REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
July 23, 2024
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Grant Application to the United States Department of Health and Human Services for the Expanded Hours Program
End
RECOMMENDATION(S)
Recommendation
1. Approve submission of a grant application to the United States Department of Health and Human Services, Health Resources and Services Administration, in the amount of $1,000,000, for the Expanded Hours program to support adding additional clinic operating hours, for a two-year period of December 1, 2024 through November 30, 2026.
2. Authorize the Director of the Department of Public Health to electronically submit the grant application documents into the United States Department of Health and Human Services, Health Resources and Services Administration portal.
(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 grant application in the amount of $1,000,000, over the two-year term, to the United States Department of Health and Human Services, Health Resources and Services Administration (HRSA) for the Expanded Hours program does not require a match. Existing staff will be utilized to administer the grant activities. If awarded, adequate appropriation and revenue will be included in the Department of Public Health’s (DPH) 2024-25 budget and in future recommended budgets.
BACKGROUND INFORMATION
The Expanded Hours program increases clinic access to physicians and health services by increasing health center operating hours to meet patient and community needs. This is a new HRSA grant opportunity, not previously offered to health jurisdictions.
DPH operates four Federally Qualified Health Centers (FQHCs) in the cities of Adelanto, Hesperia, San Bernardino, and Ontario. Services include primary care, maternal health, pediatric care, HIV care and treatment, reproductive health services, dental and nutrition services, and diagnostic radiology. Currently, health center hours are Monday through Friday 8 am to 5 pm, with the exception of some specialty care services which operate extended hours.
Under this grant opportunity, DPH proposes to expand hours in all four health centers, which include early weekday mornings and weekday evenings. Expanded hours will be up to two additional hours each day outside of the standard operating hours, when access to primary care may otherwise be limited in the community. New operating hours will allow patients to receive culturally competent care in a primary care setting, reducing emergency visits and overall health care costs. Services offered will include primary care, reproductive health care, pediatrics, and immunizations. Currently, DPH serves over 10,000 patients a year with high demand for appointments in all locations.
DPH anticipates serving 200 additional patients within the expanded hours. Under this program, DPH will connect patients to care faster and offer more flexibility to better meet patient’s schedules. Lastly, the department also expects to see a reduction in requests for rescheduled appointments and the rate of patients who fail to show as the expanded health center hours would provide the opportunity for patients who are unable to attend appointments during operational stand hours to receive care.
On May 21, 2024, HRSA released a funding opportunity announcement for the Expanded Hours grant, providing up to $500,000 per year for health centers to increase clinic hours and services to patients, for the period of December 1, 2024 through November 30, 2026. The Expanded Hours competitive grant application consists of two phases:
• Phase 1 initiated the grant application process, and was approved by County Counsel and the County Administrative Office to submit placeholder documents by the June 24, 2024 deadline. Documents included the Application for Federal Assistance (SF-424), Project Abstract, Project Performance Site Locations, and the Lobbying form.
• Phase 2 is due by July 23, 2024 and includes the Project Narrative, Budget Information Form (SF-424A), Budget Narrative and Table of Personnel Paid with Federal Funds, Program-Specific Forms, and Attachments, if applicable.
Both phases constitute the complete application eligible for HRSA consideration. If awarded, DPH will return to the Board of Supervisors for approval and acceptance of the funding.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on July 8, 2024; Finance (Carl Lofton, Administrative Analyst, 387-5404) on July 2, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on July 2, 2024.