DATE: March 28, 2023
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Retroactive Amendments to Revenue Agreement with the United States Department of Health and Human Services
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Amendment to the Notice of Award and Agreement No. 21-265 with the United States Department of Health and Human Services, Centers for Disease Control and Prevention effective October 24, 2022 to extend the Agreement term by twelve (12) months from June 1, 2023 to May 31, 2024, with no change to the maximum compensation of $7,897,935.
2. Approve and authorize the Chairman to execute a retroactive Amendment to the Notice of Award and Agreement No. 21-265 with the United States Department of Health and Human Services, Centers for Disease Control and Prevention effective February 2, 2023 to amend the budget with no change to the term of June 1, 2021 through May 31, 2024, or maximum compensation of $7,897,935.
REPORT
There is no additional Net County Cost associated with the recommended actions. The recommended actions will allow the County to extend the agreement term by twelve months and amend the budget to carryover unspent funds into years two and three, while also readjusting line-item amounts to fulfill Year 3 scope of work activities. The recommended actions are fully funded with existing grant funds. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, Federal funding would end on May 31, 2023, and the awarded amount of $7,897,935 would not be fully expended. Additionally, agreements under the Department’s Health Disparities program would end on May 31, 2023, which would shorten their implementation period and not allow maximum utilization of their full contract amounts.
RETROACTIVE AGREEMENT:
The recommend actions are retroactive to October 24, 2022, and February 2, 2023, the dates the Department was notified of being awarded the no cost extension and budget amendments. The October 24, 2022 dated amendment was delayed for submission to your Board, as the Department was awaiting a pending second amendment to be provided by the funding agency, which would allow both amendments to be submitted for Board approval simultaneously.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended amendments do not result in a change to the maximum agreement amount ($7,897,935), which will be fully offset with federal grant funds. Sufficient appropriations and estimated revenues are included in the Department of Public Health’s Org 5620 FY 2022-23 Adopted Budget and will be included in the Department’s FY 2023-24 budget request.
DISCUSSION:
On July 13, 2021, your Board retroactively approved Agreement No. 21-265 which allowed the County to accept the grant award for a non-competitive National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities grant (CDC-RFA-OT21-2103) through the United States Department of Health and Human Services, Centers for Disease Control and Prevention. The grant awarded was in the amount of $7,897,935 for the period from June 1, 2021, through May 31, 2023.
On October 4, 2022, the Department applied for a 12-month No Cost Extension of the grant funding to account for a delayed start of program implementation due to the County’s late acceptance of funds and the length of time required to complete the County’s procurement process and select subcontractors to be funded by the grant funds. On October 24, 2022, the Department received an amended Notice of Award approving the Department’s requested No Cost Extension submission.
On January 23, 2023, the Department applied for a Budget Redirection in order to adjust the previously submitted grant budget to account for the approved 12-month extension. On February 2, 2023, the Department received an amended Notice of Award approving the Department’s requested Budget Redirection submission.
Approval of the recommended actions will allow the Department and subcontractors adequate time and resources to fully execute the scope of work activities currently in progress, which include:
• Alignment of regional health equity activities as well as health equity objectives from the California Department of Public Health.
• Integration of an information exchange system for the County.
• Implementation of community health worker interventions to address social determinants of health and COVID-19 health related disparities.
All activities are currently at various stages of implementation; approving the recommended actions will provide additional time for more robust data to be collected, improved outcomes and allow for maximal utilization of grant funds.
The recommended Amendments do not include the County’s standard insurance language and limits. However, the grantor’s full terms and conditions were previously reviewed by Risk and Counsel and accepted when the Agreement was approved on July 13, 2021, as the Department is the recipient of grant funding from a federal agency.
REFERENCE MATERIAL:
BAI #43, July 13, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment with DHHS CDC (No Cost Extension Notice of Award)
On file with Clerk - Amendment with DHHS CDC (Budget Redirection Notice of Award)
CAO ANALYST:
Ron Alexander