Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Children and Families Commission of Fresno County-Community Health Teams Program_A-24-687.pdf
COtj County of Fresno Hall of Records, Room 301 2281 Tulare Street Fresno,California 601 Board of Supervisors 93721-2198 O� 1$56 O Telephone: (559)600-3529 FRV,t' Minute Order Toll Free: 1-800-742-1011 www.fresnocountyca.gov December 17, 2024 Present: 5- Supervisor Steve Brandau, Chairman Nathan Magsig,Vice Chairman Buddy Mendes, Supervisor Brian Pacheco, and Supervisor Sal Quintero Agenda No. 60. Public Health File ID: 24-0384 Re: Approve and authorize the Chairman to execute retroactive revenue Agreement with Children and Families Commission of Fresno County,for the Nurse-Family Partnership program, effective July 1, 2024 to June 30, 2026($420,498); approve and authorize the Chairman to execute retroactive revenue Agreement with Children and Families Commission of Fresno County,for the Nurse Liaison program, effective July 1, 2024 to June 30, 2026($788,722); and approve and authorize the Chairman to execute retroactive revenue Agreement with Children and Families Commission of Fresno County,for the Community Health Teams program, effective July 1, 2024 to June 30, 2026($1,790,780) APPROVED AS RECOMMENDED Ayes: 5- Brandau, Magsig, Mendes, Pacheco, and Quintero Agreement No. 24-685,Agreement No. 24-686,Agreement No. 24-687 County of Fresno Page 68 co Board Agenda Item 60 O 1856 O FRE`'� DATE: December 17, 2024 TO: Board of Supervisors SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health SUBJECT: Retroactive Agreements with Children and Families Commission of Fresno County RECOMMENDED ACTION(S): 1. Approve and authorize the Chairman to execute retroactive revenue Agreement with Children and Families Commission of Fresno County,for the Nurse-Family Partnership program, effective July 1, 2024 to June 30, 2026 ($420,498); 2. Approve and authorize the Chairman to execute retroactive revenue Agreement with Children and Families Commission of Fresno County,for the Nurse Liaison program, effective July 1, 2024 to June 30, 2026($788,722); and 3. Approve and authorize the Chairman to execute retroactive revenue Agreement with Children and Families Commission of Fresno County,for the Community Health Teams program, effective July 1, 2024 to June 30, 2026 ($1,790,780). There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will provide the Department of Public Health (Department)with two years of funding from Children and Families Commission of Fresno County (First 5)to support the existing Nurse-Family Partnership (NFP), Nurse Liaison (NL), and Community Health Teams (CHT) programs. The recommended agreements with First 5 will also allow the County to use the funds as the local match to draw down Federal Financial Participation (FFP) at around fifty percent. The First 5 funding will continue to support salary and benefits for Public Health Nurses (PHN)and four subcontracts with local community-based organizations (CBOs)to provide direct home visitation services. This item is countywide. ALTERNATIVE ACTION(S): There are no viable alternative actions. Should your Board not approve the recommended actions, the Department would not be able to accept the First 5 funds or draw down FFP funding, which supports salary and benefits, as well as operational and indirect costs for all three programs. Non-approval would also lead to a reduction in the Department's NFP, NL, and CHT staff and services that currently provide much needed assistance to children ages 0 to 5 and their families in Fresno County. RETROACTIVE AGREEMENT: The recommended actions are retroactive to July 1, 2024. The First 5 agreements were initially received as amendments to the previous agreements. However, the amendments were not received in time to follow the board agenda item deadlines to be presented to your Board before the end of the fiscal year. All three amendments had to be converted into a new agreement with a new budget that excludes allowable carryover of unexpended funds from previous fiscal years. The item is now being brought to your Board in accordance with the agenda item processing deadline. County of Fresno Page I File Number.24-0384 File Number:24-0384 FISCAL IMPACT: There is no increase in Net County Cost associated with the recommended actions. The First 5 agreement for the NFP program will provide $420,498 for the next two years. The First 5 agreement for the NL program will provide $788,722 for the next two years. The First 5 agreement for the CHT program will provide $1,790,780 for the next two years and fund four CBOs providing home visitation services for the CHT program. The recommended actions will allow the County to use the funds as the local match to draw down Federal dollars under Title XIX as FFP for eligible services through the Maternal, Child and Adolescent Health (MCAH)grant. Sufficient appropriations and estimated revenues are included in the Department's Org 5620 FY 2024-25 Adopted Budget and will be included in subsequent budget requests. DISCUSSION: On December 16, 2016, the Board approved agreements with First 5 to receive funding supporting the NFP and NL programs for two years. On August 7, 2018, September 10, 2019, September 1, 2020, September 7, 2021, and August 23, 2022, the Board approved first, second, third, fourth, and fifth amendments to extend the agreements with First 5 for an additional year with each amendment and receive additional funding supporting the NFP and NL programs. PHNs in the NFP program provide evidence-based nurse home visitation services to low-income, pregnant, or parenting first-time mothers in the County. PHNs in the NL program work with Valley Children's Hospital and Community Regional Medical Center as well as the medical community outside these facilities to ensure that referred high-risk infants and children under six years of age living in the County receive medical care, resources, and support as needed. In FY 2023-24, the NFP program: • NFP PHNs served 193 pregnant and parenting women; • Completed 1,889 visits with clients, of which 1,645 were in-person home visits and 244 were virtual telehealth visits; • 96% of women served initiated breastfeeding after birth of infants; • 93% of infants served were current on immunization at 6-months; and • 255 referrals were completed for needed services including: mental health, dental services, Medi-Cal assistance, Women Infant and Children Nutritional Program, medical referrals, and referrals for developmental delays in children. In FY 2023-24, the NL program: • Provided case management services to 181 children; • Administered developmental screening for 101 children; • Provided 253 referrals to children and families including: mental health, dental, primary care, domestic violence assistance, early intervention, and immunizations; and • Had a rehospitalization rate of less than 1%for children in the NL program . On October 6, 2020, the Board approved the agreement with First 5 to receive funding supporting the creation of the CHT program and the agreements with the four contracted CBOs, which pairs a Department PHN with teams of paraprofessionals from local CBOs to provide research-based and evidence-informed home visitation services to underserved families in Fresno County communities. On October 19, 2021, June 21, 2022, and August 23, 2022, the Board approved first and second amendments to extend the agreement with First 5 and receive additional funding supporting the CHT program, as well as approved the first amendments for the four contracted CBOs to extend the agreement for an additional two years. These teams provide much needed assistance to children ages 0 to 5 and their families who otherwise would not qualify for existing nurse-based home visitation programs. The PHN provides guidance and support on medically challenging cases to the CBO's home visitors that County of Fresno Page 2 File Number.24-0384 File Number:24-0384 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 for families. The CHT meets on a regular basis for trainings provided by the PHN, case consultations, and other program issues. In FY 2023-24, the CHT program: • Provided case management services to 233 families; • Provided developmental screening to 239 children; • Provided referrals for 220 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 approve two years of funding from First 5, providing the local match to leverage Federal funding, further supporting the programs, and allowing the NFP and NL, and CHT programs to continue improving pregnancy outcomes, child health and development, and linkage to resources as needed. Approval will also allow the Department to continue using an integrated approach to enhance 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. REFERENCE MATERIAL: BAI #33, August 23, 2022 BAI #71, June 21, 2022 BAI #30, October 19, 2021 BAI #50, September 7, 2021 BAI #42, October 6, 2020 BAI #33, September 1, 2020 BAI #46, September 10, 2019 BAI #47, August 7, 2018 BAI #35, December 6, 2016 ATTACHMENTS INCLUDED AND/OR ON FILE: On file with Clerk-Agreement with First 5 for NFP On file with Clerk-Agreement with First 5 for NL On file with Clerk-Agreement with First 5 for CHT CAO ANALYST: Ron Alexander County of Fresno Page 3 File Number.24-0384 Agreement No. 24-687 County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 1 PROGRAM SERVICES AGREEMENT PARTIES The Commission: Children and Families Commission of Fresno County,California Contractor: County of Fresno ADMINISTRATIVE Contract Number: 202425-102674 RECITALS A. The voters of the State of California have enacted the California Children and Families Act of 1998 (the "Act"),codified in Health and Safety Code Sections 130100 et seq.,also known as Proposition 10. B. The Board of Supervisors of Fresno County has established the Commission pursuant to the Act and Fresno County Ordinance Code,Chapter 2.38 of Title 2 Sections 2.38.010,2.38.02o and 2.38.030. C. The Commission desires to create and implement a comprehensive,collaborative,and integrated system for the purposes of promoting, supporting, and improving the early development of children residing in Fresno County from the prenatal stage through 5 years of age(the"Program"). D. The Commission is authorized to enter into agreements with third parties for performance of Program services pursuant to the Act. E. The Commission desires to retain Contractor to provide the Program services described in this Agreement. F. Contractor is able,qualified,and willing to perform these services for the Commission. Therefore,in consideration of the above recitals,which are incorporated into this Agreement by reference,the Parties agree as follows: 1. Term This Agreement begins and is made effective retroactively to July 1,2024(the"Effective Date"), and ends on June 30,2026,unless terminated earlier pursuant to Section 17 to this Agreement(the"Term"). z. Performance 2.1 Services. Contractor agrees to provide all services described in Exhibit A,"Scope of Work and Budget" (attached and incorporated into this Agreement) (the "Services"), to the complete satisfaction of the Commission,in the Commission's sole discretion. 2.2 Budget. Contractor must comply with all criteria and standards contained in Exhibit A,"Scope of Work and Budget"(attached and incorporated into this Agreement). County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 2 2.3 Purpose A. Pursuant to state law and local ordinances, Contractor certifies, represents, and warrants that it will provide the Services for the sole purposes of the Program, including promoting, supporting, and improving the early development of children residing in Fresno County from the prenatal stage through 5 years of age. Contractor shall only: (1) Provide the Services to children ages prenatal through age five (5) who reside in Fresno County; (2) Provide the Services to parents, primary care givers, or legal guardians of children ages prenatal through age five(5)who reside in Fresno County;or (3) Provide the Services to professionals or another service provider,who in turn provide services to (i) children ages prenatal through age five (5) who reside in Fresno County, or (ii) the parents,primary care givers,or legal guardians of these children. 2.4 Capabilities. Contractor represents and warrants that it has the expertise, appropriate licenses, support staff,and facilities necessary to provide the Services in a timely and professional manner. 2.5 Commencement of Services. Contractor must begin performing the Services within sixty (6o) days of the Effective Date. 3• Compliance with Strategic Plan, Funded Partner Manual,and Other Requirements 3.1 Strategic Plan. Contractor must provide the Services in a manner consistent with the objectives in the Commission's Strategic Plan, available on the Commission's website www.first5fresno.org and incorporated by reference into this Agreement(the"Strategic Plan"). In order to carry out these objectives, Commission may,from time to time and at the Commission's sole discretion,request Contractor to work with other Commission-affiliated service providers in order to integrate the Services into other programs funded directly or indirectly by the Commission. Contractor must make reasonable efforts to comply with the Commission's request. 3.2 Funded Partner Manual. Contractor must comply with all policies and procedures set forth in the Commission's Funded Partner Manual,as amended,a current version of which is available on our website www.firstSfresno.orcrand incorporated by reference (the "Manual"). The Commission may review and amend the Manual as the Commission considers necessary in its sole discretion. Contractor must review the Commission's website (www.first5fresno.org)by July 1st of each year during the Term to retrieve an updated Manual, or as otherwise notified by the Commission. Contractor must comply with any and all changes made to the Manual unless Contractor sends notice of termination of this Agreement to the Commission within ten (1o) days after it receives an updated Manual or after the Commission notifies Contractor to retrieve an updated Manual,whichever the case may be. 3.3 Other Requirements. Contractor must comply with all other criteria and standards contained in this Agreement and all exhibits, and any additional Commission policies, procedures, or other requirements in effect during the Term. 4. Compensation 4.1 Project Budget. Compensation for the Services is based on actual costs as described in Exhibit A. County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 3 4.2 Reimbursement. The Commission will reimburse Contractor for all necessary,reasonable,and justifiable expenses, as determined by the Commission,incurred in accordance with the Project Budget(Exhibit A) for providing the Services on behalf of the Commission in an aggregate amount not to exceed ONE MILLION SEVEN HUNDRED NINETY THOUSAND SEVEN HUNDRED EIGHTY DOLLARS AND No/too SPELLED ($1,790,780) (the"Contract Amount"). The Commission will follow the reimbursement process set forth in the Manual, as amended. Payment on all invoices is contingent upon Contractor's compliance with all contractual requirements including, but not limited to, the achievement of performance standards and the timely submission of Financial Reports and Progress Reports, as defined below and further described in the Manual,as amended. A. Financial Report. Contractor must request reimbursement by submitting to the Commission,as often as the Commission requires or allows, an invoice and an expenditure report setting forth actual expenditures as compared to the Project Budget (a "Financial Report"). Each Financial Report must include a disbursement list or check register reflecting all disbursements. Contractor must submit each Financial Report according to the guidelines set forth in the Manual,as amended. B. Progress Reporting Requirements. The Commission utilizes a designated, web-based data management program("Data Program"). If applicable to the Services or any program under the Scope of Work(Exhibit A), Contractor must submit data containing client information on a monthly basis via the Data Program. Contractor must also submit progress reports on a quarterly basis via the Data Program. Any and all aggregate data,if applicable to the Services or any program-under the Scope of Work, is due on a quarterly basis via the Data Program. The Commission must receive quarterly requirements no later than the fifteenth (15`h) day after the ending of the previous quarter, or as the Commission requires. Contractor must submit all data and reports in a form provided by the Commission and according to the guidelines, policies, and procedures set forth in the Manual, as amended. C. Electronic Fund Transfer. All payments by the Commission to Contractor during the term of this Agreement shall be made via electronic funds transfer("EFT"). Contractor shall be required to submit all forms necessary to facilitate EFT, including, but not limited to, the EFT authorization form. The EFT policy is contained in the Manual. 4.3 Disallowed Costs. The Commission will not reimburse Contractor for any expense that it determines,in its sole discretion,to be a supplanting of funds or program income, as described below,or a"Disallowed Cost,"as further described in the Manual,as amended. 4.4 Advances. If Contractor desires funds prior to commencing the Services, Contractor must request, by written notice received by the Commission, early release of funds from the Commission. This request must be on Contractor's company letterhead, must specify the amount requested, and must set forth all reasons why Contractor needs the funds. The Commission has the sole discretion whether or not to release any funds before Contractor performs Services but will not release more than fifty percent (505.) of the annual budget amount,as listed in the Project Budget(Exhibit A). If the Commission releases funds before Contractor performs Services,the Commission will not release any additional funds, at any time, unless and until seventy-five percent(75g,.,)of the previously released funds have been properly expended and reported. 4.5 Setoff Against Debts. The Commission may deduct from any payments due to Contractor any monies Contractor owes the Commission under this Agreement or any other agreement. County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 4 5. Supplementing Existing Service Levels and Supplanting Other Funding 5.1 Supplanting Law & Policy. The Parties are bound by the provisions of the Commission's supplanting policy(as set forth in the Manual,as amended) and Section 30131.4(a)of the Revenue and Taxation Code, which states: All moneys raised pursuant to taxes imposed by Section 30131.2 shall be appropriated and expended only for the purposes expressed in the California Children and Families Act, and shall be used only to supplement existing levels of service and not to fund existing levels of service. No moneys in the California Children and Families Trust Fund shall be used to supplant state or local General Fund money for any purpose. 5.2 Prohibition Against Supplanting. Contractor must not use any funds provided by the Commission to supplant existing funds in contravention of law or Commission policy. Contractor must use any monies leveraged, obtained through matching funds,part of governmental or private grant funds, or in any way resulting from the use of funds provided by the Commission, solely in performing the Services. Contractor's use of these funds is subject to the Commission's approval at the Commission's sole discretion. 5.3 Additional Funds A. Receipt of Additional Funds. If Contractor receives any funding for similar services from state, federal,or local governmental agencies that is not otherwise earmarked(general funds)for particular projects ("Additional Funds"), Contractor must immediately notify the Commission in writing of the amount of Additional Funds received and all terms and conditions attached to Contractor's use of the Additional Funds. Contractor must use as much of the Additional Funds as possible toward providing the Services. The Commission will no longer reimburse Contractor for any expenses Contractor incurs in providing the Services to the extent Contractor did use or could have used Additional Funds to pay for the same portion of the Services. The Commission, at its sole discretion,will continue to fund up to the current balance of the Contract Amount for the remainder of the Term,but only to the extent that the Services are unrelated to the services funded by the Additional Funds. B. Abuse of Additional Funds. The Commission may, at its sole, discretion, investigate Contractor's use of Additional Funds and may require Contractor to document its use of the Additional Funds along with funds it receives under this Agreement. If the Commission determines, in its sole discretion,that Contractor used both Commission funds and Additional Funds to pay for any expense substantially similar or reasonably related to the Services,Contractor must reimburse the Commission for all Commission funds expended in this manner. The Commission may also,at its sole discretion, require that Contractor certify to the Commission that it is not using or will not use Additional Funds to fund any portion of those services funded by the Commission. 6. Program Income 6.1 Definition. "Program Income"means gross income earned by Contractor that is directly generated by a Program activity or earned as a result of funds awarded by the Commission or procured directly or indirectly under this Agreement. Program Income includes, but is not limited to, income from fees for Services performed, the use or rental of real or personal property acquired under Commission-funded projects,the sale of commodities or items fabricated under funds awarded by the Commission,license fees and royalties on patents and copyrights, and interest on loans made with funds awarded by the Commission. County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 5 6.2 Restrictions on Use. Contractor must use Program Income only for providing the Services. Contractor must place and maintain Program Income in a separate cost center or fund trackable in Contractor's accounting system for Contractor's performance of the Services. Contractor must notify the Commission immediately upon ascertaining the existence of Program Income. The Commission may offset future disbursements and reimbursements to Contractor in an amount equal to all funds identified by Contractor as Program Income,and that the Commission determines,in its sole discretion,to be Program Income. 7. Fiscal Compliance 7.1 Management of Funds. Contractor must not comingle Program funds it receives directly or indirectly under this Agreement with any other funds. Contractor must use all Program funds procured directly or indirectly under this Agreement solely for providing the Services as set forth in this Agreement. Contractor must comply with the controls,record keeping, and fund accounting procedure requirements of the Commission(specified in the Manual,as amended),and all federal,state,and local regulations and directives, to ensure the proper disbursal of, and accounting for, Program funds paid to Contractor and disbursed by Contractor under this Agreement. Contractor must track and report costs in conformance with Generally Accepted Accounting Principles("GAAP"). 7.2 Financial Statement. Contractor must submit,upon request,an annual,independently audited,financial statement to Commission on or before April 3oth of each year during the Term. 8. Commission's Oversight of Contractor 8.1 Monitoring and Evaluation. The Commission will monitor and evaluate performance of the Services through all means it considers necessary, in its sole discretion, to ensure that Contractor is complying with the Act and the terms of this Agreement. The Commission may establish and provide policies and procedures governing the means by which it monitors,evaluates,and reports on Contractor's performance and how it makes funding decisions. Contractor understands that determining whether Contractor is performing the Services in accordance with this Agreement and whether the Commission will continue to provide funding to Contractor under this Agreement is solely the responsibility and within the discretion of the Commission. 8.2 Data Collection. Contractor must fully cooperate with the Commission in the development and implementation of monitoring and evaluation procedures including, but not limited to, data collections, data entry, reporting activities, and deadlines for deliverables described in Exhibit A, and as otherwise required by the Commission. As part of the Commission's monitoring and evaluation process,as well as the Commission's obligation to carry out its objectives under the Act, Contractor must provide all data and information required by the Commission at any time during the Term, or as otherwise required by this Agreement. The Commission will only request data that is directly or indirectly related to the Services. Contractor must enter client data in the Data Program, including, but not limited to, all individually identifiable agreed-upon information. 8.3 Annual Contract Review and Site Visits. The Commission may, at any time, annually review this Agreement as part of its monitoring or evaluation activities (the "Annual Contract Review"). During an Annual Contract Review, the Commission may visit any and all locations where the Services are being provided. The Commission may also make additional visits, at any time and at any location, at the Commission's sole discretion. The frequency of these additional visits will vary depending on the findings made by Commission staff in any Annual Contract Review. The Commission reserves the right to make unannounced visits during regular business hours or schedule a visit outside of regular business hours. County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 6 8.4 Audit and Inspection A. Contractor must maintain and make available to the Commission accurate books and records relevant to all of its activities under this Agreement. The Commission may conduct one or more audits or examinations (the"Audit and Inspection Activities"). As part of the Audit and Inspection Activities, the Commission may copy any records, including, without limitation, invoices, materials, personnel records, client files, sign-in sheets, or any other information or data related to all matters covered by this Agreement. Contractor must reasonably cooperate with the Commission's efforts to carry out the Audit and Inspection Activities. Notwithstanding the Term,the Audit and Inspection Activities will continue in full force and effect for four (4) years from the expiration of the Term, or until the Commission has notified Contractor in writing that the Audit and Inspection Activities are completed, whichever occurs last. B. Contractor must immediately report to the Commission any incidents of fraud, abuse, or other criminal activity regarding provision of the Services or otherwise related to this Agreement or the expenditure of Commission funds. 8.5 Record Retention. Contractor must maintain records in accordance with the policies and procedures set forth in the Manual,as amended. All records must describe and support the use of funds for the Services. Contractor must maintain all data and records in an accessible and secure location in good condition for at least four(4)years from the expiration of the Term or until the Commission has notified Contractor in writing that the Audit and Inspection Activities are completed,whichever occurs last. In the event that Contractor misplaces, loses, or otherwise fails to maintain all data and records in accordance with this Section or the Manual,as amended,the Commission,at its sole discretion,may disallow any costs directly or indirectly related to the missing,lost,or improperly maintained record or records. 8.6 Governmental Agencies and State Auditor General. The State of California or any state,federal,or local agency having an interest in the subject of this Agreement has the same rights as conferred upon the Commission under this Section. If this Agreement exceeds ten thousand dollars ($io,000), Contractor shall be subject to an examination and audit by the California State Auditor for a period of three(3)years after final payment under this Agreement(Government Code§8546.7). 8.7 Single Audit Act. Even though funds received under this Agreement are not federal funds,if Contractor is audited under the Single Audit Act and OMB Circular A-133, it must have its independent auditor include the funds received and expended under this Agreement as part of the testing. Although the programs tested under these provisions are selected on a risk-based approach, and for Federal Government purposes this Agreement would not be included in that analysis, the Commission requires that at least a representative number of transactions will be selected for testing from these contracted Program funds. The number of transactions selected could be based on a statistical sampling method, materiality levels, or on the auditor's judgment as long as the auditor determines that the expenditures made are appropriate under this Agreement. The Commission reserves the right to create audit guidelines with which Contractor must comply. 8.8 Costs of Oversight Activities. The Commission will bear reasonable costs in connection with or resulting from its regular monitoring, evaluation, data collection, visits, inspection, or other oversight activities related to this Agreement. If,however,the Commission(including the Commission's Executive Director) determines that it will conduct further oversight activities to determine whether or not Contractor committed fraud, breach, or other misrepresentation related to the Services or in connection with Contractor's performance of this Agreement, Contractor will bear any costs the Commission incurs as a result of conducting these additional activities. These costs will include,but are not limited to:actual costs incurred (including, without limitation, consulting, auditing, and legal fees, costs, and expenses); the County of Fresno,Department of Public Health Contract#20242$-102674 Community Health Teams Page 7 payment or repayment of any expenditures disallowed by the Commission or any federal, state, or local governmental entities;and any interest and penalties assessed by any federal,state,or local governmental agency. 8.9 Penalty. Contractor's failure to (a)timely and accurately submit any document, report,or data requested in a timely and accurate manner, or (b) otherwise adhere to the Commission's administrative, programmatic, or financial requirements specified in this Agreement or in the Manual,as amended,will result in the Commission imposing penalties as specified in the Manual, as amended. These penalties may include, without limitation: withholding of payment by the Commission; loss of rights to receive advances under Section 4.4 above;transition to monthly reimbursement and reporting;the assessment of a five percent (5%) penalty on the final invoice amount;suspension without payment;termination of this Agreement;and loss of eligibility to receive future funding from the Commission. Contractor may appeal the penalty in writing to the Commission or designated standing committee, on Contractor's company letterhead, setting forth the extenuating circumstances that caused the tardy or inaccurate submission. The Commission has sole discretion whether to waive any penalty. 8.10 Submission of Information and Data A. As part of the Commission's monitoring,evaluation,and auditing activities,Contractor will submit all requested information and data, including but not limited to, individually identifiable physical or mental health information, substance abuse information, child care or education information, personnel or employment information, financial information, criminal justice information, or demographic information to the Commission. Contractor certifies that the submission of the aforementioned information will not violate any current federal,state,or local law or regulation. B. If, during the Term, the Federal government, State of California, or any political subdivision with jurisdiction over the Services, adopts or amends a law or regulation under which Contractor believes it may no longer legally provide the Commission with some or all of the information and data requested under this Section, Contractor must submit to the Commission, in writing, a legal memorandum from Contractor's attorney detailing why Contractor believes complying with this Section would violate the new or amended law or regulation, and proposing a reasonable solution. The Commission will review this memorandum and will determine, in its sole discretion,whether to accept Contractor's proposed solution,terminate this Agreement, or pursue any other remedy under this Agreement or at law. The Commission will comply with the California Public Records Act, Government Code Sections 6250 et seq.,as may be amended during the Term. 8.11 Confidentiality A. For purposes of this Agreement and to the extent permitted by law, "Confidential Information" includes, but is not limited to, any data, ideas, know-how, materials, products, formulas, processes, technology, computer programs, specifications, drawings, diagrams, manuals, plans, policies, software, financial information, personnel information, client information, any information entered into or contained in the Commission's Data Program(or other data management program used by the Commission), and other information disclosed or submitted,orally,in writing,or by any other media; provided,however,that Confidential Information shall not include information that (i) is or becomes generally available to or known by the public other than as a result of a disclosure made by the Parties; (ii) is disclosed by Contractor because such information was compelled by court order; or (iii) was available to Contractor on a nonconfidential basis prior to disclosure by the Commission or an affiliate of the Commission and prior to the Effective Date. County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 8 B. Contractor acknowledges that during the Term it might have access to Confidential Information required for effective coordination and delivery of services to children and their families. Contractor will ensure that all of its employees,agents,contractors,and representatives will comply with the terms and conditions of this Agreement and all applicable laws regarding the access,use,and dissemination of Confidential Information. All confidential discussions,deliberations,and Confidential Information generated, submitted, or maintained in connection with this Agreement must be disclosed only to persons who have a specific and bona fide "need to know" and authority to access Confidential Information. Furthermore, Contractor must not disclose to third parties (i) any Confidential Information without the express written consent of the Commission, and (ii) any individually identifiable Confidential Information related to a child without the additional written authorization from the child's parent or legally authorized representative. g. Multi-Year Agreements If this Agreement covers more than one (1) fiscal year of the Commission (July through June), Contractor must submit a revised Scope of Work and Budget (Exhibit A) for the Commission's review, revision, and approval. Contractor must submit these documents to the Commission in accordance with the Manual, as amended. The Commission has the sole discretion whether or not to revise and/or approve any revision to a multi-year agreement. lo. Materials Identification, Ownership, and Dissemination io.1 Identification. Contractor will acknowledge and give proper credit to the Commission as the funding source in all publications that are paid for by the Commission funds or used by Contractor in providing the Services ("Information Materials"). These Information Materials include, but are not limited to, posters,press and social media releases,brochures, and other publicity or public relations materials. To appropriately credit the Commission, Contractor must comply with the Manual, as amended. The Commission may elect,at its sole, discretion,not to reimburse Contractor for the costs of any Information Materials for which Contractor fails to properly credit the Commission. The Commission, at its sole discretion, may elect to treat as a Disallowed Cost the costs of any Information Materials not properly credited to the Commission. 10.2 Ownership. All Information Materials, records, and property, either provided to Contractor by the Commission or otherwise related to the Services, are the property of the Commission. Contractor,at the Commission's sole discretion, must turn over all Information Materials to the Commission at the expiration of the Term or earlier termination of this Agreement. The Commission, at its sole discretion, may elect to treat as a Disallowed Cost the costs of any Informational Materials that Contractor fails to turn over to the Commission. 10.3 Disseminating Information and Outreach. Contractor, at the Commission's request and to the Commission's reasonable satisfaction,must disseminate Information Materials regarding outreach or any other topic that the Commission considers necessary in its sole discretion. The Commission will provide these Information Materials to Contractor with reasonable notice and instructions for dissemination. ii. Fingerprinting and Child Abuse Prevention Policy 11.i Fingerprinting and Background Checks. Contractor represents and warrants that 1) all its employees, agents,volunteers,and subcontractors,who directly provide Services to children,are(and will continue to be) fingerprinted according to state and federal law; and 2) have (and will continue to have) a criminal clearance which states that they do not have a criminal history which would compromise the safety of children. Additionally, irrespective of any federal or state legal requirements, Contractor represents and County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page g warrants that any of its employees, agents, volunteers, or subcontractors who will or may have direct, unsupervised access to children in connection with the Services,are(and will continue to be)fingerprinted and have the same criminal clearance described in the preceding sentence. Contractor may include costs associated with these fingerprinting and background checks in its proposed budget. 11.2 Child Abuse Prevention. Contractor represents and warrants that it will report all known or reasonably suspected instances of child abuse or neglect to either local law enforcement or county child welfare services consistent with state and federal law. Contractor further represents and warrants that each and every employee,agent,volunteer,or subcontractor who directly provides Services to children has received annual or otherwise state-required training regarding child abuse and neglect prevention and reporting and must sign a statement acknowledging that they understand the child abuse reporting laws and will comply with same. 12. Independent Contractor 12.1 Status. Contractor is an independent contractor. All persons employed to furnish the Services are employees of Contractor and not of the Commission. In performance of the Services, Contractor, including any and all of Contractor's owners, officers, agents, employees, and independent contractors, will at all times be acting and performing as an independent contractor, and will act in its independent capacity and not as an officer, agent, servant, employee, joint venturer, partner, or associate of the Commission. The Commission has no right to control,supervise,or direct the manner or method by which Contractor performs its obligations under this Agreement. However, the Commission may administer this Agreement so as to verify that Contractor is performing its obligations in accordance with the terms and conditions of this Agreement. 12.2 Employer Duties. Contractor has the sole obligation to provide its employees with all legally required notices and postings, as well as all employee wages and benefits, and will make all Social Security and other withholdings required by applicable federal or state laws and regulations. 13. Subcontracts 13.1 Contractor's Responsibility. Contractor assumes full responsibility for the performance of the Services, whether or not directly provided by Contractor. Contractor is considered the sole point of contact regarding contractual matters, including payment of any and all charges resulting from this Agreement. Contractor is responsible to the Commission for the full and proper performance of any subcontract. Any subcontractor is subject to the same terms and conditions to which Contractor is subject under this Agreement. 13.2 Procedures for Subcontracting. If Contractor desires to subcontract with one or more third parties to carry out a portion of the Services (e.g., subcontracting with consultants or partnering with another organization), any subcontract must (a) be in writing and approved as to form and content by the Commission prior to execution and implementation; and (b) include a budget or fee schedule for the Commission's review. The Commission has the sole right to request and/or reject any proposed subcontract. Any subcontract, together with all other activities by or caused by Contractor, may not require compensation greater than the Contract Amount. Contractor must submit an executed copy of any subcontract and must receive a receipt confirmation from the Commission before any implementation. 14. Defense, Indemnity, and Hold Harmless County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 10 The Contractor shall indemnify and hold harmless and defend the Commission(including its officers,agents, employees, and volunteers) against all claims, demands, injuries, damages, costs, expenses (including attorney fees and costs),fines,penalties,and liabilities of any kind to the Commission,the Contractor,or any third party that arise from or relate to the performance or failure to perform by the Contractor(or any of its officers, agents, subcontractors, or employees) under this Agreement. The Commission may conduct or participate in its own defense without affecting the Contractor's obligation to indemnify and hold harmless or defend the Commission. The Commission shall indemnify and hold harmless and defend the Contractor(including its officers,agents, employees, and volunteers) against all claims, demands, injuries, damages, costs, expenses (including attorney fees and costs),fines,penalties,and liabilities of any kind to the Contractor,the Commission,or any third party that arise from or relate to the performance or failure to perform by the Commission(or any of its Officers, agents, subcontractors, or employees) under this Agreement. The Contractor may conduct or participate in its own defense without affecting the Commission's obligation to indemnify and hold harmless or defend the Contractor. 15. Insurance 15.1 Required Coverage. On or before the Effective Date, Contractor must furnish to the Commission satisfactory proof of the required insurance ("Certificates of Insurance"), which must include a commitment by Contractor's insurers that they will mail notice of any cancellation or reduction of coverage below the amounts required by the Commission, at least thirty (3o) days prior to the effective date of the cancellation or change. Contractor may not perform any work under this Agreement until Contractor has obtained all insurance required under this Section and the required Certificates of Insurance have been filed with and approved by the Commission. Contractor must pay any deductibles and self-insured retentions under all required insurance policies. All insurance afforded by Contractor pursuant to this Agreement must be primary to and not contributing to any other insurance maintained by the Commission. Contractor must have the following insurance: (1) Commercial General Liability. Comprehensive general liability coverage of at least $1 million per occurrence,$2 million annual aggregate. Contractor must list the Commission as additional insured. (2) Workers' Compensation. Workers' Compensation Insurance in accordance with the California Labor Code. (3) Automobile Liability. Comprehensive automobile liability coverage with a combined single limit of at least $1 million per accident for bodily injury and property damage on all vehicles operated under Contractor's authority,whether or not owned by Contractor. Contractor must list the Commission as additional insured. (4) Professional Liability (Errors and Omissions). If Contractor employs or contracts with licensed professional staff in performing the Services, professional liability (errors and omissions) insurance with limits of at least $1 million per occurrence, $3 million annual aggregate. (5) Fidelity Bond or Insurance. In accordance with Section 17.2 below, or otherwise at the Commission's request,a Fidelity Bond of at least$1 million or insurance with limits of at least $1 million,including coverage for theft or loss of Commission property. County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 11 15.2 Rating. All insurance must be issued by a company or companies listed in the current`Best's Key Rating Guide"publication with a minimum of a`B+;V"rating,or in special circumstances,be pre-approved by the Commission. 15.3 Endorsements. Contractor must obtain endorsements to the general liability and auto insurance policies, giving the Commission an unrestricted thirty (3o) day prior written notice of cancellation or change in terms or coverage. Contractor must also obtain an endorsement to the workers' compensation policy giving the Commission an unrestricted ten-(1o) day prior written notice of any cancellation or change in terms or coverage. 15.4 Self-Insured. If Contractor is,or becomes during the Term, self-insured or a member of a self-insurance pool,Contractor must provide coverage equivalent to the insurance coverage and endorsements required above. The Commission will not accept this coverage unless the Commission determines, in its sole discretion and by written acceptance, that the proposed coverage is equivalent to the above-required coverage. 15.5 Liability and Other Actions. Compliance with the insurance requirements discussed above will not relieve Contractor of any liability,whether within, outside, or in excess of such coverage, and regardless of solvency or insolvency of the insurer that issues the coverage; nor will it preclude Commission from taking any other actions available to it under any other provision of this Agreement or otherwise in law. 15.6 Failure to Maintain Insurance. If Contractor fails to maintain the insurance required in this Section,the Commission may terminate this Agreement and recover damages in accordance with Section 17 below. Alternatively,the Commission may,in its sole discretion,purchase the required insurance coverage and, without further notice to Contractor, the Commission may deduct from sums due to Contractor any premiums and associated costs advanced or paid by the Commission for the insurance. If the balance of monies obligated to Contractor pursuant to this Agreement is insufficient to reimburse the Commission for the premiums and any associated costs,Contractor must reimburse the Commission for the premiums and pay for all costs associated with the purchase of this insurance. Any failure by the Commission to take this alternative action will not relieve Contractor of its obligation to obtain and maintain the insurance coverage required by this Agreement. 16. Individuals Handling Funds No employee, agent, or independent contractor of Contractor who has been convicted of a felony or against whom a civil judgment has been entered based upon misappropriation of funds or similar action may have authority or discretion over disbursements or withdrawals of funding provided to Contractor by the Commission. All individuals having authority to disburse or withdraw funds received by Contractor from the Commission must be bonded in the amount described in Section 15.1 above and must be identified in Exhibit B, the "Individuals Handling Funds Statement", of this Agreement (attached and incorporated into this Agreement), unless the Commission, in its sole discretion, allows Contractor to provide proof of insurance covering employee dishonesty in accordance with this Agreement. 17. Termination 17.1 Non-Allocation of Funds. The terms of this Agreement, and the Services and funds to be provided, are contingent on the continued appropriation of funds to the Commission by all federal, state, or local appropriating agencies. Should the Commission not receive, or otherwise receive a reduction of, appropriated funds from any appropriating agency,the Commission may,in its sole discretion, have the option to modify the scope of the Services,or terminate this Agreement at any time by giving Contractor thirty(3o) days prior written notice. County of Fresno,Department of Public Health Contract#2 02425-1 02 674 Community Health Teams Page 12 17.2 Breach of Contract. The Commission may immediately suspend or terminate this Agreement in whole or in part, where the Commission, in its sole discretion, determines that Contractor has breached this Agreement. Commission may determine that Contractor has breached this Agreement if it determines, in its sole discretion,that Contractor: (1) Illegally or improperly used any funds procured directly or indirectly under this Agreement; (2) Improperly performed any of the Services; (3) Failed to begin performing the Services within sixty(6o) days of the Effective Date; (4) Failed to comply with the Strategic Plan, the Manual, as amended or any other Commission policy,procedure,or requirement; (5) Failed to submit, failed to timely submit, or inaccurately or incompletely submitted, any reports,data,information,documents,books,or other records required under this Agreement; (6) Failed to maintain at all times the insurance required by this Agreement; (7) Has a financial interest,direct or indirect,that is not disclosed to Commission by the Effective Date or that conflicts in any manner with the performance of the Services; (8) Used Additional Funds in violation of this Agreement; (9) Failed to meet any deadlines specified in the Scope of Work(Exhibit A);or (1o) Failed to comply with any term of this Agreement. 17.3 Without Cause. Under circumstances other than those set forth in Section 17.2,this Agreement may be terminated by either Party upon giving the other Party thirty (3o) days advance written notice of an intention to terminate. The date of termination shall be determined pursuant to Section 18 below("Date of Termination"). 17.4 Payment to Contractor and Remedies. If this Agreement is terminated as provided above, the Commission has no obligation to further compensate Contractor, except for Services satisfactorily performed prior to the Date of Termination. The Commission may withhold payment of Program funds, or,if payment has been made,demand that Contractor repay any Program funds disbursed to Contractor under this Agreement,which in the judgment of the Commission were not expended in accordance with the terms of this Agreement. Contractor must promptly refund any such funds upon demand, or at the Commission's option,this repayment may be deducted from future payments owing to Contractor under this Agreement. In no event will any payment by the Commission constitute a waiver by the Commission of any breach of this Agreement or any default which may then exist on the part of Contractor. Neither will any payment to Contractor impair or prejudice any remedy available to the Commission with respect to any breach or default by Contractor. If Contractor breaches this Agreement,Commission may recover from Contractor all remedies available at law. A waiver of any breach of this Agreement by the Commission will not constitute a continuing waiver,a waiver of any subsequent breach of the same,or a waiver of any breach of another provision of this Agreement. 17.5 Surrender of Documentation and Equipment. At the expiration of the Term or if this Agreement is terminated earlier,Contractor must,as required by the Manual,provide to the Commission all equipment, County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 13 files, memoranda, documents, correspondence, and other property generated during the course of performing the Services or purchased with funds procured directly or indirectly pursuant to this Agreement. The Commission may,at its sole discretion,require Contractor to relinquish any equipment in good working order with reasonable wear and tear to the Commission. 18. Notices All notices required or permitted by this Agreement or applicable law must be in writing and may be delivered in person(by hand or by courier) or may be sent by regular,certified or registered mail,or U.S.Postal Service Express Mail,with postage prepaid,by facsimile/fax transmission, or by electronic transmission (email) and will be deemed sufficiently given if served in a manner specified in this Section. The addresses and addressees noted below are that Party's designated address and addressee for delivery or mailing of notices. Any Party may, by written notice to the other, specify a different address for notice. Any notice sent by registered or certified mail,return receipt requested,will be deemed given on the date of delivery shown on the receipt card, or if no delivery date is shown,three(3)days after the postmark date. If sent by regular mail the notice will be deemed given forty-eight(48) hours after it is addressed as required in this Section and mailed with postage prepaid. Notices delivered by United States Express Mail or overnight courier that guarantee next day delivery will be deemed given twenty-four(24) hours after delivery to the Postal Service or courier. Notices transmitted by facsimile/fax transmission or similar means (including email)will be deemed delivered upon telephone or similar confirmation of delivery(confirmation report from fax machine is sufficient),provided a copy is also delivered via personal delivery or mail. If notice is received after 4:30 p.m. or on a Saturday, Sunday or legal holiday it will be deemed received on the next business day. To the Commission: Fabiola Gonzalez,Executive Director Children&Families Commission of Fresno County 2405 Tulare Street,Suite 200 Fresno,California 93721 Fax: (559) 241-6510 Email:fonzalez@first5fresno.org To Contractor: David Luchini,Director of Public Health County of Fresno,Department of Public Health 1221 Fulton Street Fresno,CA 93721 Email:dluchini@fresnocountyca.gov ig. Nondiscrimination and Equal Opportunity Contractor must comply with all applicable laws providing equal employment opportunities. Contractor must not discriminate against any person on the grounds of pregnancy, childbirth or related medical conditions, sex, religious creed, race, color, national origin or ancestry, age, physical or mental disability, medical condition, genetic information, marital status, sexual orientation, gender identity and expression, natural hairstyles,military and veteran status or any other consideration made unlawful by federal,state or local laws. These nondiscrimination and equal opportunity requirements apply, without limitation, to retirement, recruitment,advertising,hiring,layoff,termination,upgrading,demotion,transfer,rates of pay or other forms of compensation,use of facilities,and other terms and conditions of employment. 20. Conflict of Interest Contractor has read and understands the provisions of Sections logo et seq.and Sections 871oo et seq.of the Government Code relating to conflict of interest of public officers and employees. Contractor represents and County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page14 warrants that, upon making diligent inquiry, it is unaware of any financial or economic interest, direct or indirect, not already disclosed to the Commission by the Effective Date,or that conflicts in any manner with the performance of the Services. Contractor must comply with the requirements of Government Code Section 871oo et seq. Should any conflicts of interest under the Government Code arise during the course of the Term, Contractor shall immediately notify Commission after becoming aware of such a conflict. 21. General 21.1 Non-Assignment and Binding Effect. Contractor may not assign all or any part of this Agreement, or any obligations,interest,or any monies due or which become due under this Agreement without the prior written consent of the Commission,which consent may be withheld in the Commission's sole discretion. Subject to the preceding sentence, this Agreement is binding upon, and inures to the benefit of, the respective heirs,executors,administrators,successors,and assigns of the Parties. 21.2 Entire Agreement. This Agreement,including all exhibits,constitutes the entire agreement between the Parties regarding the Services and supersedes all prior and contemporaneous agreements, representations, and understandings of any nature whatsoever unless expressly included in this Agreement. 21.3 Conflict with Commission Policies. Unless expressly stated otherwise in this Agreement,if there is any conflict with the terms of this Agreement and the terms of the Strategic Plan,the Manual,or other policies, procedures,or requirements of the Commission,as amended,the terms of this Agreement prevail. 21.4 No Authority to Bind Commission. Contractor, in its performance of the Services or any other duties under this Agreement,has no authority to bind the Commission to any agreements or undertakings. 21.5 Nonexclusive Agreement. Contractor understands that this Agreement is not an exclusive agreement and that the Commission, at its sole discretion, has the right to negotiate with and enter into contracts with others providing the same or similar services to the Services provided by Contractor. 21.6 Modifications. No waiver,alteration,modification,or termination of this Agreement is valid unless made in writing. 21.7 Waiver. No covenant or condition of this Agreement may be waived except by the written consent of the Commission. 21.8 Governing Law and Venue. This Agreement will be governed by and construed in accordance with the laws of the State of California. The Parties agree that venue for any dispute or litigation arising under this Agreement will be in the County of Fresno, State of California, if instituted in the State courts, or the Eastern District of California(Fresno),if instituted in the Federal courts. 21.9 Remedies. Commission may pursue any and all remedies available by law as needed to enforce its rights under this Agreement. 21.10 Partial Invalidity. If any provision of this Agreement, or any portion of a provision,is held by a court of competent jurisdiction to be invalid,void,or unenforceable,the remaining provisions of this Agreement, including,without limitation,the portions of any provision not held to be invalid,void,or unenforceable, will nevertheless continue to be in full force and effect without being impaired or invalidated in any way. County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 15 21.11 Compliance with Law. Contractor must observe and comply with all applicable federal, state, and local laws, ordinances, rules, and regulations now in effect or enacted during the Term, each of which are incorporated into this Agreement by reference. 21.12 Headings and Construction. The subject headings of the sections and paragraphs of this Agreement are included for purposes of convenience only and do not affect the construction or interpretation of any of its provisions. All words used in this Agreement include the plural as well as the singular number,and vice versa;words used in this Agreement in the present tense include the future as well as the present;and words used in this Agreement in the masculine gender include the feminine and neuter genders,whenever the context so requires. No provision of this Agreement will be interpreted for or against a Party because that Party or its legal representative drafted the provision, and this Agreement will be construed as if jointly prepared by the Parties. 21.13 Time. Time is of the essence in this Agreement. 21.14 Non-Collusion Covenant. Contractor represents and warrants that it has in no way entered into any contingent fee arrangement with any firm or person concerning the obtaining of this Agreement with the Commission. Contractor has received from the Commission no incentive or special payments, nor considerations not related to the provision of the Services. 21.15 Costs and Expenses. Each Party will pay all costs and expenses incurred, or to be incurred, by it in negotiating and preparing this Agreement and its exhibits, and in closing and carrying out the transactions contemplated by this Agreement,including,without limitation,its attorneys',paralegals',and other professionals'fees and costs. 21.16 Signature Authority. Each Party represents that it has capacity, full power, and authority to enter into and perform this Agreement, and the person signing this Agreement on behalf of each party has been properly authorized and empowered to enter into this Agreement. Contractor must sign the signatory authorization, attached as Exhibit C and incorporated into this Agreement. Contractor must complete and forward to the Commission a new signatory authorization each time any name, title, or other information in the existing authorization is no longer current. 21.17 Attorneys' Fees. If an action at law or in equity is necessary to enforce or interpret the terms of this Agreement, the prevailing Party is entitled to reasonable attorneys', paralegals', and other professionals'fees and costs in addition to any other reasonable relief to which it may be entitled. 21.18 Electronic Signatures. Each Party acknowledges and agrees that this Agreement may also be executed by electronic signature,which shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature.Without limitation,"electronic signature"shall include faxed versions of an original signature, electronically scanned and transmitted versions of an original signature,or an"e-signed"document (e.g.DocuSign). County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 16 Signatures CHILDREN AND FAMILIES COMMISSION CONTRACTOR OF FRESNO COUNTY REVIEWED AND RECOMMENDED FOR APPROVA County of Fresno, By: a political subdivision of the State of California Fabi a o z, xecu ve Director Date of Signature: (ILU By: 77,:-�� Ap'pr v d�togalo Authorized Representative By Kenneth Price Legal Counsel Date of Signature: 11/15/2024 LL Name:Nathan Magsig By: Title.Chairman of the Board of Supervisors of the County of Fresno Brian Pacheco,Commission Chair 1 Date of Signature:_ Date of Signature: ATTEST: BERNICE E.SEIDEL Clerk of the Board of Supervisors Exhibits: County of Fresno,State of California eputy A. Scope of Work and Budget Bv�L B. Individuals Handling Funds Statement C. Signatory Authorization County of Fresno,Department of Public Health Contract#202425-102674 Community Health Teams Page 17 Exhibit A Scope of Work and Budget Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(F5FC)staffand Service Provider during a development meeting. County of Fresno,Department of Public Health 202425-102674 Communily Health Teams $1,790,780 Project Name Community Health Teams Contract Number 202425-102674 Agency Name County of Fresno,Department of Public Health Contract Amount S1,790,780 GL 10-8602-00 Start Date-End Dale July 1,2024-June 30,2026 Project ID 2674-24 Name David Luchini,PHN,RN FY24-25 $895,390 Title Director FY25-26 $895,390 Phone 559 600.3200 E-mail dluchini a0fresnocounlvca.aov Commission Approval Date: T January 24,2024 Total S1,790,780 Project Description Briefly address what F5FC is funding and why. If applicable,describe the goals/outcomes. This may be placed on the F5FC website. Character limit A cost-effective model pairing a public health nurse with teams of para-professionals from community based organizations to provide research- based home visitation services to underserved families without the eligibility guidelines of other federally and state funded programs. In this model Department of Public Health(DPH)will contract with multiple community-based organizations(CBOS)creating Community Health Teams in targeted Fresno County communities. DPH will contract with four CBOs(Exceptional Parents Unlimited,Centro La Famflie,Central Valley Children's Services Network and Fresno Economic Opportunities Commission)to provide research-based or evidence-informed home visitation services to underserved families with children ages 0-5 in specific Fresno County communities.The home visitation curricula selected must address one or more of the key challenges facing families as cited in the Commission's strategic plan.Secondary services that support families may also be included in the program model (e.g.socialization groups,parent support groups,etc.).Primary services must be completed in the home or similar setting. Home visitors from the selected CBOs will be paired with a public health nurse,who will provide guidance and support on medically challenging cases and complete joint home visits as needed. These Community Health Teams will meet on a regular basis for trainings,case consultations and other program issues. Services must directly serve families with children ages 0-5 who are not being served by other home visitation programs(e.g.Nurse-Family Partnership,Healthy Families America,and Early Head Start). Agency In 'tmation Phone:559-600-3330 Mailing Address if different from left): Website:www.fcdph.org Address:1221 Fulton Street Fresno,CA 93721 Program Contact (Operations Supervisor/Coordinator) ; Name:Lie Vangyi Title:Public Health Nurse II Phone:559-600-3330 E-mail:Iva ngyi@fresnocountyca.gov Program Contact Financial Contact Enters programmatic data Enters budgets,financial reports,invoices Name:Lia Vangyi Name:Michael Chu Title:Public Health Nurse II Title:Senior Accountant Phone:559-600-3330 Phone:559-600-6426 E-mail:Ivangyi@fresnocountyca.gov E-mail:mchu@fresnocountyca.gov Data Approval Financial Approval Submits programmatic data Enters budgets,financial reports,invoices Name:Lia Vangyi _ Name:Ge Vue Title:Public Health Nurse II Title:Division Manger Phone:559-600-3330 Phone:559-600-3330 E-mail:Ivangyi@fresnocountyca.gov E-mail:gevue@fresnocountyca.gov ©FIRSTS Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(F5FC)staff and Service Provider during a development Agency. County of Fresno, Depa men 'of Public Health Program Name, Community Health Teams Contract Number 202425-102674 Contract A $1,790,780 Agency Service Locations List all physical addresses where F5FC services take place. If more than three sites, please include in this document by adding another row. Refer to the Fresno County website to find the correct County District for each service location. Location District 1 1221 Fulton Street Fresno, CA 93721 1 District 3 Types of Clients Served and Projected Numbers: Include all client level and aggregate clients included in the scope of work/activities. Number of Clients Type of Client FY24-25 FY25-26 Child 0<3 95 95 Child 3-5 100 100 Parent/Caregiver 215 215 Other (please specify): E 12 12 Total 1 422 422 Projected Numbers Served in Each Geographic Region: Use the countywide box for programs providing services throughout the county. Geographical Location of Clients Number of Clients FY24-25 FY25-26 1 County Wide 422 422 Total 422 422 Description of"Other" CBO Home Visitors Geographical Location of Clients Fiscal Year FY24-25 FY25-26 Percent Urban 70% 70% Percent Rural 30% 30% 422 422 nFIRST5S FRE2 i 3z _ zo s >E i a�- at �_g ap a Q g$og §cm v EggE mcg m�u�E`� �U2E °�,`o gd c �S�grt 8rn�gt� S�3 naa > E9-2 x�� `U& o fekE rc�sl E92 g cc Em m �• CC4 a$o = sA� x3d��8 $u '€ Eli m i ��`"E_ I « \ \ { 1- E E f- / 2 2 le y n o C n # @ 7 & m 7 E E 2 © a) $ � a _ 3 0 � 1,- m CD \ o csi m / ` m m 44 m 40 0 CDƒ \ // f �0 a) o � m 2 ( csi c o w cl� L6 m@ D C14a E % Cr) � \ Cl) o /ƒ LL 0 41 4 % Cc to m � 601, m 40 69- 69. W co 6 .g � / a q E E q / a) % N _ c o le o n c � \ r 0 w / 2 k 2 7 q U- 0 \� ƒ / m t4 m to 41 \ \ a) / E 0 0 0 k % § /© / 3 3 w 0 w w w ± N CD U m m m � ± / z CDM D % y\ \ \ U� @ m m / � Ow w w e u e e / m @ m / c E E E x F / k k CD cn w w LL \ & 2 k E m _j Z m - ® & & Q - % o \ § / < & 2 ƒ X / �b tm § § w O § ƒ 5 �§ .9 0 _ m 2 p e E § w b 0 \ % �§ Q U _j a w g w — �m z « / m LL.E 0 g K w / ® U ± w R a B L Direct Services Face Sheet Scope of Work This document will be completed with First s Fresno County(F5FC)staff and Service Provider during a development meeting. Agency: County of Fresno,Department of Public Health Program Name: Community Health Teams Contract Number: 2 22425-102674 Contract Amount:$1,790,780 `CONTRACT BUD` FY2425 FY2425 Budget Line Items Justification Original Other Funding PERSONNEL EXPENSES Base Rate/Hourly FTE/ Full Time Positions Rate Hours To provide the families with nursing consultation on medical needs,educate home visitation staff on relevant topics that will strengthen their home visitation services and to ensure quality assurance Public Health Nurse II $ 129,402 40% $ 51,761 of the CHT program. $ 77,641 Total Full Time Salaries $ 51,761 $ 77,641 Estimated benefits rates reflect Unemployment Insurance(0.0018634), Retirement(.5741),Health Insurance ($14,451 per FTE per year)and Benefits Personnel Benefits enter as%of FT salaries 68.942% $ 35,685 Administration $230 per FTE per year). $ 53,527 Estimated tax rates reflect OASDI Taxes enter as%of FT salaries 7.65%1 $ 3,960 .0765 $ 5,940 PERSONNEL EXPENSES SUBTOTAL I $ 91,405 1 1 $ 137,108 MISCELLANEOUS EXPENSES Estimated costs for interpreters/translators who provide services for various languages through a Countywide contract.Interpreting services at a rate of$40.00 per hour. Subcontract 4 CBOs under Community Health Teams.Fresno EOC-$275,000, Exceptional Parents Unlimited- $275,000,Central Valley Children's Services Network-$274,448,Centro La Familia-$261,229,United Language Professional Services $ 800,000 Group-$14,323 $ 300,000 MISCELLANEOUS EXPENSES SUBTOTAL $ 800,000 $ 300,000 ALL EXPENSES SUBTOTAL $ 891,405 $ 437,108 Indirect Costs(Max 15%) 1 4.3590% $ 31984 $ 5,977 TOTAL F5FC BUDGET $ 895,390 Other Funding $ 443,085 Total Funding(All Sources) $ 1,338,475 ©FIRST5 FRESNO5 Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(FSFQ staff and Service Provider during a development meeting. County of Fresno,Department of Public Health Program Community Health Teams 202425-102674 $1,790,780 CONTRACT BUDGET FY2526 FY2526 Budget Line Items Original Justification Other Funding PERSONNEL EXPENSES Base Rate/Hourly FTE/ Full Time Positions Rate Hours To provide the families with nursing consultation on medical needs,educate home visitation staff on relevant topics that will strengthen their home visitation services and to ensure quality assurance of the CHT Public Health Nurse II $ 130,682.00 40% $ 52,273 program. $ 78,409 Total Full Time Salaries $ 52,273 $ 78,409 Personnel Benefits enter as%of FT salaries 70.208% $ 36,700 $ 55,049 Taxes enter as%of FT salaries 7.65% $ 3,999 $ 5,998 PERSONNEL EXPENSES SUBTOTAL $ 92,971 $ 139,457 MISCELLANEOUS EXPENSES Estimated costs for interpreters/translators who provide services for various languages through a Countywide contract.Interpreting services at a rate of$40.00 per hour. Subcontract 4 CBOs under Community Health Teams.Fresno EOC-$275,000, Exceptional Parents Unlimited-$275,000, Central Valley Children's Services Network- $274,448,Centro La Familia-$261,229, Professional Services $ 800,000 United Language Group-$14,323 $ 300,000 MISCELLANEOUS EXPENSES SUBTOTAL $ 800,000 $ 300,000 ALL EXPENSES SUBTOTAL $ 892,971 $ 439,457 Indirect Costs(Max 15%) 1 2.60% $ 2,418 $ 3,627 TOTAL FSFC BUDGET $ 895,390 Other Funding $ 443,083 Total Funding All Sources $ 1,338,473 $ - ©FISRST5 County of Fresno,Department of Public Health Contract#2 02 425-1 02 6 74 Community Health Teams Page18 Exhibit B Individuals Handling Funds Statement ORGANIZATION/AGENCY NAME (CONTRACTOR): County of Fresno THE UNDERSIGNED ARE THE ONLY INDIVIDUALS AT THIS AGENCY WHO CONTROL DISBURSEMENTS AND/OR RECEIPTS AND CERTIFY BY VIRTUE OF THEIR SIGNATURE THAT: (i) THE PERSON HAS NEVER BEEN CONVICTED OF A FELONY; (z) THE PERSON HAS NOT HAD A JUDGMENT ENTERED AGAINST HIM/HER BASED UPON MISAPPROPRIATION OF FUNDS OR SIMILAR ACTION;AND, (3) THE PERSON IS BONDED, Irene Parada Name Signature Business Manager 0 / �L4 Title Date 1 Susie Federline Name Signature Supervising Account Clerk Id Is y Title Date 7 Michael Chu jl• '`� -M" Name Signature Senior Accountant 10/' y'w Title Date Nathan Magsig �����2 Name Signature Chairman of the Board of Supervisors ,�w '' of the County of Fresno 'Z- 1„7, A4 Title Date ATTEST: BERNICE E.SEIDEL Clerk of the Board of Supervisors County of Fresno,State of California By putt' County of Fresno,Department ofPublic Health Contract#2o242$-Io2674 Community Health Teams Page19 Exhibit C Signatory Authority I CERTIFY THE AGENCY OFFICIAL LISTED BELOW IS AUTHORIZED AND EMPOWERED TO SIGN AND ENTER INTO THIS AGREEMENT ON BEHALF OF THE AGENCY(CONTRACTOR) AND BY VIRTUE OF THAT PERSON'S SIGNATURE,BIND THE AGENCY. ORGANIZATION/AGENCY County of Fresno NAME(CONTRACTOR): SIGNATURE OF GOVERNING BODY OFFICIAL: DATE SIGNED: PRINTED NAME: Nathan Magsig TITLE: Chairman of the Board of Supervisors of the County of Fresno SIGNATURE OF AUTHORIZED AGENCY OFFICIAL: DATE SIGNED: 12.- 1-7 74 - TYPED NAME: Nathan Magsig TITLE: Chairman of the Board of Supervisors of the County of Fresno NOTE: SHOULD CIRCUMSTANCES REQUIRE A CHANGE IN THE ABOVE, A NEW SIGNATORY AUTHORIZATION MUST BE COMPLETED AND FORWARDED TO THE COMMISSION. ATTEST: BERNICE E.SEIDEL Clerk of the Board of Supervisors County of Fresno, ,t State ,,of--California B��tT�'WfIJF� Deputy Agreement Between the County of Fresno and Children and Families Commission of Fresno County Agreement Name: FY 2024-26 Community Health Teams Agreement Fund/Subclass: 0001/10000 Organization #: 56201670 Revenue Account #: 3530