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
Infectious Disease Testing and Vaccine Administration Services Agreements
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Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute an agreement with SpeciaLysts, Inc. to provide and independently manage clinical staff to administer infectious disease vaccines and perform infectious disease testing for the period November 7, 2023 through June 30, 2026, for an amount not-to-exceed $1,000,000 per fiscal year and a total not-to-exceed amount of $3,000,000; and to execute amendments for non-substantive changes.
B) Authorize the Director of Health Services, or designee, to execute an agreement with Longview International Technology Solutions, Inc. to provide and independently manage clinical staff to administer infectious disease vaccines and perform infectious disease testing for the period November 7, 2023 through June 30, 2026, for an amount not-to-exceed $1,000,000 per fiscal year and a total not-to-exceed amount of $3,000,000; and to execute amendments for non-substantive changes.
C) Adopt a resolution authorizing budgetary adjustments to the Department of Health Services fiscal year 2023-2024 adopted budget, increasing appropriations in the amount of $500,000 to reflect revenue and expenditures associated with infectious disease testing and vaccine administration services agreements. (4/5ths vote required)
(4/5th Vote Required)
end
Executive Summary:
The County’s Department of Health Services is responsible for preventing and controlling the spread of emerging and sustained infectious disease within Sonoma. Throughout the preparedness cycle, the Department partners with community-based organizations (CBOs), Federally Qualified Health Centers, health systems, law, fire, Emergency Medical Services, Sonoma County Office of Education, business groups and various agencies to ensure that residents of the County of Sonoma have access to emerging disease testing, vaccines, and new treatments.
In June 2023 the Department of Health Services (hereinafter, “DHS” or “the Department”) completed a request for proposals (RFP) process to identify a vendor to provide infectious disease vaccine administration and testing services in the event of a public health emergency. Agreements resulting from the RFP will ensure that infectious disease vaccine administration and testing services are in place for potential future infectious disease events.
This item requests approval to execute a primary agreement with SpeciaLysts, Inc. and a secondary agreement with Longview International Technology Solutions, Inc. for as-needed vaccine administration and disease testing services. Primary agreement would be activated first in the case of response, secondary would be used in in the case the primary contract was unable to perform for any reason, or the event required additional support beyond primary vendors capacity. These agreements will be available for use in the event of a public health emergency for the period November 7, 2023 through June 30, 2026. These vendors were chosen in response to an RFP published in February 2023.
In the event of a declared emergency, DHS is prepared to activate the aforesaid agreements as needed and cover initial costs up to $250,000 for a total of $500,000. Should the duration of the disaster become prolonged and exceed the $250,000 cap on each agreement, DHS will return to the Board of Supervisors and request additional funding from the County’s Contingency funds.
Discussion:
The County’s Department of Health Services is responsible for preventing and controlling the spread of emerging and sustained infectious disease within Sonoma. Throughout the preparedness cycle, the Department partners with community-based organizations (CBOs), Federally Qualified Health Centers, health systems, law, fire, Emergency Medical Services, Sonoma County Office of Education, business groups and various agencies to ensure that residents of the County of Sonoma have access to emerging disease testing, vaccines, and new treatments. The Department is seeking to enter into agreements with services providers to ensure that vaccines and testing related to an emerging or existing disease can be provided in a timely and sustained manner during response.
Current thinking around most infectious diseases is that the disease will circulate in the community once introduced, to varying degrees, for the foreseeable response fueled by changes in the disease and its variants. Testing for infectious disease remains an essential tool in decreasing transmission through isolation and prompt treatment. Emerging infectious disease vaccines are another essential tool to boost immunity and protection of the community; immunization has consistently decreased the risk of severe outcomes. As a potential infectious disease changes and new vaccines are developed, administration of those vaccines to the most vulnerable populations in the County will be key.
Outside of a disaster event and if funding is available, public health supported testing or vaccination efforts for emerging and sustained infectious diseases within Sonoma County may be necessary to lower the disease burden and prevent spread of the disease to populations at highest risk of exposure or illness.
In previous events, the County utilized disaster agreements established during the disaster event. Executing services agreements takes time. It is difficult to expedite the services agreement process and challenging to efficiently implement needed services while in the midst of disaster response.
The proposed agreements will allow the Department to formalize a relationship with vendors to ensure provision of services ahead of disasters.
DHS posted an RFP to the Sonoma County Supplier Portal on February 8, 2023 with proposals due on April 5, 2023. The RFP was distributed to all individuals and entities registered in the Sonoma County Portal and Purchasing Govdelivery Notification System in addition to a list of interested parties provided to Purchasing by DHS.
Six proposals were received in response to the RFP. Proposals were evaluated using the following criteria:
• Demonstrated ability to perform the services described
• Experience, qualifications and expertise
• Quality of work as verified by references
• Costs relative to the scope of services
• A demonstrated history of providing similar services to comparable entities
• Willingness to accept the County’s agreement terms
• Any other factors the evaluation committee deems relevant
Agreements resulting from the RFP process will ensure that infectious disease vaccine administration and testing services are in place for potential future infectious disease events.
DISASTER RESPONSE
Activation of the disaster response aspect of the proposed agreements is contingent on there being an active declared disaster in the County. These agreements will allow SpeciaLysts and/or Longview International Technology Solutions, Inc. to provide support for administration of infectious disease testing and vaccine administration, within Sonoma County’s Operational Area.
The contractor’s clinical team shall be responsible for the clinical operations within County-designated sites/locations. The number and location of vaccination and/or testing sites will vary depending upon the anticipated need, location logistics, etc. The team shall be composed of a range of medical and clerical skillsets to support vaccine and testing sites and events, 5 days per week, 40 hours per week, with a potential for an increase in hours.
Fiscal Accountability:
DHS is committed to being an effective, engaged, and transparent organization focused on quality programs and services with a priority on sound infrastructure and financial integrity.
The Department adheres to governmental financial accountability standards, in addition to county procurement and agreement guidelines, subrecipient monitoring. The Department will conduct audits of community-based organizations and all contracted providers will be required to provide all backup documentation for invoice processing prior to payment. Financial transactions must be supported by source documentation and accounting records must trace back to the source documentation submitted. All cost and/or source documentation must meet the following criteria: be allowable, reasonable, and allocable; within the limits of the agreement; and must align with generally accepted accounting principles which is a common set of accounting rules, requirements, and practices issued by the Financial Accounting Standards Board and the Governmental Accounting Standards Board. These principles standardize the classifications, assumptions, and procedures used in accounting industries across the United States.
The Department prioritizes financial accountability as part of the five-year strategic plan pillar, organizational excellence, goal 1 - strengthen operational effectiveness, fiscal reliability, and accountability.
References:
Department of Homeland Security ESF-8 - <https://www.fema.gov/pdf/emergency/nrf/nrf-esf-08.pdf>
California Department of Public Health Medical Health Operational Coordination Program Guidelines - https://www.cdph.ca.gov/Programs/CCLHO/CDPH Document Library/MedicalandHealthOperationalAreaCoordinationManual.pdf <https://www.cdph.ca.gov/Programs/CCLHO/CDPH%20Document%20Library/MedicalandHealthOperationalAreaCoordinationManual.pdf>
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Healthy and Safe Communities
Goal: Goal 1: Expand integrated system of care to address gaps in services to the County’s most vulnerable.
Objective: Objective 2: Identify gaps in the Safety Net system of services and identify areas where departments can address those gaps directly and seek guidance from the Board when additional resources and/or policy direction is needed.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
None
Fiscal Summary
|
Expenditures |
FY 23-24 Adopted |
FY 24-25 Projected |
FY 25-26 Projected |
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Budgeted Expenses |
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|
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Additional Appropriation Requested |
$500,000 |
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Total Expenditures |
$500,000 |
0 |
0 |
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Funding Sources |
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General Fund/WA GF |
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State/Federal |
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Fees/Other |
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Use of Fund Balance |
$500,000 |
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Contingencies |
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Total Sources |
$500,000 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
In the event of a declared emergency, DHS will pay up to $250,000 for each of the two agreements: (1) SpeciaLysts, Inc., and (2) Longview International Technology Solutions, Inc. for a total of $500,000 on both agreements. The source of funding for the DHS portion of $500,000 will be 1991 Health Realignment. Should the duration of the disaster become prolonged and exceed the $250,000 cap on each agreement, DHS will work with the disaster finance team and County Administrator’s Office to identify funding.
Appropriations of $500,000 are being requested for FY 2023-24 in case there is a declared disaster, and the Department needs to respond quickly. Funding will be from 1991 Health Realignment fund balance, estimated fund balance including this request will be $27 million as of June 30, 2024.
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Staffing Impacts: |
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Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - Agreement with SpeciaLysts, Inc.
Attachment 2 - Agreement with Longview International Technology Solutions, Inc.
Attachment 3 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None