Title
Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings that the provision of restorative dental equipment in exchange for licensed dentist services provided by El Dorado County Community Health Center (EDCHC/Grantee), are in the public's best interest and that due to the limited timeframes, temporary or occasional nature, or schedule for the project or scope of work, the ongoing aggregate of work to be performed is not sufficient to warrant the addition of permanent staff in accordance with El Dorado County Ordinance Code, Chapter 3.13.030;
2) Approve and authorize the Chair to sign Funding Out Agreement 8484 with EDCHC, in the amount of $40,000 and for a term effective upon execution through June 30, 2025;
3) Authorize the Purchasing Agent to execute amendments relating to Agreement 8484, contingent upon approval by County Counsel and Risk Management, which do not increase the maximum dollar amount or term of the Agreement; and
4) Authorize the HHSA Director, or the Director of Public Health, to execute programmatic, administrative, and fiscal documents relating to Agreement 8484.
FUNDING: 100% American Rescue Plan Act.
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DISCUSSION / BACKGROUND:
Under County Operational Agreement (OA) 6513, executed July 1, 2022, for a term though June 30, 2027, EDCHC partners with First 5 El Dorado Children and Families Commission, El Dorado Office of Education (EDCOE), El Dorado County Library, and HHSA, to provide mobile dental and oral health services to children and families within the community. Through participation in this OA, all parties agree to provide Mobile Dental Services in the County, which is comprised of: 1) the operation of a mobile dental van; 2) portable dental clinic(s); and 3) provision of oral health education. Together, these partners aim to deliver preventive dental services through licensed dental hygienists in local schools and outreach locations via mobile dental clinics. The El Dorado Dental Van, owned by EDCOE and operated by EDCHC, facilitates these initiatives.
Through the operation of portable dental clinics, EDCHC is dedicated to offering comprehensive oral health services to school-aged youth, regardless of their financial circumstances. These services include education, screenings, examinations, X-rays, cleanings, fluoride treatments, fillings, and emergency dental care. Recognizing the pressing need for dental services in the community, EDCHC serves as the primary provider of a mobile oral health prevention program in the County.
Within the County, there is a shortage of licensed dentists who accept Medi-Cal insurance for restorative dental services. The El Dorado Dental Van and connected mobile dental clinics services provided through OA 6513 intends to bridge this gap by providing mobile dental and oral health services to children and families.
The COVID-19 pandemic has had a profound impact on the health care system, including the dental industry. In March and April 2020, many dental practices closed except for emergencies. After offices re-opened, services were severely restricted, resulting in a severe economic impact on the industry. Dentists that serve our most vulnerable, including those on Medi-Cal, were most impacted, forcing many to close permanently. Prior to COVID-19, El Dorado County lacked sufficient dentists, especially those that accepted Medi-Cal or offered reduced fee based on income. Following the pandemic, the access further declined due to cutbacks and closures, including in South Lake Tahoe. Currently, the nearest dentist serving the Medi-Cal population and most vulnerable for South Lake Tahoe is in Placerville, making care prohibitive. Use of ARPA funds for the dental van will serve to improve the negative economic impact as a result of the pandemic for the dental industry by increasing the number of dentists serving in our most vulnerable communities. This addition will include services in South Lake Tahoe.
Through the proposed Funding Out Agreement 8484, EDCHC intends to utilize the County pass-through grant funds to acquire new restorative dental equipment and dental supplies for installation in the El Dorado Dental Van. In addition, EDCHC will purchase, install and configure a new wireless bridge access point for the El Dorado Dental Van. In exchange, EDCHC agrees to offer school and community dental outreach comprising both preventive and restorative services, administered by a licensed dentist, to enhance the oral health of the most vulnerable members of our community through the dental and oral health outreach program.
Funds granted to EDCHC through Funding Out Agreements was accepted by the Board on June 28, 2022 (Grant Agreements 6591 and 6592) and awarded to HHSA by the California Department of Public Health (CDPH) Oral Health Program, Moving California Oral Health Forward Grant #22-20262, to provide personnel and equipment for case management, as well as for dental van maintenance, equipment, repairs, and outreach (22-0847; 22-0848).
HHSA recommends the Board approve Funding Out Agreement 8484 with EDCHC and approve the subaward of these grant funds to EDCHC for the installation of upgraded dental equipment for restorative dental services.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA Public Health Division would need to identify an alternate plan to provide restorative oral health services in the County.
PRIOR BOARD ACTION:
1) 12/07/2021, 21-1764, HHSA EDC Community Health Center 6112
2) 06/28/2022, 22-0847, HHSA #6591 El Dorado County Community Health Center
3) 06/28/2022, 22-0848, HHSA #6592 El Dorado County Community Health Center
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel and Risk Management.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no General Fund Cost associated with this agenda item. Sufficient appropriations were included in the Fiscal year 2023-24 Budget and will be included in future budgets for the term of the Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on one (1) original Funding Out Agreement 8484.
STRATEGIC PLAN COMPONENT:
Safe and Healthy Communities
CONTACT
Olivia Byron-Cooper, MPH, Director