DATE: May 26, 2020
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Revenue Agreement with California Department of Public
Health for Communicable Disease Infrastructure
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive revenue agreement with the California Department of Public Health for Communicable Disease Infrastructure, effective February 1, 2020 through June 30, 2023 ($1,047,752).
2. Approve Amendment to the Salary Resolution adding positions to the Public Health’s Org 5620, effective June 1, 2020, as reflected in Appendix C.
REPORT
Approval of the first recommended action will provide new funding from the California Department of Public Health (CDPH) for public health infrastructure to address communicable disease prevention and control. The grant will increase the Department’s ability to actively assess and respond to infectious disease outbreaks, including COVID-19. Approval of the second recommended action will add four positions to complete required grant scope of work activities and to ensure the Department has the resources required to adequately monitor and respond to infectious disease outbreaks. There is no change in Net County Cost associated with the recommended actions. This item is Countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action to the first recommended action. Should your Board not approve the recommended grant agreement, the Department would not be able to fund critical positions and software to prevent and control infectious diseases. Should your Board not approve the second recommended action, the Department’s capacity for infectious disease response will remain limited.
RETROACTIVE AGREEMENT:
The recommended agreement was received from CDPH on April 28, 2020 and is retroactive to February 1, 2020.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. If approved, the grant will provide $1,047,752 from February 1, 2020 through June 30, 2023, with no annual maximum. There are currently no outstanding invoices related to this Agreement. For planning, the Department has requested through the grant $53,196 in FY 2019-20; $308,073 in FY 2020-21; $354,421 in FY 2021-22; and $332,062 in FY 2022-23; however, there is no yearly maximum. The added positions will be funded by the recommended grant agreement and Health Realignment as follows:
• Division Manager - Public Health Services: CARES Act funds through December 2020 or longer if funds are extended; however, if funds are not extended the position will continue to be funded with Health Realignment ($194,739 annual salary and benefit cost)
• Communicable Disease Specialist: 100% grant funded ($78,155 annual salary and benefit cost)
• Epidemiologist: 75% grant funded, 25% Health Realignment ($116,152 annual salary and benefit cost)
• Public Health Microbiologist: 75% grant funded, 25% Health Realignment ($121,451 annual salary and benefit cost)
Sufficient appropriations and estimated revenues were included in the Department’s Org 5620 FY 2019-20 Adopted Budget and will be included in future budget requests.
DISCUSSION:
On February 6, 2020, the Department received notice from CDPH of new, one-time funding available for local health departments to improve capacity for infectious disease surveillance, investigation, analysis and response. The funding is critical to ensuring the Department is equipped with the staff and resources necessary to prepare for and respond to public health emergencies such as the COVID-19 pandemic.
With your Board’s approval of the recommended actions, the Department will be positioned to effectively respond to the current public health crisis. The Department will also be able to provide reciprocal assistance to other Central Valley counties’ public health planning, research and laboratory needs, and will complement the region’s strategic laboratory plan. The recommended Division Manager - Public Health Services will coordinate the Department’s COVID-19 planning and operations, allowing existing Division Managers to return to managing normal program areas while continuing to effectively contribute to the overall response effort.
Approval of the recommended grant agreement will provide funding for one new Communicable Disease Specialist, one new Epidemiologist position, one new Public Health Microbiologist position, as well as funding for an existing Program Technician position that would have otherwise been deleted. The agreement also provides funding for a comprehensive public health laboratory information management system that will automate and integrate laboratory testing and resulting, dramatically increasing the Department’s ability to rapidly perform a wide range of public health testing. The Department is aware of unmet community health needs that expanded investigation and laboratory capacity will help address following the pandemic, including sexually transmitted disease tracing and testing to help combat the County’s ongoing congenital syphilis crisis.
The recommended agreement stipulates a dispute resolution process in which the State and County must partake to informally resolve any disputes arising from the State’s actions. The agreement also contains non-standard County general indemnification and intellectual property indemnification provisions which require the County to indemnify the State. The Agreement may be cancelled or terminated without cause by the State with 30 calendar days advance written notice. The State may also cancel immediately for cause. The County may cancel only if the State fails to perform its responsibilities.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Revenue Agreement with CDPH for Communicable Disease Infrastructure
Appendix C
CAO ANALYST:
Raul Guerra