SUBJECT
Title
AUTHORIZE ACCEPTANCE OF ADDITIONAL LABASPIRE PUBLIC HEALTH EQUITY AND READINESS OPPORTUNITY INITIATIVE TRAINING PROGRAM FUNDING (DISTRICTS: ALL)
Body
OVERVIEW
On July 18, 2023 (3), the San Diego County Board of Supervisors (Board) authorized the acceptance of LabAspire Public Health Equity and Readiness Opportunity Initiative Fellowship Program Funding. Subsequently, on December 29, 2023, the California Department of Public Health (CDPH) notified the County of San Diego (County) Health and Human Services Agency, Public Health Services, Public Health Laboratory (PHL) that it would receive an additional $392,245 from the LabAspire Fellowship Award and $150,500 from the Public Health Microbiologist (PHM) Training Award. These awards will support workforce development pathways for the PHL and support its critical role in protecting the health of county residents and visitors. PHLs are directed by highly qualified laboratory directors that are board certified and hold a doctoral degree. Over the last several decades, the number of qualified laboratory directors has declined due to requirements, retirements, and attrition to the private sector. The LabAspire Fellowship Program award supports efforts to increase the number of qualified laboratory directors. Similarly, salary support provided by the Public Health Microbiologist Training Award is intended to help train more PHMs to address the shortage of licensed PHMs in California.
Today’s action requests the Board authorize the Agency Director, Health and Human Services Agency to accept additional program funding from CDPH and to apply for additional funding opportunities, if available, to support the continuing education and training of PHL workforce.
Today's action 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, 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 County will continue to support workforce education and training to increase the number of qualified individuals for essential positions of leadership and ensure our local health department continues to ably improve the health and well-being of county residents.
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 additional funding of $542,745 from the California Department of Public Health, Center for Laboratory Sciences for the Public Health Equity and Readiness Opportunity LabAspire Fellowship Program for the period of January 12, 2024 through June 30, 2026, 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, or designee, to apply for additional funding opportunity announcements, if available, to support the continuing education and training of lab personnel.
EQUITY IMPACT STATEMENT
San Diego County has one of the busiest border crossings in the United States and is home to a diverse population including military and tribal communities. Reports from the Centers for Disease Control and Prevention have highlighted disparities among populations impacted by diseases such as HIV, viral hepatitis, sexually transmitted infection, and tuberculosis. To protect the health and well-being of all residents, the County of San Diego (County) Health and Human Services Agency, Public Health Services, Public Health Laboratory (PHL) provides diagnostic testing to detect diseases among the general public. In addition, insights from testing results and patient demographics available through the laboratory information management system enable PHL to record and monitor health disparities and inequities across a wide range of diseases. By continuing to apply for and receive funding from sources such as the Public Health Equity and Readiness Opportunity LabAspire grant, the County PHL can offer additional education and workforce training activities to PHL staff to increase skills in testing the large variety of viruses, bacteria, and pathogens more likely to affect the most vulnerable communities in San Diego County.
SUSTAINABILITY IMPACT STATEMENT
Today’s actions support the County of San Diego (County) Sustainability Goal #4 to protect the health and well-being of everyone in the region. This will be accomplished by investing available funding in workforce training for key staff in the County Health and Human Services Agency, Public Health Services, Public Health Laboratory to help them develop 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. Furthermore, investing in workforce training will increase the number of qualified individuals for positions of leadership as laboratory directors or assistant laboratory directors, ensure continuity of operations, and help avoid gaps in services, especially during outbreaks and emergencies.
FISCAL IMPACT
Funds for this request are included in the Fiscal Year (FY) 2024-26 CAO Recommended Operational Plan in the Health and Human Services Agency. If approved, this request will result in costs of $220,516 and revenue of $150,500 in FY 2024-25 and costs of $413,628 and revenue of $392,245 in FY 2025-26. The funding sources are the Public Health Equity and Readiness Opportunity LabAspire Fellowship Program award and Public Health Microbiologist Training award 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 $70,016 for FY 2024-25 and $21,383 in FY 2025-26. The funding source for these costs will be existing Health Realignment. The public benefit for providing these services far outweighs these costs. 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 April 2, 2024, and recommended approval of the recommendations.
BACKGROUND
On July 18, 2023 (3), the San Diego County Board of Supervisors (Board) authorized the acceptance of LabAspire Public Health Equity and Readiness Opportunity Initiative Fellowship Grant funding to support Public Health Laboratory workforce training. Subsequently, on December 29, 2023, the California Department of Public Health notified the County of San Diego (County) Health and Human Services Agency, Public Health Services (PHS), Public Health Laboratory (PHL) that it would receive additional funds in the amount of $392,245 from the LabAspire Fellowship Award and $150,500 from the Public Health Microbiologist (PHM) Training Award.
The LabAspire Public Health Equity and Readiness Opportunity Initiative Fellowship Program award funding will support two workforce development pathways for the PHL. The first pathway is to develop and train qualified assistant laboratory directors to become fully trained laboratory directors. The LabAspire Public Health Laboratory Director program is a collaboration with the California Association of Public Health Laboratory Directors (CAPHLD), California Conference of Local Health Officers, and the County Health Executives Association of California to conduct these training activities. The second workforce development pathway includes salary support and training for PHMs to work in a public health laboratory through a six-month didactic training program and subsequent certification exam. Funding awards will support education and workforce training to increase the number of qualified individuals for essential positions of leadership and ensure PHL continues to operate in compliance with State and federal standards, has the mandated level of oversight, and has a succession plan in place.
PHLs were initially established in response to outbreaks of diseases like typhoid, smallpox, and diphtheria. They continue to perform a critical role to ensure the well-being of communities by analyzing samples and identifying potential outbreaks. The CAPHLD is comprised of various laboratories, including the PHL, which play an important role in disease diagnosis and epidemiological surveillance of 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 statewide decline in the number of qualified laboratory directors, due to requirements, retirements, and attrition to the private sector. 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. The PHL has been directly impacted by personnel turnover and shortages. During this time, PHL has worked in partnership with other laboratories and leveraged updates to technology and processes to continue providing excellent service to residents and visitors of San Diego County. With the continued addition of testing requirements and the construction of a new and larger PHL, there is an identified need for additional leadership positions in this profession.
Funding from the initial LabAspire Public Health Equity and Readiness Opportunity Initiative Fellowship Program award funding in July 2023 has supported the PHL to provide training for three PHMs, all of whom passed their certification exams and are now full-time PHMs with the PHL. The funding has also supported an assistant laboratory director in completing over 50% of their work towards the Practitioner Doctorate for Public Health. Moreover, the funding has supported another assistant laboratory director in completing one of the two required board exams to be a fully qualified lab director. Continued funding from the Public Health Equity and Readiness Opportunity LabAspire Fellowship Program is instrumental in preparing individuals for leadership roles within the PHL.
A waiver of Board Policy B-29 is requested because the funding does not offset all costs. Unrecovered costs are estimated at $70,016 for Fiscal Year (FY) 2024-25 and at $21,383 FY 2025-26 due to unrecovered benefits and indirect costs. The funding source for these costs will be existing Health Realignment. The public benefit for providing these services far outweighs these costs. 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. 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 action requests the Board authorize the Agency Director, Health and Human Services Agency to accept additional program funding from CDPH and to apply for additional funding opportunities, if available, to support the continuing education and training of PHL workforce.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed action supports the County of San Diego 2024-2029 Strategic Plan Initiatives of Equity (Health) and Community (Quality of Life) as well as the regional Live Well San Diego vision of healthy, safe, and thriving communities. This is accomplished by reducing disparities and disproportionality of individuals by building better health and protecting the health of residents through enhanced and increased testing, prevention, and intervention to interrupt transmission of disease.
Respectfully submitted,
SARAH E. AGHASSI
Interim Chief Administrative Officer
ATTACHMENT(S)
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