DATE: January 28, 2025
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Retroactive Revenue Agreement with California Department of Public Health Office of AIDS
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive revenue agreement with the California Department of Public Health Office of AIDS, effective August 1, 2024 through May 31, 2029, total not to exceed $1,546,556; and
2. Approve and authorize the Director of the Department of Public Health to execute the State Contractor’s Release for the final invoice.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the first recommended action will provide the Department of Public Health (Department) with funding from the California Department of Public Health Office of AIDS (CDPH-OA) to supplement and enhance existing human immunodeficiency virus (HIV) prevention program activities and services in the local health jurisdiction. The funding will support related salary and benefits, training, and supply costs. Approval of the second recommended action will allow the Director of the Department to execute the Contractor’s Release for the final invoice at the close of the grant term. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended actions, the Department would not be able to accept the CDPH-OA funding to provide enhanced integration to HIV prevention program activities and services in the County, causing a void in services to address HIV prevention within the community.
RETROACTIVE AGREEMENT:
The CDPH-OA notified the County of the grant award on October 21, 2024. The grant award is retroactive to August 1, 2024 due to the fact that the previous grant expired on July 31, 2024 and being retroactive will prevent a lapse in service coverage. This item is being brought to your Board in accordance with the agenda item processing timelines.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The allocation ($1,546,556) will offset salary and benefit costs, provide staff training, and fund supplies to enhance HIV prevention program activities. The agreement allows full indirect cost recovery which is currently at 24.426 percent of salaries and benefits. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2024-25 Adopted Budget and will be included in future budgets for the duration of the term.
DISCUSSION:
The Department offers clients HIV prevention services at no cost. Services include, but are not limited to, HIV prevention education, rapid testing, linkage to care and counseling services. The annual reported new HIV and AIDS cases for the County of Fresno include the following: 152 HIV and 67 AIDS cases in 2021, 172 HIV and 66 AIDS cases in 2022, and 177 HIV and 57 AIDS cases in 2023. This shows that while annual new AIDS cases have gone down slightly the last few years the total HIV cases the Department is dealing with is trending upward and has been since 2018 when there were 110 HIV new cases for that year. The Department is also continuing to see co-infections of HIV and Syphilis with 175 infections of both Syphilis and HIV in 2021, 217 in infections 2022, and 194 infections in 2023. These numbers show the need for these services to the community and the funding to support the important work being done by program staff.
On September 12, 2024, CDPH-OA issued a letter stating the County was awarded funds for CY 2024 for evidence-based public health activities to address HIV prevention within the local health jurisdiction. The proposed scope of work includes activities that allows 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 recommended Agreement deviates from the County’s standard indemnification language and requires the County (and the County’s contractors receiving this funding) to provide one-way indemnification to the State in the performance of the Agreement. This language is typically present in State grants. Therefore, the Department has determined that its acceptance of the indemnification language is advantageous to the County, as the State-grant is an essential funding source for DPH HIV-related activities, without which the continued provision of these services would be negatively impacted.
REFERENCE MATERIAL:
BAI #36, April 25, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CDPH
CAO ANALYST:
Ron Alexander