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DATE: |
September 27, 2022 |
11 |
SUBJECT
Title
AUTHORIZE ACCEPTANCE OF EPIDEMIOLOGY AND LABORATORY CAPACITY STRENGTHENING HEALTHCARE-ASSOCIATED INFECTIONS/ANTIMICROBIAL RESISTANCE PROGRAM CAPACITY GRANT ALLOCATION (DISTRICTS: ALL)
Body
OVERVIEW
The County of San Diego (County) has been 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 remains a high priority for the County. The emergence of COVID-19 in 2020 was the largest infectious disease outbreak in recent history. To continue efforts to test and identify future outbreaks of infectious diseases, the California Department of Public Health (CDPH) released the Epidemiology and Laboratory Capacity (ELC) Strengthening Healthcare-Associated Infections/Antimicrobial Resistance Program (SHARP) grant funding.
This ELC SHARP grant funding will support the expansion of Antimicrobial Resistance (AR) surveillance in California, via screening and testing activities for antibiotic resistant organisms, such as Carbapenem-Resistant Organisms, multi-drug resistant Candida auris, a yeast that can cause healthcare-associated infections with a high mortality rate in immunocompromised patients and Neisseria gonorrhoeae, the bacterium which causes the sexually transmitted disease gonorrhea. In addition, this funding will support testing of these organisms by Whole Genome Sequencing, which provides a very precise DNA fingerprint that can help link cases to one another, allowing an outbreak to be detected and solved sooner.
On May 26, 2022, the County Public Health Laboratory received a notification of award from CDPH for $343,781 in one-time funding for the ELC SHARP, for the term June 1, 2022 through July 31, 2024. Today’s action requests the San Diego County Board of Supervisors (Board) to authorize acceptance of $343,781 in ELC SHARP grant funding from CDPH. Additionally, today’s action requests the Board authorize the Agency Director, Health and Human Services Agency to apply for additional funding opportunities, if available, to support strengthening HAI/AR Program capacity and testing services.
Today's actions support 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 ensuring the local health department can continue to ably improve the health and well-being of San Diego County residents through enhanced and increased testing, prevention, and intervention to interrupt transmission of disease.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Authorize the acceptance of $343,781 from the California Department of Public Health, for the Epidemiology and Laboratory Capacity Strengthening Healthcare-Associated Infections/Antimicrobial Resistance Program grant allocation for the period of June 1, 2022 through July 31, 2024, and authorize the Agency Director, Health and Human Services Agency, or designee, to execute all required grant documents, upon receipt, including any annual extensions, amendments, or revisions that do not materially impact or alter the services or funding level.
2. Authorize the Agency Director, Health and Human Services Agency, to apply for additional funding opportunity announcements, if available, to support Strengthening Healthcare-Associated Infections/Antimicrobial Resistance Program capacity and testing services.
EQUITY IMPACT STATEMENT
The County of San Diego (County) Health and Human Services Agency, Public Health Laboratory (PHL) continually monitors changes to laboratory and testing processes and advancements from technology to testing analysis in order to continue providing the best possible service, in both efficiency and effectiveness, to our communities. The Centers for Disease Control and Prevention data show that there is a link to health disparities and inequalities across a wide range of diseases, behavioral risk factors, environmental exposures, social determinants, and health-care access by sex, race and ethnicity, income, education, disability status, and other social characteristics. By continuing to apply for and receive grant funding such as the Epidemiology and Laboratory Capacity Strengthening Healthcare-Associated Infections/Antimicrobial Resistance Program, the County PHL can acquire additional equipment and supplies to increase testing capabilities and response times to provide critical information of outbreaks to the most vulnerable communities.
SUSTAINABILITY IMPACT STATEMENT
The proposed action aligns with the County of San Diego’s (County) Sustainability Goals to strive for County programs, operations, and contracts that reflect the County’s values and priorities, including equity and sustainability, protecting health and well-being, reduce pollution and waste by lowering greenhouse gas emissions, and striving to become a zero-waste region. The Epidemiology and Laboratory Capacity Healthcare-Associated Infections/Antimicrobial Resistance Program grant will provide additional funding to support the Public Health Laboratory with capacity and testing services aimed to detect and prevent illnesses. Testing and identification will improve the overall health of communities, reduce the demand of associated care services, while increasing effectiveness of care providers and lowering operating costs of facilities, thus reducing greenhouse gas emissions and waste generated within the care sector. Since climate change and air pollution are direct threats to human health, the reduction of pollution, which can negatively impact human health is also considered a preventative healthcare measure.
FISCAL IMPACT
Funds for this request are not included in the Fiscal Year 2022-24 Operational Plan in the Health and Human Services Agency. If approved, this request will result in costs and revenues of $149,042 in Fiscal Year 2022-23 and will result in costs and revenue of $194,739 in Fiscal Year 2023-24. The funding source is the Epidemiology and Laboratory Capacity Strengthening Healthcare-Associated Infections/Antimicrobial Resistance Program grant from the California Department of Public Health. Funds for this program will use existing appropriations and be incorporated into future Operational Plans as needed. There will be no change in net General Fund costs and no additional staff years.
BUSINESS IMPACT STATEMENT
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Details
ADVISORY BOARD STATEMENT
The Health Services Advisory Board reviewed this item on September 6, 2022, and recommended approval of the recommendations.
BACKGROUND
The County of San Diego (County) Health and Human Services Agency (HHSA), Public Health Laboratory (PHL) has the responsibility to detect and control communicable diseases within the region. These responsibilities are mandated by State law, and the County has a strong track record of effectively investigating disease incidents, ending outbreaks, and protecting the public’s health. The County PHL strives to provide testing for the early detection and prevention of outbreaks for communicable diseases in the region. The emergence of COVID-19 in 2020 was the largest outbreak in recent history and challenged the capacity of the PHL. The County HHSA, Public Health Services (PHS) tackled this outbreak head-on with the support of all County departments.
On May 26, 2022, the County PHL received a notification of award from the California Department of Public Health (CDPH) for $343,781 in one-time Epidemiology and Laboratory Capacity (ELC) Strengthening Healthcare-Associated Infections/Antimicrobial Resistance Program (SHARP) funding, for the term of June 1, 2022, through July 31, 2024. The CDPH ELC SHARP grant funding will allow the County PHL to expand Antimicrobial Resistance (AR) surveillance in the region. AR surveillance is essential to slow the emergence and spread of antibiotic resistant organisms by detecting and characterizing these organisms for outbreak detection purposes. This expansion of AR surveillance in California, will be via screening and testing activities for antibiotic resistant organisms, such as Carbapenem-Resistant Organisms, multi-drug resistant Candida auris, a yeast that can cause healthcare-associated infections with a high mortality rate in immunocompromised patients and Neisseria gonorrhoeae, the bacterium which causes the sexually transmitted disease gonorrhea. In addition, this funding will support Whole Genome Sequencing, which provides a very precise DNA fingerprint that can help link cases to one another, allowing an outbreak to be detected and solved sooner.
Funding will be used primarily for equipment, supplies, and personnel to perform screening and testing for Candida auris, an emerging fungus that is often multidrug-resistant. Funds will also provide testing supplies to identify Carbapenem-Resistant organisms to the species level, as well as test them for mechanisms of resistance. Organisms that are resistant to these antibiotics are very difficult to treat. Funding was provided to further characterize these organisms with the addition of whole genome sequencing, which will provide robust surveillance to enhance understanding of the complex epidemiology of AR. The data collected is crucial for developing strategies to reduce AR within the county before large-scale emergencies occur.
Today’s action requests the San Diego County Board of Supervisors (Board) to authorize acceptance of $343,781 in ELC SHARP grant funding from CDPH to be expended by Fiscal Year 2023-24. Additionally, today’s action requests the Board authorize the Agency Director, Health and Human Services Agency to apply for additional funding opportunities, if available, to support strengthening HAI/AR Program capacity and testing services.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed action supports the Equity (Health) and Community (Quality of Life) initiatives in the County of San Diego’s 2022-2027 Strategic Plan, as well as the regional Live Well San Diego vision, by building better health and protecting the health of our residents through enhanced and increased testing, prevention, and intervention to interrupt transmission of disease.
Respectfully submitted,
HELEN N. ROBBINS-MEYER
Chief Administrative Officer
ATTACHMENT(S)
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