HomeMy WebLinkAboutAgreement A-15-548-1 with PHI.pdf
COUNTY OF FRESNO
Fresno, CA
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AMENDMENT I TO AGREEMENT
THIS AMENDMENT, hereinafter referred to as “Amendment I”, is made and entered into this
____ day of __________, 2017, by and between the COUNTY OF FRESNO, a Political Subdivision
of the State of California, hereinafter referred to as “COUNTY”, and PUBLIC HEALTH
INSTITUTE, a California Non-Profit Organization, whose address is 555 12th Street, Oakland,
California, 94607, hereinafter referred to as “CONTRACTOR” (collectively the “parties”).
WHEREAS the parties entered into that certain Agreement, identified as COUNTY Agreement
No. A-15-548, effective November 1, 2015, hereinafter referred to as “Agreement”, whereby
CONTRACTOR agreed to provide certain program oversight and provision services to COUNTY’s
Department of Public Health; and
WHEREAS the parties now desire to amend the Agreement regarding changes as stated below
and restate the Agreement in its entirety.
NOW, THEREFORE, in consideration of their mutual promises, covenants and conditions,
hereinafter set forth, the sufficiency of which is hereby acknowledged, the parties agree as follows:
1. That the existing COUNTY Agreement No. A-15-548, Page 2, Section 2, “TERM,”
beginning on Line 15 with the word “This” and ending on Line 20 with the word “term,” be deleted
and the following inserted in its place:
“This Agreement shall become effective on the 1st day of November, 2015 and shall
terminate on the 31st day of July, 2017.”
2. That the existing COUNTY Agreement No. A-15-548, Page 3, Section 4,
“COMPENSATION,” beginning on Line 18 with the word “In” and ending on Line 25 with the word
“2018,” be deleted and the following inserted in its place:
“In no event shall actual services performed under this Agreement be in excess of One
Million, Three Hundred Twenty-Nine Thousand, Four Hundred Eighty-Nine and No/100 Dollars
($1,329,489) during the period of November 1, 2015 through September 29, 2016, and Three Hundred
Forty-One Thousand, One Hundred Ninety-Five and No/100 Dollars ($341,195) during the period of
September 30, 2016 through July 31, 2017.”
3. That all references in existing COUNTY Agreement No. A-15-548 to “Exhibit A” shall
COUNTY OF FRESNO
Fresno, CA
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be changed to read “Revised Exhibit A”, attached hereto and incorporated herein by reference.
4. That all references in existing COUNTY Agreement No. A-15-548 to “Exhibit B” shall
be changed to read “Revised Exhibit B”, attached hereto and incorporated herein by reference.
5. Except as otherwise provided in this Amendment I, all other provisions of the
Agreement remain unchanged and in full force and effect. This Amendment I shall become effective
November 1, 2015.
6. COUNTY and CONTRACTOR agree that this Amendment I is sufficient to amend the
Agreement, and that upon execution of this Amendment I, the Agreement and Amendment I together
shall be considered the Agreement.
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Revised Exhibit A Page 1 of 9 Partnerships to Improve Community Health (PICH) Scope of Work The Fresno County Department of Public Health is identified as “FCDPH.” Public Health Institute is the Lead Contractor and is identified as “PHI.” Subcontractors are Youth Leadership Institute, “YLI;” Food Commons Fresno, “FCF;” Fresno Metro Ministry, “FMM;” and Cultiva La Salud “Cultiva.” Consultants will include ChangeLab Solutions, “CLS;” and Berkeley Media Studies Group, “BMSG.” Initiative 1: Storefront Advertising Project Period Objective (PPO) Increase the number of people with improved access to smoke-free and/or tobacco-free environments from 0 to 528,090 by July 2017. The retail environment is the tobacco industry’s main point of entry into local communities, and where the bulk of its advertising and promotional budgets are spent. Tobacco retail stores are more densely distributed in low income and communities of color, and rural areas tend to have the lowest tobacco prices and the highest amount of tobacco promotions and ads. Tobacco advertising and promotions have an even greater effect on youth than peer pressure, and exposure increases the likelihood that youth will start to smoke. Exposure to tobacco marketing has also been shown to prevent current users from quitting. In Fresno County, tobacco retail store observation survey data that was collected in the summer of 2013 found that of the stores surveyed, 189 (48.0%) displayed tobacco advertisements, 200 (50.8%) displayed alcoholic beverage advertisements and 197 (50.0%) displayed sugary drink advertisements on storefront windows. Only 20 (5.1%) of the stores displayed healthy beverage advertisements (such as water or 100% juice) and 8 (2.0%) displayed fruit and vegetables advertisements on storefront windows. The survey also documented that the cities focused on for this intervention had excessive advertising. For example, in the City of Kingsburg 46.2% of stores had more than 33% of storefront windows and clear doors covered by signs; in the City of Parlier 42.1% of stores had more than 33% of storefront windows and clear doors covered by signs; in the City of Fresno 40% of stores had more than 33% of storefront windows and clear doors covered by signs; in the City of Firebaugh 35.7% of stores had storefront windows covered by signs. FCDPH will reduce unhealthy storefront and outdoor advertising at Fresno County tobacco retailer locations to reduce the appeal of tobacco products. A reduction in the initiation of tobacco use in youth will decrease tobacco-related illnesses. FCDPH will educate and inform community members, retailers, and decision makers and provide technical assistance in the development and implementation of the proposed solution. An estimated 528, 090 people will be reached in a minimum of three communities including: the Cities of Kingsburg, Fresno, Parlier and Firebaugh. The City of Fresno is the largest city in the County and the majority of tobacco retailers approximately half of all tobacco retailers in the County of Fresno are located in the City of Fresno. Annual Objective 1 (AO1) Year 1 Increase the number of communities with point of sale communication strategies that reduce storefront window and outdoor advertising of any sort, including tobacco to reduce appeal of tobacco products in retail environments from 0 to 1 by September 2016. YLI in partnership with the FCDPH will work with partners to reduce the appeal of tobacco products in retail environments. Utilize the assessment of the Healthy Stores for a Healthy Community Workgroup to identify 2-4 local target communities in Fresno County. In year one, the goal is for at least one city (City of Kingsburg) in Fresno County, to adopt a practice that reduces storefront window and outdoor advertising of any sort, including tobacco, for alcohol/tobacco retailers. This will be accomplished through approved activities to educate and inform the community member, leaders, and retailers of the current advertising practices, the effects that unhealthy advertising has on youth health behaviors such as smoking initiation, and co-benefits of reducing advertising (safety, improved community aesthetics, etc.). Educate community members on industry marketing tactics to help people critically assess the advertising they see around them. Activity Activity Name Description Deadline Responsible Party Deliverables 1.1.1 Public Opinion Surveys Utilize the previously existing tobacco and storefront advertising public opinion survey. Collect 162 public opinion surveys at community events, health fairs, swap meets, etc. in the City of June 3, 2016 PHI: YLI Written report of data analysis, pictures of events
Revised Exhibit A Page 2 of 9 Kingsburg. The public opinion survey will assess such elements as: demographics (gender, age, ethnicity, smoking/ electronic cigarettes use status); concerns and knowledge related to youth exposure to unhealthy advertising and its impact on health behaviors such as tobacco use; perception of safety in shopping in stores with excessive signage vs. stores with minimal signage; and support for the proposed solution. At these events, education will be provided to community residents on the impact of storefront advertising on health behaviors and the Healthy Stores for a Healthy Community Campaign. 1.1.2A Education and Outreach Conduct one on one educational presentations to four city council members in the City of Kingsburg to provide education on the impact of storefront advertising on health behaviors such as tobacco use and tobacco cessation, the Lee Law, and possible solutions. May 31, 2016 PHI: YLI Log of educational presentations, packet of information provided 1.1.2B Education and Outreach Continued Conduct at least three educational presentations to community and philanthropic groups such as, (chamber of commerce, Lions Club, Ministerial Association, Rotary Club) June 30, 2016 PHI: YLI Sign-in sheets, factsheets distributed 1.1.2C Education and Outreach Continued Attend at least three Kingsburg City Council meetings with FCDPH, and youth partners to conduct formal educational presentation to provide information on the impact of storefront advertising on health behaviors such as tobacco use and tobacco cessation, the Lee Law, and possible solutions. August 31, 2016 PHI: YLI, FCDPH City council meeting minutes, packet of information provided 1.1.3 Retailer Education Provide education to at least 12 retailers in the City of Kingsburg before policy adoption. Educational presentations will include information on youth exposure to unhealthy advertising and its impact on health behaviors such as tobacco use, how storefront advertising impacts safety and community aesthetics. Upon implementation of the policy work with the City of Kingsburg to conduct one training with local retailers on the provisions and purpose of the new ordinance. September 29, 2016 PHI: YLI Sign-in sheets, meeting notes, packet of information provided 1.1.4 Provide Technical Assistance Provide ten hours of technical assistance to target city in the development and implementation of the proposed solution such as, the development of a model ordinance, development of educational materials for retailers, press conference/news release, sample letter informing retailers of new policy, etc. September29, 2016 PHI: YLI Technical assistance log, technical assistance materials developed, copy of signed ordinance Annual Objective 1 (AO1) Year 2 Increase the number of communities with point of sale communication strategies that reduce storefront window and outdoor advertising of any sort, including tobacco to reduce appeal of tobacco products in retail environments from 1 to 2 by July 2017. YLI in partnership with the FCDPH will work with partners to reduce the appeal of tobacco products in retail environments. In year two of the grant, the goal is for at
Revised Exhibit A Page 3 of 9 least two cities in Fresno County and/or the County of Fresno, to adopt a practice that reduces storefront window and outdoor advertising of any sort, including tobacco, for alcohol/tobacco retailers. This will be accomplished through approved activities to educate and inform the community and decision makers of the current advertising practices, the effects of advertising (particularly on youth), and co-benefits of reducing advertising (safety, improved community aesthetics, etc.). Educate community members on industry marketing tactics to help people critically assess the advertising they see around them. Activity Activity Name Description Deadline Responsible Party Deliverables 1.1.1 Education and Outreach Conduct 10 educational presentations to community members and key leaders to provide education on the impact of storefront advertising on health behaviors such as tobacco use and tobacco cessation, the Lee Law, and the best-practice solution. This will include educational presentations to: community and philanthropic groups (such as chamber of commerce, parent groups, Lions Club, Rotary Club, Boys and Girls Club, Ministerial Associations, etc.), key community leaders, and city staff (such as city planner, police chief, code enforcement, etc.). April 30, 2017 PHI: YLI Agendas, PowerPoint presentation, packet of information provided, log of presentations, city council meeting minutes 1.1.3 Provide Technical Assistance Work with the Cities of Clovis, Fresno, and Kingsburg to develop approved materials and strategies to inform retailers, residents, and key community stakeholders of the adopted policies and develop a method in each city for communicating violations to improve compliance. April 30, 2017 PHI: YLI Developed materials; strategic plan for Cities of Clovis, Fresno, Kingsburg; developed materials; signed ordinance; meeting notes 1.1.4 Post-Policy Retailer Education Provide drop-by educational visits to at least 50 tobacco-alcohol retailers in Fresno and 30 in the Clovis post-policy adoption. Additionally, conduct at least one educational presentation at a meeting of the American Petroleum Convenience Store Association Fresno Chapter. Education provided at these visits and presentations includes: information on youth exposure to unhealthy advertising and its impact on health behaviors such as tobacco use, how storefront advertising impacts safety and community aesthetics, restrictions on storefront advertising in each respective city, penalties for non-compliance. Implement the approved strategies agreed upon by each city to inform local retailers about passed storefront advertising policies. April 30, 2017 PHI: YLI FCDPH Log of presentations, packet of information provided 1.1.6 Healthy Stores for a Healthy Community Workgroup Collaborate with the Fresno County Tobacco Prevention Program to convene at least 2 Fresno County Health Improvement Partnership Healthy Stores for a Healthy Stores for a Healthy Community Workgroup meetings. Workgroup members will serve as an advisory board and provide feedback on development of meeting and presentation materials, coordination of events and trainings, and provide collaborative support. April 30, 2017 FCDPH, PHI: YLI Meeting agenda, meeting notes 1.1.8 Youth Partner Engagement Train and maintain a local youth coalition (at least 10 youth) in each of the target cities (Fresno, Clovis). Conduct 2-3 leadership April 30, 2017 PHI: YLI List of recruited youth, participation log, training
Revised Exhibit A Page 4 of 9 and skill development trainings for the youth partners. agenda, training materials 1.1.9 Toolkit Develop a toolkit that outlines the key steps of planning and implementing an effective storefront advertising initiative. This will include supporting materials used in each step of the model. This toolkit will help to facilitate ongoing technical assistance to Fresno County cities that are interested in passing/adopting a storefront advertising point of sale communication policy. April 30, 2017 FCDPH Developed toolkit Initiative 2: Farm to Table Project Period Objective (PPO) Increase the number of people with improved access to environments with healthy food and beverage options from 0 to 45,480 by July 2017. There is growing evidence that what individuals choose to consume is influenced by what is available locally. In Fresno County, there are more than five times as many fast-food restaurants and convenience stores as supermarkets. Research also documents that small food stores such as corner stores and convenience stores, predominantly sell highly processed foods that are high in fat and are low in nutrients and tend to sell little fresh produce, whole grains, and low-fat dairy products. Furthermore, convenience stores and other small stores that sell unhealthy snack foods are more likely to be located in low-income neighborhoods and often are near schools. Small food stores are also more likely to be located near schools with more Hispanic and African American students, even after accounting for students’ poverty level. Access to grocery stores or markets can limit families’ choices of food options. Many families are limited to what is available in corner stores or fast food outlets in the neighborhood. In order to find a wider variety of produce at more affordable prices, residents have to drive –if able – to larger communities with supermarkets or big box stores. A survey conducted in 2013 at 394 local retail stores in Fresno County reveals that only 28.8% of stores sold non-fat or low-fat milk (1%), 28.3% sold whole wheat bread, 20.9% sold 4 or more types of fresh fruit and 21.2% sold 4 or more types of fresh vegetables. The quality of the fresh fruit and vegetables available at surveyed retail stores was mixed. A total of 42.7% of surveyed Fresno County stores offered all or mostly good quality fresh fruit, and 40.9% offered all or mostly good quality fresh vegetables. In Fresno County over 350 crops are grown, many of them grown nowhere else in the nation, at least not commercially. However, food deserts and lack of access to transportation severely impact access to healthy foods and beverages for thousands of Fresno County residents. The United States Department of Agriculture Food Access Research Atlas identifies 93 census tracks (46.5%) in Fresno County identified as low-income census tracks with a significant number or share of residents living more than one-half mile (urban) or 10 miles (rural) from the nearest grocery store. FCDPH will increase access and consumption to fruits and vegetables in neighborhood locations including school sites by increasing the availability of fresh produce. Affordable and convenient access to healthy foods will encourage the consumption of fresh local produce that will result in improved health of the community due to improved dietary conditions. Fresno County and the Farm to Table Workgroup will work with local farmers, and school districts to build and strengthen infrastructure in order to increase access to fresh produce. School sites can select one or both models: food recovery or community supported agriculture (CSA). Food recovery involves recovering perishable whole produce that would otherwise go to waste and redistributing it to the community at no cost. The CSA model involves purchasing produce at the district’s lowered cost and selling it at a low cost to community members. The CSA model was proven effective in a school district in a neighboring county. All activities will target local school sites located in low-access areas. An estimated 45,480 residents will have increased access and consumption to fresh fruits and vegetables. Annual Objective 1 (AO1) Year 1 Increase the number of neighborhood locations that offer fresh fruits and vegetables for purchase to local residents with low access to produce from 0 to 3 by September 2016.
Revised Exhibit A Page 5 of 9 FCF, FMM and FCDPH will increase access and consumption of fruits and vegetables for residents living in low-access areas through the implementation of a food distribution hub at local school sites. FCDPH and the Farm to Table Work group will work with local farmers and school districts to build and strengthen infrastructure to increase access and consumption to fruits and vegetables at low or no cost. In year one, the goal is for at least three school sites, located within low-access areas, in the Fresno Unified School District to implement a Farm to Table program. This will be accomplished through approved activities such as partner collaboration, identifying participating school sites, developing an online purchasing tool and hosting a vendor showcase. Additional activities include surveying market preference of produce for the targeted community and promoting the program through various media outlets. Activity Activity Name Description Deadline Responsible Party Deliverables 2.1.1 Partner Collaboration Collaborate with community partners such as: nutrition center staff, food service directors, local distributors, farmers and school staff to implement Farm to Table program to increase access to and consumption of fruits and vegetables. Convene at least 5 Farm to Table workgroup meetings. Workgroup members will serve as an advisory board and provide feedback on development of meeting and presentation materials, coordination for events and trainings, and provide collaborative support. September 29, 2016 FCDPH & PHI: FCF Meeting agenda and notes 2.1.2 Vendor Showcase Host at least two Farm to Table Vendor Showcases to connect Fresno County school districts to local distributors and farmers to facilitate farm to table process. September 29, 2016 PHI: FCF Sign-in sheet, pictures of vendor showcase, meeting notes 2.1.3 Identify School Sites Identify and confirm additional school sites located within low-access areas and logistical processes such as method of distribution, ordering and payment. September 29, 2016 FCDPH & PHI: FCF Roster of school sites and logistical plan 2.1.4 Online Purchasing Tool Refine online purchasing tool (mobile app or website) to address any deficiencies. September 29, 2016 PHI: FCF List of updates 2.1.5 Technical Assistance Provide at least 5 hours of technical assistance to school sites, local distributors, farmers and other staff to implement distribution method. September 29, 2016 PHI: FCF Technical assistance log 2.1.6 Market preference Survey the targeted community members near new additional selected school sites within food deserts to determine market preference of produce. Share results with distributors to guide purchase of produce for distribution. September 29, 2016 PHI: FCF Survey instrument and results 2.1.7 Program promotion Promote program through the use of flyers, school site newsletters, recorded phone messages, social media platforms, and other media resources (such as radio, newspaper, movie theater) as appropriate. Messages will be composed in appropriate languages (English, Spanish, Hmong). September 29, 2016 PHI: FCF Copies of promotional materials Annual Objective 2 (AO2) Year 1 Increase the number of community locations that offer fresh fruits and vegetables for distribution at no cost to local residents with low access to produce from 0 to 6 by September 2016. FMM and FCDPH will increase access and consumption of fruits and vegetables for residents living in low-access areas through the implementation of a food
Revised Exhibit A Page 6 of 9 distribution hub at local school sites. FCDPH and the Farm to Table Work group will work with local farmers, distributers, and school districts to build and strengthen infrastructure to increase access and consumption to fruits and vegetables at low or no cost. In year two, the goal is for an additional three school sites, located within low-access areas, in rural Fresno County to implement a Farm to Table program. This will be accomplished through approved activities such as partner collaboration, identifying participating school sites, developing an online purchasing tool and hosting a vendor showcase. Additional activities include surveying market preference of produce for the targeted community and promoting the program through various media outlets. Activity Activity Name Description Deadline Responsible Party Deliverables 2.2.1 Program promotion Attend at three community events in the targeted school areas to promote the Food to Share Farm to Table program. Distribute flyers, articles in school site newsletters, utilize social media platforms, educational presentations, and other media resources (such as radio, newspaper) as appropriate to promote the program. Messages will be composed in appropriate languages (English, Spanish, Hmong) August 31, 2016 PHI: FMM Pictures of event, copies of promotional materials, newsletter articles 2.2.2 Food Recovery Infrastructure Strengthen Food to Share Infrastructure for Farm to Table; including securing partner food donors and recipients, research and identify potential sites for additional distribution in target school site census tracts. August 26, 2016 PHI: FMM Donor/Recipient Database 2.2.3 Technical Capacity for Food Recovery Revise Food To Share online food donor/receiver tool as needed. September 16, 2016 PHI: FMM Food to Share website updates, technical assistance and training for donor, receivers and staff. 2.2.4 Cooking Demonstrations and Education Partner with Farm to Table Workgroup members to host at least six healthy cooking demonstrations/nutrition education events in targeted school neighborhoods. The purpose is to teach community members how to prepare meals with foods that are featured in produce boxes and/or food recovery distribution sites. September 19, 2016 PHI: FMM Pictures of events, event agenda 2.2.5 Asset Mapping Conduct mapping in project neighborhoods to map potential assets, resources, and partners. September 30, 2015 PHI:FMM Digital maps with assets plotted, list of potential assets, resources, and partners. Annual Objective 2 (AO2) Year 2 Increase the number of neighborhood locations that offer fresh fruits and vegetables for purchase to local residents with low access to produce from 6 to 9 by July 2017. FMM and FCDPH will increase access and consumption of fruits and vegetables for residents living in low-access areas through the implementation of a food distribution hub at local school sites. FCDPH and the Farm to Table Work group will work with local farmers, distributers, and school districts to build and strengthen infrastructure to increase access and consumption to fruits and vegetables at low or no cost. In year two, the goal is for an additional three school sites, located within low-access areas, in rural Fresno County to implement a Farm to Table program. This will be accomplished through approved activities such as partner collaboration, identifying participating school sites, developing an online purchasing tool and hosting a vendor showcase. Additional activities include surveying market preference of produce for the targeted community and promoting the program through various media outlets.
Revised Exhibit A Page 7 of 9 Activity Activity Name Description Deadline Responsible Party Deliverables 2.2.1 Partner Collaboration Collaborate with Fresno County to convene at least 4 Fresno Community Health Improvement Partnership Farm to Table Workgroup meetings. Workgroup members will serve as an advisory board and provide collaborative support for PICH and Fresno Community Health Improvement Partnership activities. June 30, 2017 FCDPH & Farm to Table Co-Chairs, PHI: FMM Meeting agenda and notes 2.2.2 Program Promotion Attend at least nine school or community events in the targeted school areas to promote the Food to Share Farm to Table program. Distribute flyers, articles in school site newsletters, utilize social media platforms, educational presentations, and other media resources (such as radio, newspaper) as appropriate to promote the program. Messages will be composed in appropriate languages (English, Spanish, Hmong). June 30, 2017 PHI: FMM Pictures of food distributions, copies of promotional materials and newsletter articles, food distribution log 2.2.3 Food Recovery Infrastructure Strengthen Food to Share Infrastructure for Farm to Table, including securing partner food donors, recipients, and volunteers. Provide at least 12 hours of technical assistance to existing six PICH Food Distribution sites to support them in being a sustainable food distribution site on their own. The PICH sites include: Homan, Wolters, Muir, Lowell, King and Addams. June 30, 2017 PHI: FMM Donor/Recipient Database; presentation materials, log of presentations, technical assistance log 2.2.4 Technical Capacity for Food Recovery Revise Food To Share online food donor/receiver tool as needed, provide technical assistance training for donors and recipients including updating and populating user profiles. June 30, 2017 PHI: FMM Log of Food to Share website updates, log of technical assistance and training for donors and recipients. 2.2.5 Cooking Demonstrations and Education Host at least nine healthy cooking/nutrition education demonstration events in targeted school neighborhoods. The purpose is to teach community members how to prepare recipes with foods that are provided at food recovery distribution sites. June 30, 2017 PHI: FMM Pictures of events, distributed recipe cards 2.2.6 Community Food System Design Workshops Conduct at least one community food system design workshops “Wasted Food is Wasted Potential” with local stakeholders. June 30, 2017 PHI: FMM Agenda, copies of promotional materials, workshop results/ minutes, pictures of workshops Initiative 3: Rx for Health Project Period Objective (PPO) Increase the number of people with improved opportunities for chronic disease prevention, risk reduction or management through improved clinical referral programs from 0 to 363,214 by September 2016. Studies show that people who lead a physically active life, engage in chronic condition self-management programs, and are in good physical condition have a lower mortality rate and a longer life expectancy. Several types of interventions for the promotion of self-care and physical activity (PA) in Primary Care have been reported. Programs that combine written instructions, with several training sessions, an exercise program and strategies to change behavior increased
Revised Exhibit A Page 8 of 9 effectiveness. Various authors have stressed the importance of patient referral to professionals who specialize in the design of healthy exercise programs outside the healthcare environment, making use of the local resources available in each area as a strategy for effective integration of the promotion of exercise in Primary Care. Growing evidence exists that educational and supportive interventions directed at helping patients to change risky behaviors or become better self-managers, improve outcomes across a range of chronic illnesses. FCDPH will increase the number of people with improved opportunities for chronic disease prevention, risk reduction or management through improved clinical referral programs. In Year 1 of the grant, the Department with work with one managed care plan (CalViva Health) to reduce financial barriers to patient participation in lifestyle interventions through increased insurance coverage offered by one local managed care plan. A second managed care plan will also be engaged in the process in Year 1 but the majority of the focus will be on CalViva Health. In Year 2 of the grant, the Department will work with Anthem Blue Cross to reduce financial barriers to patient participation in lifestyle interventions through increased insurance coverage offered. Additionally, in Years 2 and 3, the Department will utilize local resources to integrate the promotion of lifestyle interventions in Federally Qualified Health Centers and rural health clinic sites. This program will be called “Prescription for Health” (RX for Health System) Referrals will result in increased utilization of Take Off Pounds Sensibly Clubs, tobacco cessation (the California Smokers’ Helpline provides free tobacco cessation counseling to California residents), and Chronic Disease Self-Management Program workshops. The RX for Health System will include training and support for clinicians, changes to electronic medical record to track referrals, and relationships with communities to track referral outcomes. Provider outreach and orientation trainings will be followed by a pilot implementation that will test the system to track referrals. Chronic Disease Self- Management workshop leader trainings will increase the capacity of the health clinic site staff to provide chronic disease prevention self- management workshops. Workshops classes provided by health clinic site staff and not funded by the grant will provide for sustainability for the program. Referral, patient participation and physician feedback will contribute to prevention and successful management of chronic illness. An estimated 363,214 patients will be provided with coverage for participation in lifestyle interventions benefits. The number of patients reached through referrals through the “Prescription for Health Program” will be identified in Year 2 of the grant. Annual Objective 1 (AO1) Year 1 Increase the number of managed care plans that provide reimbursement for lifestyle intervention programs (such as Take Off Pounds Sensibly Clubs and Chronic Disease Self-Management Program workshops) from 0 to 1 by September 2016. Cultiva La Salud in partnership with FCDPH will increase the number of Lifestyle Intervention Programs that are covered by managed care plans. An assessment of managed care plans reimbursement strategies for Lifestyle Intervention Programs will establish a baseline for this intervention. Educational presentations and planning meetings with managed care plan staff will provide a pathway for systematic change. An estimated 242,542 patients will be impacted among the one-targeted managed care plan. Activity Activity Name Description Deadline Responsible Party Deliverables 3.1.1A Educational Materials Identify strategic supportive materials that will facilitate negotiation with managed care plan and clinics, specifically data reports that build the case for coverage in patient outcomes, referral success, and cost savings. September 15, 2016 PHI: Clinica Sierra Vista List of materials to be developed 3.1.1B Educational Materials Continued Develop supportive materials needed to facilitate negotiation with managed care plan and clinics, specifically data reports that build the case for coverage in patient outcomes, referral success, and cost savings. September 15, 2016 PHI: Clinica Sierra Vista Educational materials developed 3.1.2 Managed Care Plan Outreach Conduct at least three meetings with managed care plan Chief Executive Officers, Regional Directors, and other staff about how the increase in coverage for lifestyle intervention programs can September 15, 2016 FCDPH & PHI: Clinica Sierra Vista Talking points, agendas, meeting notes
Revised Exhibit A Page 9 of 9 prevent and manage chronic illness. 3.1.3 Secure Coverage Document the support of the managed care plan to provide coverage of lifestyle intervention programs (such as National Diabetes Prevention Program and Chronic Disease Self-Management Program workshops). September 29, 2016 PHI: Clinica Sierra Vista Documentation of Coverage 3.1.4 Technical Assistance Provide five hours of technical assistance to the targeted managed care plan to help facilitate the adoption and implementation of a new policy. September 29, 2016 PHI: Clinica Sierra Vista Technical Assistance Log Administrative Activity Activity Name Description Responsible Party Deliverables 4.1.1 Establish Subcontracts Establish subcontracts within three months of execution of lead contract with FCDPH. PHI Copy of executed contracts 4.1.2 Monitor Subcontracts Monitor subcontracts to insure compliance with the agreements. Process invoices. PHI Copies of monthly invoices from contractors and documentation of payment. 4.1.3 Administrative Meetings Meet monthly with FCDPH. Include subcontractors quarterly. PHI & All SubcontractorsMeeting agendas, sign-in sheets 4.1.4 Training Attend training sessions, conferences, conference callas, and webinars on specific content areas to augment the internal team’s skills and program effectiveness. PHI Copies of training agendas. Document will be provided with semi-annual progress report. 4.1.5 Evaluation Work collaboratively with the contracted Evaluator in the implementation of the Evaluation Plan including convening meetings with subcontractors and community partners for planning and training, data collection, and facilitation of data collection activities by staff and volunteers with subcontractors and community partners. PHI Meeting agendas, sign-in sheets 4.1.6 Communication Work collaboratively with the Communication Coordinator (county staff) in the implementation of the Communication Plan including convening meetings with subcontractors and community partners for planning and training as appropriate. PHI & BMSG Meeting agendas, sign-in sheets 4.1.7 Success Stories Submit a minimum of one success to FCDPH monthly that can be used for public communication/media purposes. PHI & BMSG Copy of communication submitted to FCDPH 4.1.8 Progress Reports Submit progress bi-annual reports following guidelines from FCDPH and the Centers Disease Control and Prevention. Submit electronic documentation of deliverables. PHI Semi-annual progress report with supporting documents. 4.1.9 Invoicing Submit monthly Invoices to FCDPH by the fifth of each month. Backup documentation includes timesheets, expenditure detail and copies of respective receipts. PHI Monthly invoices, backup documentation
Revised Exhibit B
SALARIES
Position Title and Name Annual Salary % FTE Program Salary
Program Director, Genoveva Islas 102,743$ 15.62%16,050$
Program Manager, Monica Guerra/Austin Hall 73,500$ 74.97%55,103$
Fiscal Coordinator, Art Tanner 59,929$ 74.05%44,380$
Communications Manager, Brandie Banks-Bey 70,754$ 57.71%40,833$
Administrative Assistant, Lucia Navarro 45,449$ 69.04%31,376$
Total Salaries 2.91 187,742$
BENEFITS
30.61% of Total Salaries 57,461$
Total Benefits 57,461$
CONSULTANTS
Consultants 10,980$
Total Consultants 10,980$
SUPPLIES
General Office Supplies 4,524$
Computer 2,935$
Total Supplies 7,459$
TRAVEL
In-state travel 921$
Total Travel 921$
OPERATIONAL
Facilities 14,169$
Communications 2,450$
Equipment Maintenance 397$
Postage 56$
Reproduction & Printing 4,720$
Conference Meeting 2,867$
Total Operational 24,659$
SUBCONTRACTS
Healthy Retail (Youth Leadership Institute) 238,147$
Farm to Table (FCF +FMM) 581,869$
Rx for Health (Clinica Sierra Vista) 173,108$
Total Contractual 993,124$
Total Direct Costs 1,282,346$
Administrative (Indirect) Costs (16.3%)47,143$
TOTAL BUDGET 1,329,489$
YEAR 1 · 11/1/2015 - 9/29/2016
Page 1 of 2
Revised Exhibit B
Page 2 of 2
SALARIES
Position Title and Name Annual Salary % FTE Program Salary
Project Director, Genoveva Islas 102,720$ 4.17%4,280$
Fiscal Coordinator, Arthur Tanner 67,700$ 1.00%677$
Program Manager, Brandie Banks-Bey 70,795$ 66.67%47,197$
Administrative Assistant, Lucia Navarro 45,449$ 29.17%13,256$
Total Salaries 1.01 65,410$
BENEFITS
38.95% of Total Salaries 25,475$
Total Benefits 25,475$
SUPPLIES
General Office Supplies 577$
Total Supplies 577$
OPERATIONAL
Facilities 5,065$
Communications 2,091$
Equipment Maintenance 74$
Postage 60$
Printing 476$
Total Operational 7,766$
SUBCONTRACTS
Healthy Retail (Youth Leadership Institute)85,393$
Farm to Table (Fresno Metro Ministry)140,400$
Total Subcontracts 225,793$
Total Direct Costs 325,021$
Administrative (Indirect) Costs (16.3%)16,174$
TOTAL BUDGET 341,195$
YEAR 2 · 9/30/2016 - 7/31/2017