REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
April 9, 2024
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Allocation from the California Department of Public Health for the Southern California Pregnancy-Associated Mortality Review Project
End
RECOMMENDATION(S)
Recommendation
1. Accept and approve the allocation agreement with the California Department of Public Health for the Southern California Pregnancy-Associated Mortality Review Project, in the amount of $51,000, for the period of December 1, 2023 through June 30, 2024.
2. Approve purchase and distribution of prepaid gas cards and prepaid restricted gift cards to eligible community residents to increase access to attend Pregnancy-Associated Mortality Review Project focus groups, in an amount not to exceed $8,700, for the period of December 1, 2023 through June 30, 2024.
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The California Department of Public Health (CDPH) allocation in the amount of $51,000, which includes the $8,700 for the purchase of prepaid gas cards and restricted gift cards, supported by the Centers for Disease Control and Prevention (CDC), for the Southern California Pregnancy-Associated Mortality Review Project (SoCal PAMR) does not require a local match. Adequate appropriation and revenue are included in the Department of Public Health’s (DPH) 2023-24 budget.
BACKGROUND INFORMATION
The CDC tracks pregnancy related deaths, causes, contributing factors, and prevention opportunities. In California, pregnancy related deaths are tracked and reviewed via the California Pregnancy Mortality Surveillance System and the California Pregnancy-Associated Review Committee (Committee), for quality improvement. In-depth case reviews are conducted by the Committee in the Southern California region consisting of Los Angeles, Riverside, and San Bernardino counties.
In 2023, CDPH was awarded a CDC grant to develop a pilot collaborative community engagement plan with local partners representing communities that are disproportionately affected by maternal mortality in the Southern California region. CDPH awarded DPH a portion of the CDC grant to support a pilot collaborative to increase transparency of the SoCal PAMR review process for maternal deaths, utilization of data to guide action and policy, prioritize recommendations which reflect community needs, disseminate findings to partners, and build collaborative partnerships to implement recommendations for prevention of pregnancy-related deaths.
In implementing the SoCal PAMR, DPH will conduct three community-based focus groups throughout the county, which includes the high desert, west end, and central valley areas, scheduled in May and June. The focus groups are to identify opportunities for improvement and the development of data-driven actionable recommendations for change. DPH will invite physicians with patient safety expertise to speak as subject matter experts on pregnancy-related mortality, who will also contribute to the development of recommendations with community members.
The project will engage in targeted outreach to members of the impacted community, who will be invited to participate in one of the three focus groups. Outreach will be developed in collaboration with maternal mortality stakeholders and partners, and include radio advertisements, social media channels, and other media-related promotion to increase awareness about SoCal PAMR in underserved communities and invite members to the focus groups. Further, DPH will collaborate with Los Angeles and Riverside counties, which have received equal funding allocations from CDPH, to formulate strategies for community engagement and develop complementary media content.
SoCal PAMR funds may be used to compensate community participants for time and involvement in project focus groups. Upon approval of Recommendation No. 2, DPH will purchase $50 prepaid restricted gift cards (cannot be used to purchase alcohol or tobacco) and $10 gas cards, which will be distributed to community members who attend the SoCal PAMR focus groups. All community members who attend the event are eligible for the $50 restricted gift card, however individuals may receive one or more gas cards based on distance traveled. It is estimated approximately 50 community members will be in attendance per focus group.
Because focus groups are spread throughout the county, the need for gas cards is expected to be minimal, with approximately 20 attendees requiring one to two $10 gas cards each, to meet the specific transportation need. To avoid a surplus, DPH will initially purchase 40 gas cards for the first focus group, with future purchases based on the attendance and needs established during the first focus group. DPH proposes up to $1,200 for gas cards. DPH has budgeted up to $7,500 for restricted gift cards.
In accordance with the Auditor-Controller/Treasurer/Tax Collector Internal Controls and Cash Manual, DPH maintains and ensures adherence to internal policies and procedures regarding safeguards and proper handling of prepaid negotiables. This includes the appointment of a card custodian who is responsible for card inventory and distribution directly to eligible community members.
On November 12, 2023, DPH received an email informing the department of the allocation and a request from CDPH to submit a proposed budget for SoCal PAMR in the amount of $51,000 for the period of December 1, 2023 through June 30, 2024. Focus groups will begin following Board of Supervisors (Board) approval and submission of the proposed budget to CDPH.
On March 20, 2024, CDPH provided the allocation agreement to DPH, which requires Board approval for acceptance of the allocation and approval of the allocation agreement. Due to the limited timeframe between the state’s submission of the allocation agreement and the remaining time in the performance period, CDPH allows counties to retroactively invoice SoCal PAMR development work back to December 1, 2023.
This item is presented at this time as this is the first available date following the development of the SoCal PAMR, and required operational, fiscal and legal reviews. Approval at this time will not impact DPH services or activities.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on March 19, 2024; Auditor-Controller (Vanessa Doyle, Deputy Chief Controller, 382-3195, and Denise Mejico, Chief Deputy Auditor, 382-3107) on March 19, 2024; Finance (Iliana Rodriguez, Administrative Analyst, 387-4205) on March 25, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on March 25, 2024.