DATE: July 13, 2021
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Interim Director, Department of Public Health
SUBJECT: Public Health Strategic Grant Applications/Agreements
RECOMMENDED ACTION(S):
TITLE
1. Retroactively approve and authorize the Department of Public Health’s previous submittal of a California Community Reinvestment Grants Program application to the California Governor’s Office of Business and Economic Development for the advancement of health, wellness, and economic justice for populations and communities harmed by the war on drugs ($900,000);
2. Retroactively approve and authorize the Department of Public Health’s previous submittal of a grant application, accept the Notice of Award and approve and authorize the Chairman to execute the grant agreement from the Department of Health and Human Services, Office of the Assistant Secretary for Health to implement evidence-based health literacy strategies to enhance COVID-19 testing, contact tracing and/or other mitigation measures for time period July 1, 2021 through June 30, 2023 ($3,000,000);
3. Retroactively approve and authorize the Department of Public Health’s previous submittal of a grant application, accept the Notice of Award and approve and authorize the Chairman to execute the grant agreement from the Centers for Disease Control Agency for Toxic Substances and Disease Registry, effective June 1, 2021 through May 21, 2023 ($7,897,935); and
4. Retroactively approve and authorize the Department of Public Health’s previous submittal of a grant application to the Centers for Disease Control National Center for Chronic Disease Prevention and Health Promotion for capacity building to fight COVID-19 by addressing existing health disparities with an anticipated start date of August 1, 2021 through July 31, 2024 ($3,000,000).
REPORT
There is no additional Net County Cost associated with the recommended actions. All four recommended actions align with the Department of Public Health’s (DPH) long-term strategy which includes assisting in building the capacity for community-based organizations (CBO) to address COVID-19 related health disparities, as well as, other underlying health issues which include social determinants of health. The grant applications were submitted contingent upon your Board’s approval. DPH was notified it did not receive recommended action number one and is still waiting to hear back on recommended action number four. Recommended actions number two and three were awarded. This item is countywide.
ALTERNATIVE ACTION(S):
Not approving the recommended actions will result in DPH withdrawing the grant applications which were strategically submitted to those whose mission aligns with DPH’s mission to improve public health. Not approving recommended action numbers two and three would also result in DPH not accepting funding from the Department of Health and Human Services, Office of the Assistant Secretary for Health and Centers for Disease Control Agency for Toxic Substances and Disease Registry.
RETROACTIVE AGREEMENT:
Recommended action number two is retroactive to June 24, 2021 and recommended action number three is retroactive to June 1, 2021, the dates that DPH was notified of being awarded with the grant funds and both actions are being brought to your Board in accordance with the agenda item processing timelines.
FISCAL IMPACT:
There is no Net County Cost associated with the recommended action. The maximum amount of the agreements in recommended actions two, three and four is $13,897,935 and will be fully offset with federal, state and CDC grant funds. Sufficient appropriations and estimated revenues will be included in the Department’s Org 5620 FY 2021-22 Recommended Budget.
DISCUSSION:
The Department of Public Health has applied for four funding opportunities that will assist with building capacity for CBOs to address COVID-19 related health disparities, as well as, other underlying health issues, including social determinants of health.
In February 2021, DPH applied for the California Reinvestment Community Grants Program (CalCRG). This funding is provided through the California Governor’s Office of Business and Economic Development from the Adult Use of Marijuana Act (Proposition 64) in order to advance health, wellness, and economic justice for populations and communities harmed by the war on drugs. DPH partnered with the Fresno City College Rising Scholars program that serves recently incarcerated individuals. Had DPH been awarded this grant, funding would have provided a navigator program to assist those being released from the jail to get connected to resources and training opportunities. On May 4, 2021 DPH was notified that it was not awarded this funding.
In April 2021, DPH applied for the Advancing Health Literacy to Enhance Equitable Community Responses to COVID-19 (MP-CPI-21-006) grant through the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health. This federal funding provides $3 million over two years to implement evidence-based health literacy strategies that are culturally appropriate to enhance COVID-19 testing, contact tracing and/or other mitigation measures in racial and ethnic minority populations and other socially vulnerable populations, including racial and ethnic minority rural communities. DPH’s proposal included recruiting and training community health workers (CHWs) with culturally and linguistically appropriate materials and deploying them on the west side of the County to reach vulnerable populations in those communities. CHWs would provide outreach and education regarding COVID-19 and provide linkages to resources such as assistance with food, bills, childcare, and transportation. DPH received notification on June 24, 2021 that the grant was awarded in the amount of $3,000,000 for the period of July 1, 2021 to June 30, 2023. The Notice of Award sets forth the terms of the grant agreement the County must agree to as a condition of accepting the grant award.
In May 2021, DPH applied 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 CDC Agency for Toxic Substances and Disease Registry (ATSDR). DPH received notification on May 27, 2021 that the grant was awarded in the amount of $7,897,935 for the period from June 1, 2021 through May 5, 2023. The Notice of Award sets forth the terms of the grant agreement the County must agree to as a condition of accepting the grant award. Major objectives for this project include recruitment and training of a Health Equity Officer who will align with regional health equity activities as well as health equity objectives from the California Department of Public Health (CDPH), identifying and integrating a community information exchange system that will build capacity for our CBO partners to more efficiently and effectively make and track referrals to services throughout the county to address social determinants of health, increasing capacity for outreach and education in regards to COVID-19, as well as issues exacerbated by the pandemic, through CHW coordination, training, and establishing long-term sustainability through policy efforts.
In May 2021, DPH, in partnership with the Fresno Community Health Improvement Partnership (FCHIP), applied for Community Health Workers for COVID Response and Resilient Communities (CCR) grant (CDC-RFA-DP21-2109) through the CDC National Center for Chronic Disease Prevention and Health Promotion. DPH applied for Component A - Capacity Building, which would provide $1 million per year for three years. The purpose of the funding is to train and deploy CHWs for response efforts and build and strengthen community resilience to fight COVID-19 by addressing existing health disparities. The proposal included supporting the establishment of a Pathways Community Health HUB (PCH) for Fresno County by FCHIP. Under the proposal, FCHIP will also coordinate with the existing COVID Equity Project that has built significant infrastructure to manage CHWs within existing networks. This collaboration is key to ensure that the establishment of the HUB supports, aligns, improves and continues to build on an existing infrastructure the County has supported throughout the COVID response. The PCH would act as a resource for CBO partners in the community to use for training, alignment, resources, and would work on policy efforts to create a sustainable funding model for CHWs so work can continue after the grants are expended. This funding would leverage efforts from the previous grant applications mentioned to ensure that thorough and adequate training for CHWs is provided; that there is a common data infrastructure that will be used by participating CBO partners; that outreach and education efforts can be aligned and supported; and that through policy efforts, a sustainable payment model can be developed. By establishing this resource, DPH can assist with building capacity efforts for our CBO partners to assist with response efforts for future pandemics and to assist with addressing health disparities and social determinates of health now, to lessen the burden on our vulnerable populations in the future.
The overall goal of the department through year 2023 is to establish a fiscally sustainable CHW network that can be significantly funded from other funding resources.
The typical County insurance language and limits are not contained within the Agreement. The Department is the recipient of grant funding from a federal agency.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - California Community Reinvestment Grants Program Application
On file with Clerk - DHHS OASH Grant Application
On file with Clerk - DHHS OASH Agreement
On file with Clerk - CDC Toxic Substances and Disease Registry Application
On file with Clerk - CDC Toxic Substances and Disease Registry Agreement
On file with Clerk - CDC National Center for Chronic Disease Prevention Application
CAO ANALYST:
Ron Alexander