To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Jennifer Solito, 707-565-4774
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Infectious Disease Testing and Vaccine Administration Agreements
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Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute an agreement with Advocacy Home Nursing dba Fox Home Health for a period of three years from the effective date to perform infectious disease testing and vaccine administration during outbreak events, for an annual not-to-exceed amount of $250,000 and total not-to-exceed amount of $750,000, subject to review and approval as to form by counsel.
B) Authorize the Director of Health Services, or designee, to execute an agreement with Longview International Technology Solutions, Inc. for a period of three years from the effective date, to perform infectious disease testing and vaccine administration during outbreak events, for an annual not-to-exceed amount of $250,000 and total not-to-exceed amount of $750,000.
C) Authorize the Director of Health Services, or designee, to execute modifications to the agreements in this Board Item which do not significantly change the scopes of service and/or to increase the total not-to-exceed amount in order to address increased service needs, subject to available funding and review and approval by County Counsel.
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Executive Summary:
From the onset of the COVID-19 pandemic in early 2020 to its conclusion in February 2023, the County undertook the task of managing COVID vaccine and testing distribution throughout the Sonoma County Operational Area. During that time, the County entered into emergency contracts to provide these services in response to the disaster.
The Department of Health Services (“DHS” or "the Department") is proactively enhancing existing systems, personnel, and services to ensure readiness ahead of future potential outbreaks. The proposed agreements coming to the Board from DHS will enable more efficient mobilization of resources to support Sonoma County residents.
This item requests Board authorization for the Director of DHS, or designee, to execute a primary agreement with Advocacy Home Nursing, dba Fox Home Health, and a secondary agreement with Longview International Technology Solutions, Inc., to operate vaccine and disease testing sites should future outbreaks occur for three-year terms. Approval of these agreements would ensure the county will be prepared to mobilize and provide essential services in the event of future infectious disease outbreaks, while enhancing the County’s preparedness efforts. The proposed vendors were selected through a competitive request for proposals (RFP) process. The resulting contracts seek to establish a proactive framework to manage future infectious disease events.
Agreements include allowance for working capital to initiate response operations, which provides for the Contractor to request in advance a lump sum not to exceed 25% of annual max contract amount for ramp-up costs. Payment request must include the breakdown of costs used to derive the lump-sum amount with documentation.
Discussion:
The Department is responsible for preventing and controlling the spread of emerging and sustained infectious diseases within Sonoma County (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%20Document%20Library/MedicalandHealthOperationalAreaCoordinationManual.pdf>). In preparation for future disasters, the DHS Public Health Preparedness Unit has collaborated with community-based organizations (CBOs), Federally Qualified Health Centers, health systems, law enforcement, fire departments, Emergency Medical Services, the Sonoma County Office of Education, business groups, and various other agencies to lay a structure in place to ensure that County residents have access to testing, vaccines, and new treatments for emerging diseases.
The Department is requesting authority to enter into agreements with two service providers to ensure that testing and vaccines related to emerging or existing diseases can be delivered in a timely and sustainable manner during a public health response.
Current thinking on most infectious diseases suggests that, once introduced, they will likely circulate within the community to varying degrees for the foreseeable future, fueled by changes in the disease and its variants. Testing remains an essential tool for reducing transmission by enabling isolation and treatment for those infected. Emerging infectious disease vaccines are another critical tool to boost immunity and protect the community; immunization has consistently decreased the risk of severe outcomes. As new variants emerge and new vaccines are developed, it will be crucial to administer these vaccines to the County's most vulnerable populations in a timely manner.
As funding permits, public health-supported testing or vaccination efforts may be necessary to reduce the disease burden and prevent the spread of infectious diseases, especially among populations at the highest risk of exposure or illness.
In previous emergencies, the County relied on emergency disaster contracts established during the event. However, procuring services and executing service contracts can be time-consuming, and expediting this process during a disaster response is challenging. The proposed contracts will allow the Department to formalize relationships with contractors in advance, ensuring the timely provision of critical services during emergencies and strengthening the County’s preparedness efforts.
Procurement Process
The Department released a Request for Proposals (RFP) on February 8, 2023. The RFP was distributed to registered entities and interested parties, ensuring broad participation. Six proposals were received by the April 5, 2023, deadline. The proposals were scored based on a detailed scoring matrix that included points for the demonstrated ability to perform the services, experience, qualifications and expertise, examples of previous work, cost, quality of work as verified by references, and a willingness to accept the County’s contract terms.
After a thorough evaluation, the panel recommended two vendors for further consideration and contract negotiation. Interviews and presentations were held with the two finalists. At the conclusion of the evaluation and interview process, the review committee recommended awarding two contracts: one primary contract with Advocacy Home Nursing, dba Fox Home Health, and a secondary contract with Longview International Technology Solutions, Inc., to be activated if Advocacy Home Nursing, dba Fox Home Health, is unable to respond or if their systems are overwhelmed during a catastrophic emergency.
Contract Activation
The activation of these contracts is contingent upon a determination by the DHS Director and County Health Officer of a disease event requiring county-sponsored vaccine or disease testing services within the county. If activated, the contracts will allow Advocacy Home Nursing, dba Fox Home Health and/or Longview International Technology Solutions, Inc. to coordinate vaccine and disease testing services at public sites. These services may include administering vaccines, conducting disease testing events, and operating pop-up sites.
Funding
The proposed contracts will only be activated in the event of an infectious disease outbreak requiring public testing or vaccine services in Sonoma County.
In the case of an infectious disease event impacting Sonoma County, DHS will allocate up to $500,000 for event-response expenditures from the Department’s 1991 Health Realignment Fund balance. $500,000 has been set-aside for all Department response efforts. For expenditures exceeding the initial $500,000 event-response allocation, DHS will return to the Board of Supervisors to request additional appropriations, with the source of funding to be determined-whether from expected FEMA or state funds.
Fiscal Accountability
The Department is committed to being an effective, engaged, and transparent organization, focused on delivering quality programs and services while maintaining sound infrastructure and financial integrity. The Department adheres to governmental financial accountability standards, county procurement guidelines, and subrecipient monitoring. DHS will conduct audits of community-based organizations, and all contracted providers will be required to submit backup documentation for invoice processing prior to payment. All financial transactions must be supported by source documentation, and accounting records must be traceable to this documentation. All costs and source documents must meet the following criteria: they must be allowable, reasonable, and allocable; within the limits of the agreement; and compliant with generally accepted accounting principles (GAAP), which are issued by the Financial Accounting Standards Board (FASB) and the Governmental Accounting Standards Board (GASB). These principles standardize the classifications, assumptions, and procedures used in accounting across the United States.
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 |
FY24-25 Adopted |
FY25-26 Projected |
FY26-27 Projected |
|
Budgeted Expenses |
$500,000 |
$500,000 |
$500,000 |
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
$500,000 |
$500,000 |
$500,000 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$500,000 |
$500,000 |
$500,000 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$500,000 |
$500,000 |
$500,000 |
Narrative Explanation of Fiscal Impacts:
The adopted budget within the DHS Public Health Division Preparedness Program includes $500,000 for the execution of emergency response agreements. This action will allow for a rapid response in the event an infectious disease outbreak requiring public testing or vaccine services in Sonoma County. Available 1991 Realignment state funds based on sales tax and Vehicle License Fee will be utilized initially, until Federal or State disaster funding sources become available should an event unfold. Future fiscal years’ funding will be included in the appropriate year budgets. If and when a disaster is declared, disaster funding will be utilized in place of 1991 Realignment funding.
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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):
None
Attachments:
Attachment 1 - Draft Advocacy Home Nursing dba Fox Home Health Agreement
Attachment 2 - Draft Longview International Technology Solutions, Inc. Agreement
Related Items “On File” with the Clerk of the Board:
None