DATE: May 7, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Second Amendment to the Revenue Agreement with California Department of Public Health Office of AIDS
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Second Amendment to revenue Agreement (State Agreement No. 22-10785) with the California Department of Public Health Office of AIDS, extending the term by two months from May 31, 2024 to July 31, 2024 and increasing the maximum compensation by $124,669 for a total of $423,874.
REPORT
There is no additional Net County Cost associated with the recommended action. Approval of the recommended action will allow the County to continue providing services without any disruption and to align the grant term with the federal award for Integrated HIV Surveillance and Prevention Programs. The additional funds being provided for this extension are expected to cover the current two-month extension request and the five-month extension from the previous amendment. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended action, the agreement will expire on May 31, 2024 and Department would not receive the additional funding from the California Department of Public Health Office of AIDS (CDPH-OA) to cover the extended grant period causing a void in services to address HIV prevention within our Community.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The amendment to the revenue agreement will provide an additional $124,669 in funding that will cover this two-month extension request and the five-month extension from the first amendment to the agreement. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY23-24 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
On September 19, 2023, your Board approved an amendment to revenue agreement (A-23-190/A-23-503) with CDPH to extend the term of the agreement for five months. The funding for the five-month extension was promised to come at a later date by CDPH. This new amendment to the agreement provides funding for the five-month extended term previously amended and extends the agreement a further two months with funding for those additional two months.
On April 25, 2023, your Board approved a revenue agreement (A-23-190) with CDPH to provide continued funding from the CDPH-OA for the Department’s HIV Prevention Program (Program) for staff, supplies, and to provide HIV prevention services to clients.
The Department offers clients HIV prevention services at low or no cost. Services include, but are not limited to, HIV prevention education, rapid testing, linkage to care and counseling services. In 2022, the Program established the HIV Intervention Unit (HIV IU). This team of four communicable disease specialists assist newly HIV diagnosed individuals with linkage to HIV care services, offer partner notification options, and will provide transportation to the individual’s first two HIV care appointments. In 2023 there were 189 total HIV cases created, 164 of these being new cases, and only 17 of the 189 are still pending the establishment of linkage to care.
The Program provides referrals to HIV testing and HIV PrEP/PEP navigation to partners of HIV positive clients and all individuals who test negative through the Department’s rapid testing clinic. In addition, CDPH, Office of AIDS alerted the HIV IU of several molecular HIV clusters involving Fresno County residents. Program staff are assigned these cases to confirm the identified individuals are in HIV care, have received adequate treatment for syphilis and/or other sexually transmitted diseases and to reintroduce partner notification assistance. Case conferences with Office of AIDS are held to review the team’s findings.
Program staff also participate in the following county and regional groups: Fresno HIV Stakeholders, Central Valley HIV Stakeholders, Central Valley Harm Reduction Coalition, and the Central Valley Opioid Safety Coalition.
On October 12, 2022, CDPH-OA issued a letter stating the County was awarded funds for CY 2023 for evidence-based public health activities to address HIV prevention within the local health jurisdiction. The proposed scope of work includes activities that allow the Department to provide increased prevention opportunities, reach high-risk individuals, and offer testing and prophylaxis opportunities to reduce the risk of contracting HIV.
The Department’s proposed activities will focus on the following strategies from the CDPH-OA HIV Enhanced Integration: Guide to HIV Prevention and Surveillance:
• Strategy 1: Strengthen disease investigation infrastructure
• Strategy 2: Expand and provide navigation services
• Strategy 3: Expand access to syringe services for people who inject drugs
The recommended amendment extends the term of the agreement by two months to continue providing services without any disruption and to align the grant term with the federal award for Integrated HIV Surveillance and Prevention Programs for the Department.
REFERENCE MATERIAL:
BAI #52, September 19, 2023
BAI #36, April 25, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment to Agreement with CDPH
CAO ANALYST:
Ron Alexander