DATE: April 25, 2023
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 January 1, 2023 through December 31, 2023, total not to exceed $299,205.
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 geared towards those with HIV.
RETROACTIVE AGREEMENT:
The CDPH-OA notified the County of the grant award on January 20, 2023. The grant award is retroactive to January 1, 2023 and 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 ($299,205) 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 currently at 18.816% of salaries and benefits. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2022-23 Adopted Budget and will be included in the Department’s Org 5620 FY 2023-24 requested budget.
DISCUSSION:
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 Department’s HIV prevention program (Program) established the HIV Intervention Unit. This team of four communicable disease specialists assists newly HIV diagnosed individuals with linkage to HIV Care services, offers partner notification options, and will provide transportation to the individual’s first two HIV Care appointments. Staff offer 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 Program of several molecular HIV clusters involving Fresno County residents. 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 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 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 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 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.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with the California Department of Public Health
CAO ANALYST:
Ron Alexander