SUBJECT
Title
AUTHORIZE ACCEPTANCE OF LABASPIRE PUBLIC HEALTH EQUITY AND READINESS OPPORTUNITY INITIATIVE FELLOWSHIP GRANT FUNDING, AND AUTHORIZE APPLICATION FOR FUTURE FUNDING OPPORTUNITIES (DISTRICTS: ALL)
Body
OVERVIEW
The County of San Diego (County) Health and Human Services Agency, Public Health Services, Public Health Laboratory (PHL) plays a critical role in protecting the health of San Diego County (county) residents and visitors. PHLs were established in response to outbreaks of diseases like typhoid, smallpox, and diphtheria, which are now considered diseases of the past. The California network is comprised of various laboratories which play an important role in disease diagnosis and epidemiological surveillance of routine public health reportable diseases. Each individual laboratory further serves as a source of surge capacity for other local laboratories and the State laboratory in emergency situations and outbreaks.
PHLs are directed by highly qualified laboratory directors that are board certified and hold a doctoral degree. Over the last several decades there has been a decline in the number of qualified laboratory directors, due to requirements and attrition to the private sector. Many California PHL Directors are currently directing more than one PHL to meet the demand and need in California. The County PHL has been directly impacted by personnel turnover and shortages. With the growth of the PHL scope and testing, the need for additional leadership positions has been identified in this profession. A strategy many larger laboratories are employing is the addition of assistant laboratory director positions to support the administrative functions of a laboratory, and to provide succession planning for continuity of operations.
Through the California Department of Public Health (CDPH) LabAspire Fellowship program, the Public Health Equity and Readiness Opportunity (HERO) grant was created. This HERO LabAspire Fellowship grant funding will support LabAspire Public Health Laboratory Director training activities in collaboration with the California Association of Public Health Laboratory Directors, California Conference of Local Health Officers, and the County Health Executives Association of California. This grant award will assist in response to the ongoing recruitment efforts and the need to increase workforce training programs in the county.
Today’s action requests the San Diego County Board of Supervisors (Board) authorize acceptance of grant funding from CDPH to support the development of qualified PHL directors and assistant directors. 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 the continuing education and training of PHL personnel.
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 $581,586 in funding from the California Department of Public Health, Center for Laboratory Sciences for the Public Health Equity and Readiness Opportunity LabAspire Fellowship grant for the period of July 1, 2022 through June 30, 2025, for laboratory workforce training, 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.
3. Authorize the Agency Director, Health and Human Services Agency, to apply for additional funding opportunity announcements, if available, to support the continuing education and training of lab personnel.
EQUITY IMPACT STATEMENT
The County of San Diego (County) Health and Human Services Agency, Public Health Services, Public Health Laboratory (PHL) continually monitors changes to laboratory and testing processes and advancements from technology to testing analysis, in order to continue providing efficient and effective services to San Diego County (county) communities. Data from the Centers for Disease Control and Prevention shows that there is a link between health disparities and inequalities across a wide range of diseases, behavioral risk factors, environmental exposures, social determinants, and health care access by sex, race, ethnicity, income, education, disability status, and other social characteristics. By continuing to apply for and receive funding from sources such as the Public Health Equity and Readiness Opportunity LabAspire Fellowship grant, the County PHL can provide additional education and training to improve PHL personnel’s skills in testing the large variety of viruses, bacteria, and pathogens more likely to affect the county’s most vulnerable communities.
SUSTAINABILITY IMPACT STATEMENT
The proposed actions align with the County of San Diego’s (County) Sustainability Goal #4 to protect the health and wellbeing of everyone in the region by providing additional funding to support the County Health and Human Services Agency, Public Health Services, Public Health Laboratory and additional training to key laboratory staff to help them gain enhanced leadership capabilities and overall laboratory function management including testing and identification of emerging pathogens. This will improve the overall health of communities and reduce the demand of associated care services. The proposed actions will increase the number of qualified individuals for positions of leadership as lab directors or assistant lab directors and will ensure continuity of operations and help to avoid gaps in services, especially during outbreaks and emergencies.
FISCAL IMPACT
Funds for this request are included in the Fiscal Year (FY) 2023-25 Operational Plan in the Health and Human Services Agency. If approved, this request will result in costs of $281,674 and revenue of $197,488 in FY 2023-24, and costs of $406,378 and revenue of $384,098 in FY 2024-25. This will result in total costs of $688,052 and revenue of $581,586 for FY 2023-24 through FY 2024-25. The funding source is the Public Health Equity and Readiness Opportunity LabAspire Fellowship grant from the California Department of Public Health. A waiver of Board Policy B-29 is requested because the funding does not offset all costs. These costs are estimated at $84,186 for FY 2023-24, and $22,280 for FY 2024-25, for a total of $106,466. The funding source for these costs will be Realignment. The public benefit for providing these services far outweighs these costs. Funds for subsequent years will be incorporated into future operational plans. 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 June 6, 2023 and recommended approval of the recommendations.
BACKGROUND
The County of San Diego (County) Health and Human Services Agency, Public Health Services, Public Health Laboratory (PHL) has the responsibility to detect and control communicable diseases within the San Diego County (county) region. These responsibilities are mandated by State and federal law, and the County has a strong track record of effectively investigating disease incidences, ending outbreaks, and protecting the public’s health. The Clinical Laboratory Improvement Amendments regulations and 42 CFR § 493.1443, specify the requirements for becoming a laboratory director. Rigorous standards ensure laboratories have qualified directors for moderate and high complexity testing. This work begins and is ushered forward by PHL leadership positions such as laboratory directors and assistant laboratory directors. The emergence of COVID-19 in 2020 accentuated the PHL’s capacity and ability to keep the region safe and healthy and made clear the need to develop additional public health leadership personnel, qualified to conduct moderate and high complexity testing.
In an effort to assist counties in the State, the California Department of Public Health (CDPH), California Association of Public Health Lab Directors, Office of the State Public Health Laboratory, and CDPH Laboratory Field Services have sponsored the LabAspire Fellowship Program. The program focuses on training and preparing qualified professionals to direct local public health laboratories. The program requires candidates to have a Public Health Microbiologist certification and at least four or more years of supervisory experience after their certification. The Health Equity and Readiness Opportunity (HERO) grant program was created to assist with funding for personnel to attend the LabAspire Fellowship Program.
On February 24, 2023, the County PHL received a notice of award from CDPH for an estimated $581,586 in funding from the HERO grant program for the LabAspire Fellowship for the period of July 1, 2022 through June 30, 2025. The PHL has continued to experience employee turnover and recruitment challenges which negatively impacts services and timing, especially during outbreaks and pandemic situations. This funding strives to educate and train additional personnel to have strong candidates who possess the required qualifications and certifications for leadership roles at the PHL.
A waiver of Board Policy B-29 is requested because the funding does not offset all costs. Unrecovered costs are estimated at $84,186 for Fiscal Year (FY) 2023-24 and $22,280 for FY 2024-25. The funding source for these costs will be Realignment. The public benefit for providing these services far outweighs these costs. Funds for subsequent years will be incorporated into future operational plans. Funding will be used for personnel salaries, tuition fees, books, certification examinations, attendance to State conferences, and travel costs. The selected PHL staff will be working towards their doctoral degree in public health, which is required to meet the minimum qualifications of a laboratory director or an assistant laboratory director. Funding will support education and training with the goal of increasing the number of qualified individuals for these essential positions of leadership. This funding will increase the number of qualified individuals for these essential positions of leadership, which will protect and strengthen public health efforts.
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. The HERO LabAspire Fellowship Program will be instrumental in preparing individuals for leadership roles within the PHL, which impacts the public’s health throughout the county. This will be accomplished by ensuring our local health department can continue to ably improve the health and well-being of county residents through a properly run laboratory that meets State and federal standards, has the mandated level of oversight, and has a succession plan in place.
Today’s actions, if approved, would authorize the acceptance of $581,586 in HERO LabAspire Fellowship grant funding from CDPH to be expended by FY 2024-25, and would authorize the Agency Director, Health and Human Services Agency to apply for additional funding opportunities, if available, to support the continuing education and training of laboratory personnel.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed action supports the Empower (Workforce) and Sustainability (Resiliency) Initiatives in the County of San Diego’s 2023-2028 Strategic Plan, as well as our commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by investing in workforce and ensuring we are prepared for unforeseen health emergencies through exemplary leadership at the County of San Diego Health and Human Services Agency, Public Health Services, Public Health Laboratory.
Respectfully submitted,
HELEN N. ROBBINS-MEYER
Interim Chief Administrative Officer
ATTACHMENT(S)
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