DATE: May 23, 2023
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director
SUBJECT: California Strengthening Public Health Initiative Award Agreement
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive California Strengthening Public Health Initiative Award Agreement with California Department of Public Health, effective December 1, 2022 through November 30, 2027 ($1,275,543).
2. Retroactively approve and authorize the Director of Public Health’s previous submittal of the Acknowledgement of Allocation Letter acknowledging receipt of the letter and accepting the funds to be used as outlined under the submission requirements.
3. Approve and authorize the Director of Public Health, or designee, as signatory on behalf of the Board of Supervisors on associated award documents, including submission of all future reports, claims, certification forms and adjustments to subsequent California Strengthening Public Health Initiative work plans and spend plans.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will provide the Department of Public Health (Department) with funding from the California Department of Public Health (CDPH) to supplement existing levels of services provided by the Department, referred to as California Strengthening Public Health Initiative (CASPHI) funding. The funding will support hiring, training and retention of staff, as well as supplies and other related administrative costs.
It should be noted that the Department received the Acknowledgement of Allocation Letter on February 23, 2023. The letter was required by CDPH in advance of the Work Plan, Spend Plan and Certification Form with the due date of April 7, 2023; therefore, the Department submitted the Letter with the Director of the Department’s signature on March 17, 2023, contingent upon the Board’s approval.
The third recommended action will authorize the Director, or designee, to sign and submit required documentation including the Acknowledgement of Allocation Letter, work plan, spend plan, invoices, semi-annual reports and annual Certification form required yearly by CDPH. 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 CASPHI funding to supplement existing levels of services, which would negatively impact public health services to the community. The Department would need to submit a subsequent acknowledgement letter to CDPH rejecting the funds.
RETROACTIVE AGREEMENT:
The recommended allocation is retroactive to December 1, 2022, because the Allocation Letter was provided by CDPH to the Department on February 23, 2023. The recommended allocation 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. CDPH approved a non-competitive CASPHI funding allocation of $1,275,543 to the County for FY 2022-23 to be expended through November 30, 2027. A subsequent salary resolution will be presented to your Board as an amendment once CDPH has approved the Work Plan and Spend Plan.
DISCUSSION:
On December 4, 2022, CDPH received a Notice of Award from the Centers for Disease Control and Prevention (CDC) for $36,800,000 to be allocated to 50 of the 61 local health jurisdictions (LHJ) in California, which included the Department. The remaining 11 LHJs will receive funding directly from the CDC and are not part of this CASPHI allocation process.
As a condition to receive CASPHI funding, LHJs are required to have a minimum 1.0 full time equivalent (FTE) equity staff position with roles and responsibilities dedicated to advancing health equity and/or eliminating health disparities. Each LHJ will receive a base funding of $495,000 to cover the position, but if the LHJ has funding allocated for this position under other funding sources, the base allocation can be utilized for other workforce development activities. The remaining balance of the CASPHI appropriation is allocated to each LHJ using three weighted inputs: population, poverty and demographic diversity. Based on these factors, the Department has been allocated $1,275,543 in FY 2022-23 to be expended through November 30, 2027.
The funding must be used to supplement, rather than supplant, existing levels of service, such as recruiting and hiring new staff, including benefits, providing training and developmental opportunities, supporting workplace well-being programs to promote staff retention, and strengthening human resources systems for effective workforce management. The limitations of CASPHI funds are that they may not be expended for research, clinical care, or purchase of equipment (defined as a single unit cost exceeding $5,000) or furniture.
CASPHI also provides funding to strengthen the County’s ability to provide a culturally and linguistically responsive workforce with sufficient capacity to assess and respond to public health needs and crises. Fresno County is a richly diverse community and approval of the recommended actions will allow the Department to continue rendering quality services using a health equity focus that understands and addresses the health disparities affecting disproportionately impacted populations that are higher risk and underserved.
Like many organizations involved in public health, replenishment and retention of the workforce are pressing issues for the Department. CASPHI funding will allow the Department to expand recruitment efforts, create new positions, and introduce a paid student worker pipeline program. It will also provide for retention incentives, create new promotional opportunities and offer career ladder education and worker upskilling. CASPHI also includes support for the existing workforce members, including strengthening the Department’s Worksite Wellness Committee to address mental, emotional and physical well-being.
CDPH required submission of an Acknowledgment of Allocation Letter in advance of the Work Plan and Spend Plan due date. The letter served to acknowledge the Department’s receipt of the CASPHI Allocation Letter and acceptance and agreement to use the funds as outlined. To meet the deadline, the Department submitted the Acknowledgment of Allocation Letter signed by the Director of Public Health contingent upon approval by your Board. Approval of the recommended actions would retroactively authorize the Director of Public Health’s submission of the Acknowledgment of Allocation Letter and authorize the Director, or designee, to submit all future reports, claims, certification forms and adjustments to subsequent CASPHI work plans and spend plans.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Award Agreement with CDPH
CAO ANALYST:
Ron Alexander