HomeMy WebLinkAboutSTATE DPH-Maternal Child and Adolescent Health Black Infant Health and Preinatal Equity Initiative Programs_A-25-638.pdf COtj County of Fresno Hall of Records, Room 301
2281 Tulare Street
Fresno,California
601 Board of Supervisors 93721-2198
O� 1$56 O Telephone: (559)600-3529
FRV,t' Minute Order Toll Free: 1-800-742-1011
www.fresnocountyca.gov
December 9, 2025
Present: 5- Vice Chairman Garry Bredefeld, Supervisor Luis Chavez, Supervisor Nathan Magsig,
Chairman Buddy Mendes, and Supervisor Brian Pacheco
Agenda No. 71. Public Health File ID: 25-0896
Re: Approve and authorize the Chairman to execute a retroactive revenue Agreement with California
Department of Public Health for the Maternal, Child and Adolescent Health, Black Infant Health, and
Perinatal Equity Initiative programs, effective July 1, 2025 through June 30, 2026 ($5,626,016)
APPROVED AS RECOMMENDED
Ayes: 5- Bredefeld, Chavez, Magsig, Mendes, and Pacheco
Agreement No. 25-638
County of Fresno Page 77
co
Board Agenda Item 71
O 1856 O
FRE`'�
DATE: December 9, 2025
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Director, Department of Public Health
SUBJECT: Retroactive FY 2025-26 Agreement Funding Application with California Department
of Public Health
RECOMMENDED ACTION(S):
Approve and authorize the Chairman to execute a retroactive revenue Agreement with California
Department of Public Health for the Maternal, Child and Adolescent Health, Black Infant Health, and
Perinatal Equity Initiative programs, effective July 1, 2025 through June 30, 2026 ($5,626,016).
There is no additional Net County Cost associated with the recommended action. Approval of the
recommended action will provide the Department of Public Health (Department)continued funding support
from the California Department of Public Health (CDPH)for the Maternal, Child and Adolescent Health
(MCAH), Black Infant Health (BIH), and Perinatal Equity Initiative (PEI) programs. The funding will support
salary and benefits, operational, indirect, and subcontract costs to execute the required services. The MCAH
and BIH programs provide outreach, home visitation, health education and linkage to community resources
for pregnant and parenting women and their families. The PEI funding will support local perinatal equity
activities to fill gaps in current services and assist with development of a collective impact blueprint to
reduce African American infant mortality. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended action, the
Department would not be able to accept the program specific CDPH funds, resulting in a potential
cumulative loss of staff funding of 43.65 Full-Time Equivalent(FTE), which represents more than 10% of the
current staffing allocation for the Department. This would provide for a critical program service reduction
including 33.5 FTE in the MCAH program, 8.15 FTE in the BIH program, and 2 FTE in the PEI program,
serving nearly 2500 clients in FY 2024-25. The Department meets local match requirements required in the
proposed Agreement with other revenue agreements. These other revenue agreements would fall out of
compliance and negotiations would need to occur with those other funding agencies to assess if they would
be in support to provide continued funding.
This funding source from CDPH also supports subcontracted programs operated by subcontractors Central
California Faculty Medical Group, Centro La Familia, Central Valley Children Services Network, Exceptional
Parents Unlimited, and Fresno EOC, with approximately 20.58 FTE staff funded under these subcontracted
programs. These subcontracts will need to be cancelled should your Board not approve the recommended
action.
The MCAH, BIH, PEI programs are the only public health nursing programs focusing on preventing preterm
births and decreasing maternal and infant mortality rates in the community.
County of Fresno Page I File Number.25-0896
File Number:25-0896
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to July 1, 2025. The MCAH and BIH programs have been CDPH
supported programs for over three decades. The process for receiving a yearly ongoing allocation requires a
submittal of an Agreement Funding Application (AFA). The Department received the CDPH MCAH, BIH, and
PEI Fiscal Year(FY)2024-25 Agreement Funding Application (AFA) on May 25, 2025. The AFA required the
State's pre-approval of the budgeted amount and submitted documents before the item could be presented
to your Board for approval. The Department received State's pre-approval and is submitting this item in
accordance with agenda item processing timelines.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. CDPH approved a
non-competitive allocation ($5,626,016)to the County for the MCAH, BIH, and PEI programs which include
funding from:
• MCAH $3,463,202 (Federal Title XIX$3,033,604, Federal Title V$422,226, Sudden Infant Death
Syndrome$7,372)
• BIH $1,439,990 (Federal Title XIX$535,990, Federal Title V$150,627, State General Fund $753,373)
• PEI $722,824 (Federal Title XIX$127,180, State General Fund $595,644)
MCAH uses local funding ($5,449,116) including funding from various partner agencies as a local match to
draw down Federal Financial Participation (FFP)Title XIX funds which includes funding from:
• Children and Families Commission of Fresno County($1,500,000);
• Fresno County Superintendent of Schools ($300,000);
• Department of Behavioral Health ($311,527); and
• Health Realignment ($3,337,589)
The Department's indirect cost rate of 24.47%will be fully covered with the above-mentioned resources.
Sufficient appropriations and estimated revenues are included in the Department's Org 5620 FY 2025-26
Adopted Budget.
DISCUSSION:
For over three decades, CDPH funding has supported the Department's MCAH and BIH programs in
providing outreach, home visitation, health education and linkage to community resources for pregnant and
parenting women and their families. Some of these programs include Nurse-Family Partnership (NFP),
Sudden-Infant Death Syndrome/Fetal-Infant Mortality Review (FIMR), Child Care Health Linkages (CCHL),
Nurse Liaison, Public Health Nursing Program (PHNP), Comprehensive Perinatal Services Program
(CPSP), and Community Health Teams (CHT). FIMR funding was awarded to only two counties in the State
due to the County of Fresno having one of the highest rates of children in poverty and highest rates of infant
mortality. The recommended action will accept continued funding for staff salaries and benefits, operational
expenses, subcontracts, and indirect costs for the MCAH and BIH programs to continue their work towards:
• reducing infant mortality;
• improving the health and safety of children attending childcare programs;
• reducing maternal morbidity and mortality;
• supporting the physical and cognitive development of children;
• promoting exclusive breastfeeding; and
• optimizing the health and well-being of the client populations across their life span.
In FY 2024-25, these programs continued to provide a wide range of services to the community. Nurse
County of Fresno Page 2 File Number.25-0896
File Number:25-0896
Liaison provided case management services to 490 pregnant/parenting teens, high-risk children, and their
families. The NFP program served 187 pregnant and parenting women, helped 94.87% of women initiate
breastfeeding after birth, and completed 238 screenings for perinatal mood and anxiety disorders. CHT
provided intensive home visitation services using research-based models and curriculum to 244 families,
with 227 children ages 0-5. The CCHL program provided health/safety consultation and training to 579
childcare providers. The SIDS program disseminated guidelines on infant sleep and SIDS risk reduction to
96 medical providers and 207 community members through community presentations. Ongoing grief
support was provided to 16 SIDS families. The FIMR program established the Case Review Team (CRT)
consisting of community providers, advocates, physicians, and nurses from local hospitals and neonatal
intensive care units. There were 9 CRT meetings held, and 46 FIMR cases reviewed in the last fiscal year.
The BIH program served 60 women through the Group/Life Planning Model and 123 women served through
the Case Management Only Model.
The County's mortality rate for African American infants continues to be 2.5 times higher than the statewide
rates and 2.21 times higher than the national rates for other groups. While the Department's BIH program
continues to work toward reducing African American infant mortality, gaps in services still exist. CDPH
awarded funding to 11 local county health departments with BIH Programs to establish the PEI and support
implementation of perinatal health interventions to reduce the disparities in infant mortality rates and fill gaps
in current services.
The PEI funding will help continue PEI's activities and collaboration including, but not limited to:
• Community Based Organization (CBO)collaboration to implement legislated PEI interventions that
include fatherhood and doula services;
• oversee administration of the PEI to ensure program implementation, planning evaluation and fiscal
management in compliance with CDPH-MCAH Guidelines;
• partner with local community-based organizations to implement legislated PEI interventions;
• incorporate Results Based Accountability using the Clear Impact Scorecard to monitor program
performance;
• continue the support of a local Perinatal Health Equity Community Advisory Board efforts to engage
local leaders and stakeholders in discussing the needs and opportunities to reduce African American
infant mortality; and
• Public Health Awareness Campaign to inform the community about African American birth outcome
inequities and/or drivers of these inequities.
The Department requested CDPH to revise the MCAH and BIH scope of work to remove language regarding
birthing people and systemic racism and provided alternative language that maintained the intent of both of
these terms. However, CDPH denied the request and the Department was asked to add that language back
in. All other local health jurisdictions (LHJ) have adopted the CDPH required scope of work language.
The recommended action is based on the submitted Agreement Funding Application budget and scope of
work, as reviewed and approved by CDPH. The recommended agreement deviates from the County's
standard indemnification language and requires the County (or County's contractors receiving this funding)
to indemnify the State in the event of any exceptions (i.e., not following procedures or maintenance of
documents)found as a result of a federal audit, in connection with the performance of the agreement.
CDPH will issue the award letter for each program once the AFA is approved.
REFERENCE MATERIAL:
BAI #60, December 3, 2024
BAI #45, October 24, 2023
BAI #69, June 20, 2023
County of Fresno Page 3 File Number.25-0896
File Number:25-0896
BAI #33, November 8, 2022
BAI #49, November 16, 2021
BAI #36, November 2, 2021
BAI #36, November 3, 2020
BAI #48, May 26, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk- FY 2025-26 Agreement Funding Application with CDPH
CAO ANALYST:
Ron Alexander
County of Fresno Page 4 File Number:25-0896
"rkHealth and Human Services Agency ',
C D P H California Department of Public Health ' . w
°�iroaa`
Erica Pan, MD, MPH Gavin Newsom
Director and State Public Health Officer Governor
April 25, 2025
TO: MATERNAL, CHILD, AND ADOLESCENT HEALTH (MCAH) DIRECTORS,
MCAH COORDINATORS, BLACK INFANT HEALTH (BIH) COORDINATORS,
AND PERINATAL EQUITY INITIATIVE (PEI) COORDINATORS
RE: STATE FISCAL YEAR (SFY) 2025-2065 AGREEMENT FUNDING
APPLICATION (AFA) ANNOUNCEMENT
This letter announces the SFY 2025-2026 AFA process that provides allocation and
contract funding updates for the California Department of Public Health, Maternal, Child,
and Adolescent Health Division's Local MCAH, California Fetal Infant Mortality Review
Plus (CA FIMR+), BIH, and PEI programs.
SFY 2025-2026 funding for Local MCAH, CA FIMR+, BIH, and PEI programs are as
follows:
Local MCAH - Title V (TV) funding allocations will remain the same as SFY 2024-2025.
CA FIMR+ — Local Health Jurisdictions (LHJs) selected for the CA FIMR+ TV funding
will receive the same allocation amount as SFY 2024-2025. The CA FIMR+ funding is
included in the Local MCAH TV allocations for Fresno and San Bernardino counties.
Each LHJ will be required to track the FIMR funding separately in order to demonstrate
the agency's ability to perform the activities and associated costs to implement the CA
FIMR+ Scope of Work.
BIH - TV and State General Funds (SGF) allocations will remain the same as SFY
2024-2025
PEI — SGF allocations will remain the same as SFY 2024-2025.
CDPH MCAH, MS 8300 • P.O. Box 997420 • Sacramento, CA 95899-7420 • •
(916) 650-0300 • (916) 650-0305 FAX Q IPUABa-
CDPH.ca.gov „Ww .
Q°
MCAH Partners
Page 2
April 24, 2025
Title XIX (TXIX) Funding (if applicable) - There is no cap on the amount you may
request with the understanding that the agency must have the State General Funds
and/or additional agency funds to match TXIX and that their spending plan reflects the
agency's ability to spend all of the amount requested. Fi$Cal requirements impose a
March 31 st submission deadline for all budget revisions containing a change (either an
increase or decrease) in TXIX funding. This aligns with the Division's requirement to
submit all BRs by March 31st of the FY. Note: Budget revision requests will not be
accepted until after a Q2 invoice has been submitted.
AFA Timeline/Important Dates:
Release of MCAH SFY 2025-2026 AFA Notification.
Apr 25, 2025
The following AFA forms and documents are attached to this
email.
• AFA Checklist
• Agency Information Form
• MCAH Attestation of Compliance with the Sexual
Health Education Accountability Act of 2007 Form
• ICR Certification Form
• Annual Inventory Form
• Subcontract Agreement Transmittal Form
• Government Agency Taxpayer ID Form
• TXIX Attestation Form
• Scope of Work templates (MCAH/BIH/PEI)
• MCAH Director Verification form
• Example MCP Justification letter
• National Fatality Review-Case Reporting System form
• MCAH/BIH/PEI Budget Template
May 2, 2025 Last Day to Register for your AFA Development Support and
Budget Training Meeting — Optional budget meetings can be
provided for technical assistance necessary to complete local
agency budgets. Please reach out to your CL and PC via email to
request a Budget Training Meeting. If a meeting is requested,
Local MCAH/BIH/PEI Programs and Fiscal representatives with
decision making authority are required to attend. MCAH/BIH/PEI
AFA budget meetings will be offered via TEAMS. Meetings will be
scheduled on a first-come, first-served basis between May 5-16,
2025.
MCAH Partners
Page 3
April 24, 2025
May 5-16, 2025 MCAH/BIH/PEI AFA Development Support and Budget
Training Meetings Optional
May 23, 2025 AFA Packages Due Back to MCAH. If needed, please contact
your Contract Liaison (CL) for any extensions.
May 26, 2025 Start of MCAH CL/PC AFA Package Review and Approval
AFA Submission:
Packages are due via email to MCAHFinAct(a-)cdph.ca.gov by Friday, May 13,
2025. Please refer to the AFA Checklist instructions for guidance on how to submit your
AFA packet. If you have any questions about the AFA process, please contact your CL
as soon as possible.
Invoice Submission:
All invoices and supporting documentation must be submitted via email to the MCAH
invoice inbox: MCAHInvoicesCcDcdph.ca.gov. To ensure appropriate processing,
please use the following invoice naming protocol for the signed invoice PDF and Excel
files as well as the subject line of the email:
Agreement Number, Agency Name, Fiscal Year, and Invoice Quarter and Number -
Example: 202401 Alameda FY 24-25 Q1.
Invoice submission must include:
• Signed cover letter noting invoice amount, invoice period, remit to address, and
any personnel changes
• Signed invoice
• Excel version of the invoice
• Signed and completed TXIX Cover Sheet (if applicable)
• Signed and completed TXIX Attestation form (if applicable)
• TV and/or TXIX time studies (if applicable)
• Below is the Invoice Submission Timeline for your reference:
Invoice Submission Timeline Due date
Quarter 1 (July - September 30) November 15, 2025
Quarter 2 (October- December 31) February 15, 2026
Quarter 3 (January - March 31) May 15, 2026
Quarter 4 (April - June 30) August 15, 2026
Approved Supplemental Final Invoice September 30, 2026
MCAH Partners
Page 4
April 24, 2025
Thank you for your assistance and timely submission of your AFA package. If you have
any questions or concerns, please contact your Contract Liaison.
Sincerely,
Sydney Armendariz, Director
Maternal, Child and Adolescent Health Division
Center for Family Health
California Department of Public Health
MCAH Partners
Page 5
April 24, 2025
Agreement No. 25-638
California Department Of Public Health
Maternal, Child And Adolescent Health (MCAH) Division
Funding Agreement Period
FY 2025-2026
Agency Information Form
Agencies are required to submit an electronic and signed copy (original signatures only) of this form
along with their Annual AFA Package.
Agencies are required to submit updated information when updates occur during the fiscal year.
Updated submissions do not require certification signatures.
Agency Identification Information
Any program related information being sent from the CDPH MCAH Division will be directed to all
Program Directors.
Please enter the agreement or contract number for each of the applicable programs
MCAH 2O2510 B;H 2O2510 AFLP PE125-1 0
Update Effective Date (only required when submitting updates)
Federal Employer ID#:
Complete Official Agency Name: C o u my of Fresno
Business office Address.
Fulton Street, Fresno, CA 93721
Agency Phone: (559) 600-3330
Agency Fax: (559) 455-4705
Agency Website:WWW.fcd p h.o rg
Agency Remittance Address: 1221 Fulton Street, Fresno, CA 93721
Revised 3/28/25 Page 1 of 6
Confidential-Low
Agreement FundingApplication
Policy Compliance And Certification
Please enter the agreement or contract number for each of the applicable programs
MCAH 202510 BIH 2O2510 AFLP PEI 25-10
The undersigned hereby affirms that the statements contained in the Agreement Funding
Application (AFA) are true and complete to the best of the applicant's knowledge.
I certify that these Maternal, Child and Adolescent Health (MCAH) programs will comply with
all applicable provisions of Article 1, Chapter 1, Part 2, Division 106 of the Health, and Safety
code (commencing with section 123225), Chapters 7 and 8 of the Welfare and Institutions
Code (commencing with Sections 14000 and 142), and any applicable rules or regulations
promulgated by CDPH pursuant to this article and these Chapters. I further certify that all
MCAH related programs will comply with the most current MCAH Policies and Procedures
Manual, including but not limited to, Administration, Federal Financial Participation (FFP)
Section. I further certify that the MCAH related programs will comply with all federal laws and
regulations governing and regulating recipients of funds granted to states for medical
assistance pursuant to Title XIX of the Social Security Act (42 U.S.C. section 1396 et seq.)and
recipients of funds allotted to states for the Maternal and Child Health Service Block Grant
pursuant to Title V of the Social Security Act (42 U.S.C. section 701 et seq.). I further agree
that the MCAH related programs may be subject to all sanctions, or other remedies applicable,
if the MCAH related programs violate any of the above laws, regulations, and policies with
which it has certified it will comply.
Official authorized to commit the Agency to an MCAH Agreement
Name (Print) Title
Ernest Budd Mendes Chairman of the Board of Supervisors of the County
Y of Fresno
Original Signature Date
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of Califcrnia
MCAH/AFLP Director By J�WA,,&Lt.,ti Deputy
Name (Print) Title
Ge Vue MCAH Director
Original Signature Date
Revised 3/28/25 Page 2 of 6
Confidential-Low
MCAH Program
Program# Contact First Name Last Name Title Address Phone Email Address
1 AGENCY EXECUTIVE David Luchini Public Health 1221 Fulton Street (559)600-3200 dluchini@fresnocountyca.go� MCAH
DIRECTOR Director Fresno, CA 93721
2 MCAH DIRECTOR Ge Vue MCAH Director 1221 Fulton Street (559)600-6340 gevue@fresnocountyca.gov MCAH
Division Manager Fresno, CA 93721
3 MCAH COORDINATOR(Only Lillarose Bangs Supervising Public 1221 Fulton Street (559)600-7190 bangsl@fresnocountyca.gov MCAH
complete if different from#2) Health Nurse Fresno, CA 93721
4 MCAH FISCAL CONTACT Chashua Lor Senior Staff 1221 Fulton Street (559)600-6961 chlor@fresnocountyca.gov MCAH
�
I Analyst Fresno, CA 93721
' S FISCAL OFFICER Irene Parada Division Manager 1221 Fulton Street (559)600-6438 iparada@fresnocountyca.go% MCAH
Fresno, CA 93721
6 CLERK OF THE BOARD or Bernice Seidel Clerk of the Board 2281 Tulare Street, Room 301 (559)600-1601 bseidel@fresnocountyca.go% MCAH
of Supervisors Fresno, CA 93721
7 CHAIR BOARD OF Ernest Mendes Chairman of the Board 2281 Tulare Street, Room 301 (559)600-4000 district4@fresnocountyca.go� MCAH
SUPERVISORS Buddy of Supervisors of the Fresno, CA 93721
County of Fresno
8 OFFICIAL AUTHORIZED TO Ernest Mendes Chairman of the Board 2281 Tulare Street, Room 301 559)600-4000 district4@fresnocountyca.go� MCAH
COMMIT AGENCY Buddy of Supervisors of the Fresno, CA 93721
County of Fresno
9 SUDDEN INFANT DEATH Linda Hicks Public Health 1221 Fulton Street (559)600-0665 Ihicks@fresnocountyca.gov SIDS
SYNDROME (SIDS) Nurse II Fresno, CA 93721
COORDINATOR/CONTACT
10 PERINATAL SERVICES Yvonne Lopez Public Health 1221 Fulton Street (559)600-6387 yvolopez@fresnocountyca.gm CPSP
COORDINATOR Nurse II Fresno, CA 93721
Revised 3/28/2025 Page 3 of 6
Confidential-Low
BIH Program
Program# Contact First Name Last Name Title Address Phone Email Address
1 AGENCY EXECUTIVE David Luchini Public Health 1221 Fulton Street (559)600-3200 dluchini@fresnocountyca.gov BIH
DIRECTOR Director Fresno, CA 93721
2 BLACK INFANT HEALTH (BIH) Sabrina Beavers Health Educator 1221 Fulton Street (559)600-9384 sbeavers@fresnocountyca.gm BIH
COORDINATOR Fresno, CA 93721
3 BIH FISCAL CONTACT Chashua Lor Senior Staff 1221 Fulton Street (559)600-6961 chlor@fresnocountyca.gov BIH
Analyst Fresno, CA 93721
4 FISCAL OFFICER Irene Parada Division Manager 1221 Fulton Street (559)600-6438 iparada@fresnocountyca.gov BIH
Fresno, CA 93721
5 CLERK OF THE BOARD or Bernice Seidel Clerk of the Board 2281 Tulare Street, Room (559)600-1601 bseidel@fresnocountyca.gov BIH
of Supervisors 301
Fresno, CA 93721
6 CHAIR BOARD OF Ernest Mendes Chairman of the Board 2281 Tulare Street, Room 559)600-4000 district4@fresnocountyca.gov BIH
SUPERVISORS Buddy of Supervisors of the 301
County of Fresno Fresno, CA 93721
7 OFFICIAL AUTHORIZED TO Ernest Mendes Chairman of the Board 2281 Tulare Street, Room 559)600-4000 district4@fresnocountyca.gov BIH
COMMIT AGENCY Buddy of Supervisors of the 301
County of Fresno Fresno, CA 93721
Revised 3/28/2025 Page 4 of 6
Confidential-Low
PEI Program
Program# Contact First Name Last Name Title Address Phone Email Address
1 AGENCY EXECUTIVE David Luchini Public Health 1221 Fulton Street (559)600-3200 dluchini@fresnocountyca.gov PEI
DIRECTOR Director Fresno, CA 93721
2 PERINATAL EQUITY Gifty Kwofie Health Educator 1221 Fulton Street (559)600-6359 gkwofie@fresnocountyca.gov PEI
INITIATIVE (PEI) Fresno, CA 93721
COORDINATOR
3 PEI FISCAL CONTACT Chashua Lor Senior Staff 1221 Fulton Street (559)600-6961 chlor@fresnocountyca.gov PEI
Analyst Fresno, CA 93721
4 FISCAL OFFICER Irene Parada Division Manager 1221 Fulton Street (559)600-6438 iparada@fresnocountyca.gov PEI
Fresno, CA 93721
5 CLERK OF THE BOARD or Bernice Seidel Clerk of the Board 2281 Tulare Street, Room (559)600-1601 bseidel@fresnocountyca.gov PEI
of Supervisors 301
Fresno, CA 93721
6 CHAIR BOARD OF Ernest Mendes Chairman of the Board 2281 Tulare Street, Room 559)600-4000 district4@fresnocountyca.gov PEI
SUPERVISORS Buddy of Supervisors of the 301
County of Fresno Fresno, CA 93721
7 OFFICIAL AUTHORIZED TO Ernest Mendes Chairman of the Board 2281 Tulare Street, Room 559)600-4000 district4@fresnocountyca.gov PEI
COMMIT AGENCY Buddy of Supervisors of the 301
County of Fresno Fresno, CA 93721
Revised 3/28/2025 Page 5 of 6
Confidential-Low
ORIGINAL
F'ut]lic lie011h):.I I Ma0.x,ul,CniMs4 Di.-
BUDGETSUMMARY FISCAL YEAR BUDGET BUDGET STATUS BUDGET BALANCE
2025.26 ORIGINAL ACTIVE o.00
Vmm 7 0 150 O„x�nl 4 i 75
Frog'"':
Maternal Child and Adolescent Health MCAN UNMATCHED FUNDING NOW ENHANCED ENHANCED
As•nor� 202510 Fresno
MATCHING(50150) MATCHING(75125)
SubK: MCAN-W uCN1 Sins AGENCY FUNDS MCAH CnIy IIE MCAH_CMyE
111 121 PI NI 1'+1 Isl (71 Iel 191 Ito) 1111 INI 7 (15)
om na Cbmbinatl ComDinsd
TOTAL FUNDING % MCAH-TV % MCAN-SIDS % Agency Funds* X FaNStats % �O
ALLOCATION(S) - 422,226.00 7,372.00 RVALUEI
EXPENSE CATEGORY
(1)PERSONNEL 5,811,411.98 422,226.00 7,372.00 1,747,518.71 0.00 2,408,950.42 1,225,344.84
(1I)OPERATING EXPENSES 507,031.00 0.00 0.00 187,976.1E 20-00--.
319,054.84 0.D0
(111)CAPITAL EXPENDITURES 0.00 0.00 0.00 0,00 0,00 0.00
(IV)OTHERCOSTS 1,171,822.00 0.00 0.00 550.986,24 811,83176 0.00
(V)INDIRECT COSTS 1,422,052.51 0.00 0.00 532,700.87 889,351.64 0.00
BUDGET TOTALS* 8,912,317,49 474A 422,226.00 Dos: 7,372.00 3398% 3,028,183.98 booty 0.00 4745% 4,229,190.66 376% 1,225,344.84
BALANCE(S) -� 0.00 0.00
TOTAL MCAH-TV 422,226.00 a2zz26.0o
TOTAL MCAH-SIDS 7.372.00 7,37z.00
TOTAL TITLE XIX 3,033,603.96 0.00 ISDTI 2,114,595.33 179:I 919,008.63
TOTAL AGENCY FUNDS 5,449115.52 3,028,183.982,114,595,33 Rs 306,336.21
$ 3,463,201.96 Maximum Amount Payable from State and Federal resources
WE CERTIFY THAT S&IOGET NAS BEEHCONSTItUCTEDM COMPLUNCE WRH ALL MCA H ADMINISTRATIVE AND PROGRAM POLICIES.
fb r
MCAWH4 ECT DRECTCR'S SIGNATURE A. AGENCY FISCAL AGENT'S 5IGNANRE DATE
-these N,s�mUn lxYr.�sn„e sWm,ticd la,ntvauvon a„l marcl,ny PaP3es MCAll4ao wieemW,u AymcycmTlwiv,s
STATE USE ONLY-TOTAL STATE AND FEDERAL REIMBURSEMENT MCAH-TV MCAHSIDS AGENCY FUNDS MCAN.Cnty NE MCAH.CntyE
PCA Codas 53107 53112 1 5311E 1 53177
(1) PERSONNEL 422,226.00 7.372.00 0.00 1,204,475.21 919,008.63
(11) OPERATING EXPENSES 0.00 0.00 0.00 159,527.42 0.00
(III) CAPITAL EXPENSES 0.00 0.00 0.00 0,00 0.00
(IV) OTHER COSTS 0.00 0.00 0.00 305,916.88 0.00
IV) INDIRECTCOSTS 0.00 0,00 0.00 444,675.82 0.00
Tot•IS for PCA Codas 3,463,201.96 422.226,00 7,372.00 0.00 2,114,595.33 919,008.63
202510 Fresno Budget Template FIMR posl0ons.xlsx cm+m�ow5 Printed:10I62025 2:03 PM
e.
ORIGINAL
PubljC H1:pMh•t DI1 I Maternal,Chiltl antl Aadescent Health DiNsion
Program: Maternal Child and Adolescent Health MCAH UNMATCHED FUNDING NON-ENHANCED ENHANCED
Agency: �20251
0 Fresno MATCHING(50/50) MATCHING(75/25)
SU6K: MCAH-TV MCAH-SIDS AGENCVFUNDS MCAH-Cty NE MCAH-CmyE
(t) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (14) (15)
TOTAL FUNDING % I MCAH-TV % MCAH-SIDS % Agency Funds* % combined % Combined % Combined
Fed/State Fed/AneneN Fed/Aaan.,
(11) OPERATING EXPENSES DETAIL %TRAVEL 37 /H MATCH %TRg1997/ .02 MATCH PERSONNEL MATCH.76
TOTAL OPERATING EXPENSES 507,031.00 0.00 0.00 187,976.16 0.00 319,054.84 0.00
Ma able TRAVEL 9,000.00 0.00% 0.00 0.00 42.27% 3,804.30 0.00 57.73% 5,195.70 0.00 0.00%
TRAINING 8,250.00 0.00% 0.00 0.00 36.98% 3,050.85 0.00 63.02% 5,199.15 0.00 0.00%
1 Office Supplies 9,471.00 0.00% 0.00 0,00 36.98% 3,502.38 0.00 63.02% 5,968.62 0.00%
2 Postage 4,317.00 0.00% 0.00 0,00 36.98% 1,596.43 0.00 63.02% 2,720.57 0.00%
3 Printing(duplications) 2,205.00 0.00% 0.00 0,00 36.98% 815.41 0.00 63.02% 1,389.59 0.00%
4 Minor Equipment 2,500.00 0.00% 0.00 0,00 36.98% 924.50 0.00 63.02% 1,575.50 0.00%
5 Communications 190,328.00 0.00% 0.00 0,00 36.98% 70,383.29 0.00 63.02% 119,944.71 0.00%
6 Facilities Services Rent 159,409.00 0.00% 0.00 0.00 36.98% 58,949.45 0.00 63.02% 100,459.55 0.00%
7 Utilities 34,975.00 0.00% 0.00 0.00 36.98% 12,933.76 0.00 63.02% 22,041.25 0.00%
8 Securities 76,126.00 0.00% 0.00 0.00 36.98% 28,151.39 0.00 63.02% 47,974.61 0.00%
9 Local Travel(Home Visits) 10,450.00 0.00% 0.00 0.00 36,98% 3,864.41 0.00 63.02% 6,585.59 0.00%
10 0.00 0.00 0.00 0.00 0.00
"Unmatched Ooerating Exoenses are not eligible for Federal matching funds(Title XIX).Exoenses may only be charged to Unmatched Title V(Col.31.State General Funds(Col.5).and/or Agencv(Col.7)funds.
(U1) CAPITAL EXPENDITURE DETAIL
TOTAL CAPITAL EXPENDITURES 0.00 0.00 0.00 0.00 0.00
(1V) OTHER COSTS DETAIL PEas63.ONNE
02%ATCH
TOTAL OTHER COSTS 1,171,822.00 0.00 0.00 559,988.24 0.00 611,833.76 0.00
SUBCONTRACTS
1 Exceptional Parents Unlimited 275,000.00 0.00% 0.00 0.00 51,20% 140,786.29 0.00 48,80% 134,213.71 000
2 Centro La Familia Advocacy Services 261,229.00 0.00% 0.00 0.00 53,78% 140,494.88 0.00 46,22% 120,734.12 00
3 Central Valley Children's Services Network 274,448.00 0.00% 0.00 0.00 44,37% 121,772.53 0.00 55,63% 152,675.47 000
4 Fresno County Economic Opportunities Commission 275,000.00 0.00% 0.00 0.00 45,91% 126,254.13 0.00 54,09% 148,745.87 000
5 Central California Faculty Medical Group 70,000.00 0.00% 0.00 0.00 35.30% 24,710.00 0.00 64.70% 45,290.00 0 00
OTHER CHARGES mn q.anema
1 Behavior Motivational Materials 16,145.00 0.00% 0.00 0.00 36.98% 5,970.42 0.00 63.02% 10,174.58 Ma0.00%
2 0.00 0.00 0.00 0.00 0,00
(V) INDIRECT COSTS DETAIL
TOTAL INDIRECT COSTS 1,422,052.51 0.00 0.00 532,700.87 0.00 889,351.64
24.47% of Total Wages+Fringe Benefits 1,422,052.51 0.00% 1 0.00 11 10.00 1 37.46%1 532,700.87 11 10.00 1 62.54%1 889,351 464
202510 Fresno Budget Template FIMR positions.xlsx wn a of 5 pow Printed:10/6/2025 2:03 PM
ORIGINAL
PubljC HepMh•t DI1 I Maternal,Chiltl antl Aadescent Health DiNsion
Program: Maternal Child and Adolescent Health MCAH UNMATCHED FUNDING NON-ENHANCED ENHANCED
Agency: �20251
0 Fresno MATCHING(50/50) MATCHING(75/25)
SUbK: MCAH-N AGENCVFUNDS MCAH-C.ty NE MCAH-CnlyE
(2) (3) PEM�CAH-SIDS
(5) (6) (7) (8) (9) (10) It 1) (14) (15)
TOTAL FUNDING % MCAH 1 H-SIDS % Agency Funds* % comnlned Combined % Combinetl
Fed/State Fed/Anenev' Fed/Aaenev'
(1) PERSONNEL DETAIL
TOTAL PERSONNEL COSTS 5,811,411.98 422,226.00 7,372.00 1,747,518.71 0.00 2,408,950.42 1,225,344.84
FLANGE BENEFIT BATE 71.29% 2,418,625.98 175,724.38 3,068.12 727,292.12 0.00 1,002,570.48 509,970.88
TOTAL WAGES 3,392,786.00 246,501.62 4,303.88 1,020,226.59 0.00 1,406,379.95 715,373.96
�� m
FULL NAME TITLE OR CLASSIFICATION ANNUAL
(First Name Last Name) (No Acronyms) %FTE SALARY TOTAL WAGES
1 Ge Vue MCAH DimotodFIMR Director 35,00% 177,803.00 62,231.00 35.28% 21,955.10 0.00 0.00% 0.00 0.00 54,72% 34,052.80 10.00% 6,223.10 65.20% x
2 G.Vue Division Manager 10,00% 177,803.00 17,780.00 35.28% 6,272.78 0.00 0.00% 0.00 0.00 54,22% 9,640.32 10.50% 1,866.90 65.200/6 x
3 Melinda Meza Administrative Assistant 70,00% 58,226.00 40,758.00 0.00% 0.00 0.00 34,80% 14,183.78 0.00 65,20% 26,574.22 0.00 65.200/6
4 Vacant Staff Analyst 100,00% 59,452.00 59,452.00 0.00% 0.00 0.00 34.809/6 20,689.30 0.00 65,20% 38,762.70 0.00 65.20%
5 Chashua Lor Senior Staff Analyst 50,00% 95,331.00 47,666.00 0.00% 0.00 0.00 34,80% 16,587.77 0.00 65,20% 31,078.23 0.00 65.20%
6 Yvonne Lopez Public Health Nurse II-Perinatal Services Coordinator 50,00% 130,264.00 65,132.00 0.00% (0.00) 0.00 34,80% 22,665.94 0.00 45,00% 29,309.40 20.20% 13,156.66 65.20% x
7 Linda Hicks Public Health Nurse II-Sudden Infant Death Syndrome Coordinator 34.98% 132,748.46 46,438.00 0.00% 0.00 9.27% 4,303.88 90.739/6 42,134.12 0.00 0.00 0.00 65.20% x
8 Jennifer Pino-Xiang Medical Social Worker III 89.22% 97,238.18 86,761.00 0.00% 0.00 0.00 43,92% 38,105.43 0.00 56,08% 48,655.57 0.00 65.20% x
9 Bee Vang Epidemiologist 25,00% 112,534.00 28,134.00 0.00% 1 0.00 0.00 34,80% 9,790.63 0.00 65,20% 18,343.37 0.00 65.20%
10 Quentin Pammo Health Education Specialist 100.00% 64,137.00 64,137.00 0.00% 0.00 0.00 34.80% 22,319.68 0.00 65,20% 41,817.32 0.00 65.20% x
11 Socheata Meas Program Technician II 75,00% 58,088.00 43,566.00 0.00% 0.00 0.00 34.80% 15,160.97 0.00 65,20% 28,405.03 0.00 65.20%
12 Christina WynCk Program Technician ll 25,00% 62,174.00 15,544.00 0.00% 0.00 0.00 34.80% 5,409.31 0.00 65.20% 10,134.69 0.00 65.20%
13 Madeleine Yakoub Program Technician ll 25,00% 48,514.00 12,129.00 0.00% 0.00 0.00 34.80% 4,220.89 0.00 65.20% 7,908.11 0.00 65.20%
14 Linda Willome Office Assistant ll 100,00% 54,899,00 54,899.00 0.00% 0.00 0.00 34.80% 19,104.85 0.00 65.20% 35,794.15 0.00 65.20%
15 Sophia Annenta Q. Office Assistant 11 100,00% 54,899,00 54,899.00 0.00% 0.00 0.00 34,80% 19,104.85 0.00 65,20% 35,794.15 0.00 65.20%
16 Lynette Yamanaka Office Assistant ll 100,00% 54,899.00 54,899.00 0.00% 0.00 0.00 34,80% 19,104.85 0.00 65,20% 35,794.15 0.00 65.20%
17 Natalie Adolph Supervising Public Health Nume(1706) 30.00% 146,248.00 43,874.00 18.07% 7,926.03 0.00 6.25% 2,744.13 0.00 49,68% 21,796.60 26.00% 11,407.24 95,50% x
18 Natalie Adolph Supervising Public Health Nume(1615) 70.00% 146,248.00 102,374.00 8.03% 1 8,220.63 0.00 10.00% 10,237.40 0.00 45,77% 46,856.58 36.20% 37,059.39 85,30% x
19 Gabriel Velazquez Public Health Nurse 11(1615) 100.00% 119,251.00 119,251.00 0.00% 0.00 0.00 22.53% 26,867.25 0.00 23,32% 27,809.33 54.15% 64,574A2 85,30% x
20 Pauline Isguerra Public Health Nurse 1(1615) 100.00% 96,003.00 96,003.00 0.00% 0.00 22.53% 21,629.47 0.00 23,32% 22,387.90 54.15% 51,985.62 85,30% x
21 Elisabeth Tobiasen Public Health Nurse 1(1615) 100.00% 100,972.00 100,972.00 0.00% 0.00 0.00 20.47% 20,668.97 0.00 29,13% 29,413.14 50.40% 50,889.89 85,30% x
22 Chanell Gray Public Health Nurse 1(1615) 100.00% 101,935.00 101,935.00 0.00% 0.00 0.00 18.77% 19,133.20 0.00 28,05% 28,592.77 53.18% 54,209.03 85.30% x
23 Emily Baldwin Public Health Nurse 11(1677) 100.00% 110,852.00 110,852.00 0.00% 0.00 0.00 80.43% 89,158.26 0.00 16,48% 18,268.41 3,09% 3,425.33 65.20% x
24 Fred ToshimitsU Public Health Nurse II(1677) 100.00% 132,748.46 132,748.00 0.00% 0.00 81.70% 108,455.12 0.00 15,30% 20,310.44 3,00% 3,982.44 65.20% x
25 Vacant Public Health Nurse 1 100.00% 115,368.24 115,368.00 0.00% 0.00 0.00 18.17% 20,962.37 0.00 26,83% 30,953.23 55.00% 63,452.40 95.50% x
26 Angela Nevarez Public Health Nurse 1(1501) 100.00% 115,368.24 1 115,368.00 0.00% 0.00 0.00 30.00% 34,610.40 0.00 40,00% 46,147.20 30.00% 34,610.40 95.50% x
27 Pon Chin Public Health Nurse 11 55.00% 132,748.46 73,012.00 15.95%1 11,645.41 0.00 18.85% 13,762.76 0.00 30.20% 22,049.62 35.00% 25,554.20 65.20% x
28 Lillarose Bangs Supervising Public Health Nurse-MCAH Coordinator 100.00% 162,768.84 162,769.00 0.00% 0.00 0.00 22.45% 36,541.64 0.00 60.68% 98,768.23 16.87% 27,459.13 95.50% x
29 Deborah Omolayo Public Health Nurse II 100.00% 132,748.46 132,748.00 10.59% 14,058.01 0.00 24.00% 31,859.52 0.00 38.23% 50,749.56 27.18% 36,080.91 95.50% x
30 Erin An Public Health Nurse II 100.00% 126,135.00 126,135.00 11.50% 14,504.64 0.00 26.80% 33,805.06 0.00 38.67% 48,776.40 23.03% 29,048.89 95.50% x
31 Latoya Woods Public Health Nurse 11(1720) 100.00% 130,507.00 130,507.00 0.00% 0.00 0.00 24.52% 32,000.32 0.00 41.679/6 54,382.27 33.811/6 44,124.42 95.50% x
32 Brienna Harker Public Health Nurse 11(1720) 100.00% 132,748.46 132,748.00 0.00% 0.00 0.00 29.78% 39,532.35 0.00 33.86% 44,948.47 36.36% 48,267.17 94.40% x
33 Lorraine Hardy Supervising Public Health Nurse(1719) 15.00% 162,768.84 24,415.00 0.00% 0.00 0.00 10.28% 2,509.86 0.00 58.36% 14,248.59 31.36% 7,656.54 94.40% x
34 Kayla Marcinkevicz Public Health Nurse 11(1719) 100.00% 127,817.00 127,817.00 0.00% 0.00 0.00 28.62% 36,581.23 0.00 45.77% 58,501.84 25.61% 32,733.93 94.40% x
35 Jaynie Ortiz Public Health Nurse 11(1719) 100.00% 127,817.00 127,817.00 0.00% 0.00 0.00 21.55% 27,544.56 0.00 43.56% 55,677.09 34.89% 44,595.35 94.40% x
36 Lie Vangyi Public Health Nurse 11(1706) 60.00% 132,748.46 79,649.00 0.00% 1 0.00 39.74% 31,652.51 0.00 31.379/6 24,985.89 28.89% 23,010.60 65.20% x
37 Linda Hicks Public Health Nurse 11-Fetal Infant Mortality Review Coordinator 65.02% 132,748.46 86,310.00 100.00% 86,310.00 0.00 0.00 0.00 0.00 0.00 65.20% x
38 Yvonne Lopez Public Health Nurse 11-Fetal Infant Mortality Review Coordinator 25.00% 130,264.00 32,566.00 100.00% 32,566.00 0.00 0.00 0.00 0.00 0.00 65.20% x
39 Jennifer Pino-Xiang Medical Social Worker 111 10.78% 97,238.18 10,477.00 100.00% 10,477.00 0.00 0.00 0.00 0.00 0.00 65.20% x
40 Rosemarie Amaral Health Educator 100.00% 81,277.30 81,277.00 0.00% 0.00 0.00 34.80% 28,284.40 0.00 65.209/6 52,992.60 0.00 65.20% x
41 Carlos Cervantes Health Education Specialist 100.00% 64,750.00 64,750.00 0.00% 0.00 0.00 34.80% 22,533.00 0.00 65.20% 42,217.00 0.00 65.20% x
42 Nancy Garcia Health Education Specialist 100.00% 57,452.00 57,452.00 0.00% 0.00 0.00 34.80% 19,993.30 0.00 65.20% 37,458.70 0.00 65.20% x
43 Catlyn Bloomer Health Education Specialist 100.00% 57,113.00 57,113.00 0.00% 0.00 0.00 34.80% 19,875.32 0.00 65.20% 37,237.68 0.00 65.20% x
44 Jennifer Calderon Health Education Specialist 100.00% 59,488.00 59,488.00 0.00% 0.00 0.00 34.80% 20,701.82 0.00 65.20% 38,786.18 0.00 65.20% x
45 Vacant Epidemiologist 29.56% 110,188.00 32,566.00 1 100.00% 32,566.00 0.00 0.00 0.00 0.00 0.00 65.20% x
46 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
47 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
48 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
49 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
50 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
51 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
52 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
53 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
54 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
55 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
56 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
57 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
58 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
59 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
60 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
61 0.00 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00
62 0.00 0.00 0.00 11 0.00 11 0.00 1 0.00 0.00 0.00
202510 Fresno Budget Template FIMR positions.xlsx _3 of 5 Printed:10/6/2025 2:03 PM
California Department of Public Health(CDPH)
Maternal, Child and Adolescent Health (MCAH) Division
Local MCAH Scope of Work(SOW)
The Local Health Jurisdiction(LHJ), in collaboration with the CDPH/MCAH Division, shall strive to develop systems that protect and improve the health of California's women
of reproductive age, infants, children, adolescents and their families.
The development of the Local MCAH SOW was guided by several public health frameworks including the ones listed below. Please consider integrating these approaches when
conceptualizing and organizing local program, policy, and evaluation efforts.
o The Ten Essential Services of Public Health
o The Spectrum of Prevention
o Life Course Perspective and Social Determinants of Health
o Policy Systems and Environmental Change(PSE)-(TBD)
All Title V programs must comply with the MCAH Fiscal Policy and Procedures Manual and the Local MCAH Program Policies and Procedures Manual.
Certification by Name: Ge Vue
MCAH Director:
Title: MCAH Director/Division Manager
Date: 5/27/2025
1 certify that I have reviewed and approved this Scope of Work.
Note:
o The Title V Maternal and Child Health Block Grant provides core funding to California to improve the health of mothers and children. The Title V Block Grant is federally
administered by the Health Resources and Services Administration.
o CDPH/MCAH may post SOWs on the CDPH/MCAH website.
o CDPH/MCAH is available to provide technical assistance for any required activity and encourages LHJs to communicate their training needs.
Final 04/15/2025
Section A: General requirements and activities for all LHJs
Aligns With General Required Local Activities Time Frame Deliverable Description
Requirement(s)
Title V and Local MCAH Annual Al Annually, each fiscal year The Annual Report will report on progress of program activities and the extent
CDPH/MCAH Report Complete and submit an Annual to which the LHJ met the SOW goals and deliverables and how funds were
Requirement Report each fiscal year to report on expended.
Scope of Work activities
In addition to reporting on the status of activities in each population domain,
the LHJ shall report on the following counts of individuals served:
• the number of Pregnant Individuals served in the Fiscal Year
• the number of Infants(less than 1 year of age)served in the Fiscal Year
• Of the Infants(less than 1 year of age)in the above number,how many
are Children and Youth with Special Healthcare Needs(CYSHCN)
• the number of individuals Aaes 1-21 served in the Fiscal Year
• Of the individuals Ages 1-21 in the above number,how many are CYSHCN
• the number of Other*individuals served in the Fiscal Year
*Other: Individuals that cannot be grouped into Pregnant, Infants, or Ages 1-21;
Men and women 22 and over; any individuals with unspecified demographic
information. Families with unspecified family members may be included in this
category: count the family as one(1).(We acknowledge the undercounting but are
following the"verifiable data source"guideline.)
Guidance for Counting Individuals served are included as part of the Local
Annual Report Instruction Manual and is sent out from CDPH/MCAH with the
Local Annual Report request.
CDPH/MCAH Workforce A2 Annually, each fiscal year Report attendance in Annual Report:
Requirement Development and Attend required trainings/meetings as • MCAH Directors'Spring and Fall meetings
Training outlined in the MCAH Program Policies • SIDS Coordinators'Annual meeting
and Procedures.
• The MCAH Director or
designee is required to attend
the spring and fall MCAH
Action meetings
Final 04/15/2025
• SIDS Coordinators are required
to attend the SIDS Annual
Conference, SIDS Advisory
Council meetings
CDPH/MCAH MCAH Director A3 Ongoing The LHJ must submit a Local MCAH Director Verification form annually during
Requirement Maintain required MCAH Director the AFA process and resubmit with any changes.
position as outlined in the MCAH
Policies and Procedures.
CDPH/MCAH Community A4 By end of 2025 Report in Annual Report:
Requirement Resource and Develop a comprehensive MCAH • Submit/upload a copy or link to the existing resource and referral guide
Referral Guide resource and referral guide of • Report on how you have aligned your resource guide with the
available health, mental health, recommendations of the workgroup, when available.
emergency resources, and social
services.
QI Opportunity!
Partner(participate in short-term
workgroup, or respond to a survey, or
discuss among other MCAH Directors
at MCAH Directors call)with
CDPH/MCAH and a workgroup of LHJs
to develop a shared approach to an
up-to-date and accessible local
resource guide that supports all five
MCAH population domains, in
collaboration with strategic partners
and existing systems, such as United
Way/211.
CDPH/MCAH Protocols A5 Annually, each fiscal year Report on linkage/referral protocols for each of the five population domains
Requirement Develop and adopt protocols to ensure and opportunities for further improvement in the Annual Report.
that MCAH clients are provided
information and referred to health
insurance coverage options, including
how to access a provider and
preventive health visits.
Final 04/15/2025
Title V Conduct Local A6 Approximately every three Report on Local Needs Assessment findings as directed by CDPH/MCAH.
Requirement Needs Assessment Conduct or leverage existing local to five years
needs assessment(s)to acquire an
accurate picture of the strengths,
weaknesses and needs across the
MCAH population health domains.
Section B: Domain specific requirements and activities
Aligns With General Required Local Activities Time Frame Deliverable Description
Re uirement(s)
CDPH/MCAH Infant- B1 Annually, each fiscal year Report on SIDS/SUID services and supports in the Annual Report.
Requirement Sudden Infant Required for Infant Domain-all LHJs
Death Provide SIDS/SUID grief and
Syndrome/Sudden bereavement services and supports
Unexpected Infant through home visits and/or mail
Death(SIDS/SUID) resource packets to families
experiencing an infant loss.
CDPH/MCAH Infant- B1.a. As needed Submit form in the event of a sudden, unexpected infant death.
Requirement Sudden Infant Submit Public Health Services Report
Death Form of a sudden, unexpected infant
Syndrome/Sudden death to the CDPH/MCAH.
Unexpected Infant
Death(SIDS/SUID)
CDPH/MCAH Infant- B2 Annually, each fiscal year Report on safe sleep activities in the Annual Report.
Requirement Safe Sleep Required for Infant Domain-all LHJs
Promote the latest AAP Safe Sleep
guidance and implement Infant Safe
Sleep Interventions to reduce the
number of SUID related deaths.
CDPH/MCAH Child Health- B3 New! Replaced B3 and B4 Annually, each fiscal year Report on school-linked/school-based collaboration activities in the Annual
Requirement Schools Required for Child Domain-all LHJs Report.
Collaboration Explore opportunities to partner with
local education agencies/school
districts/schools(preschool through
12th grade and alternative education
Final 04/15/2025
settings)to collaborate on school-
linked/school-based health promotion
and services and safe and supportive
school climates.
CDPH/MCAH Children and Youth B4 New! Replaced B5 and B6 Annually, each fiscal year Report on referral pathways and service coordination for CYSHCN in the Annual
Requirement with Special Required for CYSHCN Domain-all Report.
Health Care needs LHJs
(CYSHCN) Strengthen referral pathways and
service coordination strategies to
connect CYSHCN and their families to
safety net and/or social supports,
medical service providers, public
health programs and Family Resource
Centers, as appropriate.
CDPH/MCAH Infant- B5 Annually, each fiscal year Report on activities in the Annual Report.
Requirement Infant Mortality Required for CA FIMR+funded LHJs
Reviews only
LHJs funded for infant mortality
reviews will implement activities in
accordance with Local MCAH Program
Policies and Procedures.
Final 04/15/2025
Section C: Local Activities by Domain
At least one activity must be selected or the LHJ must develop at least one activity of their own in the Women/Maternal Health Domain
� .
Women/Maternal Priority Need: Advance Black birth equity by supporting women and birthing people to thrive through pregnancy and the postpartum period.
Performance Measures NPM: Postpartum Visit:
(National/State Performance Measures) A)Percent of women who attended a postpartum checkup within 12 weeks after giving birth,and
B)Percent of women who attended a postpartum checkup and received recommended care components
Women/Maternal State Objective 1:
By 2030, reduce the rate of pregnancy-related cardiovascular deaths from 3.3 per 100,000 live births(2019-2021 CA-PMSS)to 3.0 per 100,000 live births.
Women/Maternal State Objective 2:
By 2030, reduce the rate of pregnancy-related deaths among Black birthing people from 49.7 per 100,000 live births(2019-2021 CA-PMSS)to 42.3 per 100,000 live births.
Women/Maternal Focus Area 1: Access o Ouality Care& Services
Women/Maternal Access to Quality Care&Services: Women/Maternal Access to Ouality Care&Services: Women/Maternal Access to Ouality Care&Services:
Strategy 1: Strategy 2: Strategy 3:
Improve systems of risk-appropriate maternity care including Increase the proportion of facilities that evaluate the quality of Increase maternal mortality/morbidity prevention by
(childbirth)regionalization and prenatal/postpartum access their care using both patient experience and clinical measures disseminating California Pregnancy Associated Review
Committee(CA-PARC)recommendations and engaging
potential implementation partners
Local Activities for Women/Maternal Objective: Strategy 1 Local Activities for Women/Maternal Objective: Strategy 2 Local Activities for Women/Maternal Objective: Strategy 3
w 1.1.1 w 1.2.1 w 1.3.1
❑ Suggested local activity(Optional): ❑ Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Partner with RPPC and CDPH/MCAH to identify and share local Promote policies, procedures, and practices that align with Use the CDPH/MCAH CA-PARC data-findings and
funding barriers and care delivery policies that impede those recommended by Black Birth Equity experts to help recommendations to inform policy and prevention strategies
regionalization and perinatal access to care. perinatal facilities and clinics to combat anti-Black racism and to reduce pregnancy related morbidity and mortality at the
mitigate biased treatment of people with historically local level.
marginalized identities.
What is your anticipated outcome?
Final 04/15/2025
What is your anticipated outcome?
What is your anticipated outcome?
w 1.1.2 w 1.2.2 w 1.3.2
❑ Other local activity(Please Specify/Optional): ❑ Other local activity(Please Specify/Optional): ❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome? What is your anticipated outcome? What is your anticipated outcome?
IWREW I qIr
Women/Maternal Focus Area 2: Mental Health& Substance Use
11L it i
Women/Maternal Mental Health&Substance Use: Strategy 1: Women/Maternal Mental Health&Substance Use: Strategy 2:
Implement policy, systems, and environmental change(PSE)activities to improve Improve primary prevention, early intervention and social supports across the perinatal period
mental/behavioral health, including in the postpartum period to improve mental/behavioral health
Local Activities for Women/Maternal Objective: Strategy 1 Local Activities for Women/Maternal Objective: Strategy 2
w 2.1.1 w 2.2.1
❑ Suggested local activity(Optional): 0 Suggested local activity(Optional):
Develop and implement PSE approaches to improve mental/behavioral health during pregnancy Implement postpartum mental health screenings for birthing parent and infant at well child
or postpartum. check-ups.
What is your anticipated outcome? What is your anticipated outcome?
• 90% of women in case management services will be screened for perinatal mood and
anxiety disorders utilizing PHQ-9 screening tool.
• 90% of infants will be screened utilizing the ASQ-SE.
Final 04/15/2025
w 2.1.2 w 2.2.2
❑ Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Develop"Success Story'on PSE strategy/intervention used for mental wellness. Develop"Success Story'on primary prevention used for mental wellness.
What is your anticipated outcome? What is your anticipated outcome?
w 2.1.3 w 2.2.3
❑ Other local activity(Optional): ❑ Suggested local activity(Please Specify/Optional):
Participate in CDPH/MCAH FLOURISH Training, Individualized TA or Learning Cohort
What is your anticipated outcome?
What is your anticipated outcome?
SupportsWomen/Maternal Focus Area 3: Social Determinants&Family
Women/Maternal Social Determinants&Family Supports: Strategy 1: Women/Maternal Social Determinants&Family Supports: Strategy 2:
Promote culturally appropriate care and expand perinatal care teams(e.g., doulas, midwives)to Partner to improve neighborhood conditions, quality education, economic opportunities and
include culturally congruent staff, including during the postpartum period social supports
Local Activities for Women/Maternal Objective: Strategy 1: Local Activities for Women/Maternal Objective: Strategy 2:
w 3.1.1 w 3.2.1
x❑ Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Provide education to birthing persons and their families about how to access quality care and Collaborate with strategic partners to identify best practices for Local MCAH programs to
care options. improve social determinants of health(e.g., neighborhood conditions, quality education,
economic opportunities and social supports); share best practices with CDPH/MCAH.
What is your anticipated outcome?
• Partner with Perinatal Equity Initiative(PEI)program to train 10 Doula providers in the What is your anticipated outcome?
community.
Final 04/15/2025
w 3.1.2 w 3.2.2
❑ Suggested local activity(Optional): ❑ Other local activity(Please Specify/Optional):
Partner to develop culturally and linguistically appropriate trainings and consumer education
materials and supporting tools that promote breastfeeding or birth options for specific local
populations(e.g. Mixteca). What is your anticipated outcome?
What is your anticipated outcome?
w 3.1.3
❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome?
Women/Maternal Focus Area 4: Physical Health& Prevention
Women/Maternal Physical Health&Prevention: Strategy 1: Women/Maternal Physical Health&Prevention: Strategy 2:
Promote Policy, Systems, and Environmental(PSE)strategies for leading causes of morbidity Partner on maternal anemia prevention across the perinatal period through PSE strategies
before, during and after pregnancy
Local Activities for Women/Maternal Objective: Strategy 1: Local Activities for Women/Maternal Objective: Strategy 2:
w 4.1.1 w 4.2.1
0 Suggested local activity(Optional): ❑ Other local activity(Please Specify/Optional):
Identify and implement PSE strategies that address leading causes of morbidity, including
cardiovascular disease and gestational diabetes(GDM), before, during, and after pregnancy. What is your anticipated outcome?
Final 04/15/2025
What is your anticipated outcome?
• Partner with local hospitals and providers to raise awareness of cardiovascular disease.
• Conduct two roundtables for community partners, providers, and home visiting staff to
increase knowledge of preeclampsia and use of low dose aspirin during pregnancy.
• Participate in monthly Maternal and Preventive Care Committee meetings focused on
reducing maternal morbidity and mortality rates.
w 4.1.2 w 4.2.2
❑ Suggested local activity(Optional): ❑ Other local activity(Please Specify/Optional):
Participate in a CD PH/MCAH cohort project(to receive training, technical assistance and
evaluation support)on PS strategies focused on GDM.
What is your anticipated outcome?
What is your anticipated outcome?
w 4.1.3
❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome?
Final 04/15/2025
Section C: Local Activities by Domain
At least one activity must be selected or the LHJ must develop at least one activity of their own in the Perinatal/Infant Health Domain
Perinatal/Infant Health Domain
Perinatal/Infant Priority Need: Advance Black birth equity and support birthing people and families to have thriving infants.
Performance Measures NPM: Percent of women with a recent live birth who experienced racial/ethnic discrimination while getting healthcare during pregnancy, delivery or
(National/State Performance Measures) postpartum care.
Perinatal/Infant State Objective:
By 2030, reduce the rate of Black infant deaths from 8.81 per 1,000 live births(2023 CCMBF/CCMDF)to 8.37.
Perinatal/Infant Focus Area 1: Access to Ouality Care&Services
Perinatal/Infant Access to Ouality Care&Services: Strategy 1:
Translate Fetal Infant Mortality Review(FIMR)learnings and recommendations into action, including recommendations on the care experience.
Local Activities for Perinatal/Infant Objective: Strategy 1
p 1.1.1
X Suggested local activity(Optional):
Participate in collecting infant mortality FIMR data using the National Fatal Review-Case Reporting System.
What is your anticipated outcome?
• 20% of all infant deaths will be reviewed for FIMR and entered into the NFRCRS.
p 1.1.2
0 Suggested local activity(Optional):
Conduct and collect interview of families experiencing a stillbirth or infant loss.
Final 04/15/2025
What is your anticipated outcome?
• 33% of FIMR cases reviewed will have a maternal interview conducted and collected.
p
❑ Suggested local activity(Optional):
Develop"Success Story'on prevention efforts based on FIMR recommendations.
What is your anticipated outcome?
p 1.1.4
❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome?
Perinatal/Infant Social Determinants& Family Supports: Strategy 1. Perinatal/Infant Social Determinants& Family Supports: Strategy 2:
Partner to increase economic and social supports(e.g.,transportation, childcare, parenting Promote culturally-responsive grief and bereavement and support services.
resources)to families.
Local Activities for Perinatal/Infant Objective: Strategy 1 Local Activities for Perinatal/Infant Objective: Strategy 2
p 3.1.1 p 3.2.1
M Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Identify opportunities to involve and integrate fathers into MCAH programs. Partner with CDPH/MCAH to develop and disseminate resources on navigating the legal aspects
of infant or maternal loss(e.g. death certificates, adding unmarried spouse to birth certificate,
etc.)
Final 04/15/2025
What is your anticipated outcome?
• Collaborate to train staff and community partners to implement Boot Camp for New
Dads Program. What is your anticipated outcome?
• Conduct 4 Boot Camps for New Dads workshops.
p 3.1.2 p 3.2.2
❑ Suggested local activity(Optional): ❑ Other local activity(Please Specify/Optional):
Partner with CDPH/MCAH to identify best practice strategies for MCAH programs to provide
families with economic and social supports.
What is your anticipated outcome?
What is your anticipated outcome?
p 3.1.3
❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome?
Final 04/15/2025
Perinatal Focus Area 4: Physical Health& Prevention
Perinatal/Infant Physical Health&Prevention: Strategy 1: Perinatal/Infant Physical Health&Prevention: Strategy 2:
Partner on maternal anemia prevention through policy, systems and environmental change Promote breastfeeding initiation and duration through PSE and workforce strategies, including
(PSE)strategies to improve perinatal and infant outcomes considerations of the care experience
Local Activities for Perinatal/Infant Objective: Strategy 1 Local Activities for Perinatal/Infant Objective: Strategy 2
p 4.1.1 p 4.2.1
❑ Other local activity(Please Specify/Optional): 0 Suggested local activity(Optional):
Promote training, tools, policies and best practices, including workforce strategies, that
support breastfeeding initiation and duration to families who choose to breastfeed.
What is your anticipated outcome?
What is your anticipated outcome?
• All home visiting staff will become certified Lactation Counselors to enhance their
ability to support breastfeeding families.
• Staff will participate in 2 breast feeding events
p 4.2.2
❑ Suggested local activity(Optional):
Identify resources and training opportunities for organizations, hospitals, birthing centers to
support families who choose to breastfeed.
What is your anticipated outcome?
Final 04/15/2025
p 4.2.3
❑ Suggested local activity(Optional):
Develop"Success Story'on PS strategy/intervention used for breastfeeding promotion.
What is your anticipated outcome?
p 4.2.4
❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome?
Perinatall/Infant Focus Area 5: Injury Prevention&Saf e Environments
Perinatal/Infant Injury Prevention&Safe Environments: Strategy 1:
Identify new partnerships to improve SIDS/SUID prevention
Local Activities for Perinatal/Infant Objective: Strategy 1
p 5.1.1
M Suggested local activity(Optional):
Develop population-specific recommendations for safe sleep practices based on FIMR data.
What is your anticipated outcome?
• Provide safe sleep information to at least 1000 participants/community members utilizing various outreach methods(presentations, social media platforms, roundtables, and outreach
events)
• Provide targeted and modified Safe Sleep education based on community cultural practices obtained from FIMR data, Safe Sleep Survey, and Pre and Post Safe Sleep Presentation tests.
Final 04/15/2025
p 5.1.2
❑ Suggested local activity(Optional):
Partner with local institutional organizations such as Nursing schools, Residency Programs, and other medical professions groups on Safe Sleep Education.
What is your anticipated outcome?
p 5.1.3
M Other local activity(Please Specify/Optional):
• Maintain partnership with Cribs for Kids to provide cribettes and safe sleep teaching as needed to clients in the MCAH Home Visiting Programs.
• Partner with CVSSC/other area SIDS Coordinators to develop, print, and disseminate updated Safe Sleep Educator Flipbooks to MCAH home visitors and local CBOs
• Partner with Central Valley Safe Kids and local High School Audio/Visual Career Technology Education Program to develop short Safe Sleep social media videos appealing to teens and
young adults
What is your anticipated outcome?
• Provide 100 cribettes to home visiting families, including health education, proper setup and take down, and three-month follow-up.
• Collaborate with Central Valley Safe Sleep Coalition to print and distribute 100 Safe Sleep Educator flip books to home visiting staff and contracted CBOs.
• Collaborate with Central Valley Safe Kids, Healthy Fresno social media outlets, and local CTE school programs to develop culturally relevant safe sleep social media videos.
Final 04/15/2025
Section C: Local Activities by Domain
At least one activity must be selected or the LHJ must develop at least one activity of their own in the Child Health Domain
Child Health Domain
Child Priority Need: Improve the physical and mental health and development of all children so they flourish and thrive.
Performance Measures NPM: Medical Home-Overall*:
(National/State Performance Measures) Percent of children with and without special health care needs, ages 0 through 17, who have a medical home
Child State Objective: NSCH 4.12 Medical Home
By 2030, increase the percent of children in CA who have received care within a medical home from 39.3%(NSCH 2022-2023)to 41%.
Child Focus Area 1: Access Ouality Care& Services
Child Access to Quality Care&Services: Strategy 1: Child Access to Quality Care&Services: Strategy 2:
Promote the pediatric medical home through school-linked and school-based health Promote linkage and referrals to care and support services, especially those that target social
prevention, education and services. determinants of health
Local Activities for Child Objective: Strategy 1 Local Activities for Child Objective: Strategy 2
ch 1.1.1 ch 1.2.1
❑ Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Partner with local provider groups, MCPs and organizations to increase understanding, build Work with state and local partners to promote and disseminate information to families around
capacity, and promote the seven American Academy of Pediatrics components of a medical social supports and economic family supports, especially those that target social drivers of
home. health, including housing, childcare, and nutrition.
What is your anticipated outcome?
What is your anticipated outcome?
ch 1.1.2 ch 1.2.2
❑ Other local activity(Please Specify/Optional): ❑ Other local activity(Please Specify/Optional):
Final 04/15/2025
What is your anticipated outcome? What is your anticipated outcome?
Child Focus Area 2: Mental Health&Substance Use
Child Mental Health&Substance Use: Strategy 1: Child Mental Health&Substance Use: Strategy 2:
Promote social connectedness Collaborate to improve education and awareness of, and access to mental and behavioral
health care
Local Activities for Child Objective: Strategy 1 Local Activities for Child Objective: Strategy 2
ch 2.1.1 ch 2.2.1
❑ Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Identify and lead/participate in a policy, systems and environmental change(PSE)activity or Connect with local education agencies to assist with/establish referral networks through the
primary prevention activity, in collaboration with local early childhood, parenting groups, and/or California Youth Behavioral Health Initiative School-Linked Multi-payer Fee Schedule for mental
community-based organizations, centering social connectedness for children and their and behavioral health services.
families, promoting positive parent-child relationships, connection, family wellness and
resilience, and uplifting Positive Childhood Experiences and create a success story to share.
What is your anticipated outcome?
What is your anticipated outcome?
ch 2.1.2 ch 2.2.2
❑ Suggested local activity(Optional): 0 Suggested local activity(Optional):
Partner with community organizations to promote free play for children, access to green Increase LHJ capacity and understanding of trauma-responsive/ trauma-informed care and
spaces, and safe/accessible community gathering places. primary prevention of mental and behavioral health for children and families.
What is your anticipated outcome? What is your anticipated outcome?
Final 04/15/2025
• Complete three trauma-informed care training sessions for home visiting staff and
partners to enhance their understanding and application of trauma-responsive
approaches when working with children and families.
ch 2.1.3 ch 2.2.3
❑ Other local activity(Please Specify/Optional): ❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome? What is your anticipated outcome?
Child Focus Area 4: Physical Health& Prevention
Child Physical Health&Prevention: Child Physical Health&Prevention: Child Physical Health&Prevention: Strategy Child Physical Health&Prevention: Strategy
Strategy 1: Strategy 2: 3: 4:
Increase child preventive health rates Promote early childhood prevention, Optimize nutrition and physical activity for Identify and work to reduce child health
screening and intervention children disparities
Local Activities for Child Objective: Local Activities for Child Objective: Local Activities for Child Objective: Local Activities for Child Objective:
Strategy 1 Strategy 2 Strategy 3 Strategy 4
ch4.1.1 ch4.2.1 ch4.3.1 ch4.4.1
❑ Suggested local activity(Optional): M Suggested local activity(Optional): ❑ Suggested local activity(Optional): ❑ Other local activity(Please
Lead and/or partner to participate in local Partner with local First 5, Help Me Grow, home Partner with schools, local WIC agencies, Early Specify/Optional):
activities promoting pediatric preventive visiting and other early intervention programs Childcare Education programs, and other
health visits, screening, assessments and to increase access to and promote universal organizations(such as SunBucks and The
routine pediatric vaccinations, especially infant and child developmental screening Governor's Council on Physical Fitness)to What is your anticipated outcome?
activities that are school-linked/school based based on AAP Bright Futures guidelines and improve food security and promote healthy
and/or community-based. closed-loop early intervention referrals. nutrition and physical activity choices for
children and families, including the Child
What is your anticipated outcome? What is your anticipated outcome? MyPlate nutrition guidelines.
• 90% of children enrolled in home
visitation programs will be screened What is your anticipated outcome?
Final 04/15/2025
utilizing ASQ and linked to early
intervention services.
ch 4.1.2 ch 4.2.2 ch 4.3.2
❑ Suggested local activity(Optional): ❑ Other local activity(Please ❑ Other local activity(Please
Partner with local oral health programs, CDPH Specify/Optional): Specify/Optional):
Office of Oral Health, and CDPH Office of
School Health to promote children's oral
health screening, preventive visits and closed- What is your anticipated outcome? What is your anticipated outcome?
loop referrals, especially those that are
school-linked/school-based.
What is your anticipated outcome?
ch 4.1.3
❑ Other local activity(Please
Specify/Optional):
What is your anticipated outcome?
Child Focus Area 5: Injury Prevention&Safe Environments
Child Injury Prevention&Safe Environments: Strategy 1. Child Injury Prevention&Safe Environments: Strategy 2:
Promote safe environments and communities and prevent unintentional injury for children and Uplift prevention efforts to reduce child abuse and neglect
families
Local Activities for Child Objective: Strategy 1 Local Activities for Child Objective: Strategy 2
ch 5.1.1 ch 5.2.1
❑ Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Final 04/15/2025
Create/participate in and disseminate a child injury prevention campaign locally,targeting child Partner with local All Children Thrive project and network(s)to improve community-led efforts
passenger safety, infant/toddler car seat safety, teen driving safety, bike helmet use, water to create changes within systems and structures to reduce ACEs, child abuse and neglect and
safety, or other areas of child injury prevention important to the local MCAH population. promote positive childhood experiences.
What is your anticipated outcome? What is your anticipated outcome?
ch 5.1.2 ch 5.2.2
❑ Other local activity(Please Specify/Optional): ❑ Suggested local activity(Optional):
Partner with local child welfare efforts to develop County Comprehensive Prevention Plans to
determine local primary, secondary, and tertiary prevention strategies that can reduce the
What is your anticipated outcome? incidence of children and youth engaging with the child welfare system.
What is your anticipated outcome?
ch 5.2.3
❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome?
Final 04/15/2025
Section • - by Domain
At least one activity must be selected or the LHJ must develop at least one activity of their own in the CYSHCN Health Domain
Children • Youth with Special • Domain
CYSHCN Priority Need: Improve access to supports and services.
NPM: Medical Home-Care Coordination:
Percent of children with and without special health care needs, ages 0 through 17,who receive needed care coordination
Performance Measures
(National/State Performance Measures) NPM: Transition:
Percent of adolescents with and without special health care needs, ages 12 through 17, who received services to prepare for the transition to adult
health care.
CYSHCN State Objective 1:
By 2030, increase the percentage of children with special health care needs, ages 0 through 17, who receive needed care coordination from 47.7%(NSCH 2O21-2023)to 50%.
CYSHCN State Objective 2:
By 2030, increase the percentage of adolescents with special health care needs, ages 12 through 17, who received services to prepare for the transition to adult health care from 17%(NSCH 2O21-
2023)to 18%.
CYSHCN Focus Area 1: Access Ouallity Care& Services
CYSHCN Access to Quality Care&Services Objective 1: Strategy 1: CYSHCN Access to Quality Care&Services Objective 1: Strategy 2:
Partner to improve access to quality, coordinated care and support services for CYSHCN and Fund the Department of Health Care Services(DHCS)to provide necessary care coordination
their families. and case management for California Children's Services(CCS)program clients and improve
systems to assist CYSHCN families in navigating services.
Local Activities for CYSHCN Objective 1: Strategy 1: Local Activities for CYSHCN Objective 1: Strategy 2:
cy 1.1.1 cy 1.2.1
0 Suggested local activity(Optional): ❑ Other local activity(Please Specify/Optional):
Partner with your county CCS program AND/OR an organization that provides care coordination
for CYSHCN and their families(i.e. community-based organizations, home visiting(CHVP),
schools/universities, Regional Centers, other state/local governmental agencies/departments)
to improve care coordination and communication between provider types for CYSHCN. What is your anticipated outcome?
Final 04/15/2025
What is your anticipated outcome?
• 90% of all shared clients between MCAH home visiting programs and CCS will receive a
case consult between assigned home visiting staff and CCS case manager.
cy 1.1.2
❑ Suggested local activity(Optional):
Create/join a local learning collaborative or workgroup focused on the transition to adult health
care and supports and services for youth with special health care needs.
What is your anticipated outcome?
cy 1.1.3
❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome?
CYSHCN Focus Area 2: Mental Health&Substance Use
CYSHCN Mental Health&Substance Use State Objective 2: Strategy 1: CYSHCN Mental Health&Substance Use State Objective 2: Strategy 2:
Partner to develop programs and resources to enhance resilience and mental wellness support Support local health jurisdictions(LHJs)to build workforce capacity in serving CYSHCN and
for CYSHCN and their families. their families.
Local Activities for CYSHCN Objective 2: Strategy 1: Local Activities for CYSHCN Objective 2: Strategy 2:
cy 2.1.1 cy 2.2.1
0 Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Implement a project focused on mental health for parents/caregivers of CYSHCN(examples: Participate in a workgroup or training covering primary prevention or Policy, Systems, or
connecting families in the NICU to home visiting, provider outreach to integrate parental Environmental change(PSE)strategies/interventions to enhance resilience and mental
Final 04/15/2025
mental health screening into pediatric visits, partner with family-serving organization(s)and/or wellness for CYSHCN families and develop a success story to share out best practices with
community members to develop a CYSHCN-focused/awareness building social media other local MCAH Directors.
campaign, training program, or peer support network).
What is your anticipated outcome?
What is your anticipated outcome?
• 80% of eligible NICU families from Community Regional Medical Center and Valley
Children's Hospital as identified by PHN NICU Liaison will be connected to MCAH Home
Visitation services by discharge.
cy 2.1.2 cy 2.2.2
❑ Other local activity(Please Specify/Optional): ❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome? What is your anticipated outcome?
SupportsCYSHCN Focus Area 3: Social Determinants& Family
CYSHCN Social Determinants&Family Supports Objective 2: Strategy 1: CYSHCN Social Determinants& Family Supports Objective 2: Strategy 2:
Partner with diverse organizations to build workforce capacity to serve CYSHCN and their Lead development of informational platforms and tools for CYSHCN and their families
families.
Local Activities for CYSHCN Objective 2: Strategy 1: Local Activities for CYSHCN Objective 2: Strategy 2:
cy 3.1.1 cy 3.2.1
❑ Suggested local activity(Optional): ❑ Other local activity(Please Specify/Optional):
Implement a project focused on social and community inclusion for CYSHCN and their families
(examples: partner with Parks and Recreation departments to make public spaces and events
more inclusive; partner with community organizations or government agencies to improve What is your anticipated outcome?
emergency preparedness and disaster relief support for CYSHCN and their families).
What is your anticipated outcome?
Final 04/15/2025
cy 3.1.2
❑ Suggested local activity(Optional):
Partner with youth-facing programs and organizations(examples: youth community groups,
service clubs, and youth serving non-profits)to include CYSHCN populations, considerations,
and voices in programming, resource development, and event planning.
What is your anticipated outcome?
cy 3.1.3
❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome?
Final 04/15/2025
Section C: Local Activities by Domain
At least one activity must be selected or the LHJ must develop at least one activity of their own in the Adolescent Health Domain
Adolescent Domain
Adolescent Priority Need: Enhance strengths, skills, and access to equitable supports, ensuring all youth thrive.
Performance Measures NPM: Adolescent Well-Visit:
(National/State Performance Measures) Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year
Adolescent State Objective:
By 2030, increase the percentage of adolescents,ages 12 through 17, with a preventive medical visit in the past year from 62.9% to 66%.
Adolescent Focus Area 1: Access to Ouality Care&Services
Adolescent Access to Quality Care&Services: Strategy 1: Adolescent Access to Quality Care&Services:Strategy 2:
Improve awareness of and access to quality youth-friendly care Support youth in valuing and prioritizing preventive care
Local Activities for Adolescent Objective: Strategy 1: Local Activities for Adolescent Objective: Strategy 2:
a 1.1.1 a 1.2.1
❑ Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Promote and/or collaborate with school-linked/school-based services and school-based health Disseminate information to youth and youth-serving partners about what happens during a
centers to increase youth linkage to and engagement in health services. preventive care visit and the benefits of attending recommended preventive care
appointments(youth voice is encouraged in this work).
What is your anticipated outcome?
What is your anticipated outcome?
a 1.1.2 a 1.2.2
❑ Suggested local activity(Optional) ❑ Other local activity(Please Specify/Optional):
Final 04/15/2025
Disseminate information to youth and youth-serving partners about insurance coverage, minor
consent, and confidentiality for primary and behavioral health care services.
What is your anticipated outcome?
What is your anticipated outcome?
a 1.1.2
❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome?
Adolescent Focus Area 2: Mental Health&Substance Use
Adolescent Mental Health&Substance Use: Strategy 1: Adolescent Mental Health&Substance Use: Strategy 2:
Promote primary prevention and early intervention best practices for behavioral health Enhance resilience and coping skills
Local Activities for Adolescent Objective: Strategy 1: Local Activities for Adolescent Objective: Strategy 2:
a 2.1.1 a 2.2.1
❑ Suggested local activity(Optional): 0 Suggested local activity(Optional):
Partner to disseminate training opportunities and resources for youth and those that work with Promote resources and supports for youth around healthy relationships with self and others
youth related to adolescent mental health and well-being, substance use disorder (family, peer, romantic and sexual partners).
education/prevention/intervention, and harm-reduction strategies.
What is your anticipated outcome?
What is your anticipated outcome? Increase awareness of healthy relationship practices and sexual health resources
among Fresno County college students by sharing educational materials quarterly
through campus newsletters, bathroom stall information, and social media campaigns.
a 2.1.2 a 2.2.2
Final 04/15/2025
❑ Other local activity(Please Specify/Optional): ❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome? What is your anticipated outcome?
Adolescent Focus Area 4: Physical Health& Prevention
Adolescent Physical Health&Prevention: Strategy 1: Adolescent Physical Health& Prevention: Strategy 2:
Promote youth-friendly sexual and reproductive health services, information, and education Enhance skills for independent living and transition to adulthood
Local Activities for Adolescent Objective: Strategy 1: Local Activities for Adolescent Objective: Strategy 2:
a 4.1.1 a 4.2.1
❑ Suggested local activity(Optional): ❑ Suggested local activity(Optional):
Promote medically accurate adolescent sexual and reproductive health practices by Partner with CDPH/MCAH to utilize evidence-based and/or evidence-informed tools and
disseminating information, resources, and training opportunities to local youth-serving resources(such as the AFLP Positive Youth Development(PYD)approach or other strengths-
agencies and organizations. based frameworks)to enhance autonomy and increase opportunities to improve health, social,
and educational outcomes as youth transition to adulthood.
What is your anticipated outcome?
What is your anticipated outcome?
a 4.1.2 a 4.2.2
❑ Other local activity(Please Specify/Optional): ❑ Other local activity(Please Specify/Optional):
What is your anticipated outcome? What is your anticipated outcome?
Final 04/15/2025
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BUDGET SUMMARY FISCAL YEAR BUDGET BUDGET STATUS BUDGET BALANCE
2025-26 ORIGINAL ACTIVE 0.00
ftson 70-150 Guartv 4A 25
Program: I Black Infant Health BIH UNMATCHED FUNDING NON-ENHANCED ENHANCED
Agency 202510 Fresno MATCHING(50150) MATCHING(7525)
SubH: 9111-TV BIIISOF AGEI ICY FUNDS 13111-SGF-NE BIH_11111 DIH-SGF-E RIH-CNyE
(11 (2) (3) (4) 1 (5) (6) (1) (a) (9) (101 111) (12) (13) 1 (14) (15)
TOTALFUNMNG X BIN-TV ^/, BINSCF % Agency Funds' % FedlState y, Com n % FedlState y, Cambme
ALLOCATION(S) - 150,627.00 753,373.00 #VALUEI
EXPENSE CATEGORY
(I) PERSONNEL 1,072,837.81 58,785.05 231,222.58 0.00 688,001.48 0.00 94,828.71 0.00
(11)OPERATING EXPENSES 62,129.02 0.00 16,710.50 0.00 45.418.52 0.00 0.00 0.00
(111)CAPITAL EXPENDITURES 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0,00
(IV)OTHER COSTS 42,500.00 20,881.87 16,664.03 0.00 4,764.10 0.00 0.00 0.00
(V)INDIRECT COSTS 262,523.41 70,960.08 0.00 0.00 191,663.33 0.00 0.00 0.00
BUDGET TOTALS` 1,439,990.241 1046% 150,627.00 103.9% 264,797A1 ODD% 0,00 m5m 929.737-43 000% 0.00 GM 94,828.71 00a% 0.00
BALANCE(S) 0,00 0.00
TOTAL BIH-TV 150,62T00 -� 15osz7.00
TOTAL BIH-SGF 753,373.00 264,797.11 I"I 464,868.71 125%] 23,707.18
TOTAL TITLE XIX 535,990,25 150%] 464,868.72 1-1 0.00 1 175%1 71,121.53 175%1 0.00
TOTAL AGENCY FUNDS 000 0.00 150%1 om 1 125%] 0.00
$ 1,439,990.25 Maximum Amount Payable from State and Federal resources
WE CERTIFY TH THIS DUDGET HAS BEEN CONSTRUCTED IN COMPLIANCE WITH ALL MCAH ADMINISTRATIVE AND PROGRAM POLICIES.
MCAW ROJECT DIRECTOR'S SIGNATURE DniE AGENCY FISCAL AGENTS SIGNATURE DATE
N eu-ri,c .,lm< I-w S IIIIW Im nlpnwlun Id nwlckn!1lwixlws MCAT/dour W 1'vndxx5n A0 1-111,11on
STATE USEONLY-TOTAL STATE AND FEDERAL REIMBURSEMENT BIN-TV BIHSGFAGENCY BIHSGF-NE BN-Cnty NE BINSGF-E BIH-CntyE
FUNDS
PCA Codes 53113 53127 53124 53100 53125 53102
(1) PERSONNEL 58,785.05 231.222.58 688,001AB 0.00 94,828.71 0.00
(II) OPERATING EXPENSES 0.00 16,710.50 45,418.52 0.00 0.00 0.00
(Ilq CAPITAL EXPENSES 0.00 0.00 0.00 0.00 0.00 0.00
(IV) OTHER COSTS 20,881.87 16,864.03 4,754.10 0.00 0.00 0.00
(V) INDIRECT COSTS 70,960.08 0.00 191,563.33 0.00 0.00 0.00
Totals for PCA Codes 1,439,990.25 1 150,627.00 264,797.11 929,737.43 0.00 94,826.71 0.00
202510 BIN 5 Budget Template 09.19,25,)dsx 1 of 5 Printed:101W025 2:08 PM
canuAw,I.Io,.
ORIGINAL
F691Ie Heprth.cs,)>I) Maternal,Child and Adolescent Health D ision
Program: Black Infant Health BIH NON-ENHANCED ENHANCED
Agency: 202510 Fresno UNMATCHED FUNDING MATCHING(50/50) MATCHING(75/25)
SubK: BIH-TV BIH-SGF AGENCY FUNDS BIH-SGF-NE BIH-Cnty NE BIH-SGF-E BIH-Cnty E
(11 (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15)
TOTAL FUNDING % BIH-TV % BIHSGF % Agency Funds' % om me % Combined % om me � Combined
FedlState Fed/A-n-' FedlState Fed/Ag..-
II OPERATING EXPENSES DETAIL %TRAVELNON-EN-CH %TRAVEL ENH MATCH %PERSONNEL MATCH
( ) 67.99% 5.00% 73.14%
TOTAL OPERATING EXPENSES 62,129.02 0.00 16,710.50 0.00 45,418.52 0.00 0.00 0.00 MawhArauable
TRAVEL 15,000.00 0.00% 0.00 27.01% 4,051.65 0.00 72.99% 10,948.35 0.00% 0,00 0.00 0.00 0.00%
TRAINING 5,000.00 0.00% 0.00 26.86% 1,343.00 0.00 73.14% 3,657.00 0.00% 0,00 0.00 0.00 0.00%
1 Office Supplies 2,500.00 0.00% 0.00 26.86% 671.50 0.00 73.14% 1,828.50 0.00% 0,00 0.00%
2 Postage 58.00 0.00% 0.00 26.86% 15.58 0.00 73.14% 42.42 0.00% 0,00 0.00%
3 Printing(Duplication) 757.00 0.00% 0.00 26.86% 203.33 0.00 73.14% 553.67 0.00% 0,00 0.00%
4 Communications 38,814.02 0.00% 0.00 26.86% 10,425.45 0.00 73.14% 28,388.57 0.00% 0,00 0.00%
5 0.00 0.00 0.00 0.00 0,00
6 0.00 0.00 0.00 0.00 0,00
7 0.00 0.00 0.00 0.00 0,00
8 0.00 0.00 0.00 0.00 0,00
9 0.00 0.00 0.00 0.00 0,00
10 0.00 0.00 0.00 0.00 0,00
11 0.00 0.00 0.00 0.00 0.00
12 0.00 0.00 0.00 0.00 0.00
13 0.00 0.00 0.00 0.00 0.00
14 0.00 0.00 0.00 0.00 0.00
15 0.00 0.00 0.00 0.00 0.00
"Unmatched Ovemtinq Expenses are not eligible for Federal matching funds(Title XIX).Expenses may only be charged to Unmatched Title V(Col.3).State General Funds(Col.5).and/or Agencv(Col.7)funds.
(III) CAPITAL EXPENDITURE DETAIL
TOTAL CAPRAL EXPENDITURES 0.00 0.00 0.00 0.00 0.00
(IV) OTHER COSTS DETAIL oPERS7314MATCH
TOTAL OTHER COSTS 42,500.00 20,881.87 16,864.03 0.00 4,754.10 0.00 0.00 0.00
SUBCONTRACTS
1 TBD(Child Watch) 1 10,000.00 1 100.00%1 10,000.00 1 0.00 11 1 0.00 1 1 0.00 1 1 0,00 1 1 0.00 1 1 0.00
2 0.00 0.00 0.00 0.00 0.000 0.000 0.00
3 0.00 0.00 0.00 0.00 0,00 0.00 0.00
4 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5 0.00 0.00 0.00 0.00 0,00 0.00 0.00
OTHER CHARGES
1 Participant Transportation 8,500.00 0.00% 0.00 100.00% 8,500.00 0.00 0.00 0,00 73.14%e
2 Client Meals 10,000.00 73.249/6 7,324.00 26.76% 2,676.00 0.00 0.00% 0.00 0.00 73.14%
3 Participant Motivators 7,500.00 47.44% 3,557.87 52.56% 3,942.14 0.00 0.00% 0.00 0,00 73.14%
4 Public Awareness Campaigns 6,500.00 0.009/6 0.00 26.86% 1,745.90 0.00 73.14% 4,754.10 0.00 0.00%
5 0.00 0.00 0.00 0.00 0,00
6 0.00 0.00 0.00 0.00 0.00
7 0.00 0.00 0.00 0.00 0,00
8 0.00 0.00 0.00 0.00 0.00
(V) INDIRECT COSTS DETAIL
TOTAL INDIRECT COSTS 262,523.41 70,960.08 0.00 0.00 191,563.33 0.00
24.47% of Total Wages+Fringe Benefits 262,523.41 1 27.03%1 70,960.081 1 0.00 11 1 0.00 1 72.97%1 191,563.33 1 0.00%1 00
202510 BIH 5 Budget Template 09.19.25.xlsx 2 Of 5
sd.m.si Printed:10/6/2025 2:08 PM
9 P m� m.
ORIGINAL
V691Ie Heprth.cet>I t Maternal,Child and Adolescent Heath D isi..
Program: �20N'10
l Infant Health BIH NON-ENHANCED ENHANCED
Agency: Fresno UNMATCHED FUNDING MATCHING(50I50) MATCHING(75I25)
Su bK: BIH-TV BIH-SGF AGENCY FUNDS BIH-SGF-NE BIH-Cnty NE BIH-SGF-E BIH-Cnty E
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15)
TOTAL FUNDING % BIH-TV % BIHSGF % I Agency Funds` % om Ine % Combined om rnetl Combined
FedlState Fed/Acenev FedlState I Fed/Ac..--
(I) PERSONNEL DETAIL
TOTAL PERSONNEL COSTS 1,072,837.81 1 58,785.05 1 231,222.58 11 1 0.00 1 1 688,001.48 1 1 0.00 1 1 94,828.71 1 1 0.00
FRINGE BENEFIT RATE 78.59% 472,103.81 25,868.45 101,749.83 0.00 302,756.03 0.00 41,729.51 0,00
TOTAL WAGES 600,734.00 32,916.61 129,472.75 0.00 385,245.44 0.00 53,099.20 0.00
FULL NAME TITLE OR CLASSIFICATION ANNUAL "
(First Name Last Name) (No Acronyms) %FTE SALARY TOTAL WAGES ' x
s
N
1 Janel Claybon Public Health Nurse 11 100.00% 132,748.46 132,748.00 24.801/. 32,916.61 5.20% 6,907.79 0.00 30.00% 39,824.40 0.00 40.00% 53,099.20 0.00 81.00% x
2 Susie A.Rico-Vasquez BIH Coordinator-Health Educator 100.00% 79,949.00 79,949.00 0.00% 0.00 22.63% 18,092.46 0.00 77.37% 61,856.54 0,00 0.00 0.00 81.00% x
3 Denise Simon Family Health Advocate Group Facilitate 100.00% 69,895.80 69,896.00 0.00% 31.32% 21,891.43 0.00 68.68% 48,004.57 0,00 0.00 0.00 81.00% x
4 Cherika Gamble Family Health Advocate Community Ou 100.00% 59,604.00 59,604.00 0.009/6 0.00 42.91% 25,576.08 0.00 57.09% 34,027.92 0,00 0.00 0.00 81.00% x
5 Zulema Garcia Community Outreach Liaison-HealthE 100.00% 53,196.00 53,196.00 0.00% 0.00 19.00% 10,107.24 0.00 81.00% 43,088.76 0,00 0.00 0.00 81.00% x
6 Kimberly Murphy Family Health Advocate Group Facilitate 100.00% 56,853.94 56,854.00 0.00% 0.00 30.63% 17,414.38 0.00 69.37% 39,439.62 0,00 0.00 0.00 81.00% x
7 Martha Garcia Data Entry-Office Assistant 11 100.00% 54,899.00 54,899.00 0.00% 0.00 19.20% 10,540.61 0.00 80.80% 44,358.39 0,00 0.00 0.00 81.00% x
8 Sheryl Brown-Bowden Mental Health Professional-Medical Sc 100.00% 85,371.00 85,371.00 0.00% 0.00 20.36% 17,381.54 0.00 79.64% 67,989.46 0,00 0.00 0.00 81.00% x
9 Madeleine Yakoub Program Technician 11 15.00% 54,782.00 8,217.00 0.00% 0.00 19.00% 1,561.23 0.00 81.00% 6,655.77 0,00 0.00 0.00 81.00%
10 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
11 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
12 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
13 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
14 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
15 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
16 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
17 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
18 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
19 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
20 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
21 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
22 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
23 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
24 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
25 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
26 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
27 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
28 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
29 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
30 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
31 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
32 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
33 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
34 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
35 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
36 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
37 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
38 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
39 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00%
40 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
41 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000
42 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
43 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
44 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
45 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
46 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
47 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
48 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00o.
49 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
50 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
51 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
52 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
53 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
54 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
55 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
56 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
202510 BIH 5 Bud et Tem late 09.19.25.xlsx 3 of 5
-fid-.A m. Printed:10/6/2025 2:08 PM
9 P
County of Fresno
FY 2023-2026
Exhibit A
Scope of Work
1. Black Infant Health Program Service Overview
The Contractor agrees to provide to the California Department of Public Health (CDPH)the services
described herein.
The BIH Program is a specialized CDPH MCAH program under the local MCAH system and helps to
address MCAH SOW-Women/Maternal Domain: Focus Areas 1-5: Ensure women in California are
healthy before, during and after pregnancy. Perinatal/Infant Domain: Ensure all infants are born healthy
and thrive in their first year of life. Focus Area 2: Reduce infant mortality with a focus on reducing
disparities.The goals in this SOW incorporate local problems identified by the Local Health Jurisdiction's
(Agency's') 5-Year Needs Assessments and reflect the Title V priorities of the MCAH Division.
All BIH sites are required to comply with BIH Policy and Procedures (P&P) and the MCAH Fiscal Policy
and Procedures Manual
https://www.cdph.ca.gov/Programs/CFH/DMCAH/Pages/Operations,aspx#fiscal-policy-and-procedures
in their entirety. In addition, all BIH Sites shall work towards maintaining group model fidelity by
adhering to the policies and procedures, delivering services as intended, implementing strategies to
maximize participant retention,fulfilling all deliverables, attending required meetings and trainings, and
completing other MCAH-BIH reports as required.
Certi ication Name:Ge Vue
by MCAH
Director: Title: MCAH Director
Date: 9/25/2025
i certify that 1 have reviewed and approved this Scope of Work
The CDPH Maternal, Child and Adolescent Health (MCAH) Division places a high priority on outcomes
that disproportionately impact the Black community in California due to systemic racism.The BIH site
agrees to implement all activities in this Scope of Work (SOW). Central to the efforts in reducing these
disparities, listed below are the goals that are the hallmark of the program:
1. Improve infant and maternal health of Black Women and/or Birthing People by promoting health
knowledge and healthy behaviors
2. Increase the ability of Black Women and/or Birthing People to develop effective stress reduction
strategies
3. Increase awareness of the health and social challenges for Black Women and/or Birthing People and
infants
4. Empower Black Women and/or Birthing People and build resiliency
5. Promote social support and healthy relationships
6. Connect Black Women and/or Birthing People with services
Page 1 of 30
Confidential-Low
County of Fresno
FY 2023-2026
Exhibit A
Scope of Work
7. Engage the community to support Black families' health and well-being with education and outreach
efforts
2. Service Location (s)
The services shall be performed at [West Fresno Regional Center (142 E. California Ave, Fresno, CA
93706j.
3. Service Hours
The services shall be provided during normal Contractor working hours, Monday through Friday, and
evenings or weekends as needed to meet the needs of participants except for official holidays.
4. Services to be Performed
The Contractor agrees to provide the services presented in this Scope of Work (SOW) from the
California Department of Public Health, Maternal, Child and Adolescent Health Division
(CDPH/MCAH) for implementation of the BIH Program. The funded Contractor is referred to as
"Agency" in this SOW.
Page 2 of 30
Confidential-Low
Agency Name: Click or tap here to enter text. Fiscal Year: 2023-2026
To achieve its goals, the BIH Program is a client-centered, strength-based group intervention with complementary 1:1 support that
embraces the life course perspective and promotes social support, empowerment, skill building, stress reduction and goal setting. Each
BIH Site shall also make all efforts to implement the program with fidelity, collect, and enter participant and program data into the
electronic Efforts to Outcomes (ETO) data system and engage community partner agencies.
Black Infant Health Program 2023 Model Components
The Black Infant Health (BIH) Program will provide services in designated sub-county service areas throughout the 14 counties with the
greatest number of Black women and/or birthing people in California. A service area is defined as a contiguous geographical area with a
minimum of 440 eligible Black women and/or birthing people. MCAH will fund up to 26 service areas. Each service area will be required
to provide a minimum of 9 in-person prenatal group series and 4 in-person postpartum group series per fiscal year. No virtual groups
should be conducted without utilizing the virtual guidance in the policies and procedures. Agencies may also serve participants through
1:1 support. Each service area is required to provide services to a minimum of 160 participants, with a maximum of 35% in 1:1 support.
Model Components
• Minimum Required Groups per Fiscal Year (nine prenatal and four postpartum per service area)
• Minimum Participant Reach (160 participants served; 72 prenatal, 32 postpartum, and 56 1:1
support per service area)
• Minimum Population Size (440 Black women per service area)
All BIH Sites are required to comply with the following staffing matrix per service area according to the BIH 2O23 Request For
Supplemental Information (RSI) to ensure fidelity and standardization across all sites:
Staffing Requirements
IBIH Coordinator/Program Manager 1.0 FTE
I FHA/Group Facilitator 3.0 FTE
I Mental Health Professional 1.0 FTE
I Outreach Liaison 1.0 FTE
I Data Entry 1.0 FTE
I Public Health Nurse 1.0 FTE
I Child Watch 1.0 FTE
Page 3 of 30 Effective 07/01/2023
Confidential-Low
Agency Name: Click or tap here to enter text. Fiscal Year: 2023-2026
Per the BIH P&P, the following criteria applies to participants enrolled in the 1:1 support intervention:
Eligibility:
• African-American
• 16 years of age or older
• Pregnant through 6 months postpartum
Services:
• For those 18 years of age and older, they are offered BIH Group model services before consenting to the BIH 1:1 support
Intervention.
• Has been provided with her rights and responsibilities for program participation, completed Assessment 1 or postpartum entry
assessment, documentation of a case management interaction/1:1 support intervention, received 1 referral for services.
• May receive services until infant is 1 year of age.
Contained within the BIH SOW, under the Measures (Process and Outcome) cells, there are Source Keys that are designed to provide a
reference for reporting purposes. The "E" Source Key refers to information that is based on participant-level program data included and
maintained in ETO. The "N" "Source Key refers to narrative information provided in quarterly reports or site surveys.
It is the responsibility of the Agency to meet the goals and objectives of this SOW. Agencies that enter into agreement with the Division to
provide MCAH-related services, and accept the Division funding, are legally required to provide the full level of services, outlined in the
program SOW, regardless of the proportion of funding provided by the Division. The Agency shall strive to develop systems that protect and
improve the health of California's women of reproductive age, infants, children, adolescents, and their families. All sites should have policies
that facilitate the promotion of health equity.
It is the responsibility of an Agency to solicit technical assistance and guidance from MCAH if performance issues arise. If a program does
not meet the goals and objectives outlined in this SOW, the Policies and Procedures (P&P) and the implementation measures for
accountability*, and if the compliance standards are not met in a timely manner, the Agency may be placed on a Performance
Improvement Plan (PIP). After implementation of the PIP, if the Agency does not demonstrate substantial growth, or fails to successfully
meet the goals and objectives of this SOW, MCAH may temporarily withhold cash payment pending correction of the deficiency;
disallowing all or part of the cost of the activity or action out of compliance; wholly or partly suspending or terminating the award; or
withholding further awards." Continued participation in the BIH program beyond the current fiscal year is also subject to successful
performance in meeting participant reach requirements and implementing the agreed upon activities.
Page 4 of 30 Effective 07/01/2023
Confidential-Low
Agency Name: Click or tap here to enter text. Fiscal Year: 2023-2026
*BIH Implementation Accountability Measures:
• Minimum staffing pattern is not adhered to
• Number of prenatal groups started is less than the required number in a four-month interval
• Number of prenatal group series started with less than 8-12 participants
• Average number of days to enter data (all forms) is greater than 10-12 business days or 90% percent of all forms are not entered on
time
• LHJs that fall below the 80% number served by the end of a fiscal year
The development of this SOW is a collaborative process and was guided by several public health frameworks including the Ten Essential Services of
Public Health and the three (3) core functions of assessment, policy development, and assurance; the Spectrum of Prevention; the Life Course
Perspective; the Social-Ecological Model, and the Social Determinants of Health. Please consider integrating these approaches when
conceptualizing and organizing local program, policy, and evaluation efforts.
o The Ten Essential Services of Public Health Services
o The Spectrum of Prevention
o Life Course Indicators Online Tool
o Social Determinants of Health
o A Framework for Prevention
o Strengthening Families
All activities in this SOW shall take place from receipt of funding beginning July 1, 2023, to June 30, 2026, contingent on availability of funds and
spending authority.
Page 5 of 30 Effective 07/01/2023
Confidential-Low
Agency Name: Click or tap here to enter text. Fiscal Year: 2023-2026
For each fiscal year of the contract period, the Agency shall submit the deliverables identified below. All deliverables shall be submitted to the
MCAH Division to your designated Program Consultant in accordance with the BIH P&P Manual and postmarked or emailed no later than the due
date.
Deliverables for each FY Due Date for each FY
Annual Progress Report August 15
Coordinator Quarterly Report:
Reporting Period _F%m To Due Date
First Report MI July
1, 2025 Ell= September 30, 2025 October 30, 2025
Second Report October 1, 2025I December 31, 2025 January 30, 2026
Third Report January 1, 2026 March 31, 2026 April 30, 2026
Fourth Report (this will serve April 1, 2026 June 30, 2026 August 29, 2026
as annual report)
See the following pages for a detailed description of the services to be performed.
Page 6 of 30 Effective 07/01/2023
Confidential-Low
Agency Name: County of Fresno FY 2023-2026
Exhibit A
Scope of Work
UPDATES FOR SFY 2025/26
Bold font in underline = updates or clarifying language for SFY 2025/26
Goal 1: Effectively administer and oversee the BIH Program.
1.1 Meet BIH implementation activities and reporting requirements by completing and submitting required reports.
Major Functions,Tasks,and Time Line Staff Performance Measure and/or Deliverables
Activities Responsibility
1.1.1. Implement program activities as Annually, Director, 1.1.1. Submit Agreement Funding Application
defined in the BIH P&Ps, SOW, Data each fiscal Coordinator/ (AFA) timely. (N)
Collection Manual (DCM), data year Program
collection forms, Group Curriculum and Manager
MCAH Fiscal P&Ps.
1.1.2. Complete a Quarterly Report that Quarterly Coordinator/ 1.1.2. Submit as directed by
complies with MCAH/BIH guidance. Program MCAH/BIH (N)
The fourth quarter report will serve as Manager
the annual report.
1.1.3. Coordinate to complete, review and Annually, Director, 1.1.3. Submit Agreement Funding Application
approve the BIH budget prior to each fiscal Coordinator/ (AFA) withini 45 days of release. (N)
submission. year Program
Manager
Page 7 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
1.2. Establish Agency infrastructure and capacity to meet BIH requirements by meeting hiring needs and timelines.
Major Functions,Tasks,and Activities Time Line Staff Performance Measure and/or Deliverables
Responsibility
1.2.1. Meet staffing pattern and minimum Ongoing, Director, 1.2.1. Submit organization chart and duty
qualification requirements for all Annually, Coordinator/ statements with AFA and as requested
staff roles. each fiscal Program by MCAH/BIH to
year Manager BlacklnfantHealth@cdph.ca.gov.
Quarterly
Complete required staff profiles on
SharePoint and keep up to date. (N)
1.2.2. Recruit, hire and maintain culturally Ongoing Director, 1.2.2. Percent of direct contact staff that
competent staff that reflect Coordinator/ reflect the population being served.
the community being served to Program (N)
implement a BIH Program that is Manager
relevant to the unique
traditions/heritage of Black
Birthing People, and the community.
1.2.3. Report all BIH staff changes. Within five Director, 1.2.3. Notify MCAH/BIH within five (5)
(5) Coordinator/ business day of any staff vacancy and
business Program five (5) days before hire of
days of Manager Coordinator/Program Manager by
staffing submitting an email to
change BlacklnfantHealth@cdph.ca.gov.
1.2.4. Develop, implement, and update, as Ongoing, Director, 1.2.4. Submit Professional Development Plan
requested by MCAH/BIH, a Annually Coordinator/ to MCAH/BIH upon request. (N)
Professional Development Plan to Program
support and build the capacity of all Manager
staff through assessment,
supervision, and professional
development
Page 8 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
1.3 Ensure staff capacity to implement the BIH Program by facilitating and tracking attendance at all required trainings.
Major Functions,Tasks,and Activities Time Line Staff Performance Measure and/or Deliverable
Responsibility
1.3.1. Ensure all required staff complete By end of year Director, 1.3.1 Maintain records of staff
refreshed curriculum training. 1 Coordinator/ attendance at trainings and submit
Program to MCAH/BIH upon request. (N)
Manager
1.3.2. Attend mandatory MCAH/BIH Ongoing, Staff as 1.3.2. Maintain records of staff
sponsored in-person or virtual Monthly, required by attendance at trainings and
trainings, conference calls, meetings Quarterly, MCAH/BIH submit to MCAH/BIH upon
and/or conferences as scheduled by Annually request. (N)
MCAH Division.
1.3.3. Attend non-mandatory trainings that As needed Staff as 1.3.3. Maintain staff attendance records
support the goals of BIH. directed by of all trainings and submit to
Coordinator MCAH/BIH upon request. (N)
or Program
Manager
1.3.4. Develop plan to assess the ability of At least twice Coordinator/ 1.3.4. Maintain completion records of at
staff to effectively perform their per fiscal year Program least of at least two (2) group
assigned tasks, including regular Manager observation feedback forms by
observations of group facilitators BIH Coordinator for every pair of
group facilitators. (N)
1.3.5. Perform regular observations of Quarterly Coordinator/ 1.3.5. Maintain completion records of
assessments conducted by FHAs, MHPs Program observations conducted for FHAs,
and/or PHNs. Manager MHPs and PHNs. (N)
1.3.6. Identify staff training needs and ensure Quarterly Coordinator/ 1.3.6. Describe plan to ensure that staff
those needs are met Program development needs are met in
Manager quarterly report. (N)
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Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Sco e of Work
1.3.7. Ensure that all key BIH staff Ongoing, Coordinator/ 1.3.7. Describe how cultural sensitivity
participates in on-going training or Annually Program training has enhanced Agency
educational opportunities designed to Manager staff knowledge and how that
enhance cultural sensitivity and knowledge is applied in Annual
responsiveness through webinars, report. (N)
trainings and/or conferences.
1.3.8. Ensure that all new and key BIH staff Ongoing, Coordinator/ 1.3.8. Describe how staff utilized
attend the Annual MCAH Sudden Annually Program information from the MCAH SIDS
Infant Death Syndrome (SIDS) Manager conference with participants in
Conference to receive the latest Annual report. (N)
American Academy of Pediatrics (AAP)
guidelines on infant safe sleep
practices and SIDS risk reduction
strategies.
1.3.9. Attend local SIDS collaborative Ongoing, Coordinator/ 1.3.9. Document strategies and action
workgroups with community partners Annually Program plans related to SIDS risk
to enhance awareness of Black SIDS Manager reduction strategies developed
rates and to develop SIDS risk Core staff from SIDS collaborative
reduction strategies. workgroup meetings in Annual
report. (N)
Page 10 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
1.4 Meet BIH data collection requirements by facilitating access to data collection system, SharePoint, software,
security, and proper oversight of data entry and core personnel.
Major Functions,Tasks,and Activities Time Line Staff Performance Measure and/or Deliverables
Responsibility
1.4.1. Ensure all direct Agency and Ongoing, Director, 1.4.1. Submit request for access to ETO and
subcontractor service staff have Within five Coordinator/ SharePoint for direct staff to
access to BIH Efforts to Outcomes (5) Program BlacklnfantHealth@cdph.ca.gov
(ETO) Data Management System business Manager
and SharePoint site by submitting days of
request to MCAH/BIH. any
staffing
change
1.4.2. Collect and enter all BIH participant Enter data Staff as 1.4.2. BIH PA: Timeliness of data entry report
program information and outcome within ten required by (E)
data timely and accurately per (10) business MCAH/BIH
guidance in the Data Collection days of
Manual (DCM) using BIH required collection
forms at required intervals.
1.4.3. Ensure all staff receive updates Ongoing Coordinator/ 1.4.3. Maintain attendance records of BIH
related to ETO changes and forms. Program data calls, receipt of data alerts and
Manager, Data other guidance via email or posted on
Entry Lead SharePoint.
Page 11 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
1.4.4. Ensure that a staff member with Ongoing Coordinator/ 1.4.4. Maintain attendance records of
advanced knowledge of the BIH Program participation in role-specific
Program, data collection, and ETC) is Manager calls/trainings for the Data Entry Lead.
selected as the BIH Site's Data Entry
lead and participates in all data and
evaluation calls and works to ensure
timeliness of data entry and data
quality.
1.4.5. Store participant level data forms on Ongoing Coordinator/ 1.4.5. Maintain Participant level Data forms
paper or scanned copies per security Program for a minimum of four years (prior three
guidelines in P&P for a minimum of Manager years plus current FY).
four years (prior three years plus
current FY).
1.4.6. Conduct and report on audits of Quarterly Coordinator 1.4.6. Maintain verification of data in paper
recruitment, enrollment, and service and Data Entry forms matches information in ETO for
delivery paper forms against ETO Lead all samples.
records. Audit sample must include
at least 10%of recruitment records
and 10%of enrollment records and
should include all staff collecting
data.
1.4.7. Ensure that all staff that collect and Ongoing Coordinator/ 1.4.7. Maintain attendance records of
enter data into the BIH data system Program participation in ETO training video
have completed the ETO training Manager series for all staff.
video series available in the BIH
SharePoint site.
Page 12 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
1.4.8. Ensure that all staff that have ETO Quarterly Coordinator/ 1.4.8. Completion of QRA on SharePoint.
access are currently in the SharePoint Program
roster by completing the Quarterly Manager
Roster Assessment (QRA).
1.4.9. Ensure all data collection and Ongoing Daily Director, 1.4.9. Maintain record of information privacy
reporting processes comply with Coordinator/ and security policies from CDPH.
CDPH information privacy and Program
security policies as directed in the Manager
BIH Policies and Procedures (P&Ps)
before installing and using ETO.
Page 13 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
Goal 2: Establish and maintain a structure to support recruitment, outreach, referrals and enrollment in designated service
areas of Black women and Birthing People.
Eligibility for Group Services:
• Black, 18 years of age and older, and less than 30 weeks pregnant for prenatal group services, or up to six
months postpartum for postpartum group services.
Eligibility for Case Management/1:1 Support Services:
• Black, 16 years of age, pregnant or up to 6 months postpartum.
• Group attendance is not required.
All Participants will attend in-person group or 1:1 support services
All Participants may receive services up to 1 year postpartum
2.1. Target services to areas where there is demonstrated need and Agency capacity to implement BIH.
Major Functions,Tasks, and Activities Time Line Staff Performance Measure and/or Deliverables
Responsibility
2.1.1. Define geographical service area for 06/19/23 Director, 2.1.1. Submit the defined geographical
program recruitment for in-person Coordinator/ service area and justification to
services. Program MCAH/BIH for approval.
Manager
2.1.2. Develop and implement a Participant Ongoing, Coordinator/ 2.1.2. Number and percent of recruited and
Recruitment Plan (standardized intake Annually Program referred women that were eligible for
process) according to the target Manager Group (based on age and pregnancy
population and eligibility guidelines in status) based on their recruitment
MCAH/BIH P&P and submit upon date, in FY 2023-24. € Quarterly
request. Implementation Dashboard
2.1.3. Develop and implement a Participant Ongoing, Coordinator/ 2.1.3. Number and percent of recruited and
Recruitment Plan (standardized intake Annually Program referred women that were eligible for
process) according to the target Manager Case Management (based on age and
population and eligibility guidelines in pregnancy status) based on their
MCAH/BIH P&P and submit upon recruitment date, in FY 2023-24. €
Page 14 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
request. Quarterly Implementation Dashboard
2.1.4. Identify and establish formal and Ongoing, Coordinator/ 2.1.4. Total number of service providers that
informal collaborative relationships Annually Program made referrals to the BIH Program in
with local Medi-Cal Managed Care, Manager FY 2023-24. € BIH PA: Recruitment
Commercial Health Plans, WIC, and during a specified time period report.
local agencies in the community to
support recruitment and referral
processes.
2.1.5. Obtain rights and responsibilities form Ongoing, Coordinator/ 2.1.5. Number and percent that has a
and provide signed or verbal Annually Program recruitment and a rights and
acknowledgement for all participants. Manager responsibilities (consent) touchpoint
in ETO in FY 2023-24. € Quarterly
Implementation Dashboard
2.1.6. Conduct outreach activities and build Ongoing, Coordinator/ 2.1.6. Total number (overall and by type) of
collaborative relationships with local Quarterly, Program outreach activities completed by all
WIC providers, CPSP Coordinators, Annually Manager, COL staff during FY 2023-24. (N)
social service providers, health care
providers, the faith-based community
and other community-based partners
and individuals to increase and
maximize awareness opportunities to
ensure eligible women are referred to
BIH.
2.1.7. All BIH Agencies will establish referral Ongoing, Coordinator/ 2.1.7. Maintain list of partner agencies and
mechanisms that will facilitate Annually Program submit with Annual Report. (N)
reciprocity with partner agencies as Manager
appropriate.
Page 15 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
2.1.8. All BIH Agencies will utilize social media Ongoing, Coordinator/ 2.1.8. Maintain list of social media platforms
campaigns developed by local agencies Annually Program and submit with Annual Report. (N)
and/or MCAH to increase community Manager
awareness while conducting outreach
activities during community events and
participant engagement activities.
2.1.9. For BIH Group Sessions, all BIH Ongoing, Coordinator/ 2.1.9. Number and percent of recruited and
agencies will recruit Black women 18 Annually Program referred women that were eligible for
years of age and older, and less than 30 Manager Group (based on age and pregnancy
weeks pregnant for in-person prenatal status) based on their recruitment
group services, or up to six months date, in FY 2023-24. (E) Quarterly
postpartum for in-person postpartum Implementation Dashboard
group services.
2.2.0. Enroll participants in a group within 45 Ongoing Coordinator/ 2.2.0. Number and percent of enrolled
days of enrollment. Program women who attended a prenatal
Manager, BIH group session within 30- 45 days of
Staff enrollment. (E) — BIH PP: Prenatal
Group Dose Report, BIH PP:
Postpartum Group Dose Report
2.2.1. Begin groups with the minimum Ongoing Coordinator/ 2.2.1. Percent of prenatal group sessions in a
required number of participants per Program series that were attended by at least 5
the BIH P&P. Manager, BIH participants, ideally 8-12. (E) - BIH PP:
Staff Group Attendance by Session.
2.2.2. All BIH participants (enrolled in BIH Ongoing Coordinator/ 2.2.2. Number and percent of active
Group) will receive services outlined in Program participants that are served during the
the BIH P&P to be considered served. Manager, BIH FY 23-24(E). Quarterly
Staff Implementation Dashboard
2.2.3. For 1:1 support, all BIH Agencies will Ongoing, Coordinator/ 2.2.3. Number and percent of recruited and
recruit Black teens at least 16 years Annually Program referred women that were eligible for
of age and adult women, pregnant or Manager 1:1 support (based on age and
up to 6 months postpartum. pregnancy status) based on their
recruitment date, in FY 2023-24. (E)
Page 16 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
Quarterly Implementation Dashboard
2.2.4. All BIH participants (enrolled in the BIH Ongoing, Coordinator/ 2.2.4. Number and percent of active
1:1 support intervention) will receive Annually Program Participants that are served during the
services outlined in the BIH P&P to be Manager FY (E). Quarterly Implementation
considered served. Dashboard
Page 17 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
Goal 3: All BIH Agencies will ensure participant retention strategies are in place.
3.1 Develop participant retention strategies as they relate to program implementation components.
Major Functions,Tasks, and Activities Time Line Staff Performance Measure and/or Deliverables
Responsibility
3.1.1. All BIH Agencies will develop Ongoing BIH Staff 3.1.1. Submit Participant Retention
participant retention strategies in the Strategies with Quarterly and Annual
areas of outreach/recruitment, Report. (N) BIH PP: Prenatal Group
enrollment, 1:1 support, group Dose Report; BIH PP: Postpartum
sessions and program completion. Group Dose Report (E)
3.1.2. Ensure location of group services is Ongoing BIH Staff 3.1.2. Describe process to ensure that
within the designated service area, location for group services meet
safe, accessible, culturally affirming, MCAH/BIH guidelines and submit with
and have dedicated child watch staff Annual Report. (N)
and space when group sessions are
conducted.
3.1.3. Ensure participants have access to Ongoing BIH Staff 3.1.3. Number and percent of enrolled
transportation assistance via Uber/Lyft women who have been dismissed
or other door-to-door services. from BIH with a completed participant
satisfaction survey during the FY. (E)
BIH PP: Participant Satisfaction Report
3.1.4. Ensure all group sessions include full Ongoing BIH Staff 3.1.4. Number and percent of enrolled
meals for participants. women who have been dismissed
from BIH with a completed participant
satisfaction survey during the FY. (E)
BIH PP: Participant Satisfaction Report
Page 18 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Sco e of Work
3.1.5. Ensure group motivators including but Ongoing BIH Staff 3.1.5. Submit participant retention strategy
not limited to gift cards, pack and successes and challenges with Annual
plays, items to support fitness, infant Report. (N)
feeding supplies, breastfeeding
supplies, diapers, etc. are provided to
program participants.
3.1.6. Designated staff will conduct Ongoing BIH Staff 3.1.6. Number and percent of enrolled
participant satisfaction surveys after women who have been dismissed
group sessions and at program from BIH with a completed participant
completion to obtain feedback related satisfaction survey during the FY. (E)
to improvement of retention BIH PP: Participant Satisfaction Report
strategies.
Page 19 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
Goal 4: All BIH Agencies will increase and expand community awareness of BIH.
4.1 Collaborate with other BIH Agencies regarding outreach activities including the use of social media.
Major Functions,Tasks,and Activities Time Line Staff Performance Measure and/or Deliverables
Responsibility
4.1.1. All BIH Agencies will increase and Ongoing BIH Staff 4.1.1. Total number (overall and by type) of
expand community awareness of BIH outreach activities completed by all
by collaborating with other BIH staff during FY 2023-24. (N)
agencies and individually as an agency
on communication outreach activities,
including the use of social media.
4.1.2. Conduct outreach activities and build Ongoing BIH Staff 4.1.2. Describe the types of community
collaborative relationships with local partner agencies contacted by Agency
WIC providers, CPSP Coordinators, staff. (N)
social service providers, health care
providers, the faith-based community
and other community-based partners
and individuals to increase and
maximize awareness opportunities to
ensure eligible women are referred to
BIH.
4.1.3. All BIH Agencies will establish referral Ongoing BIH Staff 4.1.3. Describe outreach activities
mechanisms that will facilitate performed to reach target population.
reciprocity with partner agencies as (N)
appropriate.
4.1.4. All BIH Agencies will utilize social media Ongoing BIH Staff 4.1.4. Document type, frequency and
campaigns developed by MCAH to number of social media activities
increase community awareness while conducted and submit with Quarterly
conducting outreach activities. and Annual Report. (N)
Page 20 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Sco e of Work
4.1.5. Develop and update, as needed, a local Ongoing Coordinator/ 4.1.5. Maintain service referral and resource
service referral and resource directory. Program directory and submit to MCAH/BIH
Manager, BIH upon request.
Staff
Ensure referral sources are up to date
in ETO.
4.1.6. Increase information sharing with other Ongoing COL 4.1.6. Number of agencies where the COL has
local agencies providing services to a documented point(s) of contact and
Black Birthing People and children in with whom information is regularly
the community and establish a clear exchanged. Submit with Annual
point of contact. Report. (N)
4.1.7 Consistent with 1.3.2, attend statewide Ongoing Coordinator/ 4.1.7 Number of program staff attending
community awareness events to COL/BIH Staff Black Joy Parade and Women's Health
support program promotion including Exposition. Note: this is of interest for
but not limited to: annual reporting and not considered a
-Black Joy Parade formal performance measure.(N)
-Women's Health Exposition
Page 21 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
Goal 5: Engage the Black community to support Black families' health and well-being with education and outreach efforts.
5.1 Increase and expand community awareness of Black Birth outcomes and the role of the Black Infant Health Program.
Major Functions,Tasks,and Activities Time Line Staff Performance Measure and/or Deliverables
Responsibility
5.1.1. All BIH Agencies will coordinate with Ongoing Coordinator/ 5.1.1. Submit CAB meeting materials (roster,
the Perinatal Equity Initiative (PEI) Program stakeholder types, attendance, agenda,
(where applicable) to implement a Manager, BIH minutes) with BIH quarterly report. (N)
Community Advisory Board (CAB) to Staff
Inform the community about disparate
birth outcomes among Black Birthing
People by delivering standardized
messages describing how the BIH
Program addresses these issues.
5.1.2. Create partnerships with community Ongoing Director, 5.1.2. Number, format, and outcomes
and referral agencies that support the Coordinator/ associated with community outreach
broad goals of the BIH Program, Program activities conducted by BIH Coordinator
through formal and informal Manager and/or MCAH Director during FY 2023-
agreements. Ensure efforts are 24 (E/N)
focused on Black Birthing People and
families in the community in need of
services and are confronting disparities
caused by systemic oppression,
marginalization, implicit bias, and
discrimination.
Page 22 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Sco e of Work
5.1.3. Develop and implement a community Ongoing BIH Staff 5.1.3. Document type, frequency and
awareness plan that outlines how number of social media activities
community engagement activities will conducted and submit with Quarterly
be conducted. and Annual Report. (N)
5.1.4. Develop and implement activities Ongoing Coordinator/ 5.1.4. Maintain service referral and resource
related to multi-level community Program directory and submit to MCAH/BIH
engagement and awareness with Manager, BIH upon request.
referral partners to identify service Staff
gaps in the Agency target area.
5.1.5. Collaborate with local MCAH programs Ongoing Coordinator/ 5.1.5. Document collaborative activities with
and other partners such as Medi-Cal to Program local MCAH programs and other
identify strategies, activities and Manager, BIH partners and submit with Annual
provide technical assistance to: Staff Report. (N)
• Improve access to health care
services
• Increase utilization of well-woman
and postpartum visits
• Identify Preterm Birth (PTB)
reduction strategies
• Increase the utilization of
preconception health services.
5.1.6. Collaborate with local MCAH programs Ongoing Coordinator/ 5.1.6. Document collaborative activities with
and Regional Perinatal Programs to Program local MCAH programs and Regional
improve maternal and perinatal Manager, BIH Perinatal Programs and submit with
systems of care. Staff Annual Report. (N)
Page 23 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Sco e of Work
5.1.7. Participate in collaboratives with Ongoing Coordinator/ 5.1.7. Document collaborative activities that
community partners to review data Program address social determinants of health
and develop strategies and policies to Manager, BIH and disparities and submit with Annual
address social determinants of health Staff Report. (N)
and disparities.
5.1.8. Produce flyers or educational materials Ongoing Coordinator/ 5.1.8. Maintain MCAH/BIH approval on file
as needed using BIH funds to support Program for all flyers, education, and outreach
community awareness efforts, ensuring Manager, BIH materials, including community
materials are properly branded with Staff awareness efforts developed.
the State BIH log and funding tagline
"Funded by the California Department
of Public Health."
Page 24 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
Goal 6: All BIH Agencies will provide resources to assist in improving the health of pregnant and parenting Black Women and/or
birthing people and their infants, including the management of chronic stress.
6.1 Provide all participants with additional services that support health and wellness while enrolled in the BIH Program.
Major Functions,Tasks, and Activities Time Line Staff Performance Measure and/or Deliverables
Responsibility
6.1.1. Assist participants in understanding Ongoing, BIH Staff 6.1.1. Document additional activities (e.g.,
behaviors that contribute to overall Quarterly Champions for Change cooking
good health, including: demonstrations) conducted that
• Stress management promote health and wellness of BIH
• Sexual health participants and their infants at least
• Healthy relationships once per quarter. (N)
• Nutrition
• Physical activity
6.1.2. Ensure that participants are enrolled in Ongoing BIH Staff 6.1.2. Number and percent of enrolled
health insurance and are receiving participants that have received a
risk-appropriate perinatal care. referral for health insurance. (E) BIH
PA: Referral Status Report (New)
6.1.3. Provide participants with health Ongoing BIH Staff 6.1.3. Describe collaborative efforts with
information that supports a healthy March of Dimes, MotherToBaby and
pregnancy. other agencies that provide health
education, preterm birth reduction
materials and resources. (N)
6.1.4. Provide participants with health Ongoing BIH Staff 6.1.4. Describe collaborative efforts with
education materials that address March of Dimes, MotherToBaby and
preterm birth reduction strategies, other agencies that provide health
such as the MCAH-BIH prematurity education, preterm birth reduction
awareness and Provider sheet tip materials and resources. (N)
sheet.
Page 25 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Sco e of Work
6.1.5. Identify participants' health, dental and Ongoing BIH Staff 6.1.5. Number and percent of enrolled
psychosocial needs and provide women who have a known referral
referrals and follow-up as needed to status for every documented referral at
health and community services. time of exit from the program (among
women dismissed from BIH). (E) BIH
PA: Referral Status Report NEW
6.1.6. Provide information and health Ongoing BIH Staff 6.1.6. Number and percent of enrolled
education to participants who report participants that have received a
drug, alcohol and/or tobacco use. referral for drug, alcohol and/or
tobacco use. (E)
6.1.7. Assist participants with completion of Prior to BIH PHN 6.1.7. Number and percent of active
the birth preference form that outlines delivery participants with a birth preference
specific labor/delivery and birthing form (relative to number of days
requests to be conveyed to their enrolled in the program). (E) Quarterly
prenatal care provider. Implementation Dashboard
6.1.8. Promote and support a reproductive Ongoing BIH Staff 6.1.8. Number and percent of enrolled
life plan and family planning by participants that have discussed
providing information and education reproductive life planning during 1:1
on birth spacing and interconception support meetings. (E)
health during group sessions and 1:1
support Meetings.
6.1.9. Ensure that participants are attending Ongoing BIH Staff 6.1.9. Number and percent of participants
postpartum visits and well-woman who attend a 4-6 week postpartum
check-ups as scheduled. checkup with a medical provider. (E)
Page 26 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Sco e of Work
6.2.0. Help participants understand the Ongoing BIH Staff 6.2.0. Describe collaborative efforts with
characteristics of healthy relationships Violence Prevention Organizations
and provide resources that can help such as Futures without Violence to
participants deal with abuse, determine service capacity to
reproductive coercion, or birth control adequately meet needs identified by
sabotage. participants and Agency staff
providing case management services.
(N)
6.2.1. Ensure that all BIH participants will be 6-8 weeks BIH MHP 6.2.1. Number and percent of active
screened for Perinatal Mood and postpartum participants with an EPDS (relative to
Anxiety Disorders (PMAD) and those and as number of days enrolled in the
with positive screens will be given a necessary. program). (E) Quarterly
referral to mental health services. Implementation Dashboard
6.2.2. Assist participants with increasing Ongoing BIH Staff 6.2.2. List and describe health education
knowledge of infant safe sleep materials provided to participants
practices, SIDS, Sudden Unexplained related to safe sleep practices and SIDS
Infant Death (SUID) risk reduction. reduction. (N)
6.2.3. Provide participants with health Ongoing BIH Staff 6.2.3. Number and percent of enrolled
education materials addressing the participants that have discussed
benefits of breastfeeding. breastfeeding/infant feeding during 1:1
support meetings. (E)
Number and percent of enrolled
participants that have received a
referral for breastfeeding or lactation.
(E) BIH PA: Referral5totus Report(New)
6.2.4. Assist participants with completing Prior to BIH PHN 6.2.4. Number and percent of active
home safety checklist. delivery participants with a safety checklist
(relative to number of days enrolled in
the program). (E) Quarterly
Implementation Dashboard
Page 27 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Sco e of Work
6.2.5. Teach participants about the Ongoing BIH Staff 6.2.5. Summarize participant successes and
importance of stress reduction and challenges in utilizing stress reduction
guide them in applying stress reduction techniques. (N)
techniques (yoga, deep breathing, or
meditation).
6.2.6. Facilitate the administration of the Ongoing BIH Staff 6.2.6. Number and percent of active
stress scale and ask questions about participants with a baseline and follow-
stress management focused on the up assessment (relative to number of
participant's ability to be resilient and days enrolled in the program). (E)
manage chronic stressors presenting
during pregnancy.
Page 28 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
Goal 7: Educate the public about the factors leading to the disparities in Black maternal and infant birth outcomes by providing
consistent and culturally responsive information and promoting enrollment in the California Department of Public Health - Black
Infant Health Program (CDPH-BIH).
7.1 Create and/or maintain a statewide public awareness campaign to inform the State about Black birth outcome inequities and/or
the root causes of these inequities.
Major Functions,Tasks,and Activities Time Line Staff Performance Measure and/or Deliverables
Responsibility
7.1.1. Develop public awareness materials Ongoing BIH Staff, 7.1.1. Provide a report that describes
that are focus tested with targeted Coordinator/ outreach engagement plan in the
community. Program community.
Manager
Share ongoing progress in
developing/maintaining the campaign
during quarterly BIH Statewide Media
Campaign meetings/reports.
Agency Program Coordinator to review
all staff/contractor/subcontractor
deliverables and methodologies to
ensure materials:
• honor the unique
history/traditions of people of
Black descent
• reflect/include the targeted
community
• are culturally responsive and
engaging applicable to all Black
birthing people, regardless of
enrollment status in the CDPH-
BIH program
Page 29 of 30
Confidential-Low
Agency Name FY 2023-2026
Exhibit A
Scope of Work
• Agency to share final campaign
deliverables and methodologies
with the State for final review and
approval. (N)
7.1.2. Hire and maintain culturally Ongoing Coordinator/ 7.1.2. Describe process of recruiting and
competent Program hiring
staff/contractors/subcontractors to Manager staff/contractors/subcontractors. (N)
develop campaign materials that are
relevant and respectful to the cultural Include resumes of
heritage of Black women and the staff/contractors/subcontractors with
community. submission of AFA packet. (N)
Submit all
staff/contractor/subcontractor
changes to the State for review (N)
Page 30 of 30
Confidential-Low
J� ORIGINAL
Public'Hetilth •L/Jru Maternal,Child and A01-1 Health DNWa
BUDGET SUMMARY FISCAL YEAR BUDGET BUDGET STATUS BUDGET BALANCE
2025-26 ORIGINAL ACTIVE 0.00
Version 7.0-150 guarterly 4.1.25
Program: Perinatat E Uit Initiative PEI NON-ENHANCED ENHANCED
Agency: 25-10 Fresno UNMATCHED FUNDING MATCHING(50150) MATCHING(75125)
SUbK: PEI-SGF AGENCY FUNDS PEI•SGF.NE PEI-Cnty NE PEI-SGF-E PEI-Cnty E
(11 (2) (31 (6) (7I (el l9) (to) (111 (12) (13) (14) (75)
am m Combined om m Combined
TOTAL FUNDING °/, PEI-SOP % Agency Funds• % % %
Fedl5lete F I e Fe
ALLOCATION(S) 595,644.00 #VALUE1
EXPENSE CATEGORY
(1) PERSONNEL 227,279.04 43,183.02 0.00 184,096.02 0.00 0.00 0.00
(11)OPERATING EXPENSES 31,129.31 5,914.57 0.D0 25,214.74 0.00 0.00 0.00
(111) CAPITAL EXPENDITURES 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(IV) OTHER COSTS 408,800.00 408,800.00 0.00 0,00 0.00 0.00 0.00
(V) INDIRECT COSTS 55,615.18 10,566.86 0.00 45.048.30 0.00 0.00 0.00
BUDGET TOTALS* 722.823.53 64.81,E 468,464.47 0.00% 0.00 35.19% 254,359-06 0.00% 0.00 0.00^6 0.00 0.00% 0.00
BALANCE(S)
TOTAL PEI-SGF 595,644.00 -> 466,464.47 t50%I 127,179.53 125%1 o.ao
TOTAL TITLE XIX 127,179.53 > 150%I 127,179.53 15o%1 o.00 (75%) o.00 (75%1 0.00
TOTAL AGENCY FUNDS o.00 150%) a.00 125%)10.00
Fs- 722,823.53 Maximum Amount Payable from State and Federal resources
WE CERTIFY X7ET HAS BEEN CONSTRUCTED IN COMPLIANCE WITH ALL MCAH ADMINISTRATIVE AND PROGRAM POLICIES,
iPhr I Z S
MCAH1 ROJECTDIRECTOR'S SIGNATURE DATE AGENCY FISCAL AGENTS SIGNATURE DATE
Thele amounts conlaln local lcve a s0mlfled for Infor 0-and matching purposes.MCAH 0oes nat relmourso Agency canirloulbns.
STATE USE ONLY.TOTAL STATE AND FEDERAL REIMBURSEMENT PEI-SGF AGENCY PE!•SGF-NE PEI-Cnty NE PEI-SGF-E PEI-Cnty E
FUNDS
PCA Codes 53115 5315E 53154 53155 53153
(I) PERSONNEL 43,183.02 184,096.02 0.00 0.00 0.00
(II) OPERATING EXPENSES 5,914.57 25,214.74 0.00 0.00 0.00
(III) CAPITAL EXPENSES 0.00 0.00 0.00 0.00 0.00
(IV) OTHER COSTS 408,800.00 0.00 0.00 0.00 0.00
IV) INDIRECT COSTS 10,566.8E 45,048.30 0.00 0.00 0.00
Tatela for PCA Codes 722,823.53 468,464.47 254,359.0E 1 0.00 0.00 O:DO
25.10 PEI S Budget Template 07.02,25.xlsx c•�na 1 of 5 Printed:101BI2025 2,09 PM
--
c.a.mm..p.nmem a ORIGINAL
Public Health .C oPH Maternal,Child and Adolescent Health Division
Program: Perinatal Equity Initiative PEI NON-ENHANCED ENHANCED
Agency: 25-10 Fresno UNMATCHED FUNDING MATCHING(50150) MATCHING(75125)
SubK: PEI-SSE AGENCY FUNDS PEI-SGF-NE PEI-Cnty NE PEI-SGF-E PEI-Cnty E
(1) (2) (3) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15)
TOTAL FUNDING % PEI-SGF % Agency Funds" % Combined % Combined % Combine Combined
Fed/State Fed/Aaencv" Fed/State Fed/Aaencv"
%TRAVEL NON-ENH MATCH %TRAVEL ENH MATCH %PERSONNEL MATCH
(II) OPERATING EXPENSES DETAIL 81.00% o.00% 81.00%
TOTAL OPERATING EXPENSES 31,129.31 5,914.57 0.00 25,214.74 0.00 0.00 0.00 Match Available
TRAVEL 0.00 0.00 0.00 0.00 0.00 0.00
TRAINING 4,265.00 19.00% 810.35 0.00 81.00% 3,454.65 0.00 0.00 0.00 0.00%
1 Office Supplies 3,000.00 19.00% 570.00 0.00 81.00% 2,430.00 0.00 0.00%
2 Postage 5,013.00 19.00% 952.47 0.00 81.00% 4,060.53 0.00 0.00%
3 Printing(Duplication) 6,019.31 19.00% 1,143.67 0.00 81.00% 4,875.64 0.00 0.00%
4 Communication 12,582.00 19.00% 1 2,390.58 0.00 81.00% 10,191.42 0.00 0.00%
5 Local Travel 250.00 19.00% 47.50 0.00 81.00% 202.50 0.00 0.00%
6 0.00 0.00 0.00 0.00
7 0.00 0.00 0.00 0.00
8 0.00 0.00 0.00 0.00
9 0.00 0.00 0.00 0.00
10 0.00 0.00 0.00 0.00
11 0.00 0.00 0.00 0.00
12 0.00 0.00 0.00 0.00
13 0.00 0.00 0.00 0.00
14 0.00 0.00 0.00 0.00
15 0.00 0.00 0.00 0.00
""Unmatched ODeratinq Expenses are not eligible for Federal matching funds(Title XIX).Expenses may only be chained to Unmatched Title V(Col.3).State General Funds(Col.51.and/or Agencv(Col.7)funds.
RHO CAPITAL EXPENDITURE DETAIL
TOTAL CAPITAL EXPENDITURES 0.00 0.00 0.00 1 0.00
(IV) OTHER COSTS DETAIL %PERS60'N6EDLMAATCH
TOTAL OTHER COSTS 1 408,800.00 408,800.00 11 0.00 11 0.00 0.00 11 0.00 0.00
SUBCONTRACTS
1 Two Q,Inc.dba HYPHEN 15,000.00 100.00% 15,000.00 0.00 0.00 0.00 0.00 0.00
2 TBD(Fatherhood Services) 180,000.00 100.00% 180,000.00 0.00 0.00 0.00 0.00 0.00
3 TBD(Doula Services) 180,000.00 100.00% 180,000.00 0.00 0.00 0.00 0.00 0.00
4 TBD(CAB Facilitator) 10,000.00 100.00% 10,000.00 0.00 0.00 0.00 0.00 0.00
5 0.00 0.00 0.00 0.00 0.00 0.00
6 0.00 0.00 0.00 0.00 0.00 0.00
7 0.00 0.00 0.00 0.00 0.00 0.00
8 0.00 0.00 0.00 0.00 0.00 0.00
OTHER CHARGES
am
1 Client Support Materials 23,800.00 100.00% 23,800.00 0.00 0.00 0.00 81.00% a
2 0.00 0.00 0.00 0.00
3 0.00 0.00 0.00 0.00
4 0.00 0.00 0.00 0.00
5 0.00 0.00 0.00 0.00
6 0.00 0.00 0.00 0.00
7 0.00 0.00 0.00 0.00
8 0.00 0.00 0.00 0.00
(V) INDIRECT COSTS DETAIL
TOTAL INDIRECT COSTS 1 55,615.18 10,W6.88 0.00 45,048.30 1 0.00
24.47% of Total Wages+Fringe Benefits 55,615.18 19.00% 10,566.88 0.00 1 81.00% 45,048.30 0.00
25-10 PEI 5 Bud et Temp late 07.02.25.xlsx 2 of 5
-fidemial Printed:10/6/2025 2:09 PM
9 p -Low
c.a.mm o.wmm.m a ORIGINAL
Public Health .C om Maternal,Child and Adolescent Health Division
Program: Perinatal Equity Initiative PEI NON-ENHANCED ENHANCED
Agency: 25-10 Fresno UNMATCHED FUNDING MATCHING(50150) MATCHING(75125)
SubK: PEI-SGF AGENCY FUNDS PEI-SGF-NE PEI-Cnty NE PEI-SGF-E PEI-Cnty E
(�) (2) (3) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15)
TOTAL FUNDING % PEI-SGF % Agency Funds* % Combined % Combined % Combined Combined
Fed/State FedlAaencv* Fed/State 0 Fed/Aaencv*
(1) PERSONNEL DETAIL
TOTAL PERSONNEL COSTS 227,279.04 43,183.02 0.00 184,096.02 0.00 0.00 0.00
FRINGE BENEFIT RATE 73.03% 95,924.04 18,225.57 0.00 77,698.47 0.00 0.00 0,00
TOTAL WAGES 131,355.00 24,957.45 0.00 106,397.55 0.00 0.00 0.00
U L =
�19A�
FULL NAME TITLE OR CLASSIFICATION ANNUAL aN
%FTE TOTAL WAGES ~
(First Name Last Name) (No Acronyms) SALARY
� H
1 Gifty Kwofie Health Educator-PEI Coordinator 100.00% 78,159.00 78,159.00 19.00% 14,850.21 0.00 81.00% 63,308.79 0.00 0.00 0.00 81.00% x
2 Vacant Health Education Specialist 100.00% 53,196.00 53,196.00 19.00% 10,107.24 0.00 81.00% 43,088.76 0.00 0.00 0,00 81.00% x
3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
4 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00%
5 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
6 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00%
7 0.00 0.00 0.00 0.00 0.00 0.00 o.00 0.00%
a 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00%
9 0.00 0.00 0.00 0.00 0.00 0.00 o.o0 0.00%
10 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00%
11 1 0.00 0.00 0.00 0.00 0.00 0.00 o.00 0.00%
12 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00%
13 0.00 0.00 0.00 0.00 0.00 0.00 a00 0.00%
14 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00%
15 0.00 0.00 0.00 0.00 0.00 0.00 a00 0.00%
16 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00%
17 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
18 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00%
19 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
20 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
21 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
22 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
23 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
24 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
25 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
26 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
27 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
28 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
29 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
30 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
31 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
32 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
33 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
34 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
35 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
36 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
37 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
38 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
39 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
40 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
41 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
42 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
43 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
44 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
45 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
46 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
47 0.00 0.00 o.00 0.00 0.00 0.00 0.00 0.00%
48 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
49 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
50 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%
25-10 PEI 5 Bud et Temp late 07.02.25.xlsx 3 of 5
-fidemial-Low Printed:10/6/2025 2:09 PM
9 p
Exhibit A County: County of Fresno
Workplan Agreement Number: 25-10
For each fiscal year (FY) of the contract period, the Local Health Jurisdictions (LHJ) shall submit the deliverables identified below. All
deliverables shall be submitted to the Maternal, Child and Adolescent Health (MCAH) Division to your designated Program Consultant in
accordance with Perinatal Equity Initiative (PEI) guidelines and emailed or uploaded to SharePoint no later than the due date.
Please visit the SharePoint site for due dates for all deliverables.
PeriodReporting From To Due Date
1) First Implementation Report January 1, 2023 June 30, 2023 July 31, 2024
2) Second Implementation Report July 1, 2023 June 30, 2024 July 31, 2025
3) Third Implementation Report July 1, 2024 June 30, 2025 July 31, 2025
4) Fourth Implementation Report July 1, 2025 June 30, 2026 July 31, 2026
a) We are aligning implementation reports with fiscal year funding cycles. As a result,the first implementation period is from the previous grant cycle.
See the following pages for a detailed description of the services to be performed.
Page 1 of 9
Confidential-Low
Exhibit A County: County of Fresno
Workplan Agreement Number: 25-10
Goal 1: To align services with the Black Infant Health Program, oversee administration of the PEI and ensure program implementation, planning
evaluation, program oversight, accurate completion of data entry activities and fiscal management is completed in compliance with CDPH-
MCAH Guidelines.
Objectives Activity Evaluation Measures/Deliverables
(Report on these measures in the Annual
Report)
1.1 LHJs will provide oversight, maintain 1. Implement the program activities as defined 1. Submit PEI Reports according to the
program fidelity, fiscal management and in the SOW. reporting schedule established by CDPH-
demonstrate that PEI activities are MCAH-PEI.
conducted as required in the PEI Scope of 2. Local PEI Coordinator will coordinate and
collaborate with MCAH Director to complete,
Work (SOW), CDPH-MCAH Fiscal Policies review, and approve the PEI budget prior to
and Procedures (P&Ps), and PEI P&Ps. submission.
cdph.ca.gov/Programs/CFH/DMCAH/Pages/Fiscal- 31ocal PEI Coordinator will coordinate and
Documents.aspx collaborate with the MCAH Director to ensure
that accurate intervention data is submitted
quarterly and as directed by CDPH MCAH-PEI.
4.Ensure the following key staffing roles are
filled:
• 1.0 Full-time (FTE) PEI Coordinator
5. Notify MCAH-PEI within five (5) business
days of any hire (include start date) or staff
vacancy (indicate last day in program).
1.2 All local PEI staff will maintain and increase 1. Ensure that all key local PEI staff 1. Submit number of activities, trainings, and
staff competency. participates in training or educational conferences (both state and local) attended by
local PEI staff and/or subcontractors during
each FY according to the reporting schedule.
Page 2 of 9
Confidential-Low
Exhibit A County: County of Fresno
Workplan Agreement Number: 25-10
opportunities designed to enhance cultural
sensitivity.
2. Ensure that the local PEI Coordinator and all
direct service staff attend mandatory MCAH
Division-sponsored training(s) and make best
efforts to attend optional activities or
trainings.
3. Ensure all key local PEI staff and/or their
subcontractors participate in available
trainings pertinent to the interventions
selected in their jurisdiction.
1.3 Complete annual Turn the Curve (TTC) 1. Complete TTC process with PEI learning 1. Submit annual TTC report by July 31"of
thinking process, for at least one cohorts and with county partners for each each state fiscal year.
intervention per year. implemented intervention based on guidance
provided by CDPH-MCAH.
2. Complete annual TTC process with learning
collaborative cohort for each implemented
intervention.
3. Complete TTC process as needed with
county partners.
Page 3 of 9
Confidential-Low
Exhibit A County: County of Fresno
Workplan Agreement Number: 25-10
Goal 2: Fund county health departments to develop local community grants to reduce Black Maternal and Infant Mortality/Morbidity by
expanding the scope of interventions to compliment current Black Infant Health (BIH) Programming.
objectives Activity Evaluation Measures/Deliverables
(Report on these measures in the Annual
Report)
2.1 To reduce Black Maternal and Infant 1. Attend all learning collaborative cohorts: 1. Provide intervention progress and share
Mortality/Morbidity, fund/contract with successes and challenges on monthly or bi-
community-based organizations (CBOs) to • Monthly calls or meetings for monthly learning collaborative calls (LHJ's can
implement at least two (2) of five (5) legislated Community Advisory Board and Public continue to utilize the learning collaborative
PEI interventions: Awareness Campaign updates. forms, as needed.
• Monthly or Bi-monthly calls/meetings
• Evidence-based or evidence- for legislated PEI interventions.
informed group prenatal care
program
2. Ensure Results-Based Accountability
• Pregnancy intentionality, activities are completed. 2. See Goal 3 outcomes.
preconception and/or 3. Ensure there is plan in place to meet the
interconception care program needs of your populations in the event of an
• Fatherhood or partnership initiative emergency that may disrupt services. 3. Share your plan for meeting the needs of
that supports engagement of your populations in the event of an emergency
partners in pregnancy and 4. Maintain records and other documentation
for auditing purposes. See Audit and Record that may disrupt services.
childbearing g p p
• Evidence-based or evidence- Retention Section in the CDPH-MCAH Fiscal
informed home visitation program PUS.
• A strategy not described above that 5) Develop and implement unique strategies,
is justified based on local needs and activities, and services for each
resources, that combines social intervention that address social issues
interventions with medical
Page 4 of 9
Confidential-Low
Exhibit A County: County of Fresno
Workplan Agreement Number: 25-10
interventions including but not impacting birth outcomes among Black
limited to: women as approved by CDPH-MCAH-PEI.
a) Assessment
b) Increase patient empowerment
c) Doulas
d) Patient navigator services
2.2 Conduct site visits (either virtually or in- 1. Develop a schedule for visiting each CBO. 1. Submit schedule to CDPH-MCAH-PEI
person) to ensure culturally affirming sites for through the implementation report according
implementation of services. to the reporting schedule.
Goal 3: Incorporate Results-Based Accountability (RBAj-to monitor program performance.
Objectives Activity Evaluation Measures/Deliverables
(Report on these measures in the Annual
Report)
3.1 LHJs and their subcontractors will attend 1.County and community-based organizations 1. Submit a list of staff that have attended RBA
RBA training(s). will utilize the RBA framework to monitor the training (either virtually or in-person).
performance of their interventions.
2. Complete quarterly TTC meetings, at least
one intervention per year, for each
implemented intervention.
Page 5 of 9
Confidential-Low
Exhibit A County: County of Fresno
Workplan Agreement Number: 25-10
2. Ensure that local key county personnel and
CBOs participate in and/or review CDPH
approved RBA training(s).
3. Learn when and how to implement the TTC
process to review and analyze data to
measure program performance.
3.2 Maintain and/or establish data collection 1. Develop, identify, and utilize existing 1. Submit name of software used to
and management methods for CBOs and Local software to collect and manage data that will collect/manage data for each of your
Health Jurisdictions to submit data to CDPH- later be summarized for submission to CDPH- interventions (i.e., evidenced-based,
MCAH. MCAH PEI according to the reporting schedule. evidenced-informed, promising practice,
public awareness campaign, community-
2. Where applicable, ensure CBOs are entering advisory board).
submitting data CDPH-MCAH based on current
guidance.
3. Provide technical assistance to CBOs to 2. Share plan for CBOs to submit data,
ensure data entry is accurate and adheres to including frequency of data into to CDPH-
CDPH-MCAH guidelines. MCAH according to the reporting schedule.
3. Share your plan for LHJ review of the data
entered by the CBO prior to submission to
MCAH according to the reporting schedule.
Page 6 of 9
Confidential-Low
Exhibit A County: County of Fresno
Workplan Agreement Number: 25-10
4. Submit performance data via MCAH data
collection surveys,and according to CDPH-
MCAH reporting schedule.
3.3 Work with CDPH-MCAH to develop and/or 1. Attend learning collaborative cohort 1. Incorporate performance measures based
refine performance measures. meeting for performance measures. on LHJ priorities and guidance provided by
CDPH-MCAH.
2. Submit County data summary to MCAH by
2. Work with Community Advisory Board (CAB) July with each annual report.
and CBOs to ensure measures continue to
meet the community needs.
3.4 Participate in technical assistance (TA) calls 1. Attend and participate in quarterly TA calls 1. Update performance measure data based
with CDPH-MCAH. to provide program updates and ensure on feedback provided by CDPH-MCAH.
accuracy of data.
Goal 4: Conduct local public awareness efforts that address birth outcome inequalities to improve prenatal health and birth outcomes for Black
women and babies.
Objectives Activity Evaluation Measures/Deliverables
(Report on these measures in the Annual
Report)
4.1 Maintain a local Public Awareness 1. Maintain a Public Awareness Campaign that 1. Share ongoing progress in maintaining
Campaign to inform the community about is focus-tested with targeted community campaign in learning collaborative cohort.
Members.
Page 7 of 9
Confidential-Low
Exhibit A County: County of Fresno
Workplan Agreement Number: 25-10
African-American birth outcome inequities
and/or the root causes of these inequities.
2. Incorporate key dates into public awareness 2. Share final and/or updated campaign
efforts. For example: components once complete according to the
reporting schedule.
• National Prematurity Day
• Black Infant Mortality Week
• Black Breastfeeding Week
3. Track outreach and impact of the
awareness campaign via RBA PMs.
Goal 5: Conduct local CAB efforts around birth outcome inequalities to improve prenatal health and birth outcomes.
Objectives Activity Evaluation Measures/Deliverables
(Report on these measures in the Annual
Report)
5.1 Maintain a local collaborative that focuses 1. Reach out to local partners (i.e., hospitals, 1. Provide a list of CAB members and
on Black Maternal and Infant health centers, county clinics, CBOs, etc.) to role/affiliated agency according to the
mortality/morbidity. create a network of partnerships. reporting schedule.
2. Ensure coordination/collaboration between 2.Submit number of trainings, activities, and
PEI and BIH programs, including conferences attended by CAB members and
Page 8 of 9
Confidential-Low
Exhibit A County: County of Fresno
Workplan Agreement Number: 25-10
representation of BIH staff on PEI CAB, PAC role/affiliated agency during each FY according
and intervention Learning Collaborative calls. to the reporting schedule.
3. Ensure representation of target population
for selected interventions is on CAB.
4. Ensure that the CAB members participate in
training or educational opportunities designed
to enhance cultural sensitivity to advocate for
efforts to address racial health disparities.
5.2 Ensure community partners are engaged 1. Hold regularly scheduled CAB meetings, at 1. Provide a schedule of CAB meetings
during the implementation of the least quarterly. according to the reporting schedule.
interventions and are invited to TTC meetings.
2. Document quarterly TTC meetings as
needed via the TTC template available on
Sharepoint.
Page 9 of 9
Confidential-Low
Funding Allocation from the California Department of Public Health
Allocation Name: CHDP Maternal, Child and Adolescent Health, Black Infant
Health, and Perinatal Equity Initiative Fiscal Year 2025-26 Allocation
Fund/Subclass: 0001/10000
Organization: 56201615, 56201670, 56201677, 56201700, 56201706, 56201715,
56201719, 56201720
Revenue Account #: 4382, 3530