REPORT TO THE CITY COUNCIL FROM: JENNIFER CLARK, Director Planning and Development Department PHIL SKEI, Assistant Director Planning and Development Department BY: BRANDON SISK, Senior Management Analyst Housing and Community Development Division SUBJECT ..Title Actions pertaining to mobile medical clinic operations funded through the U.S. Department of Housing and Urban Development (HUD) entitlement funds to prevent, prepare for, and respond to COVID-19: 1. ***RESOLUTION - Adopting and approving submission of Substantial Amendment 2019-08 to the 2019-2020 Annual Action Plan to the U.S. Department of Housing and Urban Development (HUD) to reprogram $1,342,600 in Community Development Block Grant Coronavirus (CDBG-CV) funds to prevent, prepare for, and respond to the Coronavirus (COVID-19), and authorizing the City Manager or their designee to sign all necessary implementing documents. (Subject to Mayor's Veto) 2. Approve an agreement between the City of Fresno and the University of California, San Francisco, Fresno (UCSF, Fresno) in the amount of $1,342,600 in CDBG-CV funds to operate a mobile medical clinic. ..Body RECOMMENDATIONS Staff recommends the City Council approve a resolution adopting Substantial Amendment 2019-08 to allow the City to fund the operation of a mobile medical clinic to prevent, prepare for, and respond to COVID-19. Staff also recommends the City Council enter into an agreement with UCSF, Fresno in the amount of $1,342,600 in CDBG-CV funds to operate a mobile medical clinic to prevent, prepare for, and respond to COVID-19. EXECUTIVE SUMMARY The purpose of Substantial Amendment 2019-08 is to expand the description of the medical clinic activity developed under Substantial Amendment 2019-06 to allow for mobile operations. Following a Notice of Funding Availability (NOFA) process, staff has determined UCSF, Fresno to have the strongest proposal for mobile medical clinic operations. Staff is requesting Council approval to enter into a subrecipient agreement with UCSF, Fresno to operate a mobile medical clinic. BACKGROUND As part of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), HUD allocated additional entitlement funds to the City of Fresno to prevent, prepare for, and respond to COVID-19 through CDBG-CV funds. On February 18, 2021, the Council adopted Substantial Amendment 2019-06 through Resolution 2021-049 to program $1,342,600 of CDBG-CV funds for medical clinic facility investments and operations. Since that time, the City has determined there is a greater need for a mobile medical clinic that serves unsheltered and sheltered homeless individuals in underserved neighborhoods. In order to change the use of the CDBG-CV funds, a substantial amendment was required. On December 9, 2022, the City published Substantial Amendment 2019-08 for the required 5-day public comment period. Seven comments were received by the December 15, 2022, deadline. Those comments, any comments received at City Council, and the City's responses will be included in the Substantial Amendment submitted to HUD. A NOFA was published on December 19, 2022, to invite qualified applicants to request funding to operate a mobile medical clinic. Staff reviewed two applications that were received prior to the February 10, 2023, deadline. Staff found one application ineligible and UCSF, Fresno's application to be responsive in addressing all of the requested services. Therefore, staff recommends awarding the $1,342,600 in CDBG-CV funds to UCSF, Fresno for its proposed mobile medical clinic program. UCSF, Fresno's mobile medical clinic will prioritize resources towards providing COVID-19 services first that will ensure adequate testing, vaccination, and treatment services for homeless patients. Other immunizations and basic health services that will help keep the population healthier and better prepared for future COIVD-19 infections will also be provided. The specific services to be provided include: * COVID-19 vaccine administration on a walk-in basis * Testing for COVID-19 on a walk-up basis * Prescribing and filing medication to prevent or treat COVID-19 infections * Seasonal Influenza vaccine administration on a walk-in basis * On-site or telehealth screening for post-COVID conditions * Referral to homeless services * Urgent care services for common ailments * Refill common primary care medications * Screenings and initial treatment and referral for HIV, Hypertension, Diabetes * Screening, counseling, and bridge therapy for mental health and drug addiction services The proposed mobile medical clinic would be available up to five days a week and 20 days per month. UCSF, Fresno anticipates serving 50 people per day with a maximum of 12,000 services visits in a year. This agreement is intended to serve as a catalyst for UCSF's mobile medical clinic and they understand these Coronavirus funds will not be available in future years. ENVIRONMENTAL FINDINGS This is not a project for purposes of CEQA pursuant to CEQA guidelines Section 15378. These plans, strategies and studies are an exempt activity under HUD NEPA Requirements (24 CFR 58.34 (1)). The mobile medical clinic operations are Categorically Excluded not subject to 58.5 under HUD NEPA Requirements (24 CFR 58.35 (b)). LOCAL PREFERENCE Local preference is not applicable because of the use of federal funding. FISCAL IMPACT There is no fiscal impact because no funds are being reprogrammed. Attachments: Resolution with Exhibit Substantial Amendment 2019-08 Subrecipient Agreement with UCSF, Fresno for Mobile Medical Operations