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HomeMy WebLinkAboutMINUTES - 09131994 - 1.77 1 . 77 -'TO: t BOARD OF SUPERVISORS FROM: Mark Finucane, Health Services Director 1114- Contra By: Elizabeth A. Spooner, Contracts Administrator Costa DATE: August 18, 1994 County Approve Submission of Funding Application #29-265-30 with SUBJECT: the State Department of Health Services for Continuation of the Maternal and Child Health and Perinatal Improvement Program SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: Approve and authorize the Chair, Board of Supervisors, to execute on behalf of the County, Funding Application #29-265-30 with the State Department of Health Services, in the amount of $824,033, for the period from July 1, 1994 through June 30, 1995, for continuation of the Maternal and Child Health and Perinatal Improvement Program. II. FINANCIAL IMPACT: Approval of this agreement by the State will result in $824,033 for this program. Sources of funding are as follows: State Allocation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$292,641 Federal Funds (through the State DOHS) . . . . . . . . . . . . .$531,392 County (In-Kind Only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$328,030 FY 1994-95 TOTAL PROGRAM $1,152,063 III. REASONS FOR RECOMMENDATIONS/BACKGROUND: On October 5, 1993, the Board of Supervisors approved Standard Agreement #29-265- 28 with the State Department of Health Services for continuation of the Maternal and Child Health and Perinatal Improvement Program during the period from July 1, 1993 through June 30, 1994 (as amended by Standard Agreement Amendment #29-265-29, approved by the Board on August 9, 1994) . Funding Application #29-265-30 requests funding for continuation of the program through FY 1994-95. The Board Chair should sign six copies of the application. Five signed copies of the application and three certified/sealed copies of this Board Order should be returned to the Contracts and Grants Unit for submission to the State. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMEN TION F BOARD COMM TEE APPROVE OTHER SIGNATURE(S) — ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. Contact: Mary Foran (313-6254)_ cc: Health Services (Contracts) ATTESTED >hp �" , Auditor-Controller (Claims) �— T- Phil Batchelor, Clerk of the Board of State Dept. of Health Services 3UpWVWj3BRdWtyni*aW M382/7-83 BY DEPUTY. FUNDING APPLICATION 1 Control No. 94- FISCAL YEAR (FY) 1994-95 ubmit original and 2 copies complete with attachments to: 29 , 2-65 - 30 Materna) and Child Health Branch Mary Foran, MPH P.O. Box 942732 94-19548 CNTY 714 "P" Street, Room 740 Sacramento, CA 94234-7320 REVIEW ATTACHED INSTRUCTIONS CAREFULLY BEFORE COMPLETING APPLICATION licate all MCH-related state programs to which you have applied for fiscal year 1994-95 funding (blacken appropriate boxes): [] Farm workers N California Children Services 11 Indian Health [] Primary Care Grant (AB 1317) [1 Rural Health N Child Health Disability Program N Maternal and Child Health [] Adult Day Health Care (AB 161 1) N Office of Family Planning [] Genetically Handicapped Persons Program [1 Immunization Assistance N Women, Infants, and Children Supplemental Food NOtherMCH High Risk Infant Follow-up APPLICATION INFORMATION OFFICIAL AGENCY NAME AND ADDRESS (as it is to appear on agreement): Contra Costa County Health Services Department/Public Health/ -ne: Office for Service Integration Iress: 597 Center Avenue, Suite 365 r: Martinez, CA ZIP Code 94553 inty: Contra Costa County Telephone (510) 313-6254- CATEGORY OF PROJECT: MCH AMOUNT REQUESTED FOR FY 1994-95: $ 824,033 'ROPOSED FUNDING PERIOD: From 07/01/94 to 06/30/95 'M 166 (MCH) 11/94 . M1 V. -RFA CHECKLIST Please use this checklist when submitting your RFA package to MCH. Are the following documents enclosed? Is the following information contained in the package? Original and two copies of the RFA package Is the application information complete? Is the Federal Employer ID number, correct (PM 166, Page 9, Section B, Item 5)? Are there original signatures (PM 166, Page 11, Section D)? � W, t -F'J�' ..3,..r � � <....Ss .J ..i►, Of , �\nl.� �", �rc-,�'�./`dC 5 . Affirmative Action Information Sheet b j,---Scope of Work (Exhibit B) Is the SOW included? ,-,,`-Is the SOW readable and legible? �udget Worksheet Are all personnel positions listed? _/Does the .total support requested equal the amount of funding requested/provided? _ 1s a budget justification narrative attached? U/ vl_ Is the information in the RFA accurate and correct? The undersigned has checked this application for accuracy and can be reached at the telephone number listed if there are any questions. Dated: -`1 LA e Name Telephone Number 4. PROPOSED NARRATIVE SUMMARY: (Do not exceed this space.) This project coordinates MCH services for Contra Costa County. Project goals include overall MCAH coordination and advocacy, including MCAH Board, perinatal : substance abuse activities and perinatal vital statistics analysis , local CPSP planning, recruitment and implementation, maintenance of toll free telephone line, Black Infant Health activities , and the Prenatal Care Guidance program activities . PM 166 (MCH) 11 /94 Par, R cif pR B. AGENCY INFORMATION (Please type or print all information and include ZIP and Area Codes). 1 . Agency Director: Name: Mark Finucane Title: Director, Department of Health Services Address: 20 Allen Street, Martinez , CA ZIP Code: 94553 Telephone: CrIl 370-5003 2. Agency Fiscal Officer: Name: Patrick Godley Title: Chief Financial Officer Address: 20 Allen Street, Martinez , CA — ZIP Code: 94553 Telephone: (_10) 370-5005 3. Agency Official with Board Authority to Commit Agency to an Agreement: Name: Wendel Brunrier, MD Title: Assistant Director of Health Services , Public Health Division Address: 597 Center Avenue, Ste 200, Martinez , CA ZIP Code: 94553 Telephone: (_`510) 313-6712 4. Project Director (if none, agency contact regarding application): Name: Mary Foran, MPH Title: Director, Office for Service Integration Address: 597 Center Avenue, Ste 365 , Martinez, CA ZIP Code: 94553 Telephone: (_`i10) 313-6254 FAX Number:(510) 313-6708 5. Provider Numbers: Medi-Cal NLA FederalEmployer ID # 19141-16 i 0 4010151019 ! Clinic License Number and Expiration Date 3. Agency Tax Status: [ Public (Government/University) [ ) Private, Nonprofit ( ] Other(Specify) PM 166 (MCH). 1 1/94 Page 9 of 98 C. FISCAL YEAR 1994-95 ANTICIPATED FUNDS BY SOURCE List all federal,state,and local grants,contract and agreements for generic maternal,child,and adolescent health services to which you have applied for fiscal year 1994-95 funding. NAME OF FUNDING SOURCE SPECIFY FED,STATE AMOUNT OF SUPPORT FUNDING OR LOCAL PERIOD INCLUDING PRIVATE CHDP State, County $266,860 1994-95 EPSDT Federal, State, Cty $1,344,477 1994-95 CCS State, County $4,600,000 1994-95 High Risk Infant Follow—Up State $251,886 1994-95 MCH (CPSP, CPO, PCG) Federal, State, Cty $1,299,644 -- 1994-95 Family Planning State $134,500 1994-95 WIC Federal, State $993,214 1994-95 Dental Disease Program State $96,552 1994-95 African—American Infant State $102,500 1994-95 Health Project D. . AGREEMENT AND CERTIFICATION fi. Agreement: To be completed by all applicants The undersigned hereby affirms that the statements contained in the application package are true and complete to the best of the applicant's knowledge, and fur er, realizes this i a public document which is open to public inspection. Director, 'Department of Health Services Original Signature Title Mark Finucane 7 — Z 7— 9 Name (Type or Print) Date 2. Certification Statement: To be completed by all applicants I certify that this Maternal, Child, and Adolescent Health Service Program will comply w• all federal and state legal requirements pertaining to the program. under and that the State will use the materials submitted by this agency as guid ine for rogram c tation and assessment. Board of Supervisors Original Signature Title . Tom Powers.- , 9 - 13 c7i Name (Type or Print) Date 3. Certification Statement: For local health jurisdictions only I certify that the County has a Maternal, Child, and Adolescent Health Board advisory to the Maternal, Child, and Adolescent Health Service programs, the membership of which meets the requirements of the Health and Safety Code Section 321 .7. Local Health Officer Local Health Officer Title (Original Signature) William Walker, MD Name (Type or Print) Date PM 166 (MCH) 11/94 Page 11 of 98 State of Cali loin i3--HeaItn and welfare Agency Oepartment or Heal-,n Services AFFIRMIATIVE ACTION INFORMATION SHEET 1. For statistical purposes, please complete the following information to the questions belo�:r. 2. This information is for statistical use only- It is considered confidential and does not constitute a basis for award or rejection of any contract,work order, service authorization, or purchase order with the Department. VENDOR/CONTRACTOR INFORMATION Name of Firm OGS Vendo:Number Contra Costa County Health Services Department _ Nam^of Principal w other tn:!n an indiviaual ri:.r.) Ti:le Business Address City Zia 597 Center Avenue, Ste 365 Martinez CA 24553 Type of Ownership (Use 2 digits, i.e.,01,02, 10, 11,etc.); 01 = Individual 02 = Partnership 03= For Profit Corp. 04 = Not-for-Profit Corp. 05 = For Profit Hospital/Skilled Nursing Facility 06 = Not-for-Profit Hospital/Skilled Nursing Facility 07= Unincorporated Association 08 = College/University (Including both Public and Private) including University Hospitals 09= County Government only 10= Other California governmental-entity,except County and No. 11 balow. (City,School District,Water District,Joint Powers,etc.) 11 =California State Agency 12 —Other entity, including_ Federal Government,another State,any entity not identified in 1 thru 11. Indicate Ownership digit(s) here: 9 Type of Business Contractor's License Held,it any: Statistical Information Ethnic Codes: Male Female Male Female Black Americans 1 A American Indians/Alaska Natives 7 G Asian-Pacific Americans 2 B Filipino Americans 8 H Hispanic Americans 4 0 Asian-Indian Americans 9 I Pacific Islanders 6 F Caucasian/White Americans 5 E Enter Ethnicity of Vendor/Contractor from above fist: Has Vendor/Contractor applied to and been approved by the Office of Small and Minority Business, Department of General Services, as a small business? (See reverse side). Yes ❑ No ❑ If yes,enter the date of the letter OSMS sent to the Vendor/Contractor approving the small business status: His Vendor/Contractor applied to and been approved by the Office of Civil Rights, Department of Transportation,as a Minority Business Enterprise or a Disadvantaged Business Enterprise? Yes 0 No n If yes,enter CulTr3tis seven-digit cuttificate number given to Vendor/Contractor: Enter certificate expiration date: Is Vendor/Contractor a '"Women-Owned Enterprise"? Yes ❑ No U OHS Information- Date Received: By: - Date entered DHS Program Name: in CMS SA log: INFORMATION PRACTICES ACT STATEMENT This information is reGues:ed by the State of California, Department of Health Services for statistical purposes only. Completion of the for" is voluntary and there are nu consequences for not providing the information. Informaltar: vvill be provided to Contract Section, Business Services Section, Records i_-nacement and Adrnini;ira6ve Suppori Secion of the DeparEment of Health Services, an,-: Possibly -possibly other public ao�not?s. For more ir.forrnation or access to your records, contac, the Seciion Chic", Contract Management SEct:o:.. Dcpariment of Hc2;;1) S-:.. es. 7 P S:._^z, SacrJmento• CA 95514• Telephone (916) 3226)22. 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Personnel Each position carried in the personnel section of the budget is assigned to carry out specific objectives in the scope of work. The salaries and percent time for each position is documented on the budget. The percent time budgeted for each person is the amount necessary to carry out the assigned responsibilities. In addition to State and Federal funding, a substantial amount of county dollars are devoted to accomplishing the scope of work. There are three benefits rates represented in the budget. The rate for permanent county employees is 31.0%. Temporary staff rate is 10.53% and contract employee rate is 7.65%. The Epidemiologist is a contract employee. The only temporary staff are student interns. The rest of the positions are filled by permanent county employees. The MCAH Director directs the MCAH team which provides overall program planning, coordination, and advocacy. In addition, he is responsible for active participation in CCLDMCAH, and other State issue committees. The OSI Director participates on the MCAH Team. In addition, she coordinates execution of the entire scope of work, including supervision of other staff on the program. She also directs implementation of activities to improve integration of all MCAH Family Health oriented programs through special projects within the Health Services Department and between the Department and other , family-serving agencies. The BIH Director participates on the MCAH team and is responsible for monitoring the BIH portion of the contract. The PH Clinic Services Director is as member of the MCAH team whose focus is on planning and evaluating MCH clinical services and acting liaison with local SB620 projects. The Executive Assistant to the PH Director participates on the MCAH team with a special focus on ongoing support to advisory boards which advocate for MCH services (PEHAB,MCAH). The Epidemiologist is a member of the MCAH team with special responsibilities of analysis and tracking of the Year 2000 MCH Objectives. The CIP Data Analyst participates on the MCAD team and is responsible for developing and maintaining the CIP data systems. The Accountant is responsible for fiscal monitoring of the budget including all ledgers and invoicing. The clerical staff provide comprehensive clerical support including typing, word processing, ordering, filing, maintenance and distribution of educational materials for all professional staff on the budget. The CPSP Coordinator, PH Nutritionist, PH Social Worker, Senior Health Education Specialist, and Health Education Specialist (also a MCAH team member) work in the CPSP section of the program, providing recruitment, training,consultation and technical assistance to potential and approved providers. The Health Education Specialist also works on improving integration among all MCAH programs. The PCG Coordinator and team of six public health aides/outreach workers work together to locate and motivate pregnant women to enroll in early and appropriate prenatal care. Another Senior Health Education Specialist works on toll free systems and the effort to improve communication and coordination among programs. The line item for temporary staff funds short term projects for general MCH coordination which is expected to be carried out by student interns. II. Operating Expenses Travel $10,802.00 (10% MCH, 90% CNTY N) Training $3,202.00 (10% MCH, 90% CNTY N) Space $40,142.20 Supplies $9,522.00 Other Misc. $39,070.00 Communications $15,000.00 Copier $6,500.00 Education Materials $11,622.55 Publicity/Marketing $5,947.45 These operating expenses are used to support the twenty-five positions on our contract. The other miscellaneous funds are also used to support our growing CPSP provider base and necessary outreach activities. III. Indirect Costs $65,528.00 IV. Other Furniture $1,200 Subcontract A) $131,191.48 A) Contract to East Bay Perinatal Council is for continuation of current BIH activities to include support and education groups on a wide range of issues for clients. Funds support staff time, space, childcare and supplies for the groups. BIH Project Manager also coordinates the community advisory panel -- Black Infant Mortality Forum. V. Summary Total Operating Expenses $102,735.00 Total Personnel $851,409.00 Total Expenditures $1,152,063.00