Title
Chief Administrative Office and Health and Human Services Agency (HHSA), recommending the Board of Supervisors consider the following:
1) Provide direction for the use of General Fund savings generated by reimbursement for Coronavirus mitigation and response activities by the Coronavirus Aid, Relief, and Economic Security (CARES) Act in 2020;
2) Approve the spending plan for funding awarded through the Epidemiology and Laboratory Capacity Enhancing Detection program and authorize the HHSA Director to shift funding between allowable categories as needed with the concurrence of the CAO and;
3) Direct staff to return to the Board with a budget transfer for the Epidemiology and Laboratory Capacity Enhancing Detection program spending plan.
FUNDING: General Fund ($2.6m) and Federal Coronavirus Relief Funding ($6.5m).
Body
DISCUSSION / BACKGROUND
CARES ACT SAVINGS
On March 27, 2020, President Trump signed the CARES Act, an economic relief package to provide assistance to families, workers, businesses, and state, local, and tribal governments to help mitigate the impacts of the COVID-19 public health emergency. The Fiscal Year 2020-21 California State budget included pass-through allocations to Counties and Cities. El Dorado County received $19,701,722 to cover expenses that were necessary due to the public health emergency with respect to COVID-19 and were incurred during the period March 1, 2020, through December 30, 2020.
The Chief Administrative Office asked County departments to identify costs related to the public health emergency that were incurred in Fiscal Year 2019-20 and to project needs through December 30, 2020, and reached out to other local agencies, including fire districts, school districts, chambers of commerce, and hospitals to see if they needed assistance, or could help provide assistance to the community through use of these funds. The Board approved a spending plan for these funds on August 4, 2020 (file #20-1013). Some of the funding was used to cover the public safety response to the Coronavirus pandemic, offsetting General Fund costs and generating savings. In addition, the funding allocated for testing in schools in coordination with the El Dorado County Office of Education (EDCOE) was not fully expended. In total, there is a projected savings of $2,627,000 in the General Fund. The Board is asked to provide direction with regard to the use of these funds. The CAO recommends that $1,286,000 of the savings be used for the following purposes:
$36,000 wipes and sanitizing products for County offices
$150,000 continued testing for schools in coordination with EDCOE through the end of the school year
$300,000 reimburse departments for salary and benefits costs of disaster service workers diverted from their regular duties
$800,000 audit reserve- During the final budget adoption, the Board appropriated $800,000 in General Fund carryover fund balance to fund an audit reserve for the CARES Act funding allocated for County departmental operations. It is recommended that a portion of the savings be used to free up that General Fund amount for other purposes.
If the Board accepts the above recommendations, approximately $1,341,000 remains. The pandemic continues to pose challenges to County departments and the community. While there is the potential for additional relief through the stimulus package currently being considered by Congress, at the time this report was written it is not certain whether funding for local governments will be included, the exact amount of such funding and the allowable uses of the funds are unknown. The CAO recommends that the remaining savings be set aside to meet continuing pandemic-related needs until Congress acts on the stimulus package. Staff will then bring an item to the Board to discuss the use of the current savings along with any additional funding and necessary budget transfer.
ELC ENHANCING DETECTION PROGRAM OVERVIEW
As part of the CARES Act and Paycheck Protection Program and Health Care Enhancement Act supplements, El Dorado County received an allocation award of $6,503,584 from the ELC Enhancing Detection Program. By law, ELC allocation awards are intended to help prevent, prepare for, and respond to coronavirus by supporting testing, case investigation and contact tracing, surveillance, containment, and mitigation efforts. ELC funding affords jurisdictions the flexibility to enhance and maintain levels of public health specific personnel, equipment, systems, and activities as needed, which can:
1) support workforce, epidemiology, use by employers, elementary and secondary schools, child care facilities, institutions of higher education, or long-term care facilities;
2) scale up or enhance testing by public health departments, academic, commercial, and hospital laboratories, and community-based testing sites, mobile testing units, health care facilities, or other entities engaged in COVID-19 testing, and;
3) scale up or enhance case investigation and contact tracing, surveillance, containment, and mitigation (including interstate compacts or other mutual aid agreements for such purposes).
ELC SPENDING PLAN:
Based upon allowable use categories for ELC funding, coupled with current and future needs for personnel, equipment, systems, and activities that will ensure that the Public Health Division can continue facilitating key aspects of El Dorado County’s response to COVID-19, HHSA has recommended a spending plan that would allow the most flexibility in meeting local response needs as they evolve. Further detail is outlined on the attached draft budget, and the recommended plan includes the following:
1) Continuation of existing Public Health staff to be extended out through July 2023, thereby reducing realignment spending to support the COVID-19 response;
2) Additional Staffing - The attached draft budget provides an overview of additional staffing needs as identified by Public Health. It is important to note that this is the first budget draft and additional steps will be needed to finalize, including a Human Resources (HR) review to determine the most appropriate classifications for meeting the identified staffing needs. In addition to this draft budget, COVID-19 response personnel needs may continue to further evolve. In this scenario, with concurrence from the CAO, HHSA will consider flexible options if necessary such as how to maximize utilization of permanent employees, extra help employees, disaster service workers from other County departments, or possibly a combination of the above.
3) Subcontracts to allow for:
a. enhanced data system capabilities to share information, provide real time data, trends, and forecasts to public and other stakeholders to inform decisions and facilitate epidemiologic studies
b. contract nurses to maximize the ability to vaccinate the population at a larger scale and/or more rapidly as greater quantities of vaccine come available; .
c. Third Party Vendor access to testing, contact tracing, case investigation and vaccine administration.
d. Media/Web Design to support educational and social media campaigns to provide pertinent and timely information to the public as well as to reach underserved populations.
4) The purchase of Lab/Vaccine/Testing/PHN Vehicle to offer additional mobile services in the community
5) Support for vaccination delivery systems - tents, equipment, people, software, etc.
6) Expenses associated with outreach and assistance (e.g., support provided through community-based organizations) for those put at higher risk for COVID-19.
7) Means to increase and mobilize COVID-19 PCR testing, including rapid testing, allowing for more efficient identification of outbreaks to aid in mitigation efforts.
ALTERNATIVES
The Board could provide alternate direction other than the options presented by staff.
PRIOR BOARD ACTION
Legistar file 20-1013 August 4, 2020.
OTHER DEPARTMENT / AGENCY INVOLVEMENT
N/A
FINANCIAL IMPACT
General Fund ($2.6m) and Federal Coronavirus Relief Funding ($6.5m). There is no increase to Net County Cost. With regard to the General Fund savings, any approved use of the savings will offset currently budgeted expenses and potentially result in additional General Fund savings at the end of the year. With regard to the ELC funding, to the extent any of this funding is used to offset currently budgeted expenses within Public Health, the use of Public Health realignment would be reduced, potentially increasing the balance in that special revenue fund.
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT
Good Governance; Healthy Communities
CONTACT
Don Ashton, CAO
Don Semon, Director, Health and Human Services Agency