REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
February 27, 2024
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Amendment to Revenue Agreement with the California Department of Public Health for the Childhood Lead Poisoning Prevention Program
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to revenue Agreement No. 23-1112 (State Agreement No. 23-10275) with the California Department of Public Health for the Childhood Lead Poisoning Prevention Program, increasing the amount by $585,855, from $3,978,159 to $4,564,014, with no change to the term of July 1, 2023 through June 30, 2026.
(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 Childhood Lead Poisoning Prevention Program (CLPPP) funding from the California Department of Public Health (CDPH) does not require a local match. Adequate appropriation and revenue have been included in the Department of Public Health’s (DPH) 2023-24 budget and will be included in future recommended budgets. To the extent needed, DPH may return to the Board of Supervisors (Board) to seek approval for future staffing for the CLPPP funded by this allocation from CDPH.
BACKGROUND INFORMATION
Lead poisoning is a significant environmental health problem for children in California. Medical evidence indicates that neurological damage can occur at very low levels of lead exposure, resulting in learning impairments which have substantial medical and societal impacts. CDPH has allocated funds since 1991 to local health jurisdictions to provide community outreach, education, inspection, and mitigation services related to lead poisoning prevention. In 2021, a total of 315 children and youth under the age of 21 years old in San Bernardino County (County) were identified with a blood lead level requiring evaluation and intervention.
Agreement No. 23-1112 provides the CDPH Childhood Lead Poisoning Prevention Fund allocation to DPH for the CLPPP, which is authorized by the California Health and Safety Code, Section 105290. The CLPPP is intended to strengthen outreach and education to ensure access to lead-safe housing; improve lead poisoning prevention efforts through partnerships with health care providers, government agencies and community-based organizations; and conduct proactive lead inspections in areas of high risk throughout the county.
Under the terms of Amendment No. 1 to revenue Agreement No. 23-1112, DPH will use the additional $585,855 to continue to provide services and education to County residents, with the goal of decreasing the exposure of children to lead and the incidence of elevated blood lead levels. Activities include proactive home inspections and environmental investigations consisting of sampling inside and outside the home to identify potential sources of lead hazards (e.g., soil, dust, water, paint chips), and implementing remediation of identified lead hazards. Nursing staff provide case management services for children who have an elevated blood lead level. Case management services provided include coordination of care and linkage to appropriate health care services.
Additional activities include sending reminder letters to families and health care providers to encourage follow-up blood lead testing and providing community outreach on lead poisoning prevention at regional events. Lastly, as part of the program scope of work, DPH notifies the state about newly identified sources of lead exposure, barriers to care and prevention, and collaborates on strategies to improve health outcomes.
On October 3, 2023 (Item No. 35), the Board approved revenue Agreement No. 23-1112 (State Agreement No. 23-10275) from CDPH for the CLPPP, in the amount of $3,978,159 for the period of July 1, 2023 through June 30, 2026.
On October 10, 2023, CDPH clarified the use of CLPPP funding, as well as identified a previous budgeting error related to the County’s allocation, which resulted in an upward adjustment in the amount of $585,855 for the performance period through 2025-26.
On December 21, 2023, CDPH sent a retroactive amendment to State Agreement No. 23-10275 to DPH for CLPPP, increasing the amount by $585,855, from $3,978,159 to $4,564,014, with no change to the period of July 1, 2023 through June 30, 2026.
This item is being presented at this time, as this is the first date available for presentation following the required operational, fiscal, and legal reviews. Approval at this time will not impact DPH’s ongoing CLPPP 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 February 2, 2024; Finance (Iliana Rodriguez, Administrative Analyst, 387-4205) on February 9, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on February 9, 2024.