To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera 707-565-4774
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Public Health Grants Awarded to the Department of Health Services
End
Recommended Action:
Recommended action
A) Adopt a resolution authorizing budgetary adjustments in the amount of $12,042,570 to the fiscal year 2023-2024 adopted budget to reflect revenues and expenditures associated with Public Health grants awarded to the Sonoma County Department of Health Services. (4/5th Vote Required)
B) Authorize the Director of the Department of Health Services, or designee, to extend Community Health Worker agreements through the term of the grant, August 30, 2024, and increasing the not to exceed amount by a total of $921,639 in a form approved by County Counsel.
end
Executive Summary:
The Department of Health Services (hereinafter “DHS” or “the Department”) diligently seeks state and federal funding to support critical Public Health programs serving the County of Sonoma. When a grant is allocated to the Department or an existing grant is extended after the budget is finalized in June of each year, the Department is required to secure Board authorization to adjust the budget to reflect the revenue and the program expenditures. Additionally, during a departmental budget review, several grants were identified as needing budget appropriations. The Department has identified the following grants in need of budget adjustments in the amount of $12,042,570 in FY 23-24:
California Home Visiting Program FY 23-24
• State General Fund (SGF) Evidence-Based Home Visiting (EBHV) - $627,178
• CA Home Visiting Program (CHVP) American Rescue Plan (ARP) FY 22-24 - $92,625
California Department of Public Health
• Public Health Workforce Development Supplemental Funding - $1,063,039
COVID -19 Epidemiology and Lab Community Resiliency Grant
• Enhancing Detection - $226,204
• ELC Expansion Funding Extension - $6,863,225
State of California Office of Traffic Safety
• Child Passenger Safety Program - $90,000
CARES Act - Sonoma CCR Project - Community Health Workers
• Community Health Workers for Public Health Response and Resiliency carry forward unobligated balance of $887,724.
Future of Public Health
• Future of Public Health - Year two - $2,174,091
Sonoma County Animal Services Disaster Preparedness and Response Grant
• Jameson Humane Disaster Preparedness Grant - $18,484
DHS administers several programs funded by state and federal grants. The Department is requesting Board authorization of fiscal year 2023-2024 budgetary adjustments associated with above mentioned grants. The Department is also requesting authorization to extend the Community Health Worker agreements through the extended term of the grant, August 30, 2024.
Discussion:
The Director of Health Services has delegated authority to accept funding allocations for the County of Sonoma and execute revenue agreements, amendments, and related documents as necessary to receive revenue from state and federal agencies for various terms with some being for multiple years. The authority is requested annually, most recently approved by the Board of Supervisors on July 11, 2023, for fiscal year 23-24.
The Department is required to secure Board authorization to adjust the budget to reflect the unspent revenue for still authorized by grantee agencies program expenditures for the following grants.
California Home Visiting Program FY 23-24
• State General Fund (SGF) Evidence-Based Home Visiting - $627,178
• CA Home Visiting Program American Rescue Plan (ARP) FY 22-24 - $92,625
On August 16, 2023, the California Department of Public Health (CDPH) approved the Department’s Agreement Funding Application for California Home Visiting Program FY 23-24. CDPH Maternal, Child and Adolescent Health Division will reimburse up to $440,920 for the Maternal, Infant, and Early Childhood Home Visiting program (already in DHS’s budget) and $627,178 for the State General Fund (SGF) Evidence-Based Home Visiting program. The performance period is July 1, 2023, through June 30, 2024. Award letter attached as Attachment 2.
On May 5, 2023, CDPH approved the Department’s Agreement Funding Application for California Home Visiting Program ARP 22-49 FY 2022-24. CDPH Maternal, Child and Adolescent Health (MCAH) Division will reimburse up to $92,625 for the administration of MCAH related programs. The performance period is July 1, 2022 through September 30, 2024. Award letter attached as Attachment 3.
CA Home Visiting Program grants in general are not contracts, they are issued via Approval of Agreement Funding Applications. An Agreement Funding Application for State General Fund Evidence-Based Home Visiting was approved August 16, 2023. Funds are used to support DHS’ implementation of the Nurse-Family Partnership maternal-child home visiting model. Funds support staff time for Public Health Nurses to conduct home visits to low-income, first-time pregnant people. Nurse-Family Partnership is a national evidence-based model for nurse home visiting, which helps to connect families to needed services, including health care and child development resources, and gives families the information and skills they need to support and sustain thriving families. Since 2010, Sonoma County DHS has successfully implemented Nurse-Family Partnership, serving hundreds of families, resulting in decreases in pre-term births, low birth weight, referrals to child protective services, and emergency room visits. Nurse-Family Partnership promotes breastfeeding, immunization, and healthy attachment.
CA Home Visiting Plan - American Rescue Plan is a one-time grant, made available under Section 9101 of the American Rescue Plan Act, P.L. 117-2, to entities that currently receive Maternal, Infant and Early Childhood Home Visiting Program funding to address the needs of expectant parents and families with young children as a result of the COVID-19 public health emergency. Funds will be used to support Nurse-Family Partnership clients funded by Maternal, Infant and Early Childhood Home Visiting with technology to support home visiting, and emergency needs, including food, transportation, emergency preparedness, and items that support the health and safety of the family. Funds will also be used to support training for Maternal, Infant and Early Childhood Home Visiting -funded home visiting Public Health Nurses. If this budgetary adjustment is not adopted, the county will miss out on the benefits of these service expansions.
California Department of Public Health
• Public Health Workforce Development Supplemental Funding - $1,063,039
On August 31, 2021, the Department was awarded $1,063,039 of Public Health Workforce Development Supplemental funding through the American Rescue Plan Act of 2021 to establish, expand, train, and sustain the STLT (State, Tribal, Local & Territorial) public health workforce to support jurisdictional COVID-19 prevention, preparedness, response and recovery initiatives. Funding period is July 1, 2021 through June 30, 2023. On April 10, 2023, the Department received notification that the funding period was extended through June 30, 2024. Award and extension notifications are attached as Attachment 4.
The Department will use the funding from this grant to enhance its capacity to perform critical public health functions for the community. Included in this is the procurement of a consultant to draft a revised Infectious Disease Emergency Response Plan. This plan is intended to outline the steps Sonoma County will need to take in the face of a serious outbreak of infectious disease. The recent pandemic highlighted the critical need for the county to be prepared in such an event. While the Department learned a great deal from the recent pandemic, there are different kinds of infectious agents that will require a different kind of response. Some agents will be more transmissible and more lethal than COVID with varying rates of incubation time. Each of these factors influence the degree to which an outbreak becomes a public health emergency. The funds will also be used to procure a software for Emergency Management called ImageTrend. This system is also used by the Coastal Valleys Emergency Management. Funds will also go toward upgrades of the Department Operations Center which is activated as a public health hub during disasters. Extra Help Staff will also be supported with these funds to support the distribution of COVID test kits across the county as the state has transferred responsibility for distribution back to local health jurisdictions.
COVID -19 Epidemiology and Lab Community Resiliency Grant
• Enhancing Detection $4,996,352 awarded - $226,204 appropriations requested.
• Epidemiology and Laboratory Capacity (ELC) Expansion Funding Extension $17,813,262 awarded - $6,863,225 appropriations requested
On November 9, 2023, the Department of Health Services was notified of a no-cost extension to the COVID -19 ELC Enhancing Detection and ELC Expansion Funding Extension funding streams. The original funding periods for ELC Enhancing Detection of May 18, 2020, through November 17, 2022 and for ELC Enhancing Detection Expansion of January 15, 2021 through July 31, 2023, have been extended through July 31, 2026. Original allocation amounts of $4,996,352 for COVID-19 ELC Enhancing Detection and $17,813,262 for ELC Expansion Funding Extension remain unchanged. FY 2023-24 appropriations are requested for the balances of $226,204 for COVID-19 ELC Enhancing Detection and $6,863,225 for ELC Expansion Funding Extension. Grant funds were used to support lab operations, vaccine and testing efforts, in addition to COVID- outreach and engagement within low Healthy Places Index (HPI) communities and hard to reach populations, and emergency financial assistance. Award and extension letters are attached as Attachment 5.
DHS will use the requested appropriations to acquire new, up-to-date equipment for its Public Health Lab, to assure that the latest techniques in disease diagnosis and monitoring are available to the county. This equipment is expensive and needed to stay current with the latest practices in disease control including genomic identification of viruses, PCR diagnosis, wastewater detection of viruses and medications and other harmful agents. Funds will also go toward enhancing the ability of county institutions and organizations to monitor indoor air quality and identify means of enhancing air quality in the face of increased pollution from fires or dangers of air-borne illnesses. The county will seek to deploy vending machines that can be used to make critical public health tools available to county residents such as COVID or HIV test kits, Narcan or Fentanyl test strips.
State of California Office of Traffic Safety
• Child Passenger Safety Program - $90,000
The program is funded by the fines collected from violations of Vehicle Code 27360.5.
On July 14, 2023, the Department received a notification of a $90,000 grant award from the California Office of Traffic Safety, Child Passenger Safety Program to support our efforts in educating parents and caregivers about the importance of child safety seats and making sure that every child in our community travels safely. Funds will be used for a variety of community outreach events, education classes, distribution of child safety seats, and training on the installation and use of child safety seats. The period of performance is October 1, 2023, through September 30, 2024. The grant award was contingent on approval which was obtained through grant award agreement executed under Department’s delegated authority. Agreement is attached as Attachment 6.
The car seat safety program includes:
• Child Passenger Safety Technician training and recertification courses
• Child safety seats at no-cost for families in need
• Partnering with local organizations on car seat safety community outreach efforts in underserved communities
CARES Act - Sonoma CCR Project - Community Health Workers
• Community Health Workers for Public Health Response and Resiliency - $887,724
On December 6, 2022, the Board of Supervisors authorized the Director of Health Services, or designee, to execute agreements for community health worker training and deployment services to fulfill the Community Health Workers for COVID Response and Resilient Communities grant program requirements, in a total amount not-to-exceed $1,663,479 through August 30, 2024.
On June 1, 2023, the Department was awarded $2,000,000 through the Coronavirus Aide, Relief, and Economic Security Act (CARES Act) for the Sonoma County CCR Project - Community Health Workers for Public Health Response and Resilient program. The performance period for this funding is August 31, 2021, through August 30, 2024. Award letter attached as Attachment 7.
The Centers for Disease Control and Prevention has granted the County of Sonoma with expanded authority to carryover unobligated funds forward into FY 23-24.
This item seeks Board authorization to carry forward unobligated FY 22-23 federal grant funds from the Centers for Disease Control and Prevention in the amount of $887,724 to FY 23-24 as authorized by the grantor. Prior contracts have been funded by this grant. In addition, this item requests Board adoption of a resolution authorizing budgetary adjustments to the FY 23-24 adopted budget to increase appropriations and expenditures in the amount of $887,724 in addition to authorization for the Department of Health Services Director to extend Community Health Worker agreements through the term of the grant, August 30, 2024, and increasing the not to exceed amount by a total of $921,639, in a form approved by County Counsel. Contract adjustments are listed below.
|
|
Contract |
Current contract amount |
Proposed Contract Amount |
Increase Amount |
|
1 |
Alliance Medical Center |
$123,001 |
$205,020 |
$82,019 |
|
2 |
California Parenting Institute dba Child Parent Institute |
$225,375 |
$375,625 |
$150,250 |
|
3 |
Catholic Charities of the Diocese of Santa Rosa |
$150,200 |
$250,319 |
$100,119 |
|
4 |
Humanidad Therapy and Education Services |
$152,922 |
$254,871 |
$101,949 |
|
5 |
Hanna Boys Center |
$148,855 |
$248,092 |
$99,237 |
|
6 |
Petaluma Health Care District |
$150,500 |
$250,833 |
$100,333 |
|
7 |
Santa Rosa Community Health Centers |
$282,001 |
$470,002 |
$188,001 |
|
8 |
Coppertower Family Medical Center Inc dba Alexander Valley Healthcare |
$149,596 |
$249,327 |
$99,731 |
|
9 |
San Francisco Community College District dba City College of San Francisco |
$747,847 |
No change |
N/A |
|
10 |
El Sol Neighborhood Educational Center |
$113,000 |
No change |
N/A |
|
11 |
Northern CA Center for Well-Being |
$15,000 |
No change |
N/A |
|
12 |
Ponderosa Public Health Consulting, LLC |
$25,000 |
No change |
N/A |
The Community Health Workers for Public Health Response and Resiliency grant program is part of a multi-year award from the CDC to institutionalize the practice of community health work within the community and health care system. Community health workers are lay health professionals who serve as a bridge between the health system and the general public. They can assist patients in navigating the system when they have a complex diagnosis. They can also do outreach and education around healthy living and disease diagnosis, early detection and disease management. The goal of the grant is to identify core competencies needed for community health workers and then to use grant funds to establish and support training programs that can train to these competencies. The grant also awards fund to partners to employ community health workers and to realize the benefits of deploying these workers within the care and social service system.
Future of Public Health
• Future of Public Health - Year two - $2,174,091
The Budget Act of 2022 for budget year 2022-2023 [Health and Safety Code 101320, 101320.3, and 101320.5] provides $200,400,000 annually to local health jurisdictions for public health workforce and infrastructure. On June 30, 2022, the Department was notified that California Department of Public Health was allocating $2,174,091 to the County of Sonoma. The Department is requesting appropriations at this time as the initial award notification was received after the budget development process. Award letter attached as Attachment 8.
The State of California awarded $2,174,091 million in funds to Sonoma County as part of Governor Newsom’s initiative to build up and restore public health capacity in California in the wake of the pandemic. This was part of a larger package of aid which included $100 million in funds to state public health and $200 million in funds for local health jurisdictions each year. Sonoma County will use these funds to conduct a periodic community health assessment and to write a periodic community health improvement plan. It will also utilize the funds to get the Department ready for public health accreditation. The Department is using the funds to enhance staff in units that lost funds and staff over the prior decade to restore them to functional operating levels, consistent with were they were over a decade ago. This includes adding staff to public health preparedness, Coastal Valleys Emergency Medical Services Agency, community health, medical therapy, vital statistics, lead poisoning prevention, and the public health lab.
Sonoma County Animal Services Disaster Preparedness and Response Grant
• Jameson Humane Disaster Preparedness Grant - $18,484
On December 5, 2023, the Department was awarded $18,484 through Jameson Humane for Sonoma County Animal Services Disaster Preparedness and Response. Jameson Humane is a non-profit animal rescue and sanctuary organization. The Department is evaluating options to program the funds within the term of the grant. Total grant funds awarded to Sonoma County Animal Services is $18,484.21. Award letter attached as Attachment 9.
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Organizational Excellence
Goal: Goal 4: Seek out grant funding to enhance programs and improve infrastructure
Objective: Objective 1: Align the Board of Supervisor’s strategic priorities, policy, and operational goals with funding and resources.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
On October 3, 2023, Board item 2023-1070 for California Home Visiting Program State General Fund Innovation Grant requested authorizing the Director of Health Services, or designee, to execute a grant agreement with the City and County of San Francisco to receive up to $1,396,920 in revenue to implement the Trauma-Informed Approach in Public Health Nursing model through June 30, 2026, and any amendments that do not substantially change the scope of work or increase the funding amount.
On December 6, 2022 the Board A) authorized the Director of Health Services, or designee, to execute an agreement with the San Francisco Community College District dba City College of San Francisco for community health worker training services related to the Community Health Workers for COVID Response and Resilient Communities grant in an amount not-to-exceed $733,447 through August 30, 2024, including $389,586 in fiscal year 2022-2023; B) authorized the Director of Health Services, or designee, to execute agreements for community health worker training and deployment services to fulfill the Community Health Workers for COVID Response and Resilient Communities grant program requirements, competitively procured during fiscal year 2022-2023, in a total amount not-to-exceed $1,663,479 through August 30, 2024; C) authorized the Director of Health Services, or designee, to execute the first amendment to an agreement with the Petaluma Health Care District for the continuation of Community Health Worker deployment and engagement services, increasing the amount by $21,971, resulting in a new, not-to exceed amount of $133,971 for the period August 31, 2021 through December 31, 2022; and D) adopted a resolution authorizing budgetary adjustments to the Department of Health Services fiscal year 2022-2023 adopted budget to increase Centers for Disease Control and Prevention grant revenues and expenditures in support of year-two Community Health Workers for COVID-19 Response and Resilient Communities grant activities in the amount of $2,132,125.
Fiscal Summary
|
Expenditures |
FY23-24 Adopted |
FY24-25 Projected |
FY25-26 Projected |
|
Budgeted Expenses |
|
|
|
|
Additional Appropriation Requested |
$12,042,570 |
|
|
|
Total Expenditures |
$12,042,570 |
|
|
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$12,042,570 |
|
|
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$12,042,570 |
|
|
Narrative Explanation of Fiscal Impacts:
The Department has requested to program $12,042,570 in Revenue and Expenditure appropriations for FY2023-2024.
To summarize, the sources of funding totaling $12,042,570 are:
1) Evidence-Based Home Visiting (nurses): $627,178 (State)
2) ARPA CA-Home Visiting Program: $92,625, (Federal)
3) PH Workforce Development Supplemental Funding, $1,063,039 (State)
4) Enhancing Detection (COVID-19 Lab): $226,204 (State)
5) ELC: Epidemiology & Laboratory Capacity: $6,863,225 (State)
6) Child Passenger Safety Program: $90,000 (State)
7) Community Health Workers for Public Health Response and Resiliency: $887,724 (State)
8) FOPH: $2,174,091 (State)
9) Jameson Humane Disaster Preparedness Grant: $18,484 (Local)
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - Budget Resolution
Attachment 2 - Award Letter - CA Home Visiting SGF EBHV
Attachment 3 - Award Letter - CA Home Visiting Program ARP
Attachment 4 - Award and Extension Letter - Workforce Development Supplemental Funding
Attachment 5 - Award and Extension Letter - COVID-19 ELC Enhancing Detection and ELC Expansion
Attachment 6 - Grant Award Agreement - Child Passenger Safety Program
Attachment 7 - Award Letter - Community Health Worker Program
Attachment 8 - Award Letter - Future of Public Health
Attachment 9 - Award Letter - Animal Services Disaster Grant
Related Items “On File” with the Clerk of the Board:
N/A