HomeMy WebLinkAboutFresno Economic Opportunities Commission-School Based Dental Sealant Program_A-25-467 A-23-393 A-24-556.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
September 9, 2025
Present: 5- Vice Chairman Garry Bredefeld, Supervisor Luis Chavez, Supervisor Nathan Magsig,
Chairman Buddy Mendes, and Supervisor Brian Pacheco
Agenda No. 43. Public Health File ID: 25-0864
Re: Approve and authorize the Chairman to execute Amendment No.2 to Agreement No.A-24-556 with
Fresno Economic Opportunities Commission to expand the school-based dental sealant program,
effective upon execution with no change to the term of July 1,2023,through June 30, 2027, and
increasing the maximum by$150,000 to a total of$1,100,000
APPROVED AS RECOMMENDED
Ayes: 5- Bredefeld, Chavez, Magsig, Mendes, and Pacheco
Agreement No. 25-467
County of Fresno Page 45
co
Board Agenda Item 43
O 1856 O
FRE`'�
DATE: September 9, 2025
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Interim Director, Department of Public Health
SUBJECT: Amendment No. 2 to Agreement with Fresno Economic Opportunities Commission
RECOMMENDED ACTION(S):
Approve and authorize the Chairman to execute Amendment No. 2 to Agreement No.
A-24-556 with Fresno Economic Opportunities Commission to expand the school-based
dental sealant program, effective upon execution with no change to the term of July 1, 2023
through June 30, 2027 and increasing the maximum by $150,000 to a total of$1,100,000.
There is no additional Net County Cost associated with the approval of the recommended action, which will
allow Fresno Economic Opportunities Commission (Fresno EOC)to expand the school-based dental
sealant program to include new Population Health Management care-coordination activities in support of the
Department of Public Health's (Department)effort to address social determinants of health through
preventative population health intervention care coordination services to residents of Fresno County. This
item is countywide.
ALTERNATIVE ACTION(S):
Should your Board choose to not execute the recommended amendment, Fresno EOC would not be able to
address activities related to population health intervention services for students and their families who are
receiving oral health preventative screenings through Fresno EOC's school-based dental sealant program
causing no new strategies to be implemented and limiting the programs' efforts to increase sustainability in
future years.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action, which will increase the
maximum compensation of the Agreement with Fresno EOC by$150,000 to $1,100,000 for the term. The
agreement is fully funded with Oral Health grant funds and Population Health Management grant funds.
Sufficient appropriations and estimated revenues have been included in the Department's Org 5620 FY
2025-26 Recommended Budget and will be included in subsequent budget requests.
DISCUSSION:
On June 6, 2023, your Board approved an Amendment to increase the oral health grant allocation from the
California Department of Public Health to allow the Local Oral Health Program (LOHP)to continue
school-based/school-linked activities it was not able to complete in the previous grant term.
On August 8, 2023, your Board approved Agreement No. A-23-396 with Fresno EOC to leverage the
reallocated funding to complete unfinished school-based/school-linked activities from the previous oral
County of Fresno Page I File Number.25-0864
File Number:25-0864
health grant, continue providing their school-based dental sealant program in elementary schools, and assist
elementary schools with the mandated state oral health reporting requirements.
On October 22, 2024, your Board approved First Amendment Agreement No. 24-556 with Fresno EOC to
increase the maximum compensation to allow Fresno EOC to continue their school-based dental sealant
program and the distribution of dental stipends to the dentists and dental hygienists who participate in the
school-based oral health screening events during FY 2023-24, and expand their program to include a
sealant retention check on students who receive dental sealants or fluoride varnishes during the school
year.
If approved, the recommended increase will allow Fresno EOC to expand their program to include new
Population Health Management care-coordination activities including screening for Social Determinants of
Health for urgent referrals, increased collaboration with the Community Health Worker Network to track
outcomes for children and families and develop referral criteria and the protocol for linking children to a
source of dental care. It also ensures funding for dental stipends through FY 2026-27 and enhances
collaboration between schools and local dental providers to strengthen the programs' goal of long-term
sustainability.
Language revisions to the service agreement were made to add the funding source for the new
care-coordination activities and regarding the prohibition of duplicating services.
REFERENCE MATERIAL:
BAI #41, October 22, 2024
BAI #38, August 8, 2023
BAI #38, June 6, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk-Amendment No. 2 to Agreement with Fresno EOC
CAO ANALYST:
Ron Alexander
County of Fresno Page 2 File Number.25-0864
Agreement No. 25-467
1 AMENDMENT NO. 2 TO SERVICE AGREEMENT
2 This Amendment No. 2 to Service Agreement ("Amendment No. 2") is dated
3 September 9, 2025 and is between Fresno Economic Opportunities Commission, a
4 California non-profit 501 c3 organization ("Contractor"), and the County of Fresno, a political
5 subdivision of the State of California ("County").
6 Recitals
7 A. On August 8, 2023, the County and the Contractor entered into Service Agreement,
8 which is County agreement number A-23-396 ("Agreement"), for implementing evidence-based
9 programs that improve the oral health of elementary school aged children.
10 B. On October 22, 2024, the County and the Contractor entered into a First Amendment,
11 which is County agreement number A-24-556 (Agreement number A-23-396, and First
12 Amendment number A-24-556 collectively, shall be referred to herein as "the Agreement"), to
13 increase the maximum compensation Thirty Thousand and No/100 Dollars ($30,000.00).
14 C. Changes to the Agreement are necessary to increase the maximum compensation to
15 support the Department's effort to address social determinants of health through preventative
16 population health intervention services.
17 D. The County and Contractor now desire to further amend the Agreement to (1) update the
18 compensation clause and the funding source clause; (2) replace Revised Exhibit A with Revised
19 Exhibit A-2 to add care coordination activities; (3) increase the maximum compensation of the
20 Agreement and; (4) replace Revised Exhibit B with Revised Exhibit B-2 to increase annual
21 budget amounts in FY 2025-26 and FY 2026-27.
22 The parties therefore agree as follows:
23 1. In Article 3, subsection 2 of the Agreement, starting at page 2 line 10 through page 3 line
24 3 shall be deleted and replaced with the following:
25 "3.2 Maximum Compensation. The maximum compensation payable to the
26 Contractor under this Agreement is One Million One Hundred Thousand and
27 00/100 Dollars ($1,100,000.00) commencing as of the Agreement effective date,
28 for the entire term of the Agreement including any extensions set forth by section
1
1 4.2 of this Agreement. The Contractor acknowledges that the County is a local
2 government entity and does so with notice that the County's powers are limited
3 by the California Constitution and by State law, and with notice that the
4 Contractor may receive compensation under this Agreement only for services
5 performed according to the terms of this Agreement and while this Agreement is
6 in effect, and subject to the maximum amount payable under this section. The
7 Contractor further acknowledges that County employees have no authority to pay
8 the Contractor except as expressly provided in this Agreement."
9 2. In Article 7, Funding Source, located on page 6 line 13 through line 15 shall be deleted
10 and replaced with the following:
11 "7.1 Services Funding Source. Funding for these services is provided by the
12 State of California, Health and Human Services Agency, California Department of
13 Public Health, California Oral Health Program; and by the California Department
14 of Health Care Services Medi-Cal Managed Care Plan.
15 7.2 Prohibition of Duplicative Services. The Contractor certifies that
16 services performed under this Agreement do not duplicate any services
17 previously or currently funded by Federal, State, County, or any other funding
18 source and shall not use any portion of funds under this Agreement for
19 duplicative services."
20 3. All references to Revised Exhibit A in the Agreement shall be amended to refer to
21 "Revised Exhibit A-2" which is attached and incorporated by this reference.
22 4. All references to Revised Exhibit B in the Agreement shall be amended to refer to
23 "Revised Exhibit B-2", which is attached and incorporated by this reference.
24 5. When both parties have signed this Amendment No. 2, the Agreement, Amendment
25 No. 1, and this Amendment No. 2 together constitute the Agreement.
26 6. The Contractor represents and warrants to the County that:
27 a. The Contractor is duly authorized and empowered to sign and perform its obligations
28 under this Amendment No. 2.
2
1 b. The individual signing this Amendment No. 2 on behalf of the Contractor is duly
2 authorized to do so and his or her signature on this Amendment No. 2 legally binds
3 the Contractor to the terms of this Amendment No. 2.
4 7. The parties agree that this Amendment No. 2 may be executed by electronic signature
5 as provided in this section.
6 a. An "electronic signature" means any symbol or process intended by an individual
7 signing this Amendment No. 2 to represent their signature, including but not limited
8 to (1) a digital signature; (2) a faxed version of an original handwritten signature; or
9 (3) an electronically scanned and transmitted (for example by PDF document)
10 version of an original handwritten signature.
11 b. Each electronic signature affixed or attached to this Amendment No. 2 is deemed
12 equivalent to a valid original handwritten signature of the person signing this
13 Amendment No. 2 for all purposes, including but not limited to evidentiary proof in
14 any administrative or judicial proceeding, and (2) has the same force and effect as
15 the valid original handwritten signature of that person.
16 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5,
17 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part
18 2, Title 2.5, beginning with section 1633.1).
19 d. Each party using a digital signature represents that it has undertaken and satisfied
20 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)
21 through (5), and agrees that each other party may rely upon that representation.
22 e. This Amendment No. 2 is not conditioned upon the parties conducting the
23 transactions under it by electronic means and either party may sign this Amendment
24 No. 2 with an original handwritten signature.
25 8. This Amendment No. 2 may be signed in counterparts, each of which is an original, and
26 all of which together constitute this Amendment No. 2.
27
28
3
1 9. The Agreement as amended by this Amendment No. 2 is ratified and continued. All
2 provisions of the Agreement and not amended by this Amendment No. 2 remain in full force and
3 effect.
4 [SIGNATURE PAGE FOLLOWS]
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
4
1 The parties are signing this Amendment No. 2 on the date stated in the introductory
2 clause.
3
FRESNO ECONOMIC OPPORTUNITIES COUNTY OF FRESNO
4 COMMISSION
5 � - .'
6 Ernest Buddy Mendes Chairman of the
Salam M. Nalia, Chief Executive Officer Board of Supervisors of the County of Fresno
7 1920 Mariposa Street
Fresno, California 93721 Attest:
8 Bernice E. Seidel
Clerk of the Board of Supervisors
9 County of Fresno, State of California
10
By: _
11 Geputy
12 For accounting use only:
13 Org No.: 56201553
Account No.: 7295
14 Fund No.: 0001
Subclass No.: 10000
15
16
17
18
19
20
21
22
23
24
25
26
27
28
5
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
Community-Clinical Linkages
2.1 Participate in a Strengths, Weaknesses, 07/01/23- A) SWOT analysis summary report,
Opportunities, and Threats (SWOT) analysis 12/31/23 which include:
of your program in preparation for -List of participating and identified
implementing school-based/linked programs. schools and grades
Note: Activity will be led and facilitated by DPH -Report program model selected
staff and tracking system
-List of partners and roles
-List of services
-Early Prevention Program
-Submit implementation plan
-List of equipment purchased
-Invoices for billing
School Dental Program Planning
2.2 Build partnerships: Identify, maintain, and 07/01/23- A) Memorandums of understanding
expand partnerships with dental providers 06/30/27 (MOUs), other partnership
and schools to implement, administer, and agreements
sustain school dental programs in targeted
sites.
2.2.a Recruit schools: Engage local school 07/01/23- A) List of participating schools,
stakeholders and gain support from schools 06/30/27 number of children to be served at
to implement, administer, and sustain school each school site, grade level for
dental programs in targeted sites. each child
2.2.b Connect schools to providers for school 07/01/23- A) List of dental providers in
dental programs. Facilitate the formalization 06/30/27 partnership agreements with school
of partnerships through MOUs and other programs
agreements.
Page 1 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
2.2.c Assist dental providers by coordinating with 07/01/23- A) Maintain a log of activities,
schools and obtaining input from school 06/30/27 which includes a written summary
administrator, lead teacher, school nurse, or of input from each person
oral health contact at identified schools to contacted, schedule of planned
schedule activities. activities
B) Include reports, logs, and other
tracking methods as applicable
2.2.d Promote school dental program: Annually 07/01/23- Updated educational materials:
update educational materials for teachers, 06/30/27
parents, and students. Ensure materials A) Sealant
follow the national Culturally and Linguistically B) Fluoride
Appropriate Services (CLAS) standards and C) Preventive dental services
use appropriate health literacy level that align
with the target population. List of sealant educational
materials provided; copy of consent
form if applicable)
2.2.e Annually facilitate distribution of oral health 07/01/23- A) Distribution list and format (e.g.,
educational materials including sealant and 06/30/27 in person meeting, student packets,
fluoride to teachers, parents, and students, virtual meetings, emails, etc.)
and send educational information home with B) Number of stakeholders reached
consent form (if referral provider will provide with educational sessions
services on-site at the school). C) List of educational materials
provided
D) Consent form (keep on file)
E) Include reports, logs, and other
tracking methods as applicable
2.2.f Plan dental program events: Work with 07/01/23- A) Maintain a schedule for
providers and schools and develop a 06/30/27 implementing a school dental
schedule for implementing school dental program
programs. B) Include reports, logs, and other
tracking methods as applicable
Page 2 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
2.2.g Annually deliver educational sessions to 07/01/23- A) Number of education sessions
teachers, parents, and students. 06/30/27 held
B) List of trainings provided and
names of school site. Training log
should state if training was to
students, teachers/faculty, or
parents
C) Include reports, logs, and other
tracking methods as applicable
2.2.h Facilitate basic dental screenings for students 07/01/23- A) Number of schools with a
to determine dental status with passive 06/30/27 program
consent. B) Number of children screened
C) Signed consent forms (keep on
file)
D) Include reports, logs, and other
tracking methods as applicable
2.2.i Annually identify students who receive at 07/01/23- A) List of schools identified to
least one instructional visit on oral health, 06/30/27 participate
using appropriate scope and sequence B) Number of children receiving
principles. education
C) List of materials provided
Topics will include: D) List of training topics
• Brushing and flossing E) Include reports, logs, and other
• Nutrition and healthy snacks, tracking methods as applicable
sugar sweetened beverages
• The need for regular dental care
and preparation for visiting the
dentist
• Tobacco prevention
Page 3 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
School-Linked Services
2.3 Implement a dental screening program with a 01/01/24- Annual referral tracking system
robust community-clinical linkage system 06/30/27 reports to include:
using a referral management electronic
platform for connecting with A) Number and proportion of
parents/caregivers and linking children to a eligible schools participating
source of dental care, tracking the progress of B) Number and proportion of
care from referral to completion of treatment eligible children screened
plan. C) Referral acceptance: whether
the receiving organization accepted
the referral, or if not, why not
D) Patient contact: whether the
receiving organization and the
patient interacted, or if not, why not
E) Receipt of services: whether the
patient received help from the
organization; if yes, what kind; or if
not, why not
F) Need resolution: whether the
need that triggered the referral was
resolved (or is in the process of
being resolved), or if not, why not
G) Include reports, logs, and other
tracking methods as applicable
2.3.a Create a network of dental care providers 07/01/23- A) Number dental care providers
willing to accept referrals. 06/30/27 willing to accept referrals
B) A list of participating providers
2.3bl Develop a protocol to implement assessment, 07/01/23- A) Submit a written care
counseling, and linkage to providers, as well 06/30/27 coordination protocol
as care coordination using the 5A's strategies
for addressing oral health problems and
social determinants of health for children and
families.
Page 4 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
2.3b 2 Develop and implement a Quality 07/01/23- A) Submit quarterly reports
Improvement (QI) plan based on Plan-Do- 06/30/27 summarizing QI activities, and
Study-Act (PDSA) cycles. progress towards improvement
goals
B) Use data tracking systems to
monitor program performance
C) Include reports, logs, and other
tracking methods as applicable
2.3c 1 Develop referral criteria (e.g., all children 07/01/23- A) An estimate of the number and
needing dental sealants, having urgent or 06/30/27 percentage of high-risk children in
immediate care) and the protocol for linking the county who need sealants and
children to a source of dental care. referrals
B) Submit referral criteria
Ensure that children who already have a C) Include reports, logs, and other
dental home are linked to the same provider tracking methods as applicable
unless the parent/guardian requests a
different provider.
2.3c 2 Screen for Social Determinants of Health 07/01/23- A) Referral tracking
(SDoH) for urgent referrals and collaborate 06/30/27 B) Include reports, logs, and other
with the Community Health Worker (CHW) tracking methods as applicable
Network to track outcomes for children and
families.
School Based Programming
2.3.d School-based Program: Evaluate readiness 07/01/23- A) In partnership with school dental
for expanding the school dental program to 06/30/27 program providers create a
include preventive services and implement checklist for steps 1 — 10 based on
when feasible. Seal America: The Prevention
Note: Activity will be led and facilitated by DPH Intervention Manual to determine
staff program readiness
Page 5 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
2.3.e Annually determine the number of children 07/01/23- A) List of children needing sealants
that need dental sealants and the number of 06/30/27 at each school site
sealants per child. Follow-up with teachers to B) Cumulative totals for each list
ensure notices were sent home.
2.3.f Annually, facilitate dental sealant placement 07/01/23- A) List of the schedule of events,
by a dentist, registered dental hygienist in 06/30/27 B) Number of children served at
alternative practice or registered dental each school site
hygienist at provider site, or will place C) Number of sealants provided
sealants and dental screenings on a minimum D) Include reports, logs, and other
of 5% of targeted children with signed tracking methods as applicable
parental consent form at a coordinated
sealant event with teachers, site personnel,
and volunteers.
2.3.g Implement the activities to expand the 07/01/23- A) Narrative summary of preventive
program to include preventive services. 6/30/27 activities implemented
Facilitate the implementation of a school B) List of schools and classrooms
dental program and ensure the provision of C) Number of children eligible to
services to children. receive fluoride varnish
D)Number of sealants provided
E) Number of students receiving
fluoride varnish
F) Number of students receiving
toothbrush prophylaxis
G) Total number of students
receiving preventive services
H) Include reports, logs, and other
tracking methods as applicable
Page 6 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
2.3.h Annually, complete sealant retention checks 07/01/23- Summary of follow-up
on a minimum of 10% of the children who 6/30/27 activities, number of
received sealants during the school year. children who received
retention checks, screening
forms on file.
2.3.i Participate with DPH Staff to establish 07/01/23- A) Efficient communication with
performance measures (PM) and track 06/30/27 parents/caregivers/school officials
progress in achieving targets. Consider and clinicians
quality improvement strategies. B) Tracking the success of referrals
C) Data metrics to communicate
findings to school administrators,
stakeholders, and funding agencies
D) Number of successful referrals
E) Development of quality
improvement strategies
F) Increase % of children served by
10% over 5 years
G) Establish timelines for
performance data review
H) Include reports, logs, and other
tracking methods as applicable
Kindergarten Oral Health Assessments (KOHA)
3.1 Assess the number of schools currently not 07/01/23- A) List and number of non-
reporting Kindergarten Oral Health 06/30/27 participating schools identified
Assessments (KOHA) to the System for
California Oral Health Reporting (SCOHR).
3.1.a Identify current processes of participating 07/01/23- A) List of best practices identified
schools and identify best practices. 06/30/27
3.1.b Identify target schools for intervention. 07/01/23- A) List of target schools identified
06/30/27
Page 7 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
3.1.c Recruit and enroll champions. 07/01/23- A) List and number of champions
Support onboarding and training of 06/30/27 recruited and/or trained
champions. B) Onboarding and training
materials
Champions such as school nurses, PTA, C) Number of school districts
school site council, school registrar, etc. Ask participating
a key person from a successful school to D) Number children served
make a presentation to other schools in their E) Include reports, logs, and other
district or at a district in-service. tracking methods as applicable
3.1.d Provide or adapt tools and training to make 07/01/23- A) Tool kit prepared
presentations and write letters for educating 06/30/27 B) List of presentations made
school board members to include KOHA C) Copy of letters written
activities in the Local Control funding formula D) Number of schools adopting
and the Local Control Accountability Plan. policies or participating in KOHA as
a result of efforts
3.1.f Provide guidance for implementation KOHA 07/01/23- A) Guidance documents distributed
participation and reporting. 06/30/27 to schools
B) Distribute Fact Sheets to build
support for KOHA
3.1.g Conduct meetings of key partners, mobilize 07/01/23- A) List of key partners
the community, and set targets. 06/30/27 B) Schedule of meetings held
C) Targets identified
D) Include reports, logs, and other
tracking methods as applicable
Page 8 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
3.1.h Identify successful strategies to increase the 07/01/23- A) Provide summary in progress
number of Kindergarten Oral Health 06/30/27 reports of successes, challenges,
Assessments, barriers, and challenges to lessons learned, and
progress. Identify if any new policies were recommendations
developed because of efforts. B) Identify if any policies were
revised or new policies developed
C) Number of new school districts
participating
D) Number of children served
E) Submit data annually on oral
health assessment activities
F) Include reports, logs, and other
tracking methods as applicable
3.1 i Assist DPH in developing a quality 07/01/23- (A) Quality Improvement Project for
improvement project for KOHA 06/30/27 KOHA
Note: Activity will be led and facilitated by DPH
staff.
Page 9 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
4.1 Coordinate and plan logistics with dental 07/01/22- A) Coordination with school site
providers and/or hygienists to attend 6/30/27 officials will occur before event is
screening event and provided screening to scheduled
youth. B) Number of kindergarten classes
in the school site
Develop a screening stipend log to track C) Number of students expected to
stipends provided to dental providers, be screened for that event
registered dental hygienist in alternative D) Number of children screened
practice, or registered dental hygienist for this based on the number of
activity. kindergarten classes per site and
student attendance for that
particular day
E) Number of screening stipends
provided to support staff for each
school site
F) Submit invoice for each
provider/hygienist and screening
event between the dates of 7/1/22-
6/30/27with every monthly invoice
G) Include reports, logs, and other
tracking methods as applicable
5.1 Attend and provide program updates in a 07/01/23- A) OHAC Meeting Agenda and/or
collaborative effort to LOHP's Oral Health 06/30/27 Notes
Advisory Committee B) Submit meeting updates one
week prior to OHAC meeting
6.1 Attend monthly calls with LOHP staff to 07/01/23- A) Submit meeting notes
discuss progress in activities. 06/30/27 B) Submit numbers template form
bi-monthly prior to check-in with
LOHP
Page 10 of 11
Revised EXHIBIT A-2
School-Based Sealant Program Scope of Work FY July 1, 2023 —June 30, 2027
# Activity Description Time Performance Measure/ Progress Notes/ Deliverable
Frame Deliverable Attached
6.1a Attend trainings identified by LOHP. Training 07/01/24- A) Submit training log
topics to include: 06/30-27
- Health Equity & Social Determinants
of Health (SDoH)
- Care Coordination System (CCS)
- Culturally and Linguistically
Appropriate Services (CLAS)
- Other trainings as identified
7.1 Submit progress reports in January and July 07/01/23- Submit a narrative of the work
of every year. Dates: 1/2024,7/2024,01/2025, 06/30/27 completed during the 6 previous
7/2025,1/2026,7/2026,1/2027, and 7/2027. months for the July through
December report and again for the
January through June report.
7.1a Submit biannual report on Care Coordination A) Include reports, logs, and other
System (CCS) data to track oral health tracking methods as applicable
outcomes to improve population health
management.
8.1 Submit monthly invoices by 151" of the month 07/01/23- Monthly invoice with back up
for the prior month's expenses 06/30/27 documentation for hours worked,
mileage, office supplies, oral health
kit items and other items invoiced
to support the amount being
reflected.
Page 11 of 11
REVISED EXHIBIT B
SBSP Budget
Year 1
07/1/2023 through 6/30/2024
Personnel
Position Title Monthly Annual FTE % Months Requested
Amount
Project Director
Project Coordinator $6,494.17 $ 77,930.04 50% 12 $ 38,965.02
Health Educator $4,581.08 $ 54,972.96 100% 12 $ 54,972.96
Health Educator $4,301.50 $ 51,618.00 58% 12 $ 29,938.44
Total Personnel $ 123,876.42
Total Fringe
Fringe Benefits @ 35.87% Benefits $ 44,434.88
Total $ 168,311.30
Operating Expenses
Space/Rent $ 1,200.00 12 $ 14 400.00
Communications $ 314.00 12 $ 3,768.00
Printing $ 40.00 12 $ 480.00
Office Supplies $ 131.00 12 $ 1,572.00
Total Operating Expenses $ 20,220.00
Travel
Mileage $ 0.655 200 12 $ 1572.00
Total Travel $ 1,572.00
Other Costs
Laptops & software $ 1,550.00 3 $ 4,650.00
Oral Health Kits $ 10,000.00
Oral Health Screening Stipends for $ 30,000.00
Total Other Costs $ 44,650.00
Subtotal $ 234,753.30
Indirect Costs (15% of Total Personnel Costs) Total Indirect Costs $ 25,246.70
TOTAL COSTS $ 260,000.00
REVISED EXHIBIT B
SBSP Budget
Year 2
07/1/2024 through 6/30/2025
Personnel
Position Title Monthly Annual FTE% Months Requested
Amount
Project Director
Project Coordinator $6,688.33 $80,259.96 50% 12 $ 40,129.98
Health Educator $4,718.33 $56,619.96 100% 12 $ 56,619.96
Health Educator $4,430.42 $53,165.04 57% 12 $ 30,304.07
Total Personnel $ 127,054.01
Fringe Benefits @ 36.27% Benefits $ 46,082.34
Total $ 173,136.35
Operating Expenses
Space/Rent $ 1,200.00 12 $ 14,400.00
Communications $ 314.00 12 $ 3,768.00
Printing $ 35.00 12 $ 420.00
Office Supplies $ 80.75 12 $ 969.00
Total Operating Expenses $ 19,557.00
Travel
Mileage $ 0.655 170 12 $ 1,336.20
Total Travel $ 1,336.20
Other Costs
Oral Health Screening Stipends for Providers $ 30,000.00
Total Other Costs $ 30,000.00
Subtotal $ 224,029.55
Indirect Costs (15%of Total Personnel Costs) Total Indirect Costs $ 25,970.44
TOTAL COSTS $ 250,000.00
REVISED 7-26-24
AMENDMENT#1
ADDED$30k FOR Dental Stipends
2
REVISED EXHIBIT B-2
SBSP Budget
Year 3
07/1/2025 through 6/30/2026
Personnel
Position Title Monthly Annual FTE% Months Requested
Amount
Project Director
Project Coordinator $5,900.42 $70,805.04 100% 10 $ 70,805.04
Health Educator $5,900.42 $70,805.04 60% 10 $ 35,402.52
Health Educator $4,176.25 $50,115.00 60% 10 $ 18,542.55
Community Health Worker $6,581.25 $78,975.00 50% 10 $ 39,487.50
Total Personnel $ 164,237.61
Fringe Benefits @37.96% Benefits $ 62,344.60
Total $ 226,582.21
Operating Expenses
Space/Rent $ 1,706.00 10 $ 17,064.00
Communications $ 432.00 10 $ 4,320.00
Printing $ 54.00 10 $ 540.00
Office Supplies/Program Supplies $ 123.84 10 $ 1,238.40
Total Operating Expenses $ 23,162.40
Travel
Mileage
Mileage $ 0.700 324 10 $ 2,268.00
Total Travel $ 2,268.00
Other Costs
Laptops&software $ -
Dental Kits $ 4,000.00
Oral Health Screening Stipends for Providers $ 30,000.00
Total Other Costs $ 34,000.00
Subtotal $ 286,012.61
Indirect Costs(15%of Total Personnel Costs) Total Indirect Costs $ 33,987.33
TOTAL COSTS $ 320,000
AMENDMENT#2
SOW revised to add 5 NEW activities
REVISE Year 3 budget to add$100,000 to complete new activities related to Care Coordination work.
add new position,revised FTE's and operating expenses,added Dental Kits and Stipends money.
Update Mileage to 0.70/per mile.
lZe�fiepd 111512025
Revised 8/14/2025 3
REVISED EXHIBIT B-2
SBSP Budget
Year 4
07/1/2026 through 6/30/2027
Personnel requested
Position Title Monthly Annual FTE % Months Requested
Amount
Project Director
Project Coordinator $6,018.42 $ 72,221.04 100% 12 $ 72,221.04
Health Educator $ 6,018.42 $ 72,221.04 50% 12 $ 36,110.52
Health Educator $4,259.83 $ 51,117.96 25% 6 $ 6,389.75
Community Health Worker $ 6,712.92 $ 80,555.04 37% 12 $ 29,805.36
Total Personnel $ 144,526.67
Fringe Benefits @ 37.54% Benefits $ 54,255.28
Total $ 198,781.95
Operating Expenses
Space/Rent $ 1,272.00 12 $ 15,264.00
Communications $ 350.00 12 $ 4,200.00
Printing $ 45.00 12 $ 540.00
Office Supplies/Program Supplies $ 114.73 12 $ 1,376.76
Total Operating Expenses $ 21,380.76
Travel
Mileage $ 0.700 300 12 $ 2,520.00
Total Travel $ 2,520.00
Other Costs
Laptops & software $ -
Dental Kits $ 2,500.00
Oral Health Screening Stipends for Providers $ 15,000.00
Total Other Costs $ 17,500.00
Subtotal $ 240,182.71
Indirect Costs (15% of Total Personnel Costs) Total Indirect Costs $ 29,817.29
TOTAL COSTS $ 270,000.00
Rkvi"7/15/202.5
Revised 8/14/2025 Page 4
Justification Year J.
Personnel Justification Year 1
Position Title
Project Director $ - Direct,manage,assess,plan,implement and evaluate progam
activities such as overseeing the completion of Project Coordinator
and Dental Assistant's duties,completion of reports and attendance
to all required meetings.10%of salary zero cost to SBSP.
Project Coordinator Cost to coordinate all activities and ensures implementation of work
plan activities of SBSP. Oversees day to day activities and provide
assistance in problem solving and goal setting to meet high quality
standards of all deliverables.50%of salary based on an 12 month
$ 38,965.02 period for Year 1.
Health Educator An SBSP Outreach Health Educator is needed to case manage the
clients and assist with the coordination of educational services such
as providing dental presentations to teachers,students,and parents.
The health educator will also be assisting dental hygienists with
services such as set-up,clean-up,and documenting all services
provided to students.The health educator will be responsible for
entering all data into the FUSE software.He/she will have to follow
up with parents whose youth requires"urgent"dental care and refer
them to Free Medi-Cal Dental Youth Services to link them to a local
dental care provider. 100%of salary based on 12 month period for
$ 54,972.96 Year
Health Educator An SBSP Outreach Health Educator is needed to case manage the
clients and assist with the coordination of educational services such
as providing dental presentations to teachers,students,and parents.
The health educator will also be assisting dental hygienists with
services such as set-up,clean-up,and documenting all services
provided to students.The health educator will be responsible for
entering all data into the FUSE software.He/she will have to follow
up with parents whose youth requires"urgent"dental care and refer
them to Free Medi-Cal Dental Youth Services to link them to a local
$ 29,938.44 dental care provider. 58%of salary based on 12 month period for
Cost includes FICA,SUI,Workers Compensation,Medical/Health
Fringe Benefits @ 35.87% $ 44,434.88 benefits and retirement benefits.
Operating Expenses
Space/Rent $ 14,400.00 Office space for staff implementing SBSP($1,200 X 12 months)
Communications $ 3,768.00 Landline connections,internet and Wifi connections,servers,cell
phones($314 X 12 months).
Printing $ 480.00 Printing of any materials,flyers,forms,copies of documents needed
to implement project ($40 X 12 months).
Office Supplies $ 1,572.00 Office and consumable supplies such as papers,pens,note pads,
toners,print cartridges,folders,laptop case,planners,binders and
other supplies ($131 X 12 months).
Travel
Mileage $ 1,572.00 Mileage to and from meetings,trainings,project implementation,and
site visits(200 miles @$.655 per mile X 12 months).
Other Costs
Laptops $ 4,650.00 Purchase of 3 laptops for Project Coordinator and 2 Health
Educators
Oral Health Kits $ 10,000.00 2,000 oral health kits(bag,toothbrush,toothpaste,floss)x$5=
$10,000,will be used for KOHA,SBSP initiatives,and oral health
education and will be shared with community partners."These funds
Oral Health Screening $ 30,000.00 $400 per provider who screens children for oral health outcomes
Stipends for Dental during a single event. 'These funds are only available in this fiscal
Provider year.
Indirect Costs(15%of $ 25,246.70
Total Personnel Cost)
TOTAL COSTS YR 1 $ 260,000.00
5
Justification Year 2
Personnel Justification Year 2
Position Title
Project Director $ - Direct,manage,assess,plan,implement and evaluate progam
activities such as overseeing the completion of Project Coordinator
and Dental Assistant's duties,completion of reports and attendance
to all required meetings.10%of salary zero cost to SBSP.
Project Coordinator $ 40,129.98 Cost to coordinate all activities and ensures implementation of work
plan activities of SBSP. Oversees day to day activities and provide
assistance in problem solving and goal setting to meet high quality
standards of all deliverables.50%of salary based on12 month period
for Year 2.
Health Educator $ 56,619.96 An SBSP Outreach Health Educator is needed to case manage the
clients and assist with the coordination of educational services such
as providing dental presentations to teachers,students,and parents.
The health educator will also be assisting dental hygienists with
services such as set-up,clean-up,and documenting all services
provided to students.The health educator will be responsible for
entering all data into the FUSE software.He/she will have to follow
up with parents whose youth requires"urgent"dental care and refer
them to Free Medi-Cal Dental Youth Services to link them to a local
dental care provider. 100%of salary based on 12 month period for
Year
Health Educator $ 30,304.07 An SBSP Outreach Health Educator is needed to case manage the
clients and assist with the coordination of educational services such
as providing dental presentations to teachers,students,and parents.
The health educator will also be assisting dental hygienists with
services such as set-up,clean-up,and documenting all services
provided to students.The health educator will be responsible for
entering all data into the FUSE software.He/she will have to follow
up with parents whose youth requires"urgent"dental care and refer
them to Free Medi-Cal Dental Youth Services to link them to a local
dental care provider. 57%of salary based on 12 month period for
Year
Cost includes FICA,SUI,Workers Compensation,Medical/Health
Fringe Benefits @ 36.27% $ 46,082.34 benefits and retirement benefits.
Operating Expenses
Space/Rent $ 14,400.00 Office space for staff implementing SBSP($1,200 X 12 months)
Communications $ 3,768.00 Landline connections,internet and Wifi connections,servers,cell
phones($314 X 12 months).
Printing $ 420.00 Printing of any materials,flyers,forms,copies of documents needed
to implement project ($35 X 12 months).
Office Supplies $ 969.00 Office and consumable supplies such as papers,pens,note pads,
toners,print cartridges,folders,laptop case,planners,binders and
other supplies ($80.75 X 12 months)
Travel
Mileage $ 1,336.20 Mileage to and from meetings,trainings,project implementation,and
site visits(170 miles @$.655 per mile X 12 months)
Other Costs
Oral Health Screening $ 30,000.00 $400 per provider who screens children for oral health outcomes
Stipends for Dental during a single event. "These funds are only available in this fiscal
Indirect Costs(15%of $ 25,970.44
Total Personal Cost)
TOTAL COSTS YR 2 $ 250,000.00
Justification Year 3
Personnel
Position Title
$ - Direct,manage,assess,plan,implement and evaluate progam activities such as
Project Director overseeing the completion of Project Coordinator and Dental Assistant's duties,
completion of reports and attendance to all required meetings.10%of salary zero
cost to SBSP.
$ 70,805.04 Cost to coordinate all activities and ensures implementation of work plan activities
of SBSP. Oversees day to day activities and provide assistance in problem solving
Project Coordinator and goal setting to meet high quality standards of all deliverables.100%of salary
based on 12 month period for Year 3.
$ 35,402.52 An SBSP Outreach Health Educator is needed to case manage the clients and
assist with the coordination of educational services such as providing dental
presentations to teachers,students,and parents.The health educator will also be
assisting dental hygienists with services such as set-up,clean-up,and documenting
all services provided to students.The health educator will be responsible for
Health Educator entering all data into the FUSE software.He/she will have to follow up with parents
whose youth requires"urgent"dental care and refer them to Free Medi-Cal Dental
Youth Services to link them to a local dental care provider. 50%of salary based on
12 month period for Year 3
$ 18,542.55 An SBSP Outreach Health Educator is needed to case manage the clients and
assist with the coordination of educational services such as providing dental
presentations to teachers,students,and parents.The health educator will also be
assisting dental hygienists with services such as set-up,clean-up,and documenting
all services provided to students.The health educator will be responsible for
Health Educator entering all data into the FUSE software.He/she will have to follow up with parents
whose youth requires"urgent"dental care and refer them to Free Medi-Cal Dental
Youth Services to link them to a local dental care provider. 37%of salary based on
12 month period for Year 3
$ 39,487.50
Community Health Worker is responsible for coordinating services for
clients identified as meeting criteria related to the Social
Determinants of Health. This role includes referral tracking,
Community Health worker maintaining reports and logs and collaborating closely with the
Community Health Worker Network. 50%of salary based on 12
month period for Year 3
Tinge ene L s Cost includes FICA,SUI,Workers Compensation,Medical/Health benefits and
37.96% $ 62,344.60 retirement benefits.
Operating Expenses
Space/Rent $ 17,064.00 Office space for staff implementing SBSP($1,422 X 12 months)
Communications $ 4,320.00 Landline connections,intemet and Wifi connections,servers,cell phones($360 X
12 months).
Printing $ 540.00 Printing of any materials,flyers,forms,copies of documents needed to implement
project ($45 X 12 months).
Office/Program Supplies $ 1,238.40 Office and consumable supplies such as papers,pens,note pads,toners,print
cartridges,folders,laptop case,planners,binders and other supplies ($103.20 X 12
months)
Travel
Mileage $ 2,268.00 Mileage to and from meetings,trainings,project implementation,and site visits
(324x10x.70=$2268 )
Other Costs
Laptops $ -
Dental Kits $ 4,000.00 800 dental kits(bag,toothbrush,toothpaste,floss)x$5=$6,000,will be
used for KOHA,SBSP initiatives,and oral health education and will be
shared with community partners. *These funds are only available in this
fiscal year.
Oral Health Screening $ 30,000.00 $400 per provider who screens children for oral health outcomes during a
Stipends for Dental single event. *These funds are only available in this fiscal year.$500 for
Provider events with over SO screenings.
Indirect LoStS o Of $ 33,987.33
Total Perssonnel Cost)
TOTAL COSTS vo a $ 220 000.00
Revised Total $ 320,000
INCREASE $ 100,000
Justification Year 4
Personnel Justification Year 4
Position Title
Project Director $ - Direct,manage,assess,plan,implement and evaluate progam
activities such as overseeing the completion of Project Coordinator
and Dental Assistant's duties,completion of reports and attendance
to all required meetings.10%of salary zero cost to SBSP.
Project Coordinator $ 72,221.04 Cost to coordinate all activities and ensures implementation of work
plan activities of SBSP. Oversees day to day activities and provide
assistance in problem solving and goal setting to meet high quality
standards of all deliverables.50%of salary based on12 month
period for Year 4.
Health Educator $ 36,110.52 An SBSP Outreach Health Educator is needed to case manage the
clients and assist with the coordination of educational services such
as providing dental presentations to teachers,students,and parents.
The health educator will also be assisting dental hygienists with
services such as set-up,clean-up,and documenting all services
provided to students.The health educator will be responsible for
entering all data into the FUSE software.He/she will have to follow
up with parents whose youth requires"urgent"dental care and refer
them to Free Medi-Cal Dental Youth Services to link them to a local
dental care provider. 100%of salary based on 12 month period for
Year 4
Health Educator $ 6,389.75 An SBSP Outreach Health Educator is needed to case manage the
clients and assist with the coordination of educational services such
as providing dental presentations to teachers,students,and parents.
The health educator will also be assisting dental hygienists with
services such as set-up,clean-up,and documenting all services
provided to students.The health educator will be responsible for
entering all data into the FUSE software.He/she will have to follow
up with parents whose youth requires"urgent"dental care and refer
them to Free Medi-Cal Dental Youth Services to link them to a local
dental care provider. 25%of salary based on 6 month period for
Year
$ 29,805.36
Community Health Worker is responsible for coordinating services
for clients identified as meeting criteria related to the Social
Determinants of Health. This role includes referral tracking,
Community Health Worker maintaining reports and logs and collaborating closely with the
Community Health Worker Network. 37%of salary based on 12
month period for Year 4
Cost includes FICA,SUI,Workers Compensation,Medical/Health
Fringe Benefits @ 37.54% $ 54,255.28 benefits and retirement benefits.
Operating Expenses
Space/Rent $ 15,264.00 Office space for staff implementing SBSP($1,272 X 12 months)
Communications Landline connections,internet and Wifi connections,servers,cell
$ 4,200.00 phones($350 X 12 months).
Printing Printing of any materials,flyers,forms,copies of documents needed
$ 540.00 to implement project ($45 X 12 months).
Office/Program Supplies Office and consumable supplies such as papers,pens,note pads,
toners,print cartridges,folders,laptop case,planners,binders and
$ 1,376.76 other supplies ($114.75 X 12 months)
Travel
Mileage Mileage to and from meetings,trainings,project implementation,and
$ 2,520.00 site visits(300 miles @$.70 per mile X 12 months)
Other Costs
Laptops&Software $ -
Dental Kits $ 2,500.00 500 dental kits(bag,toothbrush,toothpaste,floss)x$5=$2,500,will
be used for KOHA,SBSP initiatives,and oral health education and
will be shared with community partners. *These funds are only
available in this fiscal year.
$ 15,000.00 $400 per provider who screens children for oral health outcomes
during a single event. *These funds are only available in this fiscal
year.$500 for events with over 50 screenings.
Oral Health Screening Stipenc
Indirect Costs(15%of Total $ 29,817.29
Personnel Cost)
TOTAL COSTS YR 4 $ 270,000.00
Health Services: County of Fresno Amendment
No. 2 to Agreement A-23-396_Revise #3
Final Audit Report 2025-08-20
Created: 2025-08-20
By: Elionora Vivanco(elionora.vivanco@fresnoeoc.org)
Status: Signed
Transaction ID: CBJCHBCAABAAis6OXb4_X2yVGRY7nNNMShxOPkVLOfk4
"Health Services: County of Fresno Amendment No. 2 to Agree
ment A-23-396_Revise #Y History
Document created by Elionora Vivanco (elionora.vivanco@fresnoeoc.org)
2025-08-20-5:24:52 PM GMT
Document emailed to Salam Nalia (Salam.M.Nalia@fresnoeoc.org)for signature
2025-08-20-5:25:28 PM GMT
°`_? Email viewed by Salam Nalia (Salam.M.Nalia@fresnoeoc.org)
2025-08-20-5:29:36 PM GMT
v Document e-signed by Salam Nalia (Salam.M.Nalia@fresnoeoc.org)
Signature Date:2025-08-20-5:29:52 PM GMT-Time Source:server
Agreement completed.
2025-08-20-5:29:52 PM GMT
Q Adobe Acrobat Sign