HomeMy WebLinkAboutExceptional Parents Unlimited-Community Health Teams_A-24-332 A-20-405 A-22-288.pdf COUP County of Fresno Hall of Records,Room 301
2281 Tulare Street
Fresno,California
' Board of Supervisors 93721-2198
O i85 0 Telephone:(559)600-3529
FRE`' Minute Order Toll Free: 1-800-742-1011
www.fresnocountyca.gov
June 18, 2024
Present: 5- Supervisor Steve Brandau,Chairman Nathan Magsig,Vice Chairman Buddy Mendes,
Supervisor Brian Pacheco, and Supervisor Sal Quintero
Agenda No. 69. Public Health File ID:24-0486
Re: Approve and authorize the Chairman to execute the Second Amendment to Agreement with Central
Valley Children's Services Network for the Community Health Teams program,to revise the scope of
work to provide home visitation services to unduplicated families with at least one(1)parent/caregiver
attending each visit,extending the term by two years from July 1,2024 to June 30,2026,and
increasing the compensation by$548,896 to a total of$1,646,688;approve and authorize the
Chairman to execute the Second Amendment to Agreement with Centro La Familia Advocacy
Services for the Community Health Teams program,to revise the scope of work to provide home
visitation services to unduplicated families with at least one(1)parent/caregiver attending each visit,
extending the term by two years from July 1,2024 to June 30,2026,and increasing the compensation
by$522,458 to a total of$1,565,968;approve and authorize the Chairman to execute the Second
Amendment to Agreement with Exceptional Parents Unlimited for the Community Health Teams
program,to revise the scope of work to provide home visitation services to unduplicated families with at
least one(1)parent/caregiver attending each visit,extending the term by two years from July 1,2024
to June 30,2026,and increasing the compensation by$550,000 to a total of$1,650,000;and, approve
and authorize the Chairman to execute the Second Amendment to Agreement with Fresno County
Economic Opportunities Commission for the Community Health Teams program,to revise the scope of
work to provide home visitation services to unduplicated families with at least one(1)parent/caregiver
attending each visit,extending the term by two years from July 1,2024 to June 30,2026,and
increasing the compensation by$550,000 to a total of$1,650,000
APPROVED AS RECOMMENDED
Ayes: 5- Brandau,Magsig, Mendes, Pacheco,and Quintero
Agreement No.24-330,Agreement No.24-331,Agreement No.24-332,Agreement No.24-333
County of Fresno Page 73
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Board Agenda Item 69
O 1$56 O
DATE: June 18, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Approve Second Amendment to Agreements for the Community Health Teams
RECOMMENDED ACTION(S):
1. Approve and authorize the Chairman to execute the Second Amendment to Agreement with
Central Valley Children's Services Network for the Community Health Teams program,to
revise the scope of work to provide home visitation services to unduplicated families with at
least one(1) parent/caregiver attending each visit, extending the term by two years from
July 1, 2024 to June 30, 2026, and increasing the compensation by$548,896 to a total of
$1,646,688.
2. Approve and authorize the Chairman to execute the Second Amendment to Agreement with
Centro La Familia Advocacy Services for the Community Health Teams program,to revise
the scope of work to provide home visitation services to unduplicated families with at least
one (1) parent/caregiver attending each visit, extending the term by two years from July 1,
2024 to June 30, 2026, and increasing the compensation by$522,458 to a total of$1,565,968.
3. Approve and authorize the Chairman to execute the Second Amendment to Agreement with
Exceptional Parents Unlimited for the Community Health Teams program, to revise the
scope of work to provide home visitation services to unduplicated families with at least one
(1) parent/caregiver attending each visit, extending the term by two years from July 1, 2024
to June 30,2026, and increasing the compensation by$550,000 to a total of$1,650,000.
4. Approve and authorize the Chairman to execute the Second Amendment to Agreement with
Fresno County Economic Opportunities Commission for the Community Health Teams
program,to revise the scope of work to provide home visitation services to unduplicated
families with at least one(1) parent/caregiver attending each visit, extending the term by two
years from July 1, 2024 to June 30, 2026, and increasing the compensation by$550,000 to a
total of$1,650,000.
There is no additional Net County Cost associated with the recommended actions. Approval of the
recommended actions will revise the scope of work to provide home visitation to unduplicated families with
at least one (1) parent/caregiver attending each visit and allow the Department to extend the agreements
with Central Valley Children's Services Network(CVCSN), Centro La Familia Advocacy Services (CLFA),
Exceptional Parents Unlimited (EPU), and Fresno County Economic Opportunities Commission (Fresno
EOC)through June 30, 2026. The contracted partners provide research-based and evidence-informed
home visitation services for the Community Health Teams (CHT) program. The recommended actions will
also increase the total maximum compensation of each agreement and will be offset with grant funds.This
item is countywide.
County of Fresno Page 1 File Number.24-0486
File Number.24-0486
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, the
Department would not be able to continue the partnerships with the four community-based organizations
(CEOs) providing research-based and evidence-informed home visitation services for the County's CHT
program.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The annual
compensation for each of the recommended amendments is as follows:
Contractor FY 2024-25 FY 2025-26
Central Valley Children's Services Network $274,448 $274,448
Centro La Familia Advocacy Services $261,229 $261,229
Exceptional Parents Unlimited $275,000 $275,000
Fresno County Economic Opportunities Commission $275,000 $275,000
Funding is provided by a grant from the Children and Families Commission of Fresno County(First 5
Fresno) and Federal Title XIX through the State Maternal, Child and Adolescent Health program. Sufficient
appropriations and estimated revenues will be included in the Department's Org 5620 FY 2024-25
Recommended Budget and will be included in subsequent budget requests.
DISCUSSION:
On October 6, 2020, the Board approved the agreements with CVCSN, CLFA, EPU, and Fresno EOC to
provide research-based and evidence-informed home visitation services to underserved families in Fresno
County communities. On June 21, 2022, the Board approved the first amendments to the agreements with
the four CBOs, extending the services for an additional two years through June 30, 2024. As part of the
CHT, a Public Health Nurse (PHN)from the Department is paired with teams of paraprofessionals from the
contracted CBOs to provide a cost-effective approach to home visitation services to families who otherwise
would not qualify for an existing nurse-based home visitation program.
Approval of the recommended actions will allow the Department to continue the partnerships with the four
CBOs and efforts to improve home visitation services in Fresno County. The PHN provides guidance and
support on medically challenging cases to the CBO home visitors who provide direct home visitation
services. Depending on the home visitation model used by each CBO,the home visitors provide social
support, health information, referrals to community resources, family planning, and serve as a literacy
teacher and parenting coach.This is a unique home visitation model that provides a team approach to
provide wraparound case management services to families. The CHT meets on a regular basis for training,
case consultations, and other program issues.
In FY 2022-23, the CHT program:
• Provided case management services to 254 families;
• Provided developmental screening to 254 children; and
• Provided referrals for 264 children and family members for job assistance, Medi-Cal, health
insurance,financial assistance, primary care, dental, vision, mental health, diapers, food, housing,
special education services, and early intervention.
Approval of the recommended actions will allow the Department to continue using an integrated approach to
enhance our partner CBOs' capacity to provide licensed medical support, strengthening the early childhood
system of care, and promoting a "no-wrong-door" approach for families in the community.
County of Fresno page 2 File Number:24-0486
File Number:24-0486
REFERENCE MATERIAL:
BAI #71, June 21, 2022
BAI #42, October 6, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk-Second Amendment with CVCSN
On file with Clerk-Second Amendment with CLFA
On file with Clerk-Second Amendment with EPU
On file with Clerk-Second Amendment with Fresno EOC
CAO ANALYST:
Ron Alexander
County of Fresno Page 3 File Number:24-0486
Agreement No. 24-332
1 SECOND AMENDMENT TO AGREEMENT
2 THIS SECOND AMENDMENT TO AGREEMENT (hereinafter"Amendment') is made and
3 entered into this 181h day of June, 2024, by and between COUNTY OF FRESNO, a Political
4 Subdivision of the State of California, Fresno, California (hereinafter"COUNTY"), and Exceptional
5 Parents Unlimited, a California non-profit corporation, whose address is 4440 North Fresno Street,
6 Fresno, CA, 93726, (hereinafter"CONTRACTOR").
7 WITNESSETH:
8 WHEREAS, COUNTY and CONTRACTOR entered into Agreement number A-20-405, dated
9 October 6, 2020, pursuant to which CONTRACTOR agreed to provide research-based and evidence-
10 informed home visitation services to underserved families with children ages 0-5 to COUNTY; and
11 WHEREAS, COUNTY and CONTRACTOR entered into a First Amendment number A-22-288,
12 dated June 21, 2022, to continue the services for an extended term of July 1, 2022 to June 30, 2024
13 (Agreement number A-20-405 and First Amendment number A-22-288, collectively, shall be referred
14 to herein as "Agreement'); and
15 WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement in order to
16 revise the scope of work to provide home visitation services to unduplicated families with at least one
17 (1) parent/caregiver attending each visit and continue services for an extended term of July 1, 2024 to
18 June 30, 2026.
19 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which
20 is hereby acknowledged, COUNTY and CONTRACTOR agree as follows:
21 1. That all references in the Agreement to "Revised Exhibit A" shall be changed to read
22 "Second Revised Exhibit A", where appropriate, attached hereto and incorporated herein by reference.
23 2. That all references in the Agreement to "Revised Exhibit B" shall be changed to read
24 "Second Revised Exhibit B", where appropriate, attached hereto and incorporated herein by reference.
25 3. Section 3 of the Agreement, located on page 2, lines 5 through 10, is deleted in its
26 entirety and replaced with the following:
27 "The initial term of this Agreement shall be for a period of six (6) years, commencing on
28 July 1, 2020 through and including June 30, 2026."
- 1 -
1 COUNTY and CONTRACTOR agree that this Amendment is sufficient to amend the
2 Agreement and, that upon execution of this Amendment, the Agreement and this Amendment together
3 shall be considered the Agreement.
4 The parties agree that this Amendment may be executed by electronic signature as provided in
5 this section. An "electronic signature" means any symbol or process intended by an individual signing
6 this Amendment to represent their signature, including but not limited to (1) a digital signature; (2) a
7 faxed version of an original handwritten signature; or(3) an electronically scanned and transmitted (for
8 example by PDF document) of a handwritten signature. Each electronic signature affixed or attached
9 to this Amendment (1) is deemed equivalent to a valid original handwritten signature of the person
10 signing this Amendment for all purposes, including but not limited to evidentiary proof in any
11 administrative or judicial proceeding, and (2) has the same force and effect as the valid original
12 handwritten signature of that person. The provisions of this'section satisfy the requirements of Civil
13 Code section 1633.5, subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3,
14 Part 2, Title 2.5, beginning with section 1633.1). Each party using a digital signature represents that it
15 has undertaken and satisfied the requirements of Government Code section 16.5, subdivision (a),
16 paragraphs (1) through (5), and agrees that each other party may rely upon that representation. This
17 Amendment is not conditioned upon the parties conducting the transactions under it by electronic
18 means and either party may sign this Amendment with an original handwritten signature.
19 The Agreement, as hereby amended, is ratified and continued. All provisions, terms,
20 covenants, conditions and promises contained in the Agreement and not amended herein shall remain
21 in full force and effect.
22 H
23 H
24 H
25 H
26 H
27 H
28 H
- 2 -
I IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to
2 Agreement as of the day and year first hereinabove written.
3
4 CONTR TOR COUNTY OF FRESNO
5 Excel ' nal Parents Unlimited
6 thorized Si nature) j Nathan Magsig, Chairman of the Board
7 of Supervisors of the County of Fresno
f ell 5, [,,46 re5,
8 Print Name &'Title
9 410 3/ +
107 (�
11 Mailing Address ATTEST:
Bernice E. Seidel
12 Clerk of the Board of Supervisors
County of Fresno, State of California
13
14
15
16
17 By:
Deputy
18 FOR ACCOUNTING USE ONLY:
19
20 Fund: 0001
21 Subclass: 10000
22 ORG: 56201706
23 Account: 7295
24
25
26
27
28
- 3 -
Second Revised Exhibit A
Page 1 of 2
SCOPE OF WORK
Exceptional Parents Unlimited
DESCRIPTION OF SERVICES
CONTRACTOR's Community I-Iealth"Team services trust directly serve Fresno County families and
children ages 0-5 who are not being served by other home visitation programs. CONTRACTOR may
obtain client referrals on their own or from COUNTY's Department of Public Health (DPH). All referrals
received will be screened to ensure the client is not being served by other home visitation programs
including DPH.
CONTRACTOR will administer an Edinburgh Postnatal Depression Scale(EPDS)or Patient Health
Questionaire-9(PHQ-9) as well as a needs assessment for all families served.
Community Health Team home visitation staff will consult with the DPH PHN for guidance and support
on medically challenging cases and complete joint home visits as needed.
CONTRACTOR will adhere to all terms set forth in the First 5 Fresno County Funded Partner
Manual(littps://\vww.first5fresno.org/forms-docs/)and the California Department of Public
Health (CDPH)- Maternal, Child and Adolescent Health(MCAH) Division's Fiscal Administration
Policy and Procedure Manual
(https://\vww.cdpil.ca.gov/Programs/CFI-I/DMCAH/Pages/FiscalDocuments.aspx)as it pertains to
subcontractors of funded recipients.
COLLABORATIVE MEETINGS
Approximately two (2) home visitors will meet with the DPH PHN two(2) times per month for case
consultations,trainings and other program issues. Sign in sheets are required for each meeting. Data is
required to be entered in the F5FC database on a quarterly basis.
PARENT PARTNERSHIP HOME VISIT
Home visit services will be focused on the parent, but children ages 0-5 in the home will also receive
services. CONTRACTOR will provide services in accordance with their research-based home visitation
model. Services must be completed in the home or a similar setting. 'Teleconferencing can be utilized in
lieu of home visitation due to COVID-19 precautions until restrictions are lifted.
• Fifty(50) unduplicated families will receive home visitation services with at least one(1)
parent/caregiver attending each visit.
• Each home visitor will carry a caseload of approximately seventeen (17)clients.
• Home visits will be conducted once per week for at least 9 months. I I Visits will last
approximately ninety(90) minutes.
Data is required to be entered in the F5FC database on a monthly basis.
Second Revised Exhibit A
Page 2 of 2
DEVELOPMENTAL SCREENING
Each child client ages 0-5 will receive an ASQ and ASQ:SE developmental screening for a total of forty
five(45)ASQs and forty five(45)ASQ:SEs. Data is required to be entered in the F5FC database on a
monthly basis.
REFERRALS
Fifty(50)children and/or parents will receive referrals to community resources (e.g., primary care
physician, early intervention, school district, mental health, medical referrals, Help Me Grow Fresno
County,day care, preschool, housing, cash aid, or food assistance). Data is required to be entered in the
F5FC database on a monthly basis.
DOCUMENTATION AND DATA COLLECTION
CONTRACTOR will collect and report data on all client services as outlined above including client
eligibility, demographics, screenings and referrals/interventions completed.
CONTRACTOR will submit a brief quarterly narrative addressing target population, intent of service,
short story,challenges, barriers and any program family event(s) as described in the Quarterly Narrative
and Aggregate Reports section of the F5FC Funded Partner Manual to COUNTY by the 5°1 of the month
following the end of each quarter.
TIME STUDY
All Community Health Team staff will prepare and submit time studies quarterly to COUNTY in order to
receive leveraged federal funding. CDPH MCAH program requires all personnel that are funded by
Federal Title XIX to prepare and submit a time study at least once per quarter.
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