REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 12, 2024
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Grant Awards from the California Department of Public Health for the Maternal, Child, and Adolescent Health Program and the Black Infant Health Program
End
RECOMMENDATION(S)
Recommendation
1. Accept and approve agreement (State Agreement No. 202336) for the following grants from the California Department of Public Health for the period of July 1, 2023 through June 30, 2024:
a. Maternal, Child, and Adolescent Health Program in the amount of $726,163
b. Black Infant Health Program in the amount of $3,214,829
2. Authorize the addition of seven regular positions for the Black Infant Health Program under the following classifications:
a. Childcare Provider, Craft, Labor and Trades, R2M ($35,027 - $38,729 annually), two positions
b. Health Education Specialist I, Administrative Services, R46 ($53,352 - $73,340 annually), one position
c. Supervising Social Worker, Supervisory, R54 ($64,792 - $89,086 annually), one position
d. Social Worker II, Administrative Services, R47 ($54,724 - $75,067 annually), three positions
3. Approve Amendment No. 3 to Contract No. 21-629 with California Health Collaborative to provide maternal and child health services in the High Desert region under the Black Infant Health Program, increasing the total contract amount by $307,261 from $1,346,529 to $1,653,790, with no change to the contract period of August 24, 2021 through August 23, 2024.
4. Authorize the Chair of the Board of Supervisors, Chief Executive Officer, or Director of the Department of Public Health to execute and submit any subsequent non-substantive amendments or documents to the agreement in Recommendation No. 1, on behalf of the County, subject to review by County Counsel.
5. Direct the Director of the Department of Public Health to transmit all non-substantive amendments to the agreement in Recommendation No. 1 to the Clerk of the Board of Supervisors within 30 days of execution.
(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
This item does not impact Discretionary General Funding (Net County Cost). The grant funding from the California Department of Public Health (CDPH) for the Maternal, Child, and Adolescent Health (MCAH) Program, in the amount of $726,163, and the Black Infant Health (BIH) Program, in the amount of $3,214,829, consists of Federal Title V, State General Fund, and Federal Title XIX funds. The MCAH Program includes a local match of $279,311, and the BIH Program includes a local match of $295,400, which will be met with 1991 Realignment funds. Adequate appropriation and revenue have been included in the Department of Public Health’s (DPH) 2023-24 budget.
BACKGROUND INFORMATION
The CDPH provides noncompetitive funding for the MCAH and BIH Programs to local health departments to promote healthy living for mothers and their families through a focus on the comprehensive health, physical, and psychosocial needs of the maternal, child, and adolescent health population. DPH has received funding for the MCAH Program since 1987, and the BIH Program since 1990, except for a four-year period where the state temporarily suspended the program.
Through the MCAH Program, DPH provides health assessments and health improvement activities. Program staff collaborate with healthcare providers, community-based agencies, and community groups to identify health issues that affect women, infants, children, youth and children with special healthcare needs. This collaboration develops best practices and interventions intended to increase access to care for mothers and families, especially those with low income or limited access to services. Additionally, the MCAH Program promotes the need for appropriate levels of care to improve pregnancy outcomes and reduce maternal and infant morbidity and mortality. In 2023-24, DPH anticipates the MCAH Program will provide services to approximately 25,727 clients, at an estimated cost of $28 per client.
The BIH Program is designed to meet the health-related needs of pregnant and postpartum Black and African American women through an evidence-informed model that features group intervention, social support, and social service case management by linking participants to community and health-related services. Activities specifically include 10 weekly prenatal and 10 weekly postnatal education group sessions, which include varying topics related to child-rearing, family dynamics, and nutrition, among other subjects. Participants engage in group/peer discussions led by BIH staff, and intense individualized case management, which includes life planning sessions addressing the participant’s plans for birth and post-natal life. Staff also support BIH mothers with accessing health care and other supportive or social services, such as navigating familial relationships, behavior modification, and guidance with family finances. DPH currently administers the BIH program in two service delivery areas, the High Desert region and the Central Valley region. With the approval of Recommendation No. 1, DPH will continue to provide BIH services and expand services to the West End region of the county.
Recommendation No. 2 would add seven regular positions to the BIH Program in accordance with CDPH program staffing requirements. One of the seven positions is recommended to provide childcare services during in-person participant group sessions. The remaining six positions would provide BIH Program support in the expanded West End region. In 2023-24, with the additional funds detailed in Recommendation No. 1, DPH anticipates the BIH Program will provide services to up to 480 Black and African American women countywide, at an estimated annual cost of $6,698 per individual.
Approval of Recommendation No. 3 will amend Contract No. 21-629, and allow the California Health Collaborative (CHC), to continue to administer BIH Program services in the High Desert region of San Bernardino County, as well as increase staffing levels to include the addition of a mental health specialist and public health nurse, to be hired and supervised by CHC.
On August 24, 2021 (Item No. 31), as a result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 21-629 with CHC to provide BIH Program services in the High Desert region, in the amount of $448,843, for the period of August 24, 2021 through August 23, 2022.
On July 26, 2022 (Item No. 36), the Board approved Amendment No. 1 to Contract No. 21-629 with CHC, which increased the total contract amount by $448,843 from $448,843 to $897,686 and extended the term by one year, for a total contract period of August 24, 2021 through August 23, 2023.
On August 8, 2023 (Item No. 34), the Board approved Amendment No. 2 to Contract No. 21-629, which increased the total contract amount by $448,843 from $897,686 to $1,346,529, and extended the term by one year for a total contract period of August 24, 2021 through August 23, 2024.
CHC’s performance is monitored by review of monthly reports and an annual site visit to verify compliance with the administrative, program, and fiscal terms and conditions of the contract. The contract may be terminated without cause by the County with a 30-day written notice.
On August 8, 2023 (Item No. 38), the Board approved the submission of a combined agreement funding application to CDPH, for the MCAH ($752,527) and BIH ($2,105,591) Programs, for the period of July 1, 2023 through June 30, 2024.
On October 31, 2023, DPH received an approval letter for the MCAH agreement funding application, and on November 30, 2023, an approval letter for the BIH agreement funding from the CDPH. Acceptance of the grant awards constitutes a binding agreement, and a subsequent agreement will not be expected. The grant periods for both programs are retroactive from July 1, 2023 through June 30, 2024. Annually, CDPH provides award letters for MCAH and BIH Programs retroactively. DPH is able to invoice for provided services back to July 1st of each year.
This item is being presented at this time, as this is the first available date following the development of an implementation plan, contract negotiations, and the required operational, fiscal, and legal reviews. Approval at this time will not impact DPH’s services or activities.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, and Cynthia O’Neill, Chief Assistant County Counsel, 387-5455) on February 22, 2024; Human Resources (Gina King, Assistant Director, 387-5560) on February 26, 2024; Finance (Iliana Rodriguez, Administrative Analyst, 387-4205) on February 26, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on February 26, 2024.