DATE: May 19, 2026
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Director, Department of Public Health
SUBJECT: Retroactive Revenue Agreement with the California Department of Public Health
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive revenue Agreement with the California Department of Public Health for enhanced congenital syphilis prevention activities, effective March 1, 2026 through February 28, 2027, total not to exceed $140,000; and
2. Approve and authorize the Director of Public Health, or designee, to execute the State Contractor’s Release for the final invoice.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the first recommended action will provide funding from the California Department of Public Health (CDPH) to continue to implement the activities of the Congenital Syphilis Case Management program (CSCMP). Approval of the second recommended action will allow the Director of the Department to execute the Contractor’s Release for the final invoice at the close of the grant term. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended actions, the Department would not be able to enhance strategies and activities aimed at reducing the rise of congenital syphilis (CS) cases in the County utilizing dedicated CDPH funding.
RETROACTIVE AGREEMENT:
The recommended revenue Agreement was received from CDPH on March 24, 2026, and retroactive to March 1, 2026.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended revenue Agreement will provide a maximum of $140,000 to offset costs associated with providing CS services from March 1, 2026 through February 28, 2027. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2025-26 Budget and will be included in subsequent budget requests for the term’s duration.
DISCUSSION:
Through the recommended Agreement, the Department will receive support from CDPH to enhance and implement robust case management for pregnant females with congenital syphilis; conduct morbidity and mortality reviews of congenital syphilis cases to identify missed opportunities for prevention. Additionally, the funding will support collaboration with correctional facilities to continue evaluating and enhancing the county jail’s syphilis screening protocol and conduct medical provider education to enhance screening and treatment practices.
In 2025 the Department recorded 35 congenital syphilis cases, which was a 40-50% increase in congenital syphilis cases for the County which saw 19 cases in 2024, and 21 in 2023. The Department also recorded 320 syphilis cases in 2025 among females of childbearing age which was a small decrease of about 11-12% from 362 cases in 2024 and 361 cases in 2023. This funding will help fund three Department staff positions responsible for the data analysis on CS throughout the County, CS case management for all active cases within the County, and review and assignment for all potential CS cases to ensure continuity of care.
The recommended Agreement requires the County to provide one-way indemnification and insurance in favor of the State. This language is typically present in State grants. Therefore, the Department has determined that its acceptance of the indemnification language is advantageous to the County, as the State-grant is an essential funding source for congenital syphilis related activities, without which the continued provision of these services would be negatively impacted.
REFERENCE MATERIAL:
BAI #60, July 9, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CDPH
CAO ANALYST:
Ron Alexander