SUBJECT
Title
AUTHORIZE ACCEPTANCE OF FUNDING FOR REFUGEE HEALTH PROGRAMS AND APPLY FOR ADDITIONAL FUNDING OPPORTUNITIES (DISTRICTS: ALL)
Body
OVERVIEW
The County of San Diego (County) Health and Human Services Agency, Public Health Services receives funding from the California Department of Public Health (CDPH) to support Refugee Health Programs, which includes the Refugee Health Assessment Program (RHAP) and the Refugee Health Promotion Project (RHPP).
Refugee Health Programs provide newly arrived refugees, asylees, victims of trafficking, and other eligible entrants with culturally and linguistically appropriate health assessments, including follow-up and referrals for health conditions identified in the assessment process. The County contracts with a community provider to complete comprehensive health assessments that focus on screening for and prevention of communicable diseases; early identification and diagnosis of chronic diseases; assessment of immunization status for children and adults; mental health screenings; and referrals to health providers for further medical evaluation and treatment within the first three months of arrival. The County uses the data to develop prevention and intervention strategies, and to allocate resources to reduce disparities.
Today’s action requests the San Diego County Board of Supervisors authorize the acceptance of funding for the Refugee Health Programs from CDPH for the term of October 1, 2025, through September 30, 2026, for approximately $412,911, and the pursuit of future funding opportunities to support Refugee Health Programs.
This item supports the County 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. These efforts support our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by providing the necessary programs to reduce the spread of disease and improve health outcomes in San Diego County.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Waive Board Policy B-29, Fees, Grants, Revenue Contracts - Department Responsibility for Cost Recovery, which requires prior approval of grant applications and full-cost recovery of grants.
2. Authorize the acceptance of approximately $367,911 in grant funds from the California Department of Public Health for the period of October 1, 2025, through September 30, 2026, for the Refugee Health Assessment Program, and authorize Chief Administrative Officer, or designee, upon receipt, to execute all required grant documents, including any annual extensions, amendments and/or revisions that do not materially impact the services or funding level.
3. Authorize the acceptance of approximately $45,000 in grant funds from the California Department of Public Health for the period of October 1, 2025, through September 30, 2026, for the Refugee Health Promotion Project, and authorize the Chief Administrative Officer, or designee, upon receipt, to execute all required grant documents, including any annual extensions, amendments and/or revisions that do not materially impact the services or funding level.
4. Authorize the Chief Administrative Officer, or designee, to pursue future funding opportunities to support the Refugee Health Programs.
EQUITY IMPACT STATEMENT
The County of San Diego (County) Health and Human Services Agency, Public Health Services, focuses on providing and expanding equitable access to healthcare. Examples include offering transportation services to medical appointments, housing for individuals experiencing homelessness while receiving treatment, and treatment for uninsured and underserved populations.
The Refugee Health Assessment Program (RHAP) provides culturally and linguistically-appropriate comprehensive health assessments not only to these newly arrived refugees but also Special Immigrant Visa holders, asylees, federally-certified victims of trafficking, and other eligible entrants. RHAP focuses on screening for and prevention of communicable diseases; early identification and diagnosis of chronic diseases and other important conditions; assessment of immunization status for children and adults; mental health screening; and referral to health providers for further medical evaluation, treatment, and follow-up. In Fiscal Year (FY) 2023-2024, a total of 1,324 eligible persons in San Diego County received a health assessment through RHAP, with 52% of those individuals completing the health assessment with 90 days of their arrival in the United States.
SUSTAINABILITY IMPACT STATEMENT
Today’s proposed action supports the County of San Diego (County) Sustainability Goal #2, to provide just and equitable access to County services and resources, particularly in the investment of historically underserved communities that are disproportionately impacted by communicable diseases. These actions also support Sustainability Goal #3 by transitioning to a green, carbon-free economy, by continuing to transition delivery of services to telehealth platforms whenever possible without sacrificing quality and thereby decreasing vehicle mileage for clients and employees. Additionally, today’s action supports Sustainability Goal #4, by protecting the health and well-being of everyone in the region, ensuring access to medical care for those newly arriving to the United States.
FISCAL IMPACT
Recommendation #2: Authorize Acceptance of Approximately $367,911 from the California Department of Public Health
Funds for this request are included in the Fiscal Year (FY) 2025-2027 Operational Plan in the Health and Human Services Agency. If approved, this request will result in estimated costs of $300,997 and estimated revenue of $275,933 in FY 2025-26 and estimated costs of $100,332 and estimated revenue of $91,978 in FY 2026-27. The funding source is the California Department of Public Health. A waiver of Board Policy B-29 is requested because the funding does not offset all costs. These unrecovered costs are estimated to be $25,064 in FY 2025-26 and $8,355 in FY 2026-27, for a total of $33,419. The funding source for these costs will be existing Realignment. The public benefit for providing these services far outweighs the B-29 unrecoverable costs. There will be no change in net General Fund costs and no additional staff years.
Recommendation #3: Authorize Acceptance of Approximately $45,000 from the California Department of Public Health
Funds for this request are included in the Fiscal Year (FY) 2025-2027 Operational Plan in the Health and Human Services Agency. If approved, this request will result in estimated costs of $38,449 and estimated revenue of $33,750 in FY 2025-26 and estimated costs of $12,816 and estimated revenue of $11,250 in FY 2026-27. The funding source is the California Department of Public Health. A waiver of Board Policy B-29 is requested because the funding does not offset all costs. These unrecovered costs are estimated to be $4,699 in FY 2025-26 and $1,566 in FY 2026-27, for a total of $6,265. The funding source for these costs will be existing Realignment. The public benefit for providing these services far outweighs the B-29 unrecoverable costs. There will be no change in net General Fund costs and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
Public Health Services presented these recommendations to the Health Services Advisory Board at its meeting on April 7, 2026.
BACKGROUND
The County of San Diego (County) Health and Human Services Agency, Public Health Services receives funding from California Department of Public Health (CDPH) Office of Refugee Health (ORH) to support the Refugee Health Programs, which includes the Refugee Health Assessment Program (RHAP) and the Refugee Health Promotion Project (RHPP).
The Federal Refugee Act of 1980 created the Office of Refugee Resettlement (ORR) to fund and coordinate post-arrival health assessments, time-limited medical services and other benefits to newly arrived refugees, asylees, and other eligible entrants to help them achieve economic self-sufficiency as quickly as possible after their arrival to the United States. In California, the CDPH-ORH provides federal pass-through funding to counties to provide services locally.
Humanitarian resettlement assistance is provided through the States but is funded through the federal Office of Refugee Resettlement. Historically, an estimated 125,000 refugees resettle in the United States each year with California receiving the largest number of new refugee arrivals. Newly arriving refugees in California are the most ethnically diverse groups in the nation originating from more than 85 different countries and speaking more than 80 different languages at any given year. Refugees must apply for and meet eligibility requirements for each specific benefit program. For Federal Year 2025-26, the refugee admission ceiling is limited to 7,500 people, with 6,500 anticipated to arrive in California.
RHAP provides newly arrived refugees, asylees, victims of trafficking, and other eligible entrants with culturally and linguistically appropriate health assessments, including follow-up and referrals for health conditions identified in the assessment process. The County contracts with a community provider to complete comprehensive health assessments that focus on screening for and prevention of communicable diseases; early identification and diagnosis of chronic diseases; assessment of immunization status for children and adults; mental health screenings; and referrals to health providers for further medical evaluation and treatment within the first three months of arrival. Early assessment and diagnosis of diseases and conditions allow the County to monitor and evaluate the health status for refugee populations, and to promote the well-being of newcomers to our community. The County uses the data to develop prevention and intervention strategies, and to allocate resources to reduce disparities and prioritize health equity.
During Fiscal Year (FY) 2022-23, a total of 1,656 eligible persons received a health assessment through RHAP, with 82% of those individuals completing the health assessment with 90 days of their arrival to the United States. In FY 2023-24, 1,324 eligible persons received a health assessment, with 52% of those individuals completing the health assessment within 90 days of arrival.
The RHPP provides additional resources to support RHAP-eligible individuals who are identified to have serious physical and mental health conditions. The program provided assistance to 375 unique individuals during the semi-annual reporting period from April 1, 2024, to September 30, 2024. These 375 individuals came from 17 different countries and 47% of these clients were children under the age of 18. All clients served were referred to ongoing care, and 81% of those clients referred for ongoing primary or specialty care kept their first appointment.
Today’s action requests the San Diego County Board of Supervisors authorize the acceptance of funding for the Refugee Health Programs from CDPH for the term of October 1, 2025, through September 30, 2026, for approximately $412,911, and the pursuit of future funding opportunities to support Refugee Health Programs.
A waiver of Board Policy B-29 is being requested because the revenues described above do not fully offset the costs for the Refugee Health Programs. The benefits of providing these services far outweigh the unrecovered costs as treatment and prevention of communicable diseases are critical to protect the public's health. These services are available to newly arrived refugees, asylees, victims of trafficking, and other eligible entrants, regardless of insurance status, which ensures refugees can receive patient navigation, health assessments, case management, contact investigation, and linkage to medical care.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions support the Equity (Health) and Community (Quality of Life) initiatives in the County of San Diego 2026-2031 Strategic Plan. This is accomplished by providing equitable access to health services for newly arrived refugees, asylees, victims of trafficking, and other eligible entrants.
Respectfully submitted,
ebony n. shelton
Chief Administrative Officer
ATTACHMENT(S)
N/A