To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera, 565-4774
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
COVID-19 Emergency Response Update and On The Move Agreement Amendment
End
Recommended Action:
Recommended action
A) Receive a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
B) Authorize the Director of Health Services, or designee, to execute the fourth amendment to an agreement with On The Move for continued COVID-19 emergency response efforts, increasing the fiscal year 2021-2022 contract amount by $3,875,000 for a new total not-to-exceed amount of $18,338,835 through June 30, 2022.
C) Adopt a resolution authorizing budgetary adjustments to the fiscal year 2021-2022 adopted budget, appropriating $3,875,000 to reflect revenue and expenditures associated with a services agreement supporting COVID-19 emergency response efforts.
(4/5th Vote Required)
end
Executive Summary:
This item provides the Board with an update of the Department’s COVID-19 response efforts and enhanced COVID-19 strategies and vaccination coordination. A COVID-19 Update PowerPoint will be presented to the Board.
This item also requests Board approval to allocate American Rescue Plan Act (ARPA) funds in the amount of $3,875,000 for emergency financial assistance to On The Move’s COVID-19 Urgent Response and Aid (CURA) project to address increased community need during the Omicron variant surge and to ensure continuity in program delivery through June 30, 2022.
This item also requests approval of a budget resolution to adjust the fiscal year 2021-2022 adopted budget to accommodate the increase in funding to the On The Move agreement.
Discussion:
This item provides the Board with an update of the Department’s COVID-19 response efforts and enhanced COVID-19 strategies and vaccination coordination. A COVID-19 Update PowerPoint will be presented to the Board.
The CURA Project has provided a culturally responsive approach to case management and services to Latinx and Indigenous Language Speaking individuals during times of crisis. Through case management CURA’s goal was to provide a safety-net of basic needs to support and help stabilize an individual or family facing a crisis due to the pandemic. The project leverages partnerships with organizations across the County and supports coordinated efforts with outreach and community engagement in a meaningful way. It has served as an interconnected safety net for people of color in our County with a focus on Latinx and Indigenous language speaking communities.
Most commonly, CURA clients were in need of rent and utility support and food support. CURA also connected people to resources for housing and family supplies, mental health, vaccinations, testing, and other COVID-19 support. The table below illustrates the services and resources CURA connected clients to in addition to EFA from October 2020 to June 2021. (Current data is not available due to surge impact.)
Since its inception individuals received case management for additional services. Case management programs largely served low wage income earners, Latinx community members, and renters throughout Sonoma County. The following demographics capture CURA’s clients from October 2020 through June of 2022.
On December 14, 2021, the Board approved a spending plan for the funds Sonoma County received as part of the American Rescue Plan Act (ARPA). This included designating $9 million in emergency financial assistance to address impacts of the COVID-19 pandemic on low-income community members. With the Omicron variant surge the need to provide financial assistance to community members who have not been able to access other forms of relief has increased considerably.
On December 7, 2021 the Board approved adding $950,000 for emergency financial assistance through an agreement with On The Move, resulting in a total of $9.5 million for the current agreement that started on December 31, 2020. A total of $11.7 million has been approved for On The Move for emergency financial assistance since the start of the pandemic, along with a total of $5.9 million for case management and outreach and $521K for general administration. Of the $11.7 million for emergency financial assistance, $7.8 million was spent during the associated funding periods, with unspent grant funds being re-allocated due to lower than anticipated emergency financial assistance expenditures beginning in April 2021 at the time the funding was available during FY 2020-2021. Over 6,300 individuals have received emergency financial assistance since October 2020. The below chart shows the number of people served each month.
Given the needs that the Omicron surge created, staff recommends that the agreement with On The Move be amended to add $3,875,000 to fund the existing need for emergency financial assistance during FY 21-22. This level of funding is based on identification of unserved individuals who are currently awaiting assistance and on COVID data.
With this contract amendment, there will be a minimal gap in service delivery and the Board’s earlier direction to quickly distribute financial assistance will be met as it pertains to the current impacts of the surge.
This item also requests approval of a budget adjustment to the fiscal year 2021-2022 adopted budget to accommodate the increase in funding to the On The Move agreement.
Strategic Plan:
This item directly support 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.
Prior Board Actions:
On February 8, 2022 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On January 19, 2022 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On January 4, 2022 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On December 14, 2021 the Board approved a spending plan for the American Rescue Plan Act funds received by Sonoma County.
On December 7, 2021 the Board A) Authorized the Interim Director of Health Services, or designee, to execute the continued COVID-19 Response Plan, obtain necessary resources, services, supplies, equipment, and other properties or needed for the protection of life and property, and to bind the County for the fair value thereof not to exceed the appropriations authorized by the Board for the COVID-19 Emergency response until the emergency declaration has ended at the local level, B) Received a staff update on the current COVID-19 Emergency Response efforts, C) Adopted a budget resolution authorizing adjustment to the Department of Health Services Fiscal Year 2021-2022 final budget to increase revenues and expenditures by $7,511,644 to support continued COVID-19 response efforts, and D) Adopted a personnel resolution amending the Department allocation list for the Department of Health Services to add the following full-time equivalent (FTE), time-limited positions: 1-1.0 FTE Health Program Manager; 1-1.0 FTE Program Planning and Evaluation Analyst; 1-1.0 FTE Administrative Aide; and 1-1.0 FTE Community Health Worker Specialist as part of the Community Health Workers for COVID-19 Response and Resilient Communities Program Grant, through August 30, 2024.
On November 16, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On October 19, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On September 28, 2021 the Board A) Authorized the Interim Director of Health Services, or designee, to execute agreements, and to obtain necessary resources, services, supplies, equipment, and such other properties to be lacking or needed for the protection of life and property, and to bind the County for the fair value thereof not to exceed the appropriations authorized by the Board in this item, and B) Adopted a budget resolution authorizing adjustments to the Department of Health Services Fiscal Year 2021-2022 final budget to increase revenues and expenditures by $9,122,900 to support continued COVID-19 response efforts.
On September 21, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On August 17, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On July 27, 2021 the Board A) received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination and B) received an update on the COVID-19 Response Point-In-Time Feedback Report.
On July 13, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On June 8, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On May 25, 2021 the Board A) received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination, B) approved the Environmental Health COVID pandemic offset to permit fees and administration costs, totaling $2,780,969 for fiscal year 2020-2021, C) adopted a resolution amending the fiscal year 2020-2021 Department of Health Services and County Administrator’s budget in the amount of $2,780,969; financed from the county’s General Fund Infrastructure Sinking balance, and D) adopted a resolution implementing local aid strategies to provide additional financial relief to local restaurants, body art, and recreational health establishments that suffered financial hardship during the pandemic.
On May 11, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On April 20, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On April 6, 2021 the Board A) received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination and B) adopted a personnel resolution amending the County Administrator’s allocation list to extend the term of 2.0 full-time equivalent time-limited positions through December 31, 2021, and the Department of Health Services allocation list to extend the term of 3.0 full-time equivalent time-limited positions through June 30, 2022, and convert a 1.0 full-time equivalent time-limited position to a permanent position, as detailed in the attached resolution.
On March 16, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On March 2, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On February 23, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On February 2, 2021 the Board A) authorized the Director of Health Services, or designee, to execute the COVID-19 Vaccination Response Plan hereby described, to execute contracts and to obtain necessary resources, services, supplies, equipment, and such other properties to be lacking or needed for the protection of life and property, and to bind the county for the fair value thereof not to exceed the cumulative appropriations already authorized by the Board for COVID-19 Response activities from July 1, 2020 through June 30, 2021; B) authorized the Director of Health Services and County Administrator’s Office to work with the Human Resources Department to hire extra-help personnel, temporary agency personnel, independent contractors, and/or other appropriate options to expeditiously hire needed staff to effectively continue the emergency pandemic response, for the Vaccination Unit of the temporary COVID-19 Section in the Public Health Division and associated departments; and C) received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On January 5, 2021 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts and vaccination coordination.
On January 5, 2021 the Board A) received a report on H.R. 133 - Consolidated Appropriations Act, 2021 and the current protections provided with the Federal, State, local Eviction and Sick Leave policies; B) authorized the Director of Health Services, or designee to execute the continued COVID-19 Response Plan hereby described, to execute agreements, and to obtain necessary resources, services, supplies, equipment, and such other properties to be lacking or needed for the protection of life and property, and to bind the county for the fair value thereof not to exceed the cumulative appropriations authorized including those in this item.; C) directed staff to return with additional budgetary adjustments necessary to expand Department of Health COVID-19 Response Plan through 6/30/2021, which may include up $5 million from county discretionary resources; D) provided direction to staff regarding the Local Aid Strategies and direct staff to return to the Board for further action, or, alternatively authorize additional appropriations to support Local Aid strategies and authorize the Director of Health Services, Community Development Commission, Department of Emergency Management, Office of Equity, County Counsel, and/or Economic Development Board, or designee, to execute the Local Aid Strategies approved by the Board, to execute agreements, disperse funding, and to obtain necessary resources, services, supplies, equipment, and such other properties and to bind the county for the fair value thereof not to exceed the appropriations authorized.
On December 15, 2020 the Board approved the following actions: A) Authorize the Director of Health Services, or designee to execute the continued COVID-19 Response Plan hereby described, to execute agreements, and to obtain necessary resources, services, supplies, equipment, and such other properties to be lacking or needed for the protection of life and property, and to bind the county for the fair value thereof not to exceed the cumulative appropriations authorized including those in this item.; B) Authorize the Director of Health Services, Human Resources, County Counsel, Auditor-Controller-Treasurer-Tax-Collector, and County Administrator, or designee to continue to hire extra-help personnel, temporary agency personnel, and/or independent contractors, whichever is the most expeditious method to effectively continue the emergency pandemic response, for the temporary COVID-19 Section in the Public Health Division and associated departments. Staffing costs are not to exceed the cumulative appropriations authorized including those in this item; and C) Adopt a resolution to execute all budget appropriations increases and adjustments up to $22,666,105 (federal/state $8,608,298 and county funds $14,057,807 for the period of December 31, 2020 to March 31, 2021 to continue the COVID-19 Response Plan per the Board’s direction.
On December 15, 2020 the Board approved 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.
On December 8, 2020 the Board received a staff update on current COVID-19 response and enhanced COVID-19 strategy efforts.
On October 20, 2020, the Board of Supervisors authorized the Director of Health Services, or designee, to execute the Enhanced COVID-19 Response Strategies and to execute agreements, and to obtain necessary resources, services, supplies, equipment, and such other properties to be lacking or needed for the protection of life and property, and to bind the county for the fair value thereof not to exceed the appropriations authorized by the Board in this item. The Board of Supervisors also approved redirecting within fiscal year 2020-2021 $4 million Coronavirus Aid, Relief, and Economic Security (CARES) Act assigned to COVID-19 response activities led by the Department of Health Services to finance the initial phase of Enhanced COVID-19 Response Strategies.
On September 1, 2020, the Board of Supervisors approved the Department of Health Services COVID-19 Emergency Plan allowing for the continuation of the COVID-19 Response plan and authorizing the Director of Health Services to obtain necessary resources, services, supplies, equipment and for the temporary COVID-19 Unit to be established.
On July 27, 2020, during Budget Workshops, the Board approved a plan to allow for a sustainable COVID-19 response through June 30, 2021 to continue the County’s COVID-19 Response efforts.
Fiscal Summary
|
Expenditures |
FY 21-22 Adopted |
FY 22-23 Projected |
FY 23-24 Projected |
|
Budgeted Expenses |
|
|
|
|
Additional Appropriation Requested |
3,875,000 |
|
|
|
Total Expenditures |
3,875,000 |
0 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
3,875,000 |
|
|
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
3,875,000 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
With the attached budget resolution, the Department is requesting adjustments to the FY 21-22 budget to increase appropriations by $3,875,000 to execute the fourth amendment to the On The Move contract and to facilitate operating transfers. Emergency Financial Assistance is being funded with the first round of ARPA funds, which were received at the end of FY 20-21. As a result, the cost of this program will be funded using available ARPA fund balance.
|
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
Related Items “On File” with the Clerk of the Board:
None