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HomeMy WebLinkAboutFresno Metropolitan Ministry-Fresno Community Health Improvement Partnership_A-25-545.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 October 21, 2025 Present: 5- Vice Chairman Garry Bredefeld, Supervisor Luis Chavez, Supervisor Nathan Magsig, Chairman Buddy Mendes, and Supervisor Brian Pacheco Agenda No. 50. Public Health File ID: 25-1042 Re: Approve and authorize the Chairman to execute Amendment No. 3 to Agreement with Reading and Beyond to continue providing health intervention activities for Fresno County's Community Health Worker Network, effective upon execution, extending the three-year base contract term by seven months from June 1, 2026,through December 31, 2026,with the two optional one-year extensions bringing the expiration date to December 31, 2028, and increasing the maximum compensation by $189,000 to a total of$1,449,000;Approve and authorize the Chairman to execute Amendment No. 1 to Agreement with Avenal Community Health Center dba Aria Community Health Center to continue providing health intervention activities for Fresno County's Community Health Worker Network, effective upon execution, extending the two-year base contract term by seven months from June 1, 2026, through December 31, 2026,with the two optional one-year extensions bringing the expiration date to December 31, 2028, and increasing the maximum compensation by$111,385 to a total of$575,453; and Approve and authorize the Chairman to execute Amendment No. 3 to Agreement with Fresno Metropolitan Ministry to continue providing health intervention activities for Fresno County's Community Health Worker Network, effective upon execution, extending the four-year and five-month contract term by seven months from June 1, 2026,through December 31,2026,with no change to the maximum compensation of$12,496,869 APPROVED AS RECOMMENDED Ayes: 5- Bredefeld, Chavez, Magsig, Mendes, and Pacheco Agreement No. 25-543,Agreement No. 25-544, Agreement No. 25-545 County of Fresno Page 54 co Board Agenda Item 50 O 1856 O FRE`'� DATE: October 21, 2025 TO: Board of Supervisors SUBMITTED BY: Joe Prado, Interim Director, Department of Public Health SUBJECT: Multiple Amendments to Agreements with Community Based Organizations to Implement Department of Public Health's Community Health Worker Network Intervention Activities RECOMMENDED ACTION(S): 1. Approve and authorize the Chairman to execute Amendment No. 3 to Agreement with Reading and Beyond to continue providing health intervention activities for Fresno County's Community Health Worker Network, effective upon execution, extending the three-year base contract term by seven months from June 1, 2026, through December 31, 2026, with the two optional one-year extensions bringing the expiration date to December 31, 2028, and increasing the maximum compensation by$189,000 to a total of$1,449,000; 2. Approve and authorize the Chairman to execute Amendment No. 1 to Agreement with Avenal Community Health Center dba Aria Community Health Center to continue providing health intervention activities for Fresno County's Community Health Worker Network, effective upon execution, extending the two-year base contract term by seven months from June 1, 2026, through December 31, 2026, with the two optional one-year extensions bringing the expiration date to December 31, 2028, and increasing the maximum compensation by $111,385 to a total of$575,453; and 3. Approve and authorize the Chairman to execute Amendment No. 3 to Agreement with Fresno Metropolitan Ministry to continue providing health intervention activities for Fresno County's Community Health Worker Network, effective upon execution, extending the four-year and five-month contract term by seven months from June 1, 2026,through December 31, 2026, with no change to the maximum compensation of$12,496,869. There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will allow Reading and Beyond, Avenal Community Health Center dba Aria Community Health Center(Aria), and Fresno Metropolitan Ministry(FMM)to continue providing essential services to residents of Fresno County experiencing health disparities through community health worker (CHW) interventions by increasing the term of each Agreement by seven months to align with new funding timelines and increasing Reading and Beyond and Aria's budgets by$189,000 and $111,385, respectively, to sustain program activities through the extended term. The recommended actions will also amend each agreement to include additional language prohibiting the duplication of services through other funding sources. The third recommended action will also amend the scope of work of FMM's agreement to include additional services identified as applicable by the Department and in alignment with health priorities. This item is countywide. ALTERNATIVE ACTION(S): County of Fresno page 1 File Number.25-1042 File Number:25-1042 Should your Board not approve the recommended actions, these Agreements will be terminated early, as there will be no alternative funding available to support program activities. Critical services that address health needs of residents in Fresno County will end and unspent grant funds for these services will be returned to the granting agencies. FISCAL IMPACT: There is no increase in Net County Cost associated with the recommended actions. The maximum compensation of the Agreement with Reading and Beyond will increase by$189,000 to $1,449,000 and the maximum compensation of the Agreement with Aria will increase by$111,385 to $575,453 for the proposed extended term. The agreements will all be fully funded with braided funding which include Population Health Management, Health Disparities, and American Rescue Plan Act (ARPA)grant funds through the end of the proposed agreement term. Sufficient appropriations and estimated revenues are included in the Department of Public Health's Org 5620 FY 2025-26 Adopted Budget and will be included in subsequent budget requests. DISCUSSION: Agreement with Reading and Beyond Background On March 28, 2023, the Board approved Agreement A-23-129 which allowed the County to partner with Reading and Beyond to promote community health support and to provide health intervention activities for implementation of Fresno County's Health Disparities Program in underserved areas of Fresno County. Agreement A-23-129 was issued in accordance with a Request for Proposal that was issued on July 13, 2022. On March 19, 2024, the Board approved First Amendment A-24-127 which allowed Reading and Beyond to carryover unspent fiscal year one funds to fiscal year two and corrected language in Article 7.1 of the Agreement in accordance with federal funding. On December 17, 2024, the Board approved Second Amendment A-24-688, which allowed the Agreement term to be extended in alignment with a no cost extension provided by federal funding that was planned to fully fund the Agreement. Reading and Beyond has provided outreach to 12,858 individuals, made 1,600 medical and social service referrals to community members, and enrolled 280 unique clients to receive tailored care-coordination services. The first recommended action would allow the Agreement with Reading and Beyond to be extended through December 31, 2026, increase the Agreement's maximum compensation by$189,000, and amend the Agreement language to add a provision prohibiting the duplication of services through other funding sources. Agreement with Aria Community Health Center Background On June 18, 2024 the Board approved Agreement A-24-327 which allowed the County to Partner with Aria to promote community health support and to provide health intervention activities in a rural clinic setting with a focus on type-2 diabetes mitigation efforts. Aria has provided outreach to 13,603 individuals, made over 1,100 social service and medical referrals to residents in rural communities of Fresno County, and has enrolled over 390 unique clients to receive tailored care-coordination services. The second recommended action would allow the Agreement with Aria to be extended through December 31, 2026, increase the Agreement's maximum compensation by$111,385, and amend the language of the Agreement to add a provision prohibiting the duplication of services through other funding sources. Agreement with Fresno Metropolitan Ministry Background On December 14, 2021 the Board approved Agreement A-21-539 which allowed the County to partner with FMM to act as the fiscal sponsor of the Fresno Community Health Improvement Partnership (FCHIP)to create the FCHIP HOPE Pathways Community Hub (HOPE HUB)and provide service delivery through a nationally recognized evidence-based CHW model. On January 24, 2023 the Board approved First Amendment A-23-047 which allowed the Agreement to be extended through July 31, 2024, and increased County of Fresno Page 2 File Number.25-1042 File Number:25-1042 the total maximum compensation by$2,400,000 to sustain services through this extension period. On July 9, 2024 the Board approved Second Amendment A-24-386 which allowed the Agreement to be extended through May 31, 2026 and increased the maximum compensation by$2,883,893 to sustain services through this extension period. The HOPE HUB provides wraparound services to over 1,600 residents, annually, throughout Fresno County. The third recommended action would allow the Agreement with FMM to be extended through December 31, 2026, and amend the scope of work of the Agreement to add additional service deliverables for the Department's Public Health Nursing Division, which align with their service delivery model. Population Health Management Grant Funding Background On May 6, 2025, your Board approved Agreements A-25-174, A-25-175, and A-25-176 which allowed the County to accept Population Health Management(PHM)grant funding through December 31, 2026. Acceptance of PHM grant funding allowed the Department to solidify funding to support these Agreements through December 31, 2026. The service Agreements with Aria, FMM, and Reading and Beyond were previously funded by federal funds, if approved, the recommended action would allow for services of the Agreements to continue with the addition of PHM funding. The recommended actions would also allow the Agreements to be extended through December 31, 2026, in alignment with the PHM grant timeline, and increase the maximum compensation of the Agreements to support services through this extended period. The PHM grant ends on December 31, 2026, the Department plans to only exercise the option to extend the Agreements if the PHM grant is extended or additional grant funding becomes available. The recommended actions are in alignment with the Department's plan of securing supplemental funding to support these critical services. REFERENCE MATERIAL: BAI #35.1, May 6, 2025 BAI #62, December 17, 2024 BAI #50, July 9, 2024 BAI #65, June 18, 2024 BAI #45, March 19, 2024 BAI #48, March 28, 2023 BAI #39, January 24, 2023 BAI #68, December 14, 2021 ATTACHMENTS INCLUDED AND/OR ON FILE: On file with Clerk-Amendment No. 3 to Agreement with Reading and Beyond On file with Clerk-Amendment No. 1 to Agreement with Aria On file with Clerk-Amendment No. 3 to Agreement with FMM CAO ANALYST: Ron Alexander County of Fresno Page 3 File Number.25-1042 I Docusign Envelope ID: 1418D86A-2F3F-49FE-BD4B-4C7AD31A84DC Agreement No. 25-545 1 AMENDMENT NO. 3 TO SERVICE AGREEMENT 2 This Amendment No. 3 to Service Agreement ("Amendment No. 3") is dated 3 October 21, 2025 and is between Fresno Metropolitan Ministry, a California 501 C3 Non- 4 Profit corporation ("Contractor"), and the County of Fresno, a political subdivision of the State of 5 California ("County"). 6 Recitals 7 A. On December 14, 2021, the County and the Contractor entered into a service 8 agreement, which is County agreement number A-21-539 to provide community health worker 9 interventions to vulnerable populations including disabled, special needs, hearing impaired, 10 vision impaired, agricultural and food process workers and other populations experiencing 11 health disparities. 12 B. On January 24, 2023, the County and the Contractor entered into a First Amendment, 13 which is County agreement number A-23-047 to update the scope of work, extend the term of 14 the Agreement, revise the budget, and increase total compensation of the Agreement. 15 C. On July 9, 2024, the County and the Contractor entered into a Second Amendment, 16 which is County agreement number A-24-386 (Agreement number A-21-539 , First Amendment 17 number A-23-047, and Second Amendment number A-24-386 collectively, shall be referred to 18 herein as "the Agreement"), to update the scope of work, extend the term of the Agreement, 19 revise the budget, and include federal requirements. 20 D. The County and the Contractor now desire to further amend the Agreement to (1) extend 21 the term of the Agreement and; (2) Include Paragraph Thirty-One "Services Funding Source" to 22 the Agreement and; (3) include Paragraph Thirty-Two "Prohibition of Duplicative Services" to the 23 Agreement and; (4) replace Exhibit A with Revised Exhibit A-2 to update the scope of work and; 24 (5) replace Exhibit B with Revised Exhibit B-3 to adjust annual budget amounts to reflect 25 actuals, carryover unspent funds from the current fiscal year three to fiscal year four, and 26 reallocate carryover funds in fiscal year four to adjust for costs of the extended term. 27 The parties therefore agree as follows: 28 1 I Docusign Envelope ID: 1418D86A-2F3F-49FE-BD4B-4C7AD31A84DC 1 1. Section Three titled Term of the Agreement located at page Three (3) beginning at line 2 Six (6) and ending at line Eleven (11) with the word "Performance" is deleted in its entirety and 3 replaced with the following: 4 "3. TERM 5 The term of this Agreement shall commence upon execution and be for a period through 6 and including December 31, 2026." 7 2. That Paragraph Thirty-One (31) —SERVICES FUNDING SOURCE shall be included in 8 the Agreement on Page Twenty-Six (26) beginning after Paragraph Thirty (30) — COMPLIANCE 9 WITH FEDERAL REQUIREMENTS and include the following: 10 "31. SERVICES FUNDING SOURCE: Funding for these services is provided by 11 the California Department of Health Care Services Medi-Cal Managed Care Plan 12 funding, and the US Department of Health and Human Services CDC —Activities 13 to Support State, Tribal, Local and Territorial (STLT) Health Department 14 Response to Public Health or Healthcare Crises (Catalog of Federal Domestic 15 Assistance Number 93.391)." 16 3. That Paragraph Thirty-Two (32)— PROHIBITION OF DUPLICATIVE SERVICES shall be 17 included in the Agreement on Page Twenty-Six (26) beginning after Paragraph Thirty (31) — 18 SERVICES FUNDING SOURCE and include the following: 19 "32. PROHIBITION OF DUPLICATIVE SERVICES: The Contractor certifies that 20 services performed under this Agreement do not duplicate any services 21 previously or currently funded by Federal, State, County, or any other funding 22 source and shall not use any portion of funds under this Agreement for 23 duplicative services." 24 4. That all references in Agreement to "Exhibit A" and "Revised Exhibit A-V shall be 25 changed to read "Revised Exhibit A-2". Revised Exhibit A-2 is attached hereto and incorporated 26 herein by this reference. 27 28 2 I Docusign Envelope ID: 1418D86A-2F3F-49FE-BD4B-4C7AD31A84DC 1 5. That all references in Agreement to "Exhibit B", "Revised Exhibit B", "Revised Exhibit B- 2 1", "Revised Exhibit B-2", and "Revised Exhibit B-Y shall be changed to read "Revised Exhibit 3 B-4". Revised Exhibit B-4 is attached hereto and incorporated herein by this reference. 4 6. When both parties have signed this Amendment No. 3, the Agreement, Amendment No. 5 1, Amendment No. 2, and this Amendment No. 3 together constitute the Agreement. 6 7. 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 8. 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 3 I Docusign Envelope ID: 1418D86A-2F3F-49FE-BD4B-4C7AD31A84DC 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 9. This Amendment may be signed in counterparts, each of which is an original, and all of 8 which together constitute this Amendment. 9 10. The Agreement as previously amended and amended by this Amendment No. 3 is 10 ratified and continued. All provisions of the Agreement as previously amended and not 11 amended by this Amendment No. 3 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 4 ii Docusign Envelope ID: 1418D86A-2F3F-49FE-BD4B4C7AD31A84DC 1 The parties are signing this Amendment No. 3 on the date stated in the introductory 2 clause. 3 CONTRACTOR COUNTY OFFRESNO 4 FRESNO METROPOLITAN MINISTRY DocuSigned by: 6 son, Executive Director Ernest Buddy Mend , Chairman of the 7 10/1/2025 1 10:02 AM PDT Board of Supervisors of the County of Fresno Date Attest: 8 Bernice E. Seidel Clerk of the Board of Supervisors 9 Mailing Address: County of Fresno, State of California 3845 N. Clark Steet#101 10 Fresno, CA 93726 By: � 11 Deputy 12 For accounting use only: 13 Org No.: 56201558, 56201022, 56201557, 56201621 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 ° d p M: rn ch N CD � � `� a U) c .N c C o N c to 0) co c � 0 -0 � � a) > c CU -0 0 > LL ` U O >1 int cucu U) O o O a) 0 U N U) O a � cu - Y O Q E O L m U O E N () ca • • • • • L C/) O O 0O Z) Q 0 2 cu CU d N 0-0 N d Q (6 L M E 3 cn m N o) N a _ c cn — � O a a a o °C_LLcU 0 dRU U U c � -r Z a LL LL LL L CD 3 c Z ++ "O B O O c O U Z vp � OC p o � W +_ i O a cu "2 a) O N Uo � co = oc� m � 3 Qj p N a. 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