DATE: December 14, 2021
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Ratification of Agreements and Amendment with Federally Qualified Health Centers for COVID-19 Vaccination
RECOMMENDED ACTION(S):
TITLE
1. Ratify Agreement No. D-21-174 with Valley Health Team Inc. to serve as COVID-19 on-call vaccine administration team previously executed by the County Administrative Officer, acting as the Emergency Services Director, effective March 24, 2021 through March 23, 2022, with one additional 12-month extension, total not to exceed $730,200.
2. Ratify Agreement No. D-21-130 with The Regents of the University of California, San Francisco to serve as on-call COVID-19 vaccine administration team, previously executed by the County Administrative Officer acting as the Emergency Services Director, effective April 15, 2021 through April 14, 2022, with two additional 6-month extensions, total not to exceed $4,444,020.
3. Ratify First Amendment to Agreement with The Regents of the University of California, San Francisco to add the provision of monoclonal antibody therapy, flu vaccine administration services, COVID-19 testing services, previously executed by the County Administrative Officer acting as the Emergency Services Director, and increase maximum by $2,961,784, with no change to the term of April 15, 2021 to April 14, 2022, total not to exceed $7,405,804.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the first and second recommended actions would ratify the agreements and continue to make available on-call COVID-19 vaccination in partnership with Federally Qualified Health Centers (FQHCs) in support of the County’s COVID-19 pandemic response. Approval of the third recommended action would ratify the first amendment with the University of California, San Francisco and continue the provision of monoclonal antibody therapy (MAB), COVID-19 testing, and flu vaccination to Fresno County residents. The option for an additional 12-month extension is included in the full term of the first recommended action and an option for two additional 6-month extensions is included in the full term of the second recommended action. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board choose not to ratify the agreements, there will be a reduction and delay of COVID-19 vaccination, COVID-19 testing, MAB treatment, and flu vaccination to Fresno County residents.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The agreements were funded by the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act funding through June 30, 2021 and the remaining terms will be funded by the COVID-19 ELC Enhancing Detection (ELC) funding and/or any other funding made available through legislative action for the COVID-19 response. The maximum payable under the first recommended action is $730,200 for Agreement No. D-21-174. The remaining recommended actions increase Agreement No. D-21-130 for a maximum payable of $7,405,804 which represents a $2,961,784 increase from the original contract. Sufficient appropriations and estimated revenues are included in the Department’s Organization 5620 FY 2021-22 Adopted Budget.
DISCUSSION:
On March 15, 2020, pursuant to California Government Code, Section 8630 and Fresno County Ordinance Code Chapter 2.44, due to the imminent and proximate threat of COVID-19, a Local Emergency was proclaimed by the County Administrative Officer as Emergency Services Director. Your Board adopted a Resolution proclaiming and ratifying the Local Emergency on March 17, 2020. As of April 13, 2021, your Board terminated the proclamation of the local emergency and Fresno County continues to function under the State proclaimed emergency.
Since the first trace of COVID-19 in the County, the numbers have been staggering. As of October 15, 2021, there have been over 132,433 COVID-19 cases and 2,051 deaths. The numbers are expected to continue to rise through community spread until more residents are fully vaccinated. At the writing of this Agenda Item, 58.7% of Fresno County residents have received at least one dose, while 52.4% of Fresno County residents are fully vaccinated.
These Agreements and Amendment allows Fresno County to partner with FQHCs to provide on-call COVID-19 vaccine administration teams to expand vaccination efforts countywide. FQHCs are formidable partners because of their strategic location and work providing community-based health care. FQHCs have the capacity and community trust with diverse populations to address immediate vaccine needs within both rural and urban communities. Additionally, UCSF also has the versatility in serving the vulnerable community and have expanded their scope of work to provide MAB treatment and flu vaccines, to be ready as an asset that county can call upon as the need and funding allow.
The Agreements and Amendment deviates from the standard agreement language by containing non-standard language allowing for the option for a single 6-month and 12-month extension. Additional non-standard language includes the contractor’s obligation to manage, administer, protect, adhere to, and follow the Health Insurance Portability and Accountability Act (HIPAA), Health Information Technology for Economic and Clinical Health Act (HITECH), and Protected Health Information (PHI) regarding clients being vaccinated.
REFERENCE MATERIAL:
BAI #2, March 17, 2020
BAI #3, March 17, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement No. D-21-174 with Valley Health Team Inc.
On file with Clerk - Agreement No. D-21-130 with UCSF
On file with Clerk - Amendment to Agreement No. D-21-130 with UCSF
CAO ANALYST:
Ron Alexander