ 350 $ 150 $ 350 $ 1,000 Printing ♦C1,all Strategies; ♦C2, all Strategies $ 750 $ 1,750 $ 750 $ 1,750 $ 5,000 B. OPERATING EXPENSES General Office Supplies $ 450 $ 1,050 $ 450 $ 1,050 $ 3,000 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes 30% Task 2b Heart 70% **Fresno County employees receive benefits based upon their date of hire, retirement tier level, and job classification. Benefit rates vary based upon the length of time in a position and changes yearly with merit adjustments. Total Personnel Costs $ 34,332 $ 80,107 $ 34,332 $ 80,107 $ 228,877 A. PERSONNEL $ 134,822 B. FRINGE BENEFITS Average 69.76% of Personnel** $ 14,108 $ 32,919 $ 14,108 $ 32,919 $ 94,055 Exhibit B, Attachment IV Budget Year 4 (10/01 09/30/2017 through 09/29/2018) County of Fresno 14-10712 A01 ♦ Key: SOW Component (C), SOW Program Strategy (S), SOW Activity (A)Page 2 Component 1 Component 2 TotalTask 1a Heart 30% Task 1b Diabetes 70% Task 2a Diabetes 30% Task 2b Heart 70% $ 39,948 $ 101,544 $ 45,281 $ 94,544 *Only the first $25,000 of each subcontract may be used in the calculation TOTAL EXPENSES $ 45,812 $ 193,321 $ 214,002 $ 185,294 $ 638,429 F. INDIRECT COSTS Calculated at 14.68% of Total Allowable* Direct Costs $ 5,864 $ 14,907 $ 6,647 $ 13,879 $ 41,297 Total Allowable Direct Costs $ 281,317 TOTAL DIRECT COSTS $ 39,948 $ 178,415 $ 207,355 $ 171,415 $ 597,132 Total Other Costs $ 3,465 $ 8,085 $ 465 $ 1,085 $ 13,100 Education/Training Materials (including related translation of materials) $ 105 $ 245 $ 105 $ 245 $ 700