Title
HEARING - Health and Human Services Agency recommending the Board:
1) Consider a reduction, elimination, and/or transfer of management of public health services provided by El Dorado County Public Health Laboratory in fiscal year 2016-17, as required by State law (Beilenson Act);
2) Authorize the Health and Human Services Agency Director to negotiate and execute an Agreement with Sacramento County for Public Health Laboratory services, effective July 1, 2017 with a maximum obligation up to $65,000, and contingent upon approval by County Counsel and Risk Management; and
3) Authorize the Health and Human Services Agency Director to execute further documents relating to said Agreement with Sacramento County, including amendments which do not increase the maximum dollar amount or term of the Agreement, and contingent upon approval by County Counsel and Risk Management. (Est. Time: 30 Min.)
FUNDING: Fee for Service.
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DEPARTMENT RECOMMENDATION
Health and Human Services Agency (HHSA) recommending the Board consider a reduction, elimination, and/or transfer of management of Public Health Laboratory services in fiscal year (FY) 2016-17, as required by California Health and Safety Code Section 1442.5 (notices appropriately posted). HHSA also recommending the Board authorize the HHSA Director to negotiate, and execute an agreement with Sacramento County for the provision of Public Health Laboratory services, to ensure availability of services in accordance with Health and Safety Code Section 101150.
BACKGROUND
During the period between fiscal year (FY) 2004-05 and 2007-08, Public Health (PH) Realignment revenues available to supplement public health programs decreased by 19%, State revenues were flat, and A87 charges for public health services increased from $0 to $850,000, thereby resulting in the need to prioritize programs to be supported. At the time, 50% of annual health realignment for programs was projected to be dedicated to support clinic and laboratory services. As a result, on April 1, 2008, the Board of Supervisors approved the reduction of services provided by the Public Health Clinic (File ID: 08-0429) and Laboratory via a Beilenson hearing. This reduction-in-force culminated in there remaining only one full-time equivalent Public Health Laboratory Director position to staff the Public Health Laboratory. Currently, all Public Health Laboratory testing is performed by the Director. There is no other staff allocated to cover for absences or to provide for succession planning.
In the last few years, the requirements to be a Public Health Laboratory Director have changed, requiring a doctoral degree, at least four years experience, passing a board examination, and holding a PH microbiologist certificate. These changes have resulted in a shortage of qualified candidates, due to the more stringent requirements. Additionally, existing Public Health Laboratory Directors were “grandfathered” in at the time the requirements were changed. As those Directors retire many agencies are choosing to close their labs and consolidate/regionalize services.
The County of El Dorado Public Health (PH) Laboratory Director is retiring effective May 5, 2017. Due to lack of other laboratoray staff and state-wide difficulties in recruiting laboratory directors, it is unlikely that there will be a successor Director. This pending vacancy leaves the County unable to comply with Health and Safety Code Section 101150, "For the purpose of protecting the community and the public health, the local health department of a city or county shall have available the services of a public health laboratory for the examination of specimens from suspected cases of infectious and environmental diseases, that may include, but need not be limited to, the examination of specimens from milk, milk products, waters, food products, vectors, and the environment. The public health laboratory shall also provide the analyses required to assist in community disease surveillance and to meet the responsibilities and support the programs of the local public health department."
It is therefore recommended that the El Dorado County Public Health Lab no longer provide testing services, and the County enter into an agreement for services with an alternate agency.
During FY 2016-17, the cost to maintain the laboratory, including labor/benefits, materials, training, maintenance and facility costs, is estimated to be $223,000. Contracting with a nearby county for Public Health Laboratory services to provide required testing is estimated at up to $65,000 per year. This cost would include specimen packaging and transportation, test fees, etc.
HHSA currently contracts with Sacramento County to provide Public Health Laboratory services on an "as requested" basis, and this contract terminates June 30, 2017. HHSA is recommending the Board approve continued use of this Agreement to ensure compliance with H&S Code 101150 for the term of the Agreement, and delegate authority to the HHSA Director to negotiate and execute a new Agreement effective July 1, 2017, to ensure continued availability of Public Health Laboratory services.
ALTERNATIVES
Should the Board decline to approve the reduction, elimination, and/or transfer of management of public health services provided by the PH Laboratory, HHSA would be unable to meet the demands of the community.
OTHER DEPARTMENT / AGENCY INVOLVEMENT
County Counsel and Risk Management
CAO RECOMMENDATION
It is recommended that the Board approve this item.
FINANCIAL IMPACT
There is no Net County Cost associated with this Agenda item. Sufficient appropriations were included in the fiscal year 2016-17 budget, and will be included in future budgets as needed to ensure contracted availability of services.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to provide one (1) certified Minute Order to the Health and Human Services Agency Contracts Unit at 3057 Briw Road, Placerville, CA.
STRATEGIC PLAN COMPONENT
County Strategic Plan - Healthy Communities: Improved health, well-being and self sufficiency of El Dorado County communities, residents and visitors.
CONTACT
Patricia Charles-Heathers, Ph.D.