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HomeMy WebLinkAboutWest Fresno Health Care Coalition dba West Fresno Family Resource Center-Health Disparities Intervention Activities_A-24-690 A-23-133 A-24-130.pdf COtj County of Fresno Hall of Records, Room 301 2281 Tulare Street Fresno,California 601 Board of Supervisors 93721-2198 O� 1$56 0 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. 62. Public Health File ID: 24-1264 Re: Approve and authorize the Chairman to execute Amendment No.2 to Agreements with the following vendors to continue providing health intervention activities for Fresno County's Community Health Worker Network, effective upon execution, to allow unspent fiscal year two funds,to be carried over to fiscal year three,to allow fiscal year three funds to be redirected to other line items, and to extend the base term of each agreement by seventeen (17)months from January 1, 2024 through May 31, 2026, with two optional one-year extension periods for a full term of March 28, 2023 through May 31,2028 and no changes to the maximum compensation: Reading and Beyond with a total not to exceed amount of$1,260,000, Centro Binacional para el Desarrollo Indigena Oaxaqueno with a total not to exceed amount of$750,000,West Fresno Health Care Coalition with a total not to exceed amount of $996,818, and Cultiva La Salud with a total not to exceed amount of$1,155,000; and approve and authorize the Chairman to execute Amendment No. 1 to Agreement with Exceptional Parents Unlimited to allow unspent fiscal year two funds,to be carried over to fiscal year three,to allow fiscal year three funds to be redirected to other line items,to amend Article 7.1 of the agreement, and extend the base term of the agreement by seventeen (17)months from January 1,2024 through May 31, 2026,with two optional one-year extension periods for a full term of March 28, 2023 through May 31, 2028 and no changes to the maximum compensation of$750,000 APPROVED AS RECOMMENDED Ayes: 5- Brandau, Magsig, Mendes, Pacheco, and Quintero Agreement No. 24-688,Agreement No. 24-689,Agreement No. 24-690,Agreement No. 24-691, Agreement No. 24-692 County of Fresno Page 70 co Board Agenda Item 62 O 1856 O FRE`'� DATE: December 17, 2024 TO: Board of Supervisors SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health SUBJECT: Amendments to Agreements with Community Based Organizations to Implement Department of Public Health's Health Disparities Program RECOMMENDED ACTION(S): 1. Approve and authorize the Chairman to execute Amendment No. 2 to Agreements with the following vendors to continue providing health intervention activities for Fresno County's Community Health Worker Network, effective upon execution, to allow unspent fiscal year two funds, to be carried over to fiscal year three,to allow fiscal year three funds to be redirected to other line items, and to extend the base term of each agreement by seventeen (17) months from January 1, 2024 through May 31, 2026, with two optional one-year extension periods for a full term of March 28, 2023 through May 31, 2028 and no changes to the maximum compensation: 1) Reading and Beyond with a total not to exceed amount of$1,260,000, 2) Centro Binacional para el Desarrollo Indigena Oaxaqueno with a total not to exceed amount of$750,000, 3) West Fresno Health Care Coalition with a total not to exceed amount of$996,818, 4) Cultiva La Salud with a total not to exceed amount of$1,155,000. 2. Approve and authorize the Chairman to execute Amendment No. 1 to Agreement with Exceptional Parents Unlimited to allow unspent fiscal year two funds, to be carried over to fiscal year three,to allow fiscal year three funds to be redirected to other line items, to amend Article 7.1 of the agreement, and extend the base term of the agreement by seventeen (17) months from January 1, 2024 through May 31, 2026, with two optional one-year extension periods for a full term of March 28, 2023 through May 31, 2028 and no changes to the maximum compensation of$750,000. There is no additional Net County Cost associated with the recommended actions, which will increase the term of each Agreement by seventeen months, carryover unspent funds from year two to year three in each Agreement's budget and reallocate funds to adjust for costs of the extended term. The second recommended action will also allow for the Agreement with Exceptional Parents Unlimited (EPU)to be updated to acknowledge the Center for Disease Control and Prevention's (CDC)grant as one of the funding sources for this agreement by including the grant's Catalog of Federal Domestic Assistance (CFDA) number. This item is countywide. County of Fresno page 1 File Number.24-1264 File Number:24-1264 ALTERNATIVE ACTION(S): Should your Board not approve the recommended actions, these Agreements will terminate on December 31, 2024 and critical programs serving the needs of community members through health disparities interventions will cease services. Additionally, the full amount of funds initially agreed upon at the time of contract execution will not be maximized, causing the organizations and the County to have unspent funds at the end of the grant term. FISCAL IMPACT: There is no increase in Net County Cost associated with the recommended actions. The agreements will continue to be fully funded with federal grants. The total costs for each recommended action are outlined below: Reading and Beyond • Year One (3/28/2023- 7/31/2023): $76,000 • Year Two (8/1/2023- 7/31/2024): $522,987 • Year Three (8/1/2024 - 7/31/2025): $661,013 • Year Four(8/1/2025- 5/31/2026): $0 • Term Maximum: $ 1,260,000 Centro Binacional para el Desarrollo Indigena Oaxaqueho • Year One (3/28/2023- 7/31/2023): $67,172 • Year Two (8/1/2023- 7/31/2024): $328,652 • Year Three (8/1/2024 - 7/31/2025): $354,176 • Year Four(8/1/2025- 5/31/2026): $0 • Term Maximum: $ 750,000 West Fresno Health Care Coalition • Year One (3/28/2023- 7/31/2023): $62,173 • Year Two (8/1/2023- 7/31/2024): $416,710 • Year Three (8/1/2024 - 7/31/2025): $517,935 • Year Four(8/1/2025- 5/31/2026): $0 • Term Maximum: $ 996,818 Cultiva La Salud • Year One (3/28/2023- 7/31/2023): $82,470 • Year Two (8/1/2023- 7/31/2024): $527,540 • Year Three (8/1/2024 - 7/31/2025): $544,990 • Year Four(8/1/2025- 5/31/2026): $0 • Term Maximum: $ 1,155,000 Exceptional Parents Unlimited • Year One (3/28/2023- 7/31/2023): $92,111 • Year Two (8/1/2023- 7/31/2024): $406,694 • Year Three (8/1/2024 - 7/31/2025): $251,195 • Year Four(8/1/2025- 5/31/2026): $0 • Term Maximum: $ 750,000 Sufficient appropriations and estimated revenues are included in the Department of Public Health's Org County of Fresno Page 2 File Number.24-1264 File Number:24-1264 5620 FY 2024-25 Adopted Budget and will be included in subsequent budget requests. DISCUSSION: On March 28, 2023, your Board approved Agreements A-23-129, A-23-130, A-23-131, A-23-132, and A-23-133 which allowed the County to partner with multiple organizations to promote community health support and to provide health intervention activities for implementation of Fresno County's Initiative to Address COVID-19 Related Health Disparities. On March 19, 2024, your Board approved First Amendments A-24-127, A-24-129, A-24-130, and A-24-131, which allowed subcontracted agencies to carryover unspent fiscal year one funds to fiscal year two and corrected language in Article 7.1 of each Agreement in accordance with federal funding. On March 28, 2023, your Board approved Agreement A-23-136 which allowed the Department to accept a 12-month no cost extension of the National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities grant (CDC-RFA-OT21-2103)through the United States Department of Health and Human Services, Centers for Disease Control and Prevention, which is a primary funding source of these Agreements. On November 9, 2023 the Department received a no cost extension of COVID-19 Epidemiology and Laboratory Capacity (ELC) Enhancing Detection and ELC Enhancing Detection Expansion grants through the California Department of Public Health, which are additional funding sources of these Agreements. Approval of the recommended actions will allow the Department to extend the offer of no cost extensions to contracted partners which will allow organizations the ability to continue providing critical interventions to County residents through May 31, 2026. The recommended actions would also allow changes to each organization's budget to reflect actuals in fiscal years one and two and carryover unspent funds into fiscal year three.A carryover of unused funds will allow each organization to fully utilize the resources provided in the original Agreements and maximize the impacts of the program in the community. The second recommended action would also allow for a correction in the wording of Article 7.1 of the Agreement with EPU to include the correct CFDA Number to acknowledge the CDC as one of the Federal funding sources of this Agreement. No changes were made to the total compensation of each Agreement. During the initial year of implementation, contracted agencies completed over 2,100 social determinants of health (SDoH)screenings and enrolled over 1,800 community members into the Health Disparities Program. Screenings and enrollment allow community health workers (CHW)to assess client needs and provide community linkages and referrals to assist clients in achieving maximum health outcomes. Social service and medical referrals are common CHW interventions, which include connecting patients to a primary health care provider. Other mitigation efforts include addressing emerging health trends within Fresno County, guided by disease surveillance indicators, and dissemination of linguistically and culturally appropriate health education materials within targeted communities. Attachment A is the Health Disparities Program annual impact summary for the period of June 1, 2023 through June 30, 2024. Contracted agencies will continue to collaborate with the Department's Rural Mobile Health Program and offer clients an opportunity to enroll into the CHW network through initial SDoH screeners used to assess the client's unique needs and develop an individualized approach to address barriers to health, while providing wrap around services to enrolled clients. While assessing spending trends, it was determined that most agencies will expend the maximum agreement amount prior to May 31, 2026. The Department is exploring supplemental funding options to sustain contracted partners through full term of their agreements. Should extensions or additional funding be available, it will be brought to your Board for approval at a later time. REFERENCE MATERIAL: County of Fresno Page 3 File Number.24-1264 File Number:24-1264 BAI #45, March 19, 2024 BAI #49, March 28, 2023 BAI #48, March 28, 2023 ATTACHMENTS INCLUDED AND/OR ON FILE: On file with Clerk-Amendment 2 to Agreement with Reading and Beyond On file with Clerk-Amendment 2 to Agreement with Centro Binacional para el Desarrollo Indigena Oaxaqueho On file with Clerk-Amendment 2 to Agreement with West Fresno Health Care Coalition On file with Clerk-Amendment 2 to Agreement with Cultiva La Salud On file with Clerk-Amendment 1 to Agreement with Exceptional Parents Unlimited On file with Clerk-Attachment A Health Disparities Annual Impact Summary CAO ANALYST: Ron Alexander County of Fresno Page 4 File Number:24-1264 Agreement No. 24-690 1 AMENDMENT NO. 2 TO SERVICE AGREEMENT 2 This Amendment No. 2 to Service Agreement ("Amendment No. 2") is dated 3 December 17, 2024 and is between West Fresno Health Care Coalition dba West Fresno 4 Family Resource Center, a California 501 C3 Non-Profit corporation ("Contractor"), and the 5 County of Fresno, a political subdivision of the State of California ("County"). 6 Recitals 7 A. On March 28, 2023, the County and the Contractor entered into a service agreement, 8 which is County agreement number A-23-133, to provide community health support and 9 promote health intervention activities for implementation of Fresno County's Initiative to Address 10 COVID-19 Related Health Disparities. 11 B. On March 19, 2024, the County and the Contractor entered into a First Amendment, 12 which is County agreement number A-24-130 (Agreement number A-23-133 and First 13 Amendment number A-24-130, collectively, shall be referred to herein as "the Agreement"), to 14 correct the Catalog of Federal Domestic Assistance Number and revise the budget. 15 C. The County and the Contractor now desire to further amend the Agreement to (1) extend 16 the term of the agreement and; (2) amend the Agreement to replace Exhibit B with Revised 17 Exhibit B-2 to adjust annual budget amounts to reflect fiscal year one and two actuals, carryover 18 unspent funds from fiscal year two to year three, reallocate carryover funds in fiscal year three 19 to adjust for costs of the extended term, and include fiscal year four in the budget. 20 The parties therefore agree as follows: 21 1. Section 4.1 titled Term of the Agreement located at page Three (3) beginning at line 22 Twenty (20) with the number "4.1" and ending at line Twenty-Two (22) with the word "below" is 23 deleted in its entirety and replaced with the following: 24 "4.1 Term. This Agreement is effective on March 28, 2023 and terminates on 25 May 31, 2026, except as provided in section 4.2, "Extension," or Article 6, 26 "Termination and Suspension," below." 27 28 1 1 2. That all references in Agreement to "Exhibit B", "Revised Exhibit B", and "Revised 2 Exhibit B-1" shall be changed to read "Revised Exhibit B-2". Revised Exhibit B-2 is attached 3 hereto and incorporated herein by this reference. 4 3. When both parties have signed this Amendment No. 2, the Agreement, Amendment No. 5 1, and this Amendment No. 2 together constitute the Agreement. 6 4. The Contractor represents and warrants to the County that: 7 a. The Contractor is duly authorized and empowered to sign and perform its obligations 8 under this Amendment. 9 b. The individual signing this Amendment on behalf of the Contractor is duly authorized 10 to do so and his or her signature on this Amendment legally binds the Contractor to 11 the terms of this Amendment. 12 5. The parties agree that this Amendment may be executed by electronic signature as 13 provided in this section. 14 a. An "electronic signature" means any symbol or process intended by an individual 15 signing this Amendment to represent their signature, including but not limited to (1) a 16 digital signature; (2) a faxed version of an original handwritten signature; or (3) an 17 electronically scanned and transmitted (for example by PDF document) version of an 18 original handwritten signature. 19 b. Each electronic signature affixed or attached to this Amendment (1) is deemed 20 equivalent to a valid original handwritten signature of the person signing this 21 Amendment for all purposes, including but not limited to evidentiary proof in any 22 administrative or judicial proceeding, and (2) has the same force and effect as the 23 valid original handwritten signature of that person. 24 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5, 25 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 26 2, Title 2.5, beginning with section 1633.1). 27 28 2 1 d. Each party using a digital signature represents that it has undertaken and satisfied 2 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1) 3 through (5), and agrees that each other party may rely upon that representation. 4 e. This Amendment is not conditioned upon the parties conducting the transactions 5 under it by electronic means and either party may sign this Amendment with an 6 original handwritten signature. 7 6. This Amendment may be signed in counterparts, each of which is an original, and all of 8 which together constitute this Amendment. 9 7. The Agreement as previously amended and amended by this Amendment No. 2 is 10 ratified and continued. All provisions of the Agreement as previously amended and not 11 amended by this Amendment No. 2 remain in full force and effect. 12 [SIGNATURE PAGE FOLLOWS] 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3 1 The parties are signing this Amendment No. 2 on the date stated in the introductory 2 clause. 3 West Fresno Health Care Coalition dba West Fresno Family Resource Center COUNTY OF FRESNO 4 5 (�2G� Ian a Randles, Executive Director _ 6 Nathan Magsig, Chairman of the Board of 02 E. California Ave. Supervisors of the County of Fresno 7 Fresno, CA 93706 Attest: 8 Bernice E. Seidel Clerk of the Board of Supervisors g County of Fresno, State of California 10 By: 11 Deputy 12 For accounting use only: 13 Org No.: 56201558, 56201019, 56201022 Account No.: 7295 14 Fund No. : 0001 Subclass No.: 10000 15 16 17 18 19 20 21 22 23 24 25 26 27 28 4 Revised Exhibit B-2 Agreement Number: 24031 Agreement Term: March 28,2023-May 31,2026 Organlzatlon Name: West Fresno Health Care Coalition dba West Fresne61111y R<PI-Center PI-Ril wlario Yl A-1, Approved Y2 Budget YZ At-11 Approved Y3 Budget Proposed Y3 Budget pro posed Y4 Budget Approved Total Budget New Total Budget 3/28/3-7/31/23 e/l/23-7/31/24 e/l/23 7/31/24 e/1/24-12/31/24 e/l/24-7/31/25 e/l/25-5/31/26 (s Monm.l (12 non.) (10 onm.l a:ui:nmatmi: Diredor d Oo itip^z-1.Malnid^ s s % $ $ ) 5 s s m 5 ecrorgfo-ionz row rear ra .251annial ssla 58],36a..2s FPE=$21,B4o.) W wpervimr $ 9,295.25 $ 54,384.% $ $ 21,665.00 $ 5 $ 85,344.25 5 1M,533.35 CDHW Su enisor,tit l.O.Overs 1h,as to da m Veaau re orti am sa�edulin. Eli PTEI-enM1anang e9izting program attivitiex,including offering teemed M1ea1tn ii-than bi-weekly;Wellness C -ily Health Worker Wetlneztlays:ln<reazing-d....ana partiapation in each bimonthly eventfrom 30 participants too minimum d 50 per 5 s % $ $ D s 0,16111 5 anth. HW(10Fr51-enhancing mistiig pro t-1,ii-tly themeshe30 P-tt tbi-wmkly:wellneu Commun tY Heal[M1 Woker Wedneztlays:Increasi^gattendance ana p rtiopatiwsin each bimonthy event from 3o participantxto a minimum of so per $ $ % $ 33A5I.85 5 1IA30.00 $ $ $ 63,6T5.% $ 85,482.85 CHW W(1.0 FTEI-enM1a^a^g existing program attivitiez,including offering teemed M1ealtn eduatian ti,weekly;Wellnf Communrty HealcM1 Worker Wetlneztlays:ln<reaangaaentlance ana partiapation in eacM1 bimonthly eventfrom 30 participantsto a minimum o!50 per 5 s % $ $ D s s s % $ ante. HW(1.0 Fr51-enha^ciig existing pro inautline onering themes heahh edumtian bi-wxkly;wellness Community Hea11h woder Wed^ezaavz:Increazing ottendanceana part dp1ation in eaon bimonthy event rrom 3o participantxto a minimum of 50 per $ $ % $ 38,445.Ia 5 5 5 $ 6,010% 5 89,]35.]8 momh. Adman Aszida^t(1.a FPE)-provides ^chiding deriol antl a a min task,ordering program z Piez, Ad-Asndant nd diemsupport logsra 11Mwth 11,entrieswlleaed from outrea<1 greets,maintaining database, s s % $ $ D s s 5 2 $ s]it Mein nand pine each Cnordinatar $ $ 22lit- $ 1TA6)3 5 5 5 $ 21,880% $ 7A67.13 W(1.a kTFI-e^M1a^a^g exizti^g program attivitle;I^duding offering themed M1ea1tn educetlon bi-weekly;Wellness Community Hedth Worker Wetlnesdays:IMre it aaentlanceantl partiapation in exit bimonthly event from 30 pa,hai,tts to i minimum d 50 per 5 s % $ U59.74 $ s s 5 m 5 54.699.74 month. $ $ $ $ 17,330.00 $ $ $ 113M.% $ S.-, 5 31A53.Bx $ 354A65.% 5 5 0 $ $ $ SMA%.B2 $ Ber�ef]s/Taaes/W odors CampensaM1on Be^efts $ s % $ 5 O 1,250.W 5 s % 5 33.065.OD 88-$L%D erR 5.$lO%=$7,2sa ayroll T.- $ 3,168.65 5 28,3(1- $ 2l,265,13 $ 9.359.00 $ 29,370.% $ $ 40,888.65 $ 53,8M.58 Pa 11 ta9es-8% Workers Camp $ $ an $ 5 SA%.aO 5 5 s 2 5 Workers cam-$1.2]er$100.36]12a/1%g$1.2]=$4,662. $ $ $ $ $ wbeeeal 5 $ ]eA62.an $ $ $ 41.xB2.% $ $ ] $ otal Mrs noel $ 3]AD.01 $ 4xgADAe $ x]6A1].11 a0$ U],140.00 $ 4%AOx.% $ $ s%5%A9 $ RL646.2x41 Equlp- s antl accessories 5 $ 31%0.% $ $ $ $ $ 8,116.68 $ 5.314.68 atm equipment ama atte H. $ 156.D3 $ 3 ] $ 3 $ 5 5 s % 5 lanalizs $ $ 600.% $ $ 5 5 5 500.% $ campu[envorkdatlonzaM a aembly $ $ 4 $ $ 5 5 $ % 5 1217,49 Ubles antl eleaa<al for equipment $ $ $ $ $ $ 5 $ Tmal Foi 5 ]AW.92 $ 3eA%.n 5 L625.99 5 5 5 5 6B 5 SUPPIies ONicewpplia $ s 0 $ 2,11014 5 0 $ 5 $ 1 $ oral a(ficezu lies faraall ac er ink note ad;celendars e[c. Outreach Materials antl Supplies $ 5 8520.92 $ $ 38,050.00 $ $ $ 86,0501. $ 32,46625 Etluch-1 mateaals,Team a rel:tolo zhnrtsantl rsweatzhirts'ackets rorwinter ew.rts antl outread,. nti.&Padage 5 s % $ 5 0 $ 5 $ 11.0.. $ 2 Sokware Subscriptions 5 39% $ 3,w0.% $ 5 1A00.00 $ $ $ 4,639.% $ 950.46 Teul Supp1., $ $ 65A10.03 531.9.445 00 $ 3.265.% $ $ OS $ 3-5.47 Travel Mi1eagefor5 CHW';supervisor antl Admi^Assistant 5,207mllez/year 1,61=53,4ee.5a Tapp-434 miles per mantM1x mileage rate.6]I betweens CHW'1wp 611antl Aamin 5 5 4- $ $ $ 5 $ 313T.22 $ 133.04 Ass ovitleoutream,aamdtminin zany meetin ztwicea montM1 for walnesz wednesaa. s s m $ $ 0 5 5 5 % $ gtalhavel 5 BLx3 5 $ $ $ 3pea.% $ $ x3.13].xx $ s,.- Other en $ s % $ $ 5 5 5 % $ maz d 2024,$K-,6 maz d 2025,s]a,a%=$1a6,]%/30 em la ees er 5=$35p52.s0 ralnlre ant Professional Development 0. 0. e5-1)Developi^gsklllz ana-iii.krwwledSeto dre^gtne^CHW-1i, clidingCPR,iedi ology,Leadership devdopmem,ativocery $ $ 0200.% $ $ $ $ $ 4200.% $ 35%.00&oli <M1a e nce nos-Gift Cards&9us Passes $ s $ 5 s 5 s $ sift-/mo-$2s=53]s/mo91 z=$4,so0 artdpa^t wppon $ _ $ _ $ _ $ $ 2942.00 $ $ $ 2992.00 kRZlapantrewltment,promotloml matMalz(water bottles,magnttic grocery list,first aid kit;-paazwlM pen;wdlness ng,Onbo mg B Training New Hires $ s % $ $ 5 5 $ % $ 361,28 mmunice ens anthlyservice ror cell phones&tablets(1ph...$45/mo=$315/mogllmoz=$3,]80)(2 tablets g$45/mo=$90x $ 1M6.42 5 % $ 5993,11 $ 0 $ $ $ 967A2 $ 119W.13 lid2=510w,mta1$4,860 n erne service s s % $ $ 25%AO $ 5 $ a $ anthl se Ice for ioh-router,i^met desk ho^ez submntrattar-Phyi.l Attirity %0. 3.2 22 ge Four Ul cehonz,5-weeks ead�-nutdnonand fitness activitlez rw 4-diem,or(1-2 dlentz per eada 5.week zezaanl$1,000 $ $ 5%0.% $ $ $ $ $ 5%0.% 5 40%.00 er whort 94wh=-k= 0% net Sewrity/Tech Support $ s % $ $ 4,a%.a0 $ 5 $ % 5 Clle^t wppon $ 2805.95 $ 28550% $ 81447,11 $ 329%.00 $ $ $ 6L95 $ 10913.01 awoll processing $ s % $ 2 $ O $ 5 $ 1 6 % $ Oab111W lm $ 200.66 $ 00.% $ $ 75.00 $ $ $ ]5.66 $ 5]00.66 OHsite Starege 5 .923.19 s % $ $ 1p%.a0 $ 5 $ 9 $Capler Lean 5 1%0.% 5 % $ 5 20%.00 $ $ 5 5050.% $ 3050.00 5 $ 5 $ -1 Oder $ $ % 5 -2.03 $ 0 $ $ $ 42 $ 128A90.2] 5 $ 6%AN.2x 5 3]8,ex].e9 $ 0 $ �0,950.3x $ 5 906.x%.% $ %6,198.86 use $ $ .22.42 5 $ $ 4]A95.03 $ $ %A29.W $ 5 $ -A%.a3 5 $ $ $ $ 9%Asa.% $ HEALTH . DIS A ITIESimsb Y• RE OFWTil IM - ACT Annual Summary June 2023 - June 2024 �..A N Transforming Community Care -_ through Care HEALTHY Coordination & FRESNO COUNTY Partnership Better Together I Community Health Workers (CHWs) or Promotores(as) provide care coordination services to residents of Fresno County at no-cost! Health Disparities Overview Partnering CHW Agencies Fresno County's Health Disparities Program Listed below are the 9 partnering is an initiative within the Fresno County's agencies who deploy CHWs to Department of Public Health (FCDPH). The provide care coordination services Health Disparities Program provides care to the underserved communities: coordination services through partnering • Aria Community Health Center agencies who deploy CHWs to provide * Black Wellness and Prosperity care coordination service interventions in Center - African American underserved communities throughout Coalition Fresno County. In addition, CHWs will • Centro Binacional para el provide health education materials in a Desarrollo Indigena Oaxaqueno culturally and linguistically sensitive • Centro La Familia Advocacy manner on a variety of topics. Services Cultiva La Salud Examples of care coordination services 9 Exceptional Parents Unlimited may include assisting residents with: • Easterseals finding a medical provider, health • Reading and Beyond insurance, transportation, employment, • West Fresno Family Resource mental health, family planning, amongst Center other resources and community linkages depending on a participant's individual needs. Community Impact Total1F810 2,1071 1111114111 81724 61521 . . Total . . Total Clients Assessments Outreach Resources Engagements Enrolled Completed* Ev- • And Direct • • - - • • CHWs Services Participated Provided C In CHWs I � Snapshot of the Program ' Partnering agencies who provide 9 care coordination services to the community HOW IS DATA OBTAINED CHWs have been implementing SDoH 34 screeners and providing services to Partnering agencies of The Health Disparities clients Program mobilize CHWs who develop community relationships with clients and Centralized data management I system that embeds a SDoH screener help identify client needs through utilization of a social determinants of health (SDoH) to capture person level data needs assessment. Information from the Initial SDoH screening sections that assessment is entered and tracked through collect client data on Income, Care Coordination Systems (CCS), a shared 7 Transportation, Housing, Food, and secure electronic health record system. Health, Personal Safety, Children This centralized data management system and Family Planning during can track gaps and opportunities through enrollment person level data specific to expressed client needs. *Total assessments completed are identified by the number of initial SDoH assessments 2 completed and follow-up assessments completed by the CHWs. **Total number of client engagements completed by CHWs which may include tele-visits, home visits,office visits,and other community locations where CHWs interact with enrolled clients. • Community Health Worker Snapshot The average impact of a 11810 single CHW in one year. 6 service needs opened Total Clients per client Enrolled by CHWs 16 client engagements per client CHWS IDENTIFIED 6 months of care per CLIENTS THROUGH: client • COVID-19 related outreach and 22 : 1 client to CHW ratio community events ) • • • • • • • • • • • Community events and canvassing efforts • • • • • • • • • • • Internal referrals from other FCDPH programs • Internal referrals from other programs within the partnering Figure 1. Client Preferred Language agencies • Community referrals sent to Not Yet CollectedOther 4.4% FCDPH and partnering agencies Hmong 5.4% English 0.8% 24.7 CHWs provide clients linkage to services and I p) resources. 1 - I Spanish l 64.6% Figure 1. Language spoken is identified as the percent of enrolled clients who indicated their preferred language as Spanish (1,170 clients), 3 �" '�'• English (447 clients), Hmong (15 clients), Other (98 clients), and Not Yet Collected (80 clients). Partner Highlights Aria Health Center Aria Community Health Center is a federally qualified health center that provides medical, dental, optometry, and specialty care to underserved rural communities across multiple counties within the San Joaquin Valley, including Fresno, Kings, and Tulare. The Fresno _ County clinics are located in Riverdale, Coalinga, and Fowler. CHWs are based at the Riverdale location but travel 30 minutes to an hour south to Coalinga and Huron. They not only encourage community members to seek primary medical care but also offer health I education and referrals to other local programs and services that address SDoH. The primary populations they serve include Hispanic or Latino individuals and undocumented population. BLACK Wellness . Prosperity Center African American . . BLACK Wellness and Prosperity Center - African American Coalition is a community-based organization (CBO) dedicated to advocating for Fresno's Black community and advancing maternal health equity to improve infant health outcomes. CHWs primarily serve the populations in downtown Fresno and at Fresno City College. They not only refer community members to in- house specialized services, such as the BLACK Doula Network and BLACK Fatherhood Legacy, but also connect them to other local programs and 4services that address .. ^ A ~ M Health Disparities Program Client Demographics As CHWs enroll and engage clients, they collect a release of information form and obtain demographic data that assists the enrollment process as they provide services to the client. Figure 3. Gender Not Yet Collected Demographic data collected may include 13' race/ethnicity, gender, pregnancy, zip code, age, Male marital status, income, and/or insurance 28.7% information. Collection of client demographic data is dependent on client consent and the amount of information shared by client is helpful in providing individualized services in a more culturally and linguistically sensitive manner. Female Figure 2. Client Overview 69.9% Figure 3. Gender is being presented by the percentage of enrolled Figure 2. 9 out of 10 clients enrolled into clients identifying as Female (1,266 the Health Disparities Program are people clients), Male (520 clients), and Not of color and more than half (61.05%) are Yet Collected (24 clients). ages ranging from 21 to 49 years old. Figure 4. Race/Ethnicity Figure 5. Zip Codes Not Yet Collected 7.5% Asian White 2% 200 2.7% Black or African American 4.4% 150 100 50 Hispanic or Latino 0 828% 93702 93706 93727 93701 93703 Figure 4. Race/Ethnicity is being presented Figure 5. The top 5 zip codes of as the percentage of enrolled clients enrolled clients include 93702 (190 identifying as Hispanic or Latino (1,498 clients), 93706 (171 clients), 93727 clients), Black or African American (79 (66 clients), 93701 (61 clients), and clients), White (48 clients), Asian (37 93703 (46 clients). All zip codes are clients), Two or More Races (8 clients), other within the Fresno County's Healthy (4 clients), Native Hawaiian/Pacific Islander Priority Index (HPI)* Quartile 1. (1 client), and Not Yet Collected (135 clients). *Fresno County HPI,a geographical mapping tool compiled using federal,state,and local data 5 sources to identify the level of health burden experienced with in each census tract in the county. HPI Quartile 1 are the communities within the top 25%of the county experiencing the lowest level health opportunities and the highest level of health burden. • • • • • — • . . . u Y. MINES IN r'� '�''¢ f • • • IF • • �?• d4. -_ t 6. ,4 Boa, WWI q • IF • • • • • ' • ?may u - 4a% ✓del) ;ter: 1 ., ,a { ,. • • • • '• • ,:::gyp • • • • • • !. AW . �� • y i �♦ - )gn)�'.. ITV, '• • •• • _ • • • • • • • • •• • on 9 • Centro La Familia Advocacy Services Centro La Familia Advocacy Services (CLFA) is a CBO that assists crime victims, supports families and children, promotes health and wellness, encourages civic engagement and provides other community services. CHWs are bilingual and deliver services in a manner that is respectful and culturally sensitive. CLFA operates three neighborhood centers in the Southwest Fresno area and one in the City of Kerman. CHWs conduct outreach primarily in the Eastside of Fresno County, serving rural communities such as Sanger, Del Rey, Parlier, Reedley, Orange Cove, Yokuts/Squaw Valley, and Selma. They not only refer community members to their in-house services, including parenting classes, the victim services department (covering domestic violence sexual assault, human trafficking and other serious crimes), and low-cost immigration services, but also offer health education and referrals to other local programs and services that address SDoH. Overview of Service Outcomes Once CHWs enroll a client, an initial J-14A) Social Service assessment is conducted and based \ was the largest on identified SDoH needs, service need ----- > opened and areas are then opened. Services needs p are used to track the progress of each completed client's service need in the centralized service need data system. Client service areas are y 4, for clients. dependent on what needs are being expressed by the client (i.e., food insecurity, housing, transportation, insurance, medical home, etc.). Figure 6. Top Client Service Areas Opened and Completed Social Service 78% completed Learning/Education -M- 8,724 Total Services Food Security Opened 83% completed Medical Referral 71602 92% completed Total Services Completed Healthcare Coverage 90% completed 0 1000 2000 3000 Opened Services Completed Services Figure 6. The top 5 opened services areas are shown by the number of client needs opened in green: Social Service (3,541), Learning/Education (2,695), Food Security (1,666), Medical Referral (538), and Healthcare Coverage (284). In comparison to the completion of the listed service areas completed shown in orange: Social Service (2,748), Learning/Education (2,695), Food Security (1,387), Medical Referral (500), and Healthcare Coverage (256). 7 H y� •- - • one • - • QD �,- - •• —• • • • • • � Wiz. • • • • • a Go - • — • • • ••• 00 • •• - • - - was •• i.:..� • - - -• • - • •• -• • - •• • — • • • • • • Poo 00, .6 A Exceptional Parents Unlimited Exceptional Parents Unlimited (EPU) supports and strengthens families and children with unique needs through early learning and intervention services. These services include child assessments, evidence-based mental health treatment, parent engagement groups, family empowerment training, and Individualized Education Program (IEP) clinics to families and children with disabilities. CHWs assist community members in the City of Fresno in both English and Spanish, providing health education and referrals to other local programs and services that address SDoH. EPU is particularly successful in hosting a monthly food distribution and vaccine clinic at one of their neighborhood resource centers. The primary populations they serve are ethnic minorities facing economic disadvantages. Easterseals Central California is a CBO subcontracted with EPU that provides early intervention services, behavior intervention services for autism and other neurodevelopment differences, and a family empowerment program to support families with children who have a disability. CHWs conduct outreach primarily in the Eastside of Fresno County, including Sanger, Del Rey, Reedley, and Orange Cove. 71 Community1 Health Workers Outreach Efforts 9 community partners working together to provide community linkages to Fresno 710 County residents during local events. Clients enrolled into - Health Disparities 58F931 During these events outreaching residents L�� events, 58,931 _, _, through community _ even From these outreach events, h.residents were 710 community residents were reached through enrolled into the Health resources and Disparities Program. 39% of education while total enrolled participants visiting the CHWsFPPPP'_ came from these outreach information table. 11, 10 j events to receive care coordination services, at no- cost. Additionally, CHWs were able to gauge the interest Community and reconnect with residents where CHWs were outreach following the event. Health39,r8T9 ,,1 present to provide wraparound services education materials provided to the community ,,,�dents The top 6 zip codes of outreaching events include: 93706 (166), In addition, 39,819 health 200 93721 (110), 93702 (83), education materials were 93662 (60), and 93234 provided to community 150 (54). All zip codes are residents who attended the events. The top health within the Healthy Place education materials provided 100 Index (HPI) Quartile 1. during the events were COVID- 19 and Vaccines, Healthcare and Medical Expansion, 50 Diabetes, Hypertension, and 9 Mental Health amongst other o . I topics. 93706 93721 93702 93662 93234 OND ■ xambu]a I g � y: Are VT A1;Mr7-'ffUVN r mean to you A Reading and Beyond Reading and Beyond (RaB) believes that strong families build strong communities. RaB provides comprehensive, tailored case management, and two-generational programming that works well with children and families to strengthen education, health, and well-being to create sustainable social and financial security. While RaB is known for their afterschool leadership, their programs range from pre-conception to employment training and health literacy to prosperity coaching. RaB assists families through complex navigation support systems to access necessary resources to empower all residents to be resilient and self- reliant. RaB population of focus areas are in City of Fresno (93701 and 93702) providing services of Family Health Clinic Days, Vaccination Clinics, biannual Block Party, Coffee with CHWs, and Wellness Wednesday workshops (English and Spanish) about health topics and seminars related to SDoH. Leveraging Partnerships & Sharing Syndromic Surveillance Information The Health Disparities Program continues Emerging Health Trends Identified and to work alongside FCDPH's epidemiology Shared by CHWs to the community_ team to assess syndromic surveillance • Stiff Neck trends and provides information for CHWs • Measles to share out to the community. Syndromic • Valley Fever surveillance assists in identifying emerging • Heat Related Illness and Heatwave health trends and diseases and early • Mental Health and Anxiety detection of outbreaks that are impacting • COVID-19 Fresno County and the utilization of • Myalgia and Hemorrhagic Anomalies emergency health services. In addition, • Cold and Flu Season the team has aided and leveraged with • Respiratory Syncytial Virus (RSV) CHWs to continue to connect community • Hospitalization Rates members to a primary healthcare provider • Diarrhea for non-emergency healthcare needs \g y Botulism ' while also linking members to healthcare • Increased Emergency 1 coverage when needed for on-going Room Visits �--� health needs. STRENGTHENING PARTNERSHIPS Referral Partnership: Rural Mobile Healfh The Health Disparities Program developed The Fresno County Rural Mobile Health (RMH) a CHW Network Referral partnership Program provides no-cost medical services and between two Fresno County Department care coordination services to Fresno County's rural of Public Health's Divisions to enhance communities by improving health equity through program services by providing key partnerships. In partnership with the RMH community care linkages and access to Program, the University of California San Francisco resources. School of Medicine in Fresno (UCSF-Fresno), Saint Referral Partnerships and Outcomes: Agnes Medical Center (SAMC), and Tzu Chi Mobile • A partnership was established in early Clinic utilize mobile health units to deliver medical September 2023 with the Community and/or vision services directly to residents. Health Division's Tuberculosis Clinic Additionally, the Health Disparities Program and 17 clients have been served to provides wraparound care coordination services date. by delivering culturally and linguistically • Another referral partnership was appropriate health education during the RMH established in early June 2024 with the program events. Public Health Nursing Division and 26 CHW Outcomes During RMH Events: clients have been serviced to date. • 91 RMH events where CHWs were present providing services • 5,279 health education materials were provided to residents • 5,462 community residents were reached during RMH events \ • 79 clients were enrolled into the " Health Disparities Program Y Ili z i L _ Partner Highlight i West Fresno Family Resource Center West Fresno Family Resource Center is a CBO with a strong record of empowering and supporting disadvantaged communities in Southwest Fresno and the Eastside of Fresno County, including Selma, to achieve optimal health and well-being. CHWs refer community members to on-site programs and services such as economic empowerment, educational advancement, health and wellness, character leadership and youth empowerment. CHWs assist community members in multiple languages including English, Spanish, and Hmong (both verbally and in writing) and provide health education and referrals to other local programs and services that address SDoH. WFFRC is particularly successful in offering free CPR training, cooking classes, and fitness classes tailored for seniors and 12 adults. Additionally, CHWs have partnered with the Department of Social Services offices in West Fresno and Selma to help community members apply for benefits such as EBT, Medi-Cal, Cash Aid, and more. These efforts would not be possible without the support from our local partners and community members. MEET OUR HEALTH DISPARITIES PROGRAM PARTNERS FROM 2023-2024: �P If, ARIA COMMUNITY C?0,gJ PA �e` CULTIVA SALUD HEALTHm r1 CENTER A o JIJI+I+I yo��fNA OAXAaJ�� BINATIONAL CENTER FOR THE DEVELOPMENT . ■■ • OF OAXACAN INDIGENOUS COMMUNITIES • CENTRO LA FAMILIA 1` ADVOCACY SERVICES E PV .. Exceptional Parents Unlimited READING BEYOND BUILDING FOUNDATIONS EORCIII-NAND 1AMILIES African GelAmerican Coalition Mesa Frcsnofamily k-resource center A member of HUD designated easterseals 'En Vision •. Central California Thank you ! This report is supported by the Centers for Disease Control and Prevention of the U.S. Department of �� Health and Human Services (HHS) as part of a financial assistance award totaling $7,897,935.00 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of,nor an endorsement,by CDC/HHS,or the U.S.Government. Ohl^ oir HEALTHY FRESNO COUNTY Better Together To connect with Fresno County Department of Public Health - CHW Network: © 559 - 600 - 6449 V CHWNetwork@)FresnoCountyCA.gov www.fcdph.org