To: Board of Supervisors
From: DHHS: Public Health
Agenda Section: Consent
SUBJECT:
title
Public Health Fiscal Year 2020-2021 Supplemental Budgets (Requires 4/5 Vote)
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Approve the attached supplemental budget in the amount of $99,685.00 for fiscal year (FY) 2020-2021 Department of Health and Human Services - Public Health Fund 1175, Budget Unit 428;
2. Approve the attached supplemental budget in the amount of $34,053.00 for FY 2020-2021 Department of Health and Human Services - Public Health Fund 1175, Budget Unit 470;
3. Approve the attached supplemental budget in the amount of $4,073,240 for FY 2020-2021 Department of Health and Human Services - Public Health Fund 1175, Budget Unit 455005;
4. Approve the attached supplemental budget in the amount of $1,069,815 for FY 2020-2021 Department of Health and Human Services - Public Health Fund 1175, Budget Unit 455006; and
5. Approve the attached supplemental budget in the amount of $193,804 for FY 2020-2021 Department of Health and Human Services - Public Health Fund 1175, Budget Unit 455007.
Body
SOURCE OF FUNDING:
Public Health Fund (1175)
DISCUSSION:
Due to the COVID-19 pandemic, Department of Health and Human Services (DHHS) - Public Health received additional Federal allocations for their Immunization, Housing Opportunities for People with AIDS (HOPWA) and Emergency Preparedness programs to provide additional services to the community during the pandemic. Supplemental budgets in several Public Health Budget Units are required to reflect these unexpected increases in allocations.
428 Immunization Program
The supplemental budget request for Fund 1175, Budget Unit 428, Immunization Program is necessary as the program received additional state allocations. The Immunization program receives funding from the Center for Communicable Disease (CDC) through the California Department of Public Health (CDPH) annually to assist in detecting, preventing and controlling vaccine-preventable disease and to immunize against childhood diseases prior to school admittance, per Health and Safety Code, Section 120325-120380. In July of 2020, CDPH awarded an additional allocation to Local Health Departments (LHD’s) to conduct enhanced influenza immunization activities. The additional allocation for Humboldt County is $45,212. Additionally, in Oct. of 2020, CDPH awarded an additional allocation to LHD’s to do COVID-19 vaccination planning. The additional allocation for Humboldt County is $54,473. These are additional allocations that were formalized by a second amendment to Grant Agreement #17-10318, executed by the Public Health Director with authority granted by your Board on Jan. 30, 2018.
470 Housing Opportunities for People With AIDS
The supplemental request for Fund 1175, Budget Unit 470, Housing Opportunities for People With AIDS (HOPWA) is necessary as the program received additional state allocations in response to the COVID-19 pandemic from the State Office of AIDS. HOPWA assists clients who are at risk of becoming homeless with emergency rent and utility payments. Grant Agreement #19-11126 for $34,053 in COVID-19 funding to the HOPWA program was approved by your Board on Aug. 25, 2020. At that time, it was anticipated that this additional funding would be presented with the First Quarter report, so a supplemental budget was not included with the agenda item.
In addition to increases in pre-existing allocations, DHHS-Public Health has received direct allocations to respond to the pandemic and has utilized existing dollars in the Public Health Fund to respond to the event in which eligible costs have been or will be claimed to the Federal Emergency Management Agency (FEMA) for reimbursement. FEMA is reimbursing 100% of eligible costs.
455 Public Health Emergency Preparedness
The total costs anticipated to be claimed to FEMA for FY 2020-21 for noncongregate sheltering is $485,835, with FEMA ineligible costs to be claimed to Project Roomkey funds. The supplemental budget requests for Fund 1175, Budget Unit 455, Public Health Emergency Preparedness are necessary as the program received additional grant funding and state allocations to respond to the COVID-19 pandemic. On March 17, 2020, your Board ratified a State of Emergency declared by the Humboldt County Health Officer in response to the COVID-19 pandemic. DHHS - Public Health has been responding to COVID-19 by conducting contact tracing, disease investigation, testing, and engaging in other prevention and control-related activities since the first positive case in Humboldt County in mid-February 2020.
455005, Emergency Response
DHHS-Public Health spent Public Health fund dollars to appropriately respond to the pandemic where state and federal funding was not available, in which it is anticipated FEMA will reimburse for eligible costs. The attached supplemental budgets address costs anticipated to be reimbursed by FEMA for both noncongregate sheltering efforts and public health response. The total costs anticipated to be claimed to FEMA for FY 2020-21 for public health response is $3,198,240, with $875,000 of ineligible costs to supplemented with Health Realignment funds.
455006, Homeless Coordinating & Financing
In FY 2019-20 and in FY 2020-21, DHHS-Public Health was awarded Project Roomkey funds from the California Department of Social Services (CDSS). These state funds were used to operate hotels to isolate and quarantine individuals experiencing homelessness that had been exposed to COVID-19 or met the criteria to be considered high risk. For the FY 2019-20 allocation of $365,000, funds had to be encumbered by June 30, 2020; therefore, funds were allowed to be spent in FY 2020-21. DHHS-Public Health spent $239,093 of these funds in FY 2020-21. The FY 2020-21 Project Roomkey allocation of $246,742 has been fully expended in FY 2020-21. The total costs anticipated to be claimed to FEMA for FY 2020-21 for noncongregate sheltering is $485,835, with FEMA ineligible costs to be claimed to Project Roomkey funds.
455007, PHEP COVID
On March 27, 2020 the Coronavirus Aid, Relief and Economic Security (CARES) Act was signed into law to aid state and local governments in the response to the COVID-19 pandemic. A portion of this funding was dedicated to supporting activities in mitigating spread of COVID-19, such as increased contact tracing and investigation and increased testing. CDPH allocated funding in the amount of $201,536 to DHHS - Public Health. Of this allocation, $82,820 was spent in FY 2020-21. In July, CDPH awarded additional Hospital Preparedness Program (HPP) funding for COVID response which was utilized to prepare the Alternate Care Site (ACS). The allocation for Humboldt County was $110,984.
FINANCIAL IMPACT:
If approved, the supplemental budgets will increase appropriations for expenditures already expended in response to the COVID-19 pandemic. For the Immunization Program additional allocation, Fund 1175, Budget Unit 428 - Immunization Program will be increased by $99,685 for FY 2020-21. For the HOPWA additional allocation, Fund 1175, Budget Unit 470 - HOPWA will be increased by $34,053 for FY 2020-21. For the Public Health Response to COVID-19, Fund 1175, Budget Unit 455005 - Emergency Response will be increased by $4,073,240 for FY 2020-21. For the Public Health noncongregate sheltering response to COVID-19 and Project Roomkey allocations, Fund 1175, Budget Unit 455006 - Homeless Coordinating & Financing will be increased by $1,069,815 for FY 2020-21. For the HPP COVID and ELC-CARES allocations, Fund 1175, Budget Unit 455007 - PHEP COVID will be increased by $193,804 for FY 2020-21.
These supplemental budgets do not directly impact the County General Fund. However, though highly unlikely, due to the unknown factors related to timeframes for FEMA reimbursement, should the Public Health fund not be able to carry these expenditures in the long-term, there could be an impact to the County General Fund since Public Health receives a General Fund allocation.
STRATEGIC FRAMEWORK:
This action supports your Board’s Strategic Framework by protecting vulnerable populations and providing community-appropriate levels of service.
OTHER AGENCY INVOLVEMENT:
N/A
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may choose not to approve one or all of the supplemental budgets; however, this alternative is not recommended since it would impact Public Health’s ability to accurately represent additional allocations in Public Health’s budgets.
ATTACHMENTS:
428 FY2020-21 supplemental budget
470 FY2020-21 supplemental budget
455005 FY2020-21 supplemental budget
455006 FY2020-21 supplemental budget
455007 FY2020-21 supplemental budget
State Standard Agreement #17-10318 Second Amendment
PREVIOUS ACTION/REFERRAL:
Board Order No.: C-14, C-7, K-1
Meeting of: 1/30/2018, 8/25/2020, 3/17/2020
File No.: 21-1026, 20-1042, 20-358