REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 16, 2021
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Fee-for-Service Agreement with the California Department of Public Health for the Refugee Health Assessment Program
End
RECOMMENDATION(S)
Recommendation
1. Approve and authorize the Department of Public Health to enter into a fee-for-service agreement (Award No. 21-36-90899-00) with the California Department of Public Health, Office of Refugee Health for the Refugee Health Assessment Program wherein the Department of Public Health agrees to provide health assessments to newly arrived refugees, asylees, entrants from Haiti and Cuba, special visa immigrants, federally certified victims of trafficking, and other eligible entrants in San Bernardino, Riverside, and Orange counties and the California Department of Public Health, Office of Refugee Health agrees to cover the cost, at $134 per comprehensive health assessment and $59,715 in administrative costs, for the period of October 1, 2021 through September 30, 2022.
2. Authorize the Director of the Department of Public Health to execute and submit the fee-for-service agreement certification document, as required by the California Department of Public Health, Office of Refugee Health, and any subsequent non-substantive amendments, on behalf of the County, subject to review by County Counsel.
3. Direct the Director of the Department of Public Health to transmit all certification documents and non-substantive amendments related to the fee-for-service agreement 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
The Department of Public Health (DPH) anticipates reimbursement under the fee-for-service agreement for the Refugee Health Assessment Program with the California Department of Public Health, Office of Refugee Health (State) to be approximately $126,746, which includes reimbursement of $134 per completed health assessment, and $59,715 in administrative costs to support operating expenses, medical staff costs, data entry and reporting, and interpretation services. The cost of providing the health assessments will be offset by fees collected from the State. Adequate appropriation and revenue have been included in DPH’s 2021-22 budget and will be included in the 2022-23 recommended budget.
BACKGROUND INFORMATION
Prior to admission to the United States, all refugees, asylees, entrants from Haiti and Cuba, special visa immigrants, victims of trafficking, and other eligible entrants (refugees) undergo a standard medical screening examination conducted by a panel of physicians under the direction of the United States Centers for Disease Control and Prevention (CDC), designed to identify applicants with inadmissible health-related conditions and communicable diseases of public health significance, such as Tuberculosis, or any quarantinable disease designated by the CDC or Presidential Executive Order. Most often, refugees arrive in California having lived in dire conditions with little or no access to healthcare services and with no understanding of western medical care practices or the concept of preventive health care. Moreover, many of these refugees have faced numerous difficulties including civil wars; social, gender, and religious persecution; nutritional deprivation; and loss of home, family, professional and social-economic status, and country. These events are stressors that may lead refugees to feeling isolated, anxious, and depressed and can have a profound impact on their physical and mental health, making it more difficult for them to practice healthful behaviors to stay healthy and vigorous enough to become self-sufficient.
DPH has provided health assessments to newly arrived refugees in San Bernardino and Riverside counties since 2014, and Orange County since 2018, as both Riverside and Orange County originally opted out of the refugee program. The fee-for-service agreement will allow DPH to continue providing health assessments to protect the health of San Bernardino, Riverside, and Orange county residents by screening for inadmissible health-related conditions in newly arrived refugees. Through the Refugee Health Assessment Program agreement, the State agrees to reimburse DPH $134 per completed health assessment and $59,715 in administrative costs to support DPH’s operating expenses, medical staff costs, data entry and reporting, and interpretation services. DPH anticipates completing approximately, but not limited to, 500 comprehensive health assessments during the period of October 1, 2021 through September 30, 2022.
On October 2, 2021, DPH received the Refugee Health Assessment Program fee-for-service agreement and program requirements from the State. This item is being presented at this time, as this is the first available date following the required operational, fiscal, and legal reviews. Approval by the Board of Supervisors at this time will not impact DPH’s refugee comprehensive health assessment services or activities.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on October 27, 2021; Finance (Paul Garcia, Administrative Analyst, 386-8392) on October 27, 2021; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on October 27, 2021.