DATE: September 10, 2024
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 for Hepatitis C Prevention and Collaboration
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive revenue agreement with the California Department of Public Health for Hepatitis C Prevention and Collaboration, effective July 1, 2024 through June 30, 2028 ($995,361); and
2. Approve and authorize the Director of Public Health, or designee, 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 allow the Department of Public Health (Department) to begin to implement activities related to Hepatitis C (HCV) within the Sexually Transmitted Disease (STD) program with funding provided by the California Department of Public Health (CDPH). 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 choose not to approve the recommended actions, the Department would not be able to begin implementing strategies and activities aimed at increasing testing and treatment for HCV in the County utilizing dedicated CDPH funding.
RETROACTIVE AGREEMENT:
The recommended revenue agreement was received from CDPH on March 29, 2024. Due to the length of time required to finalize contract negotiations with CDPH the agreement is retroactive to July 1, 2024. It is anticipated the Department will fully utilize the funding through this agreement by the end of the term to meet expected goals.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended agreement will provide $995,361 from July 1, 2024 through June 30, 2028. The annual allocation for each year of the grant will be $248,840. The agreement allows full indirect cost recovery at the Department’s rate of 24.426%. Sufficient appropriations and estimated revenues will be included in the Department’s Org 5620 FY 2024-25 Recommended Budget and will be included in future budgets for the duration of the term.
DISCUSSION:
In 2019 CDPH gave 22 local health jurisdictions (LHJ’s) funding for HCV prevention and control and in 2024 another 10 LHJ’s were chosen to receive funding. The Department was not among the first 22 LHJ’s previously chosen to receive funding from CDPH to support HCV prevention and control activities but is among the 10 LHJ’s chosen for this round of funding with this allocation is likely the beginning of continual funding to help address Hepatitis C in the County. The recommended agreement will help cover the cost of program staff in addition allowing the Department to begin community-based testing while adjoining STD program functions to ensure success and efficiently maximizing existing testing infrastructure. The Department will partner with non-profit agencies as required by the State to provide HCV testing and treatment to at risk populations within the County. An agreement is currently being worked on that will include HCV testing and treatment as part of the scope of work, and it will be brought before the Board by October.
Prior to 2020, the Department saw an average of 752 cases of Hepatitis C in the County each year. Starting in 2020 the Department began to see a decline in cases of HCV each year due to a decrease in testing. In 2020, the Department saw 493 cases of HCV, 480 cases in 2021, 430 cases in 2022, and 418 cases in 2023. While this decrease may give the appearance of a downward trend, the sudden drop in cases and lack of proper testing for HCV indicate that more testing and data is needed to assess case numbers more accurately within the County.
Ongoing funding from CPDH for HCV services is anticipated once the current grant expires in June 2028. Fifty percent of the funding will be used to cover the cost of staff working on this project, the remaining 50% of the funding provided must be awarded to CBOs or used for in-kind support. To fulfill the CBO support requirement the Department is planning to work with local partners by bringing agreements to the Board to increase HCV testing and treatment in the County, especially among the most at-risk communities.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CDPH
CAO ANALYST:
Dylan McCully