To: Board of Supervisors of Sonoma County
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Barbie Robinson, 565-7876
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
On The Move Contract Amendment - Case Management, Outreach, Engagement, and Isolation Support for At-Risk Populations
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute the second amendment to an agreement with On The Move for continued COVID-19 Response efforts in our Latinx and indigenous communities, increasing the fiscal year 2020-2021 contract amount by $1,647,378 for a new total not-to-exceed amount of $3,020,193 through June 30, 2021.
B) Adopt a resolution authorizing budgetary adjustments to the fiscal year 2020-2021 adopted budget, appropriating $1,647,378 to reflect revenue and expenditures associated with a services agreement supporting COVID-19 response efforts in our Latinx and indigenous communities. (4/5th Vote Required)
end
Executive Summary:
On July 27, 2020, during budget workshops, Health Services provided the Board with an overview of a plan to allow for a sustainable COVID-19 response through June 30, 2021. This item provides information regarding continuing COVID-19 Response efforts in our Latinx and indigenous communities with a request for a contract amendment for On the Move and the COVID-19 Urgent Response and Aid (CURA) project. The need for isolation and quarantine support and outreach and engagement with the Latinx community continues as cases in that population continue to make up approximately 70% of our overall county cases.
This amended contract extends the existing contract, which was executed on September 29, 2020, for another six months. With a vaccine imminent and an administration strategy under development, staff will return to your Board with additional appropriations requests to target the Latinx and indigenous communities after June 30, 2021, if needed.
This item also includes a request for an adjustment to the fiscal year 2020-2021 adopted budget to accommodate revenue and expenditures associated with the On The Move services agreement supporting COVID-19 response efforts in our Latinx and indigenous communities.
Discussion:
In December 2019, a novel human coronavirus (SARS-CoV-2) type emerged in China. On January 30, 2020 the World Health Organization (WHO) declared the COVID-19 outbreak a “Public Health Emergency of International Concern.” Subsequently, on January 31, 2020 the U.S. Department of Health and Human Services Secretary Alex M. Azar declared a Public Health Emergency for the United States to aid the healthcare community in responding to COVID-19. On March 2, 2020 the County identified the first case of coronavirus due to international travel. On March 4, 2020, as part of the state’s response to address the now global COVID-19 outbreak, Governor Gavin Newsom declared a State of Emergency. As a result, a Local Public Health Emergency as well as a Local Emergency was declared for Sonoma County to respond to COVID-19. The County Emergency Operations Center activated on March 4, 2020 to coordinate response activities which then transitioned to the Health Services Department Operations Center on April 5, 2020. The Sonoma County Health Officer issued a Health Order directing residents to shelter in place on March 18, 2020 in an effort to mitigate disease spread and reduce the risk of overwhelming healthcare institutions. Reopening measures for Sonoma County began at the end of May. After a spike in cases over the summer, Sonoma County is experiencing another, larger, spike in cases currently with the impact of the Thanksgiving holiday still unknown.
In addition, a defining characteristic of this pandemic nationally has been the concentration of cases in vulnerable populations and communities of color. Since data were made available in May, the County has recognized the significant disproportionate impact of COVID-19 on our Latinx and indigenous communities. The disparity of cases among the Latinx community in Sonoma County is staggering. At its peak, the Latinx community made up 90 percent of all cases in the County despite making up only 26 percent of the County population. In addition to the disproportionate number of cases, we have seen a disproportionate financial impact of the disease on this community. Our Latinx community is more likely to be part of the essential workforce, more likely to be working in general, be more burdened by housing costs, and more likely to face numerous additional systemic barriers to services. Our Latinx and indigenous communities are further likely to be burdened by a lack of a safety net due to poor worker protections, including access to paid sick leave, and lack of unemployment and other services not extended to undocumented individuals. The County has taken a number of steps to try to mitigate the dual impacts of the disease on this community. Recognizing the need to bring in expertise from the community to inform its response, the Department of Health Services established a Latinx Health Workgroup that helps drive the Department’s strategies to reduce this disparity and mitigate its affect. Part of the work here includes partnering with community-based organizations and other health partners to establish a unified approach to outreach and support for the Latinx and indigenous language community. In July, the Department issued a request for proposals to develop a system for robust case management and outreach and engagement of farmworkers that will connect Department efforts to those of health and community partners. Support of this group, and alignment of this work with the County’s new Office of Equity is essential to the response to the pandemic through June 30, 2021. Funding for the Latinx Health Workgroup and associated activities was presented to the Board of Supervisors for approval on September 1, 2020 as a part of the CARES budget adjustment agenda item. One of these strategies is the contract with On the Move for the development and operational support of the CURA project to provide culturally appropriate services through trusted community partners to support successful isolation and quarantine and to conduct outreach and engagement, meeting the community where they are.
The Latinx Health Workgroup was established in May 2020 to inform the Department of Health Services efforts to respond to the disproportionate number of cases in the Latinx community. Consisting of members from health and other service-focused sectors, the workgroup has focused its recommendations in the areas of communication, wrap around services, data, workforce, and testing with a particular emphasis on the farmworker community. To date, the workgroup's accomplishments include providing the following guidance and direction to Department of Health Services: Recommendations for pop-up testing locations that respond to the needs of the Latinx community (time of day, type of location, language access, etc.); Recommendations for ways to explore and further drill down in demographic data of cases as well as ways to interpret the data and communicate the data that considers long-standing inequities and systemic racism; Accountability for a bilingual and bicultural workforce; Suggestions for more culturally responsive messaging and messaging dissemination for individuals as well as sectors and industries employing vulnerable essential workers; and the development and release of an RFP for culturally responsive outreach and engagement strategies for farmworkers and wrap-around isolation-support services and resources for those with a positive or likely COVID case. More recently, the Latinx workgroup has helped to inform the expanded communications strategy of the CAO’s communication team, been active advocates for the CURA project, and are informing the County’s vaccination administration strategy to ensure everyone in our community has access to vaccines depending on their need and vulnerability, without regard to income, race, documentation status, and other factors.
This item also includes a request for an adjustment to the fiscal year 2020-2021 adopted budget to accommodate revenue and expenditures associated with the On The Move services agreement supporting COVID-19 response efforts in our Latinx and indigenous communities.
Prior Board Actions:
09-01-2020: Authorization of a continued COVID-19 response plan to establish the temporary COVID-19 unit and include funding to mitigate the impact on Latinx and indigenous communities.
Fiscal Summary
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Expenditures |
FY 20-21 Adopted |
FY 21-22 Projected |
FY 22-23 Projected |
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Budgeted Expenses |
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Additional Appropriation Requested |
1,647,378 |
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Total Expenditures |
1,647,378 |
0 |
0 |
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Funding Sources |
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General Fund/WA GF |
1,647,378 |
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State/Federal |
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Fees/Other |
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Use of Fund Balance |
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Contingencies |
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Total Sources |
1,647,378 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
The $1,647,378 of funding requested will come from the $20 Million of one-time discretionary General Fund that was set aside by the Board during the September 2020-21 Budget Hearings. Appropriation request is included in the attached resolution (Attachment 1).
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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: Budget Resolution
Related Items “On File” with the Clerk of the Board:
None