|
DATE: |
November 15, 2022 |
29 |
SUBJECT
Title
RECEIVE UPDATES AND TAKE NECESSARY ACTIONS REGARDING THE COVID-19 EMERGENCY RESPONSE AND THE MONKEYPOX (MPOX) OUTBREAK RESPONSE; AUTHORIZE COMPETITIVE PROCUREMENTS RELATED TO CONTINUED COVID-19 SERVICES; ACCEPT MPOX RESPONSE FUNDING; RATIFY CONTRACT FOR TESTING, TREATMENT, AND VACCINATION ADMINISTRATION SERVICES FOR MPOX; AND ADOPT A RESOLUTION AUTHORIZING CONTINUANCE OF TELECONFERENCED PUBLIC MEETINGS (DISTRICTS: ALL)
Body
OVERVIEW
As seen nationwide, community transmission of the COVID-19 and monkeypox (MPOX) viruses are occurring locally. As a leader in infectious disease control within California and across the United States, the preparation for and response to communicable disease events, outbreaks, and emerging infectious disease threats remain high priorities for the County of San Diego (County). The County continues to make significant, ongoing efforts to address the COVID-19 pandemic and the MPOX global outbreak with sustainable approaches.
In addition to receiving updates on the County’s local COVID-19 and MPOX responses, today’s action requests the Board approve the following:
• Authorize competitive solicitations for specimen collection, testing, and resulting services for COVID-19 and other infectious diseases;
• Accept MPOX response funding, from the California Department of Public Health;
• Ratify the contract with Family Health Centers of San Diego for testing, treatment, and vaccination administration for MPOX; and
• Adopt a resolution entitled RESOLUTION AUTHORIZING CONTINUANCE OF TELECONFERENCED PUBLIC MEETINGS PURSUANT TO GOVERNMENT CODE SECTION 54953.
This item supports the County’s vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by protecting the health of residents against the COVID-19 pandemic and the MPOX outbreak.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Receive an update on the COVID-19 pandemic response.
2. In accordance with Section 401, Article XXIII of the County Administrative Code, authorize the Director, Department of Purchasing and Contracting to issue a Competitive Solicitation for specimen collection, testing, and resulting services for COVID-19 and other infectious diseases, and upon successful negotiations and determination of a fair and reasonable price, award contracts for a term of one year, with one option year and up to an additional six months if needed, and to amend the contracts as needed to reflect changes to services and funding.
3. Receive an update on the monkeypox (MPOX) outbreak response.
4. Authorize the acceptance of $1,233,869 in funding from the California Department of Public Health to aid in the distribution of MPOX vaccines, tests, outreach and education, and treatments for the period of July 1, 2022 to June 30, 2023, and authorize the Agency Director, Health and Human Services Agency to execute all required documents, upon receipt, including any annual extensions, amendments, and/or revisions thereto that do not materially impact or alter the services or funding level.
5. Ratify actions taken by the Director, Department of Purchasing and Contracting, in response to the MPOX local health emergency and in accordance with San Diego County Administrative Code section 402 to execute contract #567618 for testing, treatment, and vaccination administration services for MPOX with Family Health Centers of San Diego, and authorize amendments to the contract as needed to reflect changes to services and funding allocations, subject to the approval of the Agency Director, Health and Human Services Agency.
6. Adopt a resolution entitled RESOLUTION AUTHORIZING CONTINUANCE OF TELECONFERENCED PUBLIC MEETINGS PURSUANT TO GOVERNMENT CODE SECTION 54953.
EQUITY IMPACT STATEMENT
In order to support the most vulnerable, an equity lens and risk-based approach was used to prioritize, when appropriate, the distribution of COVID-19 response and recovery-related federal, State, and local funding and resources, and the distribution of monkeypox (MPOX) vaccine and related resources. This was based on a data-driven approach, identifying communities that have the highest need for support in relation to the number of positive COVID-19 cases and the number of positive MPOX cases.
Through press conferences and presentations at the San Diego County Board of Supervisors meetings, the County of San Diego (County) has been able to disseminate critical information about the efforts being done to address and combat the COVID-19 pandemic and MPOX outbreak to a wide audience, as well as providing a forum to receive public comment. Helping people make the best-informed decisions to protect their health and the health of their community requires providing key health promotion and harm reduction prevention information to the public and working with partners and trusted messengers to ensure information reaches affected communities. In order to continue the County’s commitment to transparency and open government and to remove traditional barriers to access and participation in government affairs, today’s actions provide the mechanism to present updates on the current COVID-19 and MPOX outbreak response efforts that have an impact on the lives of Black, Indigenous, people of color, women, people with disabilities, immigrants, youth, the LGBTQ+ community, and the economically disadvantaged.
SUSTAINABILITY IMPACT STATEMENT
The proposed actions align with the County of San Diego Sustainability Goals, including engaging the community and protecting health and wellbeing. Implementation of the proposed actions will provide an opportunity to engage the community by transparently sharing any results of the pandemic and outbreak responses and/or outcomes and to protect the health and wellbeing of the residents of San Diego County.
FISCAL IMPACT
COVID-19 Response
It is estimated that through the end of Fiscal Year (FY) ending June 30, 2022, the County of San Diego (County) has spent over one billion dollars on overall COVID-19 response costs, excluding federally dedicated program funds for programs such as rental assistance and nutrition services. Funding sources include Coronavirus Aid, Relief, and Economic Security (CARES) Act, American Rescue Plan Act (ARPA), Federal Emergency Management Agency (FEMA), County General Fund Balance, Realignment, and program revenues available for response efforts. In FY 2022-23, the County will rely on ARPA funding, as well as FEMA, other stimulus funds, program revenues, Realignment, and County General Fund Balance to cover response costs as needed. The County will continue to pursue other federal and State stimulus revenue and funding sources as made available.
Recommendation #2: Authorize Competitive Solicitations for Specimen Collection, Testing and Resulting Services for COVID-19 and Other Infectious Diseases
Funds for this request are included in the FY 2022-24 Operational Plan in Health and Human Services Agency (HHSA). If approved, this request will result in costs and revenues of approximately $500,000 in FY 2022-23. The County will revisit resource needs for future fiscal years depending upon the progression of COVID-19 cases. The funding source is the Epidemiology and Laboratory Capacity (ELC) Enhancing Detection Expansion Grant. There will be no change in net General Fund costs and no additional staff years.
Recommendation #3: Monkeypox (MPOX) Outbreak Response
It is estimated that the cost in responding to the MPOX outbreak is approximately $2 million as of October 6, 2022. Costs are being covered by existing Realignment, existing General Purpose Revenue, and MPOX Response funding from the California Department of Public Health (CDPH). The County of San Diego HHSA will continue to pursue federal and State revenues to cover response costs. There is no change in net General Fund cost and no additional staff years.
Recommendation #4: Accept MPOX Response Funding
Funds for this request are included in the Fiscal Year 2022-24 Operational Plan in HHSA. If approved, this request will result in costs and revenue of $1,233,869 in Fiscal Year 2022-23 which will be covered by existing appropriations. The funding source is the CDPH MPOX Response Funding. HHSA will use this funding to support costs related to MPOX and supplement with Realignment and existing General Purpose Revenue as needed. There will be no change in net General Fund cost and no additional staff years.
Recommendation #5: Ratify Contract with Family Health Centers of San Diego
Funds for this request are included the Fiscal Year 2022-24 Operational Plan in HHSA. If approved, this request will result in costs and revenue of approximately $193,600 in FY 2022-23, which will be covered by existing appropriations. The County will revisit resource needs for future fiscal years depending upon the progression of the outbreak. The funding sources are CDPH MPOX Response Funding, Realignment, existing General Purpose Revenue, and any federal or State funding that might become available. There will be no change in net General Fund costs and no additional staff years.
BUSINESS IMPACT STATEMENT
This action will help support individuals, families, and small businesses impacted by COVID-19 and MPOX by ensuring the most up to date information as well as critical testing and treatment services are provided.
Details
ADVISORY BOARD STATEMENT
N/A
BACKGROUND
As a result of community transmissions of COVID-19 and monkeypox (MPOX) in San Diego County, as with other areas throughout the nation, the County of San Diego (County) is actively engaged in responses to both incidents. As a leader in infectious disease control within California and across the United States, the preparation for and response to communicable disease events, outbreaks, and emerging infectious disease threats remain high priorities for the County.
COVID-19 Response
COVID-19 was detected in Wuhan City, Hubei Province in China in December 2019. Since then, the virus has rapidly spread across the globe, resulting in the World Health Organization (WHO) declaring COVID-19 a pandemic on March 11, 2020. On February 14, 2020, the San Diego County Public Health Officer issued a Declaration of Local Health Emergency, pursuant to California Health and Safety Code Section 101080. Additionally, on that day, pursuant to California Government Code 8630, the Chief Administrative Officer (CAO), serving as the County of San Diego Director of Emergency Services and the Coordinator of the Unified San Diego County Emergency Services Organization, issued a Proclamation of Local Emergency regarding COVID-19. The requirements to renew the Declaration of Local Health Emergency and Proclamation of Local Emergency for COVID-19 were explicitly waived on March 4, 2020, in the Proclamation of a State of Emergency for California by Governor Gavin Newsom and remain in effect for the duration of the State of Emergency. On October 17, 2022, Governor Newsom announced that the COVID-19 State of Emergency would be rescinded on February 28, 2023. The County is planning for continuation of efforts to monitor, investigate, and respond to the incident, as needed.
As with other areas throughout the nation, there is community transmission of COVID-19 in San Diego County. To maintain transparency and to protect the health of the public, the County continues regular updates to disseminate critical information about the efforts being done to address and combat the COVID-19 pandemic to ensure the public remains informed and safe in the midst of an unprecedented pandemic. The County has made significant efforts to slow down the spread of the virus, which in turn helps to avoid an increase in the cases that overwhelm the healthcare system.
Authorize Competitive Solicitations for Specimen Collection, Testing, and Resulting Services for COVID-19 and Other Infectious Diseases
The County currently operates 13 COVID-19 specimen collection sites countywide. This request for additional specimen collection, testing, and resulting services would increase capacity and ensure coverage during surge periods. Today’s action requests the Board to authorize the Director, Department of Purchasing and Contracting to issue competitive solicitations in accordance with Section 401, Article XXIII of the County Administrative Code for the procurement of additional specimen collection, testing, and resulting services for COVID-19 and other infectious diseases.
MPOX Response
In May 2022, clusters of MPOX cases were identified in multiple countries. The first case of MPOX in the U.S. was confirmed in Massachusetts on May 20, 2022, and the first case in California was confirmed on May 27, 2022. The first case of MPOX in San Diego County was reported on June 15, 2022. MPOX is an unusual disease caused by infection with the MPOX virus. It is spread through prolonged skin-to-skin contact and symptoms of MPOX include rash, fever, muscle aches, and respiratory symptoms. Although most cases of MPOX resolve within a few weeks, MPOX can cause serious symptoms, including severe pain, hospitalization and, in rare cases, death.
On July 23, 2022, the WHO declared the multi-country spread of MPOX to be a Public Health Emergency of International Concern, which constitutes its highest alert level. On August 1, 2022, Governor Newsom declared a State of Emergency as part of California’s response to the MPOX outbreak. On August 2, 2022, the San Diego County Public Health Officer issued a Declaration of Local Health Emergency, pursuant to California Health and Safety Code Section 101080, as a result of the global outbreak of MPOX and the local impacts to public health. On August 4, 2022, the U.S. Department of Health and Human Services declared the ongoing spread of the MPOX virus a public health emergency. On August 9, 2022 (1), the San Diego County Board of Supervisors (Board) ratified the Declaration of Local Health Emergency regarding MPOX, with subsequent ratifications on August 30, 2022 (18), September 13, 2022 (13), and October 11, 2022 (13). Due to low numbers of new cases, the local health emergency for MPOX was allowed to expire on November 10, 2022, upon the recommendation of the Public Health Officer.
The County has made significant efforts to slow down the spread of the virus, through the activation of community leaders and trusted messengers, enhanced contracted services to provide person-centered messaging and foot teams in communities most impacted, increased contact tracers with training in sexual health interviewing, enhanced communication with healthcare providers for testing and treatment, and additional health promotion and harm reduction communication, education, and outreach to other communities that are at risk for MPOX outbreaks.
Weekly MPOX cases have taken a significant decline in past weeks. Based on the decrease in cases and an increase in vaccination efforts, it is anticipated that the County could more than adequately manage the capacity of cases and vaccination efforts, without the needed administrative flexibilities provided by the local health emergency. As the local health emergency expires, MPOX response efforts in testing, treatment, and vaccinations, as well as community engagement efforts will continue, with focus on ensuring access by the most vulnerable populations, including people of color.
Accept MPOX Response Funding
On October 10, 2022, the County received notification that the California Department of Public Health is allocating $1,233,869 of MPOX response funding to the County to aid in the distribution of MPOX vaccines, tests, outreach and education, and treatment to communities most at risk, including marginalized and disadvantaged communities. These funds may be used for the following activities:
• Supporting efforts to vaccinate persons at risk for MPOX and monitor vaccine delivery;
• Bolstering efforts to diagnose, manage, and report data regarding persons with MPOX;
• Providing information to the public and/or highest risk populations such as gay, bisexual, transgender, and other men who have sex with men regarding prevention of MPOX;
• Conducting or supporting community partners to conduct public outreach efforts to share prevention and harm reduction measures and encourage vaccination of eligible persons; and
• Implementing disease control activities, including supporting isolation of persons with MPOX, educating healthcare providers about MPOX, and carrying out case investigations and contact tracing in high priority situations.
Ratify Contract with Family Health Centers of San Diego
Several community-based organizations that serve communities most impacted by the MPOX outbreak were approached to potentially enter into a new agreement to provide testing, treatment, and vaccination services for MPOX. Family Health Centers of San Diego (FHCSD), a community clinic with expertise in providing the necessary services, quickly expressed interest in entering into an agreement. FHCSD’s existing structure, through which they provide limited MPOX services, readily allows for integration of additional services as a safety net provider. Therefore, on September 21, 2022, the County executed a contract with FHCSD for testing, treatment, and vaccination administration services to support the immediate response to the MPOX outbreak. The County refers clients at risk of MPOX to FHCSD for testing, treatment, and vaccination services. Today’s action requests the Board to ratify the contract with FHCSD and to authorize amendments to the contract as needed to reflect changes to services and funding allocations.
The County continues to make significant, ongoing efforts to address the COVID-19 pandemic and the MPOX outbreak, with sustainable response approaches. Today’s actions request the Board receive an update on the local COVID-19 response and authorize competitive solicitations for specimen collection, testing and resulting services for COVID-19 and other infectious diseases. Additionally, today’s actions request the Board receive an update on the local MPOX response, authorize acceptance of MPOX response funding from the California Department of Public Health, and authorize ratification of the contract with FHCSD for testing, treatment, and vaccination administration of MPOX. In addition, the Board is requested to adopt a resolution entitled, RESOLUTION AUTHORIZING CONTINUANCE OF TELECONFERENCED PUBLIC MEETINGS PURSUANT TO GOVERNMENT CODE SECTION 54953.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions support the Equity (Health) and Community (Safety) initiatives in the County of San Diego’s 2022-2027 Strategic Plan, as well as the regional Live Well San Diego vision, by protecting the population from the COVID-19 pandemic and from the global outbreak of monkeypox virus.
Respectfully submitted,
HELEN N. ROBBINS-MEYER
Chief Administrative Officer
ATTACHMENT(S)
Attachment A - RESOLUTION AUTHORIZING CONTINUANCE OF TELECONFERENCED PUBLIC MEETINGS PURSUANT TO GOVERNMENT CODE SECTION 54953