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Adopt a resolution amending the List of Numbers and Classifications of Positions for Health and Social Services, Public Health Division to add 2.0 Limited-Term Project Communicable Disease Investigators to provide additional communicable disease prevention services; and Approve an Appropriation Transfer Request (ATR) in the amount of $420,939 for unanticipated FY2019/20 revenue from the California Department of Public Health (4/5 vote required)
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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 (H&SS) recommends that the Board of Supervisors adopt a resolution amending the List of Numbers and Classifications of Positions for H&SS, Public Health Division to add 2.0 Limited-Term Project Communicable Disease Investigators to provide additional communicable disease prevention services; and Approve an Appropriation Transfer Request in the amount of $420,939 for unanticipated FY2019/20 revenue from the California Department of Public Health (CDPH) (4/5 vote required).
SUMMARY:
The Department of Health and Social Services (H&SS), Public Health Division, Communicable Diseases (CD) Bureau is mandated to prevent and control the spread of communicable diseases in Solano County with limited funding. This has resulted in significant challenges in addressing established diseases such as sexually transmitted diseases (STDs) and Tuberculosis (TB), as well as new and emerging outbreaks such as Hepatitis A, Zika and measles, posing a health and safety risk to residents in Solano County. The Governor’s FY2019/20 Budget proposal included $50 million to bolster Communicable Diseases infrastructure and funding was included in the FY2019/20 State Budget. The CDPH worked with the Health Officers Association of California (HOAC) and the County Health Executives Association of California (CHEAC) to determine the formula for allocations to local health jurisdictions. Based on population, poverty, and disease rates of specific populations, Solano County H&SS, Public Health, CD Bureau was awarded a combined $868,395 for the next three years to address STDs and CDs in Solano County. With the Board’s approval, these funds will allow the CD Bureau to hire 2.0 Limited-Term Project Communicable Disease Investigators through June 30, 2022 and to bolster the communicable disease infrastructure. If funding is renewed the Department will return to the Board to request an extension of the positions.
FINANCIAL IMPACT:
Funding for these new positions is available from the California State FY2019/20 Budget to local health jurisdictions through the CDPH. To expand STD prevention in targeted populations, Solano County H&SS was allocated an annual award of $163,235 for three years (total of $489,705) of which $81,617 is available annually for personnel with the balance funds directed to community-based organizations to prevent the spread of sexually transmitted diseases in Solano. H&SS was also allocated an additional $378,690 to bolster CD infrastructure which is available to spend for up to four years. This provides a combined $868,395 through June 30, 2023 to address communicable diseases in Solano County, of which $420,939 is available in FY2019/20.
The costs associated with preparing the agenda item are nominal and absorbed by the department’s FY2019/20 Adopted Budget.
Discussion:
Solano County H&SS, Public Health Division, CD Bureau is mandated to prevent and control the spread of communicable diseases throughout the County. To protect the public’s health and safety, the CD Bureau has employed a variety of strategies to prevent and/or reduce the spread of infectious diseases, including education and outreach to at-risk communities and healthcare providers, intensive disease investigation and contact tracing, public health laboratory testing, and epidemiologic surveillance.
The CD Bureau has carried out the mandate to prevent and control infectious diseases in the face of declining federal and State funding over time that has resulted in inadequate staffing and significant challenges in following up on the thousands of laboratory reports and referrals received for the over 80 reportable infectious diseases.
• Solano County ranks sixth in the State for highest rate of Chlamydia cases and mirrors the rising STD rates seen across the State and nationally.
• In 2018, there was one death of an infant from congenital syphilis in Solano County
Amidst the rising rates of established diseases like STDs and TB, and emerging outbreaks of Hepatitis A, Zika and measles, not bolstering the capacity of the CD Bureau may pose a serious health and safety risk to residents in Solano County.
The duties of the requested CDIs will include investigation of confirmed and suspected cases of infectious diseases reported to the CD Bureau, helping ensure adequate patient treatment and follow-up, and providing linkages to additional care and services to meet the needs of clients. CDIs may interview, test, educate, and work with other Public Health Bureaus and healthcare providers to help clients access any needed care. The CDIs can work across the CD Bureau to provide increased capacity to investigate cases and assist with follow-ups of immigrant referrals for TB evaluation. Identifying and treating immigrants with TB infection is the best method of preventing further spread of TB. The CDIs will also support the STD/HIV Prevention Team and assist with collaborations with community partners and other Public Health Bureaus to conduct outreach, education and case finding for STDs.
Alternatives:
The Board may choose not to approve this request to accept the funding from CDPH and to create the 2.0 Limited-Term Project CDI positions. This is not recommended because these additional funds will help protect the health and safety of the residents of Solano County.
Other Agency Involvement:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION