DATE: September 26, 2017
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Revenue Agreement with the California Department of Public Health for Childhood Lead Poisoning Prevention Program
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive revenue Agreement with the California Department of Public Health, for the Childhood Lead Poisoning Prevention Program, effective July 1, 2017 through June 30, 2020 ($4,204,802).
2. Adopt Resolution authorizing the Chairman to execute Childhood Lead Poisoning Prevention Program agreement documents on the County’s behalf.
3. Approve and authorize the Director of Public Health, or designee, to execute the State Contractor’s Release for the final notice.
4. Approve and authorize Clerk to the Board to execute Budget Transfer No. 3, transferring appropriations from Department of Public Health Org 56201500 ($81,908) from account 7295 (Professional & Specialized Services) to Org 56204764 various 6000 series (Salaries & Benefits) accounts, in the amount of $81,908 to provide one Environmental Health Specialist I/II/III to support childhood lead poisoning prevention activities.
5. Approve Amendment to the Salary Resolution adding one Environmental Health Specialist I/II/III to the Department of Public Health Org 5620, effective October 9, 2017 as reflected in Appendix F.
6. Authorize the Director of Public health, or designee, to execute changes in line items with no increase to the maximum for the agreement in Recommended Action No. 1.
REPORT
There is no increase in Net County Cost associated with the recommended actions. Approval of the first recommended action will allow the Department of Public Health to utilize California Department of Public Health (CDPH) funding for the Childhood Lead Poisoning Prevention Program (CLPPP). The program provides case management, health education, and environmental assessment services to children with lead poisoning. The second recommended action will authorize the Chairman to execute the recommended agreement documents on the County’s behalf. The third recommended action will authorize the Director of Public Health to execute the State Contractor’s Release for the final invoice. The fourth and fifth recommended actions will transfer appropriations for the addition of one full-time equivalent Environmental Health Specialist to support childhood lead poisoning prevention activities. The sixth recommended action will allow the Department to reallocate agreement funding, as necessary, with no change the term maximum, improving the County’s turnaround time to approve adjustments and maximize funding.
ALTERNATIVE ACTION(S):
There are no viable alternative actions for the first through fifth recommended actions. Should your Board not approve the first through fifth recommended actions; the Department will not be able to continue to provide services for lead-poisoned children in the County. Should your Board not approve the sixth recommended action, the Department would return to your Board for line item adjustments during the term of the proposed agreement.
RETROACTIVE AGREEMENT:
The recommended revenue agreement was received from CDPH on July 11, 2017 and is retroactive to July 1, 2017.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum amount of the three-year State agreement is $4,204,802, and represents an increase of $738,121 over the prior three-year award. Annual funding totals are:
• FY 2017-18: $1,410,934
• FY 2018-19: $1,396,934
• FY 2019-20: $1,396,934
Approval of the proposed Budget Transfer will reallocate appropriations in the Department’s Org 5620 FY 2017-18 Adopted Budget to support the addition of one Environmental Health Specialist.
Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2017-18 Adopted Budget and will be included in subsequent fiscal year budget requests. The agreement limits indirect cost recovery to 15% of salaries and benefits as compared to the Department’s full indirect cost rate of 26.19%. The difference of $366,791 for the three-year grant will be covered with Health Realignment funds.
DISCUSSION:
The County has received funding from CDPH for childhood lead poisoning prevention and surveillance activities since 1991. Each year, staff provides education and monitoring to over 800 new surveillance cases, and case management services for 32 children identified with very high blood lead levels (BLLs). The proposed agreement will provide continued funding for community outreach and education, healthcare provider education, surveillance, and case management services for children with elevated BLLs. The neurological effects of lead poisoning are permanent; while treatment can reduce BLLs, it cannot reverse the harmful effects of the poisoning. In a young child, this can result in life-long learning and behavioral disabilities. Early intervention prevents further exposure to risk factors and reduces potential additional harm to lead-exposed children.
Funds had previously been used to subcontract with the City of Fresno to provide required scope of work services. Due to changes in the City of Fresno’s lead program they are unable to manage these funds for CLPPP work at this time. The Department’s Environmental Health Division will therefore perform a portion of the required services, including environmental investigations and educational outreach to for residents in high-risk areas in the County.
High-risk areas include the 93701 ZIP code, where over 4,000 educational packets were distributed to residents in FY 2016-17.
The Department has also been awarded a $1,000,000 Housing and Urban Development (HUD) Lead Based Paint Hazard Control grant to provide remediation of lead hazards of up to $10,000 per home. The Department will return to your Board for approval of the HUD agreement when it is received. Funds will assist in the identification of families that will benefit from the proposed HUD funds.
Approval of the fifth recommended action would allow the Department to assign the following new position to the Community Health Division’s CLPPP:
• Environmental Health Specialist I/II/III - Position will be assigned with the primary responsibility of coordinating lead education and services to the County residents. The CLPPP provides services to the community for the purpose of increasing awareness regarding the hazards of lead exposure and the number of children tested for blood lead poisoning. This position will provide environmental investigations, risk assessments on children in the lower blood lead levels who have not previously received this service, as well as collaborate with community-based organizations, and conduct lead hazard investigations in high-risk areas of the County.
The recommended agreement contains non-standard termination language as it allows the State to terminate the agreement without cause, provided that written notice has been delivered at least 30 days prior to termination. The agreement also contains a termination clause that allows the County to submit a written request to terminate the agreement only in the event the State substantially fails to perform its responsibilities under the agreement. In the event of a dispute between parties, the resolution process outlined in the agreement terms and conditions must be followed.
REFERENCE MATERIAL:
BAI #7, August 23, 2016
BAI #68, June 16, 2015
BAI #55, October 28, 2014
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CDPH for CLPPP
On file with Clerk - Resolution
On file with Clerk - Budget Transfer (Org 5620)
Salary Resolution Amendment - Appendix F
CAO ANALYST:
Sonia De La Rosa