To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan, 707-565-4774, Amelyn Olson, 707-565-2696
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Public Health Staffing Allocation
End
Recommended Action:
Recommended action
Adopt a personnel Resolution amending the Department of Health Services’ Department Allocation List to add 1.0 Full-Time Equivalent Public Health Investigator, effective April 7, 2026.
end
Executive Summary:
The Department of Health Services, Public Health Division, requests Board approval to add 1.0 Full-Time Equivalent (FTE) Public Health Investigator to meet increased operational demands and emerging public health needs. The proposed position changes will strengthen program oversight, improve coordination of essential public health services, and enhance the County’s capacity to respond to communicable disease threats.
Discussion:
The Public Health Disease Control program safeguards county residents by detecting and responding to disease threats, conducting surveillance of reportable diseases, and equipping communities with the knowledge and resources to prevent illness. Mandated by state public health codes, the program investigates outbreaks of communicable diseases, including tuberculosis, sexually transmitted infections, and emerging threats, while providing educational materials and services that reduce disease incidence across the county.
The Disease Control Unit is experiencing sustained increases in both the number and complexity of reportable communicable disease cases. For example, cases have risen above recent norms, with a 2020-2024 median of 12 cases annually compared to 18 cases in 2025, reflecting both increased incidence and investigation workload. Similarly, emerging disease responses continue to require dedicated capacity, as demonstrated by approximately 10 Avian Influenza outbreaks in 2023, and continued activity with four outbreaks identified in 2025-2026.
While Public Health Investigators (PHIs) have traditionally focused on Sexually Transmitted Infections (STIs), case profiles now frequently involve multidrug-resistant pathogens, co-infections, and increased mobility across jurisdictions. Additionally, the department is expanding capacity to strengthen tuberculosis investigation and control efforts to meet state mandates.
The increasing complexity and volume of communicable disease investigations require dedicated staffing to ensure timely response, comprehensive case investigation, field visits for testing and treatment adherence, and consistent engagement with high-risk communities. Without additional capacity, timeliness and quality of investigations will decline and the risk of disease spread and outbreaks will increase.
To meet these operational needs, the department requests adding 1.0 FTE Public Health Investigator allocation.
The proposed Public Health Investigator position will be fully funded through a blend of existing Disease Control grants, a newly awarded State Disease Intervention Specialist (DIS) Workforce Development Grant, and available unallocated ongoing Public Health 1991 Realignment funds. The majority of funding for this position is from the Disease Control grants. Funding will be proportionally distributed across the Sexually Transmitted Disease (STD) Prevention Grant, Hepatitis C Virus (HCV) Prevention Grant, Disease Intervention Specialist (DIS) Grant, Immunization Action Plan (IAP) Grant, Tuberculosis (TB) Control Grant, Human Immunodeficiency Virus (HIV) Prevention Grant, and the Acquired Immunodeficiency Syndrome (AIDS) Surveillance and Prevention Grant, consistent with programmatic workload and grant requirements. No new General Fund contribution or additional budget appropriations are requested.
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 25-26 Adopted |
FY 26-27 Projected |
FY 27-28 Projected |
|
Budgeted Expenses |
$6,654 |
$185,268 |
$190,077 |
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
$6,654 |
$185,268 |
$190,077 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$6,654 |
$185,268 |
$190,077 |
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$6,654 |
$185,268 |
$190,077 |
Narrative Explanation of Fiscal Impacts:
The Public Health Investigator position is funded through existing Disease Control grants, a newly awarded State Disease Intervention Specialist (DIS) grant, and Public Health 1991 Realignment. The Disease Control grants operate on timelines ranging from two to five years and are ongoing funding sources not at risk of being eliminated. The total annualized cost for FY 2025-2026 would be $15,883. Filling this position will eliminate the need for an Extra Help Community Health Worker, resulting in an estimated savings of $9,229 in FY 2025-2026 leaving the net cost to $6,654. No additional budget appropriations are requested. The Extra Help staffing was not budgeted in the FY 2026-2027 budget, so costs will not be offset with planned savings.
The department has been awarded $750,240 in grant funding from the California Department of Public Health to support Disease Intervention Specialist Workforce Development in Sonoma County for FY 2025-2026 through FY 2029-2030. This grant will be blended with six existing disease control grants and 1991 Public Health Realignment revenue to fund the position. Appropriations will be added in FY 2026-2027 through either Supplemental Budgets or Consolidated Budget Adjustments for the new 1.0 FTE.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Public Health Investigator |
$6,417.89 - $7,802.35 |
1.0 |
|
Narrative Explanation of Staffing Impacts (If Required):
The position will reduce workload pressure on existing staff and replace temporary Extra Help staffing with a permanent, grant-funded role.
Attachments:
Attachment 1: Personnel Resolution
Related Items “On File” with the Clerk of the Board:
None