DATE: July 9, 2019
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Revenue Agreement with the California Department of Public Health
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive revenue Agreement with the California Department of Public Health for enhanced congenital syphilis prevention activities, effective January 1, 2019 through December 31, 2023 ($700,000).
REPORT
Approval of the recommended action will provide funding from the California Department of Public Health (CDPH) to enhance Department of Public Health congenital syphilis (CS) prevention activities to address the rise of cases within the County, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department would not be able to enhance strategies and activities aimed at reducing the rise of congenital syphilis cases in the County utilizing dedicated CDPH funding.
RETROACTIVE AGREEMENT:
The recommended revenue agreement required revisions by CDPH, with the received on May 16, 2019, and retroactive to January 1, 2019.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended revenue agreement will provide a maximum of $700,000 to offset costs associated with providing CS services from January 1, 2019 through December 31, 2023. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2019-20 Recommended Budget and will be included in subsequent budget requests for the terms duration. The recommended revenue agreement limits indirect cost recovery to 25% of salaries and benefits only. The Department’s current indirect rate is 25.42%; the difference of $443 in year one will be covered with Health Realignment.
DISCUSSION:
In 2018, the Department, in collaboration with CDPH, conducted a pilot program to address the rising instances of CS in the County. The pilot addressed the rise through various activities including:
• follow up with pregnant mothers to ensure continued pre-natal care;
• syphilis treatment and follow ups until newborns were determined non-infected,
• conduct morbidity and mortality reviews;
• conduct quality improvement reviews;
• evaluate county jail’s syphilis screening protocol; and
• educate local providers.
The recommended agreement builds upon some activities conducted during the pilot.
Through the recommended agreement, the Department will receive support from CDPH to enhance and implement robust case management for pregnant females with congenital syphilis; conduct morbidity and mortality reviews of congenital syphilis cases to identify missed opportunities for prevention. Additionally, the funding will support collaboration with correctional facilities to continue evaluating and enhancing the county jail’s syphilis screening protocol, and conduct medical provider education to enhance screening and treatment practices
The recommended agreement contains non-standard termination language as it allows CDPH to terminate for cause, cancel immediately for cause, or upon 30 days written notice, the CDPH may terminate with or without cause. CDPH may, at its discretion, require the County to cease portions of its scope of work while completing other components prior to the termination date of the proposed agreement.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file With Clerk - Agreement with the California Department of Public Health
CAO ANALYST:
Sonia M. De La Rosa