REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 15, 2022
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Award from the California Department of Public Health for the Refugee Health Assessment Program
End
RECOMMENDATION(S)
Recommendation
1. Approve award (Award No. 21-36-90899-00) from the California Department of Public Health for the Refugee Health Assessment Program to provide health assessments to newly arrived refugees, asylees, entrants from Haiti and Cuba, special visa immigrants, federally certified victims of human trafficking, eligible Afghan and Ukrainian parolees, and other eligible entrants in San Bernardino, Riverside, and Orange Counties, for reimbursement at $575 per completed comprehensive health assessment, and $50,285 in administrative costs, for the period of October 1, 2022 through September 30, 2023.
2. Authorize the Director of the Department of Public Health to execute and submit the Refugee Health Assessment Program certification and confidentiality of patient documents, as required by the California Department of Public Health, and any subsequent non-substantive documents, on behalf of the County, subject to review by County Counsel.
3. Direct the Director of the Department of Public Health to transmit all non-substantive documents related to the Refugee Health Assessment Program 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) estimates reimbursement under the Refugee Health Assessment Program (RHAP) through the California Department of Public Health (State) to be approximately $222,785 which consists of 300 completed comprehensive health assessments at a cost of $575 per assessment, and $50,285 in administrative costs to offset operating expenses, medical staff costs, data entry and reporting, and interpretation services. Adequate appropriation and revenue have been included in DPH’s 2022-23 budget and will be included in the 2023-24 recommended budget.
BACKGROUND INFORMATION
Prior to admission to the United States, all refugees, asylees, entrants from Haiti and Cuba, special visa immigrants, federally certified victims of human trafficking, eligible Afghan and Ukrainian parolees, and other eligible entrants (refugees) undergo a standard medical screening 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 Counties originally opted out of the refugee program. To date, Orange County has since established their RHAP program and Riverside County remains uninvolved. The fee-for-service agreement will allow DPH to continue providing health assessments to protect the health of San Bernardino and Riverside residents by screening for inadmissible health-related conditions in newly arrived refugees. Through the RHAP agreement, the State agrees to reimburse DPH on a fee-for-service basis for completed health assessments, as well as administrative costs to support DPH’s operating expenses, medical staff costs, data entry and reporting costs, and interpretation services. DPH anticipates completing approximately, but not limited to, 300 comprehensive health assessments during the period of October 1, 2022 through September 30, 2023.
On October 18, 2022, DPH received the Refugee Health Assessment Program award notice (Award No. 21-36-90899-00) from the State for the Refugee Health Assessment Program for reimbursement at $575 per completed comprehensive health assessment, and $50,285 in administrative costs, for the period of October 1, 2022 through September 30, 2023. This item is being presented at this time, as this is the first available date following the required operational, fiscal, and legal reviews. Approval at this time will not impact DPH’s 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 28, 2022; Finance (Paul Garcia, Administrative Analyst, 386-8392) on October 28, 2022; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on October 31, 2022.