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Approve the updated Joint Exercise of Powers Agreement (JEPA) with Napa-Solano-Yolo-Marin County Regional Public Health Laboratory to remove Mendocino County, rename the joint public health testing lab as Napa-Solano-Yolo-Marin County Regional Public Health Laboratory (NSYM PHL), and extend the JEPA through June 30, 2027 for the continuation of shared public health laboratory services; and Authorize the County Administrator to execute the JEPA
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Published Notice Required? Yes _____ No __X__
Public Hearing Required? Yes _____ No __X__
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services recommends that the Solano County Board of Supervisors approve the updated Joint Exercise of Powers Agreement (JEPA) with Napa-Solano-Yolo-Marin County Regional Public Health Laboratory to remove Mendocino County, rename the joint public health testing lab as Napa-Solano-Yolo-Marin County Regional Public Health Laboratory (NSYM PHL), extend the JEPA through June 30, 2027 for the continuation of shared public health laboratory services; and authorize the County Administrator to execute the JEPA.
SUMMARY:
Since July 1, 2013, the existing JEPA between Solano, Napa, Yolo, and Marin counties has provided regional public health laboratory services to four counties. A fifth county, Mendocino, joined the JEPA on July 1, 2021. Solano County's successful model of shared public health laboratory services is unique in the State of California and the JEPA has improved laboratory performance, proficiency, and emergency response and reduced costs for laboratory testing.
The updated JEPA includes the removal of Mendocino County from the JEPA effective July 1, 2024, per that county’s request, and maintains Solano, Napa, Yolo, and Marin counties as part of the JEPA. Under the terms of the JEPA, Napa, Yolo, and Marin counties will reimburse Solano County for the costs of providing public health laboratory services to their jurisdictions. The term of the updated agreement shall expire on June 30, 2027. It will automatically extend for an additional two-year period through June 30, 2029, unless a party provides a written 60-day notice before the end of the term.
FINANCIAL IMPACT:
This JEPA will provide Solano County with $832,315 in annual revenue. The contribution from each county reflects the cost of providing a specific combination of laboratory services that each of the respective counties has requested. The combination varies considerably according to the JEPA county member. In FY2024/25, Napa County will provide $155,394, Yolo County will provide $198,989, and Marin County will provide $402,932 to Solano County to support the general operational costs of the Napa-Solano-Yolo-Marin County Regional Public Health Laboratory (NSYM PHL). In addition, all member counties will contribute a proportionate amount to cover the $75,000 annual equipment maintenance fee for newly acquired instruments purchased in response to the COVID-19 pandemic. In each subsequent year of the JEPA, the annual compensation from Napa, Yolo, and Marin counties (Counties) will increase by an amount equal to the Consumer Price Index (CPI).
The payments from the Counties are intended to offset the costs associated with providing services. Solano County also receives revenue collected by the counties at locations where test specimens are submitted and by billing third-party payers directly. This cost offset allows the NSYM PHL to provide a more extensive menu of tests and services than it could afford as a single-county laboratory at an efficient scale and with a faster turnaround time.
In FY2023/24, the County General Fund contribution to the Public Health Laboratory is $477,076. Costs not covered by the member counties, third-party payers, and County General Fund are funded with Public Health Realignment, amounting to $1,548,288 in the FY2023/24 Working Budget.
DISCUSSION:
In 1998, when Napa County lacked the personnel, capacity, and facility to provide the full scope of public health laboratory services, Napa and Solano Counties created a JEPA for the Napa-Solano County Public Health Laboratory. On August 15, 2011, public health laboratory services were expanded to include Yolo County, and subsequently, on July 1, 2012, the JEPA was formally amended to include Yolo County. Then, on July 1, 2013, the JEPA was amended, and public health laboratory services were expanded to include Marin County.
Mendocino County approached the Public Health Laboratory in late 2020 requesting assistance with testing for COVID-19. After establishing a contract for laboratory testing with Mendocino County, the JEPA was amended on July 1, 2021, to include Mendocino County as a member. With the COVID-19 public health emergency declaration ending, the volume of testing requests from Mendocino County has decreased substantially, and given its significant budgetary constraints, Mendocino County has requested to end its relationship with the JEPA.
Continuing the JEPA agreement to provide regional public health laboratory services delivers multiple benefits to Solano County and its regional laboratory partners, Napa, Yolo, and Marin Counties. California Health and Safety Code (sections 101150-101165) and California Code of Regulations (sections 1075-1080) require local health departments to have available services from an official public health laboratory. This regional public health laboratory model was tested during the COVID-19 response and could meet the demands of each local health jurisdiction.
This agreement maintains a partnership that is unique in California. Solano County is the only local health jurisdiction with a formal agreement to provide regional public health laboratory services for multiple counties. This partnership creates an economy of scale for public health laboratory services in the region. The Napa, Yolo, and Marin County partners will provide funding to offset personnel expenses, equipment, and facility costs while increasing the capacity of the laboratory to provide services that may generate additional revenue in the future. A new capital equipment provision in this agreement of the JEPA allows the cost of public health lab equipment and their maintenance to be shared among the JEPA partners. Also, through this partnership, each county will access a more extensive range of public health laboratory services.
ALTERNATIVES:
The Board may choose not to approve this agreement This is not recommended because it supports the Board's goal of improving the efficiency and effectiveness of mandated services.
OTHER AGENCY INVOLVEMENT:
This agreement will become binding when approved by all partners to the JEPA, including Napa, Yolo, and Marin Counties. County Counsel has reviewed the agreement for legal sufficiency.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION