DATE: November 16, 2021
TO: Board of Supervisors
SUBMITTED BY: David Luchini RN, PHN, Director, Department of Public Health
SUBJECT: Acceptance of non-competitive award allocated by the California Department of Public health
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize acceptance of a non-competitive award allocation from the California Department of Public Health for the Public Health Workforce Development Supplemental funding through the American Rescue Plan Act of 2021, retroactive to July 1, 2021 thru June 30, 2023, total to not exceed $1,749,848;
2. Retroactively Approve and Authorize the Director of Public Health’s submittal of the spending plan and workplan documents and authorize the Director or his designee to execute any state required documents including reports, claims and other documentation as may be required by the State;
3. Adopt Budget Resolution Increasing FY 2021-22 appropriations and estimated revenues for the Department of Public Health Fund 0080, Subclass 17366, Miscellaneous Public Health Fund Org 1166 in the Amount of $437,462 (4/5 vote);
4. Adopt Budget Resolution Increasing FY 2021-22 appropriations and estimated revenues for the Department of Public Health Org 5620 in the amount of $757,243 (4/5 vote); and
5. Approve Amendment to the Salary Resolution adding the following positions to the Department of Public Health Org 5620: one Staff Analyst, two Program Technicians, one Health Educator, and one Administrative Assistant-Confidential effective November 15, 2021, as reflected in Appendix E.
REPORT
Approval of the first and second recommended actions would provide a total of $1,749,848 in State allocated funding from the American Rescue Plan Act of 2021 through the State’s Public Health Workforce Development Supplemental funding, to establish, expand, train, and sustain the short term/long term public health workforce to support jurisdictional COVID-19 prevention, preparedness, response, and recovery initiatives, including school-based health programs. This funding was a formula-based allocation from the State and is contingent upon State approval of the submitted spending plan as well as your Board’s approval to accept the funds. Approval of the third and fourth recommended actions will increase the Department of Public Health FY 2021-22 appropriations and estimated revenue to implement dedicated workforce development staffing and related operational cost to train and prepare for future public health emergencies. Approval of the fifth recommended action will amend the Salary Resolution adding one Staff Analyst, two Program Technicians, one Health Educator, and one Administrative Assistant-Confidential to the Public Health’s Org 5620. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the County would decline funding to implement additional public health crisis response and workforce development. As required by the awarded allocation, your Board would then need to take action to direct the Interim County Health Officer to draft and submit a letter outlining the refusal of the funding on the Board’s behalf.
RETROACTIVE AGREEMENT:
Approval of the first recommended action allows acceptance of the funds retroactive to July 1, 2021 as set in the award letter provided by California Department of Public Health (CDPH) which allows for qualifying expenses, including producing and creating the required work and spending plans. The County’s Department of Public Health (DPH) was notified of the grant award on August 31, 2021, which required a completed work and spending plan for the allocated award by September 30, 2021. This agenda item is being brought to your Board in accordance with processing timelines.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The COVID-19 Public Health Crisis Response and the Public Health Workforce Development Supplemental Funding allocation is non-competitive and does not require matching funds.
The maximum amount of the award is $1,749,848 to cover estimated costs for the program and has no annual maximum.
CDPH will provide 25% of the total allotment, or $437,462 upfront to the Department upon approval of work and spending plans, the remainder of the funds will be provided via quarterly invoices submitted for reimbursement. Recommended Actions three and four will allow the Department to make budget adjustments of $757,243 to accommodate the estimated use of funds during FY 2021-22. Indirect cost recovery at the Department’s full rate of 22.579% is allowed by this grant. Approval of Recommended Action five will add one Staff Analyst, two Program Technicians, one Health Educator, and one Administrative Assistant at an estimated cost of $290,360. Should funding for these positions be exhausted at the end of the grant period and the Department is unable to fund these positions through other resources, they will be deleted, and the Department will prioritize placing incumbents in other positions.
DISCUSSION:
At the onset of the COVID-19 pandemic in February 2020, the Department of Public Health (DPH) had a critical shortage of staff that were fully trained in Contact Tracing, Case Investigation, Disease Investigation, and the Incident Command System which made it challenging to respond to the public health emergency quickly and efficiently. This was further exasperated in September 2020 with the start of the Creek Fire, in which DPH once again struggled with staffing shortages as the County faced two immediate and urgent emergencies. As a result, DPH found itself instructing staff in emergency training as they were being assigned to assist with one of these emergencies.
DPH was notified by CDPH on August 31, 2021 that the County would be allocated funding from the State’s American Rescue Plan Act of 2021 allocation to work on securing additional training and staff to boost workforce development both within the department as well as work with outside agencies and Community Based Organizations (CBOs) to train in preparation of future emergency situations.
The funds allow for DPH to implement several key initiatives to make sure the County has a strong and responsive workforce in future emergencies. As part of this strategy, DPH has a work plan that allows for training of all DPH current and future staff in the Incident Command System (ICS) as well as Communicable Disease Contact Tracing. Training of staff will also be part of the onboarding of current and future support staff who will be universally trained in the needs of each division within DPH to allow for a more knowledgeable and cross trained workforce in the event of an emergency.
In addition, this grant funding allows for DPH to partner with local schools to provide school health education programs, including workforce development to provide job training to local students interested in a career in Public Health. Careers include nursing, epidemiology, physical therapy, disease control and prevention, environmental health, emergency services, and food inspections.
Finally, this grant funding also requires that we work towards the goal of controlling the continued spread of COVID-19 in the community through workforce development, school safety, and health equity. With that, DPH has outlined goals to raise COVID-19 vaccination rates by the following:
• in the Department by 10%,
• in schools to 50% of students and 75% of faculty,
• in the county from 63% to 75%, and
• assist the 9 lowest vaccinated zip codes in HPI Quartile 1 to achieve at least 50% vaccination over the next two years of this grant.
In order to implement and execute these strategies and programs, DPH is recommending the addition of five positions and three Extra-help Student Workers. These positions will assist in the management and execution of the allocation, accomplishment of goals DPH has set, and to coordinate with education institutions to promote and assist in syllabus and course writing, and acquisition of additional grant funding to continue workforce development beyond FY 2023.
Approval of the recommended actions will allow the Department to utilize this funding to ensure a better trained, maintained, and prepared future workforce to meet the County’s public health emergency needs in current and future years. As part of this process, the Department will also research and apply for additional workforce development grants that may be available to sustain the ongoing and continued development and training of current and future staff.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Exhibit A - Fresno WFD Allocation Letter
On file with Clerk - Exhibit B - Work Plan Template
On file with Clerk - Exhibit C - Budget Template
On file with Clerk - Resolution (Org 1166)
On file with Clerk - Resolution (Org 5620)
Salary Resolution Amendment - Appendix E
CAO ANALYST:
Ronald Alexander