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Home My WebLink AboutSTATE DPH-Tuberculosis Control Assistance Base Award and Food Shelter Incentives and Enablers Funds_A-25-421.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 August 19, 2025 Present: 5- Vice Chairman Garry Bredefeld, Supervisor Luis Chavez, Supervisor Nathan Magsig, Chairman Buddy Mendes, and Supervisor Brian Pacheco Agenda No. 51. Public Health File ID: 25-0697 Re: Approve and authorize the Chairman to execute a retroactive award from the California Department of Public Health for the Tuberculosis Control Local Assistance Base Award ($275,170)and includes Food, Shelter, Incentives and Enablers($16,048)funds, effective July 1, 2025,through June 30, 2026; and approve and authorize the Director of the Department of Public Health to execute the State Contractor's Release for the final invoices APPROVED AS RECOMMENDED Ayes: 5- Bredefeld, Chavez, Magsig, Mendes, and Pacheco Agreement No. 25-421 County of Fresno Page 52 co Board Agenda Item 51 O 1856 O FRE`'� DATE: August 19, 2025 TO: Board of Supervisors SUBMITTED BY: Joe Prado, Interim Director, Department of Public Health SUBJECT: Retroactive Revenue Award from the California Department of Public Health for Tuberculosis Control Program RECOMMENDED ACTION(S): 1. Approve and authorize the Chairman to execute a retroactive award from the California Department of Public Health for the Tuberculosis Control Local Assistance Base Award ($275,170) and includes Food, Shelter, Incentives and Enablers ($16,048)funds, effective July 1, 2025, through June 30, 2026; and 2. Approve and authorize the Director of the Department of Public Health to execute the State Contractor's Release for the final invoices. There is no additional Net County Cost associated with the recommended actions. Approval of the first recommended action will fund tuberculosis (TB) control activities in the Department of Public Health (Department), which includes screening, case management, treatment, contact investigation, and incentives to improve treatment compliance of TB patients. Approval of the second recommended action will allow the Director of the Department to execute the Contractor's Release for the final invoice at the close of the grant term. The activities are funded with State and Federal funding and any additional costs will be covered with Health Realignment. This item is countywide. ALTERNATIVE ACTION(S): There is no viable alternative action. Should your Board not approve the recommended actions, the Department would be unable to fully fund TB control activities in the County, leading to a decrease in the TB related services that the Department would be able to provide to residents. RETROACTIVE AGREEMENT: The recommended agreement is retroactive to July 1, 2025. The TB Base Award and Food, Shelter, Incentives, Enablers (FSIE)Award agreement was received from CDPH on June 14, 2025 The agreement is being brought to your Board in accordance with the agenda item processing timelines. FISCAL IMPACT: There is no increase in Net County Cost associated with the recommended actions. The sum of the awards will provide$275,170 in revenue in the current fiscal year. The Base Award is comprised of State ($136,974) and Federal ($138,196)funds. The State funds portion of the award includes the full FSIE amount ($16,048). The Department will cover any additional costs that may arise with Health Realignment. Sufficient appropriations and estimated revenues will be included in the Department's Org 5620 FY 2025-26 County of Fresno Page I File Number.25-0697 File Number:25-0697 Recommended Budget. DISCUSSION: In 2024, the Department's TB Control Program provided treatment, case management, contact investigation, referral, and follow-up activities for 52 county residents newly diagnosed with active TB. Department staff also provided care for patients diagnosed prior to 2024 who had not yet completed treatment. The standard treatment regimens are six to twelve months; however, patients with drug-resistant TB may be treated as long as two years. Active TB patients receive Directly Observed Therapy (DOT)or video DOT(vDOT) in which program staff visit or view a daily video recording of patients to ensure ingestion of appropriate TB medications. TB Control Program staff provided 5,456 DOT visits and 5,152 vDOT viewings in 2024. The Department also screened an additional 1,226 new patients with inactive TB or a disease other than TB. The Department's Hospital Liaison and other TB Control Program staff closely monitored and managed 265 cases of the 1,610 additional cases as follow-up to immigration screening mandated by Federal law. Residents at high risk of developing TB include close contacts with active TB patients and people experiencing homelessness. Approximately 584 close contacts were evaluated for latent TB infections, and over 223 TB screenings were conducted on individuals who were identified as unhoused. In FY 2024-25, the County expended an average of$964.85 per TB patient for treatment, hospital case management, contact investigation, and/or screening. The recommended Agreement deviates from the County's standard indemnification language in that it requires the County agrees to indemnify, hold harmless and defend the State against any claims, losses, or legal costs that arise only from Fresno County's own actions, such as negligence, willful misconduct, or failure to comply with the terms of the agreement. This is a one-way indemnification, meaning Fresno County is agreeing to protect the State from any liability resulting from the County's actions, but the State does not provide the same protection to Fresno County. The Department has determined that its acceptance of the indemnification language is advantageous to the County, as the State-grant is a funding source for Fresno County's TB control and prevention activities, without which the continued provision of these services would be negatively impacted. REFERENCE MATERIAL: BAI #48, September 10, 2024 ATTACHMENTS INCLUDED AND/OR ON FILE: On file with Clerk-Agreement with CDPH CAO ANALYST: Ron Alexander County of Fresno page 2 File Number.25-0697 Agreement No. 25-421 Health and Human Services Agency , %CDPH California Department of Public Health Erica Pan, MD, MPH Gavin Newsom Director and State Public Health Officer Governor ACCEPTANCE OF AWARD Tuberculosis Control Local Assistance Funds County of Fresno, Department of Public Health FUNDING SOURCE FEDERAL BASE STATE BASE AWARD NUMBER: 2510BASE-F 2510BASE-S AWARD AMOUNT: $138,196 $136,974 FUNDING PERIOD: 7/1/2025-6/30/2026 1 hereby accept this award. By accepting this award, I agree to the requirements as described in the FY 2025 Tuberculosis Control Local Assistance Funds Standards and Procedures Manual and any other conditions stipulated by the California Department of Public Health, Tuberculosis Control Branch. This award is contingent upon the availability of funds appropriated by the State of California and the federal government. The CDPH TBCB reserves the right to reduce, amend, or withdraw funding, in whole or in part, should funding from the state or federal government be reduced, delayed, or otherwise adjusted. Authorized Signature Date Chairman of the Board of Supervisors of Ernest Buddy Mendes the County of Fresno Print Name Title Federal funds fiscal information: Project Grants and Cooperative Agreements for Tuberculosis Control Programs; CFDA number: 93.116; FAIN number: NU52PS910282 CDPH Tuberculosis Control Branch {pA�'a� 850 Marina Bay Parkway P2 • Richmond, CA 94804-6403 4-11PWAB ATTEST: (510) 620-3000 • (510) 620-3034 FAX f BERNICE E.SEIDEL CDPH.ca.gov/tbcb Clerk of the Board of Supervisors County of Fresno,State of California By_ Deputy CALIFORNIA DEPARTMENT OF PUBLIC HEALTH Tuberculosis Control Branch (TBCB) Thank you for your interest in being a subawardee and working with us to provide services under the Project Grants and Cooperative Agreements for Tuberculosis Control Programs administered by the Centers for Disease Control and Prevention.Subrecipients will assist State, local health agencies, political subdivisions, and other government entities to conduct tuberculosis (TB) preventive health service programs to assist in carrying out TB control activities designed to prevent transmission of infection and disease. As a condition of the grant,the Notice of Award (NOA) and the General Terms and Conditions are attached for your records and reference.The Category of Federal Domestic Assistance(CFDA) number is 93.116- Project Grants and Cooperative Agreements for Tuberculosis Control Programs. You can obtain general information about the grant by searching the CFDA number on https:Hbeta.sam.gov/.The Notice of Award Number for Federal Fiscal Year 2025 is 1 NU52PS910282-01-00. Subrecipient'sName: County of Fresno Digital signature of person agreeing to NOA T&C: Printed Name/Date Signed: Ernest Buddy Mendes 8-/q aoas Funding Source(s): Project Grants and Cooperative Agreements for Tuberculosis Control Programs ATTEST: BERNICE E.SEIDEL Please answer the following questions below: Clerk of the Board of Supervisors County of Fresno,State of California 1. Is your agency registered in the System for Award Management(SAM)? BY Deputy (Check one) ® Yes ❑ No If so, please attach a SAM screenshot confirming your active status in SAM. 2. What is your agency's Unique Entity Identifier(UEI) number? 3. 1 have read the attached Notice of Award and the General Terms and Conditions. I agree to adhere to the General Terms and Conditions. (Check one) ®Yes ❑ No 4. 1 have attached my agency's most current Single Audit;or financial and performance evaluations because my agency is exempt from the Single Audit Requirement. (Check one) IN Yes ❑ No The following Terms and Definitions are for use by the TBCB and Subrecipients. Terms and Definitions: 1) Category of Federal Domestic Assistance(CFDA) number identifies the federal assistance program and provides general information about the grant, such as the program objectives.This must be shared with potential subrecipients prior to entering into contract negotiations (2 CFR § 200.331). 2) System for Award Management(SAM)and Unique Entity Identifier(UEI) Requirements(2 CFR 25.200(b)): • The potential subrecipient that applies(1) must be registered in SAM prior to submitting an application of plan. • The subrecipient(2) must also maintain an active SAM registration with current information at all times during which it has an active Federal award or an application or plan under consideration by an agency. • The subrecipient(3) must provide its UEI number in each application or plan. SAM aka CCR= Central Contractor Registration SAM is the Federal repository into which a subrecipient must provide information required for the conduct of business as a subrecipient. Registration information is available at the SAM Website https://www.sam.gov/. Requirement for SAM Unless exempted from this requirement under 2 CFR§ 25.110*,the subrecipient must maintain their current information in the SAM.This requires that the subrecipient review and update their information at least annually after the initial registration, and more frequently if required by changes in their information or another award term. (*2 CFR§ 25.110 (b) and (c)exempts individuals and Federal agencies. See statute for more information.) UEI is the 12-digit alphanumeric number issued to business entities registered in SAM; https:// sam.gov/(works best with Internet Explorer). California Department of Public Health Tuberculosis Control Branch Certification of Established Electronic Directly Observed Therapy (eDOT) Policy and Procedures Jurisdiction: Local Assistance Subvention Award The Local Health. Jurisdiction named above hereby certifies that a policy and procedures document has been established for the use of electronic directly observed therapy (eDOT) that includes the minimum requirements listed in the California Department of Public Health-California Tuberculosis Controllers Association joint guidelines, "Guidelines for Electronic Directly Observed Therapy (eDOT) Program Protocols in California 2016." Please sign and return this form with your funding request for equipment and services for use with eDOT. ATTEST: BERNICE E.SEIDEL Clerk of the Board of Supervisors County of Fresno,State of California By_ Deputy Authorized Signature Date Ernest Buddy Mendes Print Name L 1 Title Guidelines for eDOT Program Protocols in California 2016 can be found on the CTCA website at: https:Hctca.org/wp-content/uploads/2018/11/CDPH_CTCA-eDOT- Guidelines-Cleared-081116.pdf Page 1 of 1 April 2025 California Department of Public Health Name/No.: Tuberculosis Control Branch Base Award (No.2510BASE-F & 2510BASE-S) Fund/Subclass: 0001/10000 Organization #: 56201658 Revenue Account #: 3530, 4380