HomeMy WebLinkAboutHealth Management Associates Inc.-Strategic Planning Consultation Services_A-26-017.pdf COtj County of Fresno Hall of Records, Room 301
2281 Tulare Street
Fresno,California
601 Board of Supervisors 93721-2198
O� 1$56 0 Telephone: (559)600-3529
FRV,t' Minute Order Toll Free: 1-800-742-1011
www.fresnocountyca.gov
January 6, 2026
Present: 5- Chairman Garry Bredefeld, Vice Chairman Luis Chavez, Supervisor Nathan Magsig,
Supervisor Buddy Mendes, and Supervisor Brian Pacheco
Agenda No. 40. Public Health File ID: 25-1294
Re: Approve and authorize the Chairman to execute Amendment No.2 to Agreement No. 24-337 with
Health Management Associates, Inc.to provide additional consultation and assistance to the
Department of Public Health with completing development of the 10-year Strategic Plan,with no
change to the term of June 18, 2024, through December 31, 2026, and increasing the maximum by
$14,000 to a total of$331,843
APPROVED AS RECOMMENDED
Ayes: 5- Bredefeld, Chavez, Magsig, Mendes, and Pacheco
Agreement No. 26-017
County of Fresno Page 43
co
Board Agenda Item 40
O 1856 O
FRE`'�
DATE: January 6, 2026
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Director, Department of Public Health
SUBJECT: Amendment No. 2 to Agreement with Health Management Associates, Inc.
RECOMMENDED ACTION(S):
Approve and authorize the Chairman to execute Amendment No. 2 to Agreement No. 24-337 with
Health Management Associates, Inc. to provide additional consultation and assistance to the
Department of Public Health with completing development of the 10-year Strategic Plan, with no
change to the term of June 18, 2024, through December 31, 2026, and increasing the maximum by
$14,000 to a total of$331,843.
There is no additional Net County Cost associated with the recommended action. Approval of the
recommended action will increase the maximum compensation of the agreement with Health Management
Associates, Inc. (HMA) by$14,000 to a total of$331,843. HMA would provide the Department of Public
Health (Department)with additional consultation and training to complete development and implementation
of the Strategic Plan. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department will not be able to obtain additional
consultation services from HMA to operationalize and enhance implementation of the Strategic Plan within
each of the Department's divisions.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. Upon execution of the
recommended amendment, the maximum compensation for the agreement will increase by$14,000 to a
total of$331,843. The additional consultation services to assist the Department with the Strategic Plan will
be funded by a State grant: Future of Public Health. Sufficient appropriations and estimated revenues are
included in the Department's Org 5620 FY 2025-26 Adopted Budget and will be included in subsequent
budget requests.
DISCUSSION:
On June 18, 2024, the Board approved an agreement with HMA for consultation services in developing the
Department's new 10-year Strategic Plan with a focus on providing essential services in the most
cost-effective manner possible. HMA worked with the Department to confirm goals and initiatives, complete
stakeholder engagement, develop a departmental framework, evaluate revenue sources, and create an
official document of the Plan.
On March 11, 2025, the Board approved Amendment I to Agreement 24-337 with HMA to increase the
County of Fresno page 1 File Number.25-1294
File Number:25-1294
maximum compensation and add to the scope of services provided by HMA. The additional consultation
services provided assistance with navigating a complex California Department of Health Care Services
(DHCS) application for the Department's inclusion to the DHCS's VRRP and development of the Strategic
Plan. Participation in the VRRP will allow the County to transfer funds to the DHCS to be used as the
non-federal share in claiming Federal Financial Participation dollars for Medicaid covered services. The
eligible funds will be used by DHCS to draw down federal funds, which can then be disbursed to the
Managed Care Plans and participating counties as additional funding.
Approval of the recommended amendment No. 2 will increase the maximum compensation upon execution
and add to the scope of services provided by HMA. The additional consultation services will assist each of
the Department's divisions with development of an operational implementation plan that aligns with the
10-year Strategic Plan. HMA will meet with each of the divisions and provide leadership coaching and
support to enhance implementation of the Strategic Plan.
REFERENCE MATERIAL:
BAI #41, March 11, 2025
BAI #74, June 18, 2024
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk-Amendment No. 2 to Agreement with HMA
CAO ANALYST:
Ron Alexander
County of Fresno Page 2 File Number.25-1294
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Docusign Envelope ID:C75775D9-556E-4807-8748-3DE4646F8310
Agreement No. 26-017
1 AMENDMENT NO. 2 TO SERVICE AGREEMENT
2 This Amendment No. 2 to Service Agreement ("Amendment No. 2") is dated
3 January 6, 2026 and is between Health Management Associates, Inc., a Michigan
4 corporation ("Contractor"), and the County of Fresno, a political subdivision of the State of
5 California ("County").
6 Recitals
7 A. On June 18, 2024, the County and the Contractor entered into Service Agreement,
8 which is County agreement number 24-337 ("Agreement"), for strategic planning consultation
9 services.
10 B. On March 11, 2025, the County and the Contractor entered into Amendment I to extend
11 the term from June 18, 2026 through December 31, 2026 and increase the maximum
12 compensation to a total of Three Hundred Seventeen Thousand Eight Hundred Forty-Three
13 Dollars ($317,843) for assistance with implementing and managing the County's inclusion into
14 the California Department of Health Care Services' Voluntary Rate Range Program.
15 C. The County and Contractor have determined additional resources and further training
16 are needed in developing each division's Strategic Plan.
17 D. The County and the Contractor now desire to amend the Agreement to increase funding
18 to complete the additional consultation services for the Strategic Plan.
19 The parties therefore agree as follows:
20 1. All references in the Agreement to "Revised Exhibit A" shall be changed to read
21 "Revised Exhibit Al," where appropriate, attached hereto and incorporated herein by reference.
22 2. All references in the Agreement to "Revised Exhibit B" shall be changed to read
23 "Revised Exhibit B1," where appropriate, attached hereto and incorporated herein by reference.
24 3. Section 3.2 of the Agreement, "Maximum Compensation," located at Page 2 is deleted in
25 its entirety and replaced with the following:
26 "3.2 Maximum Compensation. The maximum compensation payable to the
27 Contractor under this Agreement is One Hundred Ninety-Eight Thousand Five
28 Hundred Ninety-Four Dollars ($198,594) for the period June 18, 2024 through
1
I
Docusign Envelope ID:C75775D9-556E-4807-8748-3DE4646F8310
1 June 17, 2025, One Hundred Fifteen Thousand One Hundred Eleven Dollars
2 ($115,111) for the period June 18, 2025 through June 17, 2026, and Eighteen
3 Thousand One Hundred Thirty-Eight Dollars ($18,138) for the period June 18,
4 2026 through December 31, 2026. The total maximum compensation payable for
5 the entire term of this Agreement shall not exceed Three Hundred Thirty-One
6 Thousand Eight Hundred Forty-Three Dollars ($331,843). The Contractor
7 acknowledges that the County is a local government entity and does so with
8 notice that the County's powers are limited by the California Constitution and by
9 State law, and with notice that the Contractor may receive compensation under
10 this Agreement only for services performed according to the terms of this
11 Agreement and while this Agreement is in effect, and subject to the maximum
12 amount payable under this section. The Contractor further acknowledges that
13 County employees have no authority to pay the Contractor except as expressly
14 provided in this Agreement."
15 4. When both parties have signed this Amendment No. 2, the Agreement and this
16 Amendment No. 2 together constitute the Agreement.
17 5. The Contractor represents and warrants to the County that:
18 a. The Contractor is duly authorized and empowered to sign and perform its obligations
19 under this Amendment.
20 b. The individual signing this Amendment on behalf of the Contractor is duly authorized
21 to do so and his or her signature on this Amendment legally binds the Contractor to
22 the terms of this Amendment.
23 6. This Amendment may be signed in counterparts, each of which is an original, and all of
24 which together constitute this Amendment.
25 7. The Agreement as amended by this Amendment No. 2 is ratified and continued. All
26 provisions of the Agreement and not amended by this Amendment No. 2 remain in full force and
27 effect.
28 [SIGNATURE PAGE FOLLOWS]
2
ii
Docusign Envelope ID:C75775D9-556E-4807-8748-3DE4646F8310
1 The parties are signing this Amendment No. 2 on the date stated in the introductory
2 clause.
3
HEALTH MANAGEMENT ASSOCIATES, COUNTY OF FRESNO
4 INC. 0
6 F "I Garry Brreeddlefeld, Chairman of the Board of
Kelly-Johnson, Chief Administrative Officer Supervisors of the County of Fresno
7
2501 Woodlake Cir, Ste 100 Attest:
8 Okemos, Michigan 48864 Bernice E. Seidel
Clerk of the Board of Supervisors
9 County of Fresno, State of California
10
By:
11 Deputy
12 For accounting use only:
13 Org No.: 56201508; 56201500
Account No.: 7295
14 Fund No.: 0001
Subclass No.: 10000
15
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3
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Docusign Envelope ID:C75775D9-556E-4807-8748-3DE4646F8310
Revised Exhibit Al
1 Scope of Services
2 Strategic Plan:
3 The Contractor will provide the County with consultation and support in the
development of DPH's new 10-year strategic plan. DPH's strategic plan is expected to be
4 developed in approximately twelve (12) months. This estimated time frame will include
5 stakeholder engagement, discussions with the DPH, and final review.
6 The Contractor will work with DPH to confirm goals and initiatives, develop a departmental
framework, review the strategic plan, and create an official document of the plan. This will
7 include:
8 • Development or revision of the DPH Core Purpose, Vision, Mission, and Values
statements.
9
• Facilitation of discussions with DPH management, employees, and other County
10 departments to identify how DPH can be more impactful.
11 . Review of current DPH programs to categorize which direct services are managed by
12 DPH or subcontracted, including annual contract amounts.
13 • Facilitation of discussions with DPH management, employees, and other County
departments to identify how DPH can be more aligned with equity, diversity and
14 inclusion priorities.
15 • Facilitation of stakeholder engagement activities to evaluate the community's
perception on DPH's current service delivery, focus and future expectations.
16 Stakeholders should represent rural, metropolitan, and diverse communities within
17 Fresno County.
18 • Review of required public health mandates, mandate levels, and revenue sources.
19 • Identification of public health priority outcomes and actions after research and analysis
is completed.
20
• Documentation of this information for current and future planning and budgetary
21 purposes.
22 . Final review and creation of an official document of the Strategic Plan.
23 The Contractor will provide a service plan that includes preliminary timelines for key
24 activities, implementation and deliverables. The Contractor will review the most recent
information regarding the Fresno County Community Health Improvement Plan Healthy
25 Fresno County (healthyfresnocountydata.orc, and Community Health Needs Assessment
"` ' to reference in developing DPH's strategic plan. The
26 Contractor will also consider DPH's plans to achieve its goal of accreditation through the
National Public Health Accreditation Board within the next few years.
27
Upon completion of DPH's strategic plan, the Contractor will assist each of the seven
28 DPH divisions with developing their strategic plan that aligns with the department's strategic
A-1
I
Docusign Envelope ID:C75775D9-556E-4807-8748-3DE4646F8310
Revised Exhibit Al
1 plan. The Contractor will work with each division to confirm goals and initiatives, develop a
division framework, review each strategic plan, and create an official document of each plan.
2
3 Voluntary Rate Range Program:
The Contractor will provide the County with consultation and assistance with the
4 Voluntary Rate Range Program (VRRP). The Contractor will provide the following services
5 and any other tasks, as required.
6 • Research and investigate to determine the opportunity for the County's participation in
the VRRP.
7
• Provide assistance and support to DPH with participation in the VRRP with CalViva,
8 Anthem, and Kaiser. This work will include the following:
9 o Provide initial information and education to DPH regarding participation in the
VRRP process; this may take the form of conference calls and the provision of
10 written materials. As necessary, the Contractor will work with executive
11 managers, elected officials, attorneys, and others throughout the VRRP
process.
12 o Assist DPH to identify and submit its costs for the provision of plan services to
13 plan member patients during the reporting year to which the VRRP pertains.
This involves understanding the California Department of Health Care Services
14 (DHCS) requirements for calculating unreimbursed costs, etc.
15 o Provide financial calculations to DPH regarding the dollar amounts involved in
their VRRP at each step of the process.
16
o Communicate with DHCS and/or Partnership Health Plan of California
17 regarding any issue related to the VRRP including but not limited to the VRRP
18 timelines, document language, etc.
19 o Provide DPH with drafts for their approval of any VRRP documents required by
DHCS, including the Health Plan-Provider Agreement and the
20 Intergovernmental Agreement with DHCS. These drafts will be based on the
latest document templates provided by DHCS, modified to include information
21 specific to the County Partnership Health Plan of California.
22 o Provide instruction and support to DPH regarding the timely execution and
23 transmittal of the final signed documents to DHCS.
o Assist DPH with any issues regarding the wiring of funds to DHCS and the
24 payment of the VRRP-funded proceeds by the plan.
25 Perform other activities as required to support the efficient and prompt implementation
26 of the VRRP.
27 The Contractor's Associate Principal will serve as the project manager and will ensure
timely completion of deliverables, coordinate team activities, and provide consistent
28 communication with the County. The Contractor's Managing Principal will also be assigned to
this project. Additional HMA staff will provide services for the project as appropriate.
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Docusign Envelope ID:C75775D9-556E-4807-8748-3DE4646F8310
Revised Exhibit B1
1 Compensation
2 The Contractor will be compensated for performance of its services under this
3 Agreement as provided in this Revised Exhibit B1. The Contractor is not entitled to any
4 compensation except as expressly provided in this Revised Exhibit 131. The total maximum
5 compensation payable for the entire term of this Agreement shall not exceed Three Hundred
6 Thirty-One Thousand Eight Hundred Forty-Three Dollars ($331,843).
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