(213) 240-8101
December 29, 1998
Honorable Board of Supervisors
County of Los Angeles
383 Kenneth Hahn Hall of Administration
500 West Temple Street
Los Angeles, California 90012
TUBERCULOSIS CONTROL SUBVENTION PROGRAM (All Districts) (4 Votes)
IT IS RECOMMENDED THAT YOUR BOARD:
1. Accept the attached Fiscal Year (FY) 1998-99 Letter of Award from the California Department of Health Services (CDHS), which includes State Subventive Award No. TBCSGF-89-70 in the amount of $1,554,761, and the State Housing Award No. HOUSES 89-70 in the amount of $500,000 to support the County's Tuberculosis Control Program.
2. Delegate authority to the Director of Health Services, or his authorized designee, to accept the revised Letters of Award from the CDHS, Housing Award No. HOUSES-89-70, to increase funding by $174,000 for the period July 1, 1998 through June 30, 1999.
3. Approve an appropriation adjustment in the amount of $500,000, to increase expenditure authority in the Department of Health Services FY 1998-99 Budget.
PURPOSE OF THE RECOMMENDED ACTIONS:
In approving these actions, the Board is:
- accepting a Letter of Award (LOA) from the CDHS for the continued provision of TB Control services to targeted populations and for the provision of services and activities that would enhance adherence, prevent homelessness, and allow the use of less restrictive alternatives which decrease or obviate the need for detention.
- authorizing the Director of Health Services, or his designee, to reallocate funds in the budget for the LOA through revised LOA amendments to enable the Department of Health Services (DHS) to maximize expenditures.
Honorable Board of Supervisors
December 29, 1998
Page 2
- Authorize an increase in expenditure authority in the DHS FY 1998-99 Budget.
JUSTIFICATION:
On September 14, 1998, CDHS issued an LOA to DHS for the TB Control Program for FY 1998-99.
Board approval is required in order for the County to access and receive financial assistance from CDHS for the TB Control Program.
FISCAL IMPACT:
Net County cost will consist of administrative overhead, in the amount of $204,392 for the Subvention Award and $44,943 for the Housing Award.
FINANCING:
The FY 1998-99 CDHS Subvention Award totals $1,554,761 and the FY 1998-99 Housing Award totals $500,000. Total program costs for Subvention are $1,759,153, which include net County cost of $204,392. The total program costs for Housing are $544,944, which include net County cost of $44,943.
An appropriation adjustment in the amount of $500,000 is required to increase expenditure authority in the DHS Budget.
FACTS AND PROVISIONS/LEGAL REQUIREMENTS:
County has received local assistance subvention funding from CDHS to provide surveillance, prevention, treatment and follow-up efforts related to TB through the TB Control Program for a number of years. The annual subvention awards have been utilized to support staff efforts to monitor health care and treatment methods throughout the County.
On May 7, 1998, CDHS notified DHS that separate Housing funds would be available for FY 1998-99 and a Request for Application (RFA) for these funds would be forwarded along with the annual RFA for local assistance Subvention funds. In the past, the County has utilized a portion of the local assistance award to fund housing subcontracts.
On June 16, 1998, DHS submitted applications to the State requesting subvention funds in the amount of $1,554,761 and Housing funds in the amount of $500,000.
Honorable Board of Supervisors
December 29, 1998
Page 3
On June 30, 1998, the Board approved LOA funding to establish a Regional Tuberculosis Detention Program at High Desert Hospital (HDH) and Acton Rehabilitation Center (ARC) in the amount of $527,857 for FY 1997-98.
In August 1998, the State agreed to rollover FY 1997-98 Housing Award funds in the amount of $174,000 to be used for the Regional TB Detention Program FY 1998-99 expenditures.
On September 14, 1998, DHS received the LOA for FY 1998-99 approving the amounts as requested: $1,554,761 for local assistance Subvention and $500,000 for Housing.
Funding in the amount of $104,403 is included in the LOA to fund the automatic renewals of subcontract Agreement Nos. H-204465 and H-204466 with Homeless Health Care Los Angeles and JWCH Institute, Inc., respectively, for the continued provision of TB prevention and control activities during the period July 1, 1998 through June 30, 1999. The Board approved the two subcontract agreements on April 11, 1995, and subsequent amendments on June 17, 1997, with provisions for automatic renewal for 24 additional months, contingent upon the availability of State funds.
The request for delegation of authority to the Director of Health Services, or his designee, to approve and execute amendments to the LOA that do not require appropriation adjustments would greatly expedite the implementation of grant-funded programs. The Department will prepare and submit regular reports to the Board offices, advising of any amendments to the LOA.
Attachments A and B provide additional information.
County Counsel has reviewed and approved Exhibit I as to use and form
CONTRACTING PROCESS:
Not applicable for this Board action.
IMPACT ON CURRENT SERVICES (OR PROJECTS):
The recommended Board actions will support the current level of services.
Honorable Board of Supervisors
December 29, 1998
Page 4
When approved, this Department requires three signed copies of the Board's action.
Respectfully submitted,
Mark Finucane
Director of Health Services
MF:wbc
Attachments
c: Chief Administrative Officer
County Counsel
Executive Officer, Board of Supervisors
BLETRAHI4.GE
ATTACHMENT A
Page 1 of 3
SUMMARY OF AWARD
1.) LOCAL ASSISTANCE SUBVENTION FUNDING
1. Type of Service:
Tuberculosis Control Program surveillance, prevention, treatment and follow-up efforts related to tuberculosis disease with County support staff efforts to monitor treatment method used by providers for patients throughout Los Angeles County.
2. Agency Address and Contact Person:
Sarah Royce, M.D., M.P.H., Chief
Tuberculosis Control
Department of Health Services
2151 Berkeley Way, Room 70
Berkeley, CA 94704
Telephone: (510) 540-2973
3. Term:
Budget Period: July 1, 1998 through June 30, 1999.
4. Financial Information:
7/1/98 - 6/30/99
Salaries and Employee Benefits $1,518,544
Operating Expenses $36,217
CBO Subcontracts (transferred to
Housing Award) $0
County Indirect Costs $204,392
Total Program Costs $1,759,153
Less: State Financial Assistance $1,554,761
Net County Cost $ 204,392
5. Service Information:
Approximate number of new cases anticipated during the project period: 1300 people.
6. Geographic Area to be Served:
Countywide.
ATTACHMENT A
Page 2 of 3
2.) HOUSING AWARD
1. Type of Service:
Provide services and activities that would enhance program adherence, prevent homelessness, and allow the use of less restrictive alternatives which decrease or obviate the need for detention (i.e. incentives and enablers, DOT workers).
2. Agency Address and Contact Person:
Sarah Royce, M.D., M.P.H., Chief
Tuberculosis Control
Department of Health Services
2151 Berkeley Way, Room 70
Berkeley, CA 94704
Telephone: (510) 540-2973
3. Term:
Budget Period: July 1, 1998 through June 30, 1999
4. Financial Information:
7/1/98 - 6/30/99
Salaries and Employee Benefits $335,447
Operating Expenses 32,400
CBO Subcontracts * 132,153
County Indirect Costs 44,943
Total Program Costs $544,943
Less: State Financial Assistance (500,000)
Net County Costs: $44,943
5. Service Information:
Approximate number of new cases anticipated during the project period: 1300 people.
6. Geographic Area to be Served:
Countywide.
7. Accountable for Program Evaluation:
Deputy Director, Public Health Programs
* The subcontracts with Homeless Health Care Los Angeles and John Wesley Community Health were approved by the Board on June 17, 1997, with provisions of automatic renewal through June 30, 1999.
ATTACHMENT A
Page 3 of 3
8. Approvals:
Public Health Programs and Services: John F. Schunhoff, Ph.D., Chief of Operations
Contracts and Grants Division: John H. Ricks, Chief
County Counsel (approval as to form): Rose Belda, Senior Deputy County Counsel
BLETRAHI4.GE
ATTACHMENT B
PAGE 1 OF 2
STATE TUBERCULOSIS SUBVENTION AWARD
AWARD NUMBER HOUSES 89-70
JULY 1, 1998 THROUGH JUNE 30, 1999
MONTHLY
I. PERSONNEL FTE MTHS SALARY BUDGET
Full-Time Staff:
Senior Community Worker I 2 12 $2,568 $ 61,632
Community Worker 5 12 2,481 148,860
Research Analyst I 1 12 3,141 37,692
Senior Typist Clerk 1 12 2,364 28,368
Subtotal Full-Time Staff: $276,552
Less: Salary Savings @ 6.2053% (17,161)
Subtotal Full-Time Staff (less sal. sav.) $259,391
Employee Benefits @ 27.1005%* $ 70,296
Bilingual Bonus 6 12 $ 80 5,760
TOTAL PERSONNEL & EBS: $335,447
II. OPERATING EXPENSES
Mileage 13,076@ 0.26/mile $ 3,400
Training/Travel 0
Patient Incentives 7,000
Equipment
PHI Vehicle 22,000
Contractual
Skilled Nursing Unit 27,750
Homeless Health Care Project 59,403
Wesley Homeless Outreach 45,000
TOTAL OPERATING EXPENSES: $164,553
III. ADMIN. OVERHEAD on Salaries & Wages @ 16.3265% $ 44,943
TOTAL PROJECT COST $544,943
LESS COUNTY COST (44,943)
TOTAL GRANT COST $500,000
*TB Control will revise the Employee Benefits rate to reflect the current rate.
ATTACHMENT B
PAGE 2 OF 2
STATE TUBERCULOSIS SUBVENTION AWARD
AWARD NUMBER TBCSGF-89-70
JULY 1, 1998 THROUGH JUNE 30, 1999
MONTHLY
I. PERSONNEL FTE MTHS SALARY BUDGET
Full-Time Staff:
Clinic Nurse 1 5 12 $3,770 $ 226,200
Community Worker 2 12 2,481 59,544
Contract Program Auditor 1 12 4,077 48,924
Data Conversion Supr. 1 1 12 2,657 31,884
Epidemiology Analyst 1 12 3,505 42,060
Intermediate Typ. Clk. 4 12 2,094 100,512
Physician Specialist, MD 2 12 8,828 211,872
Program Manager II 1 12 4,492 53,904
Public Health
Microbiologist I 2 12 4,077 97,848
Nurse 2 12 4,303 103,272
Research Analyst I 2 12 3,141 75,384
Research Analyst II 1 12 3,592 43,104
Senior Typist Clerk 1 12 2,364 28,368
Statistical Analyst 1 12 2,928 35,136
Supervising Clinic
Nurse I 1 12 4,324 51,888
Subtotal Full-Time Staff: $1,209,900
Less: Salary Savings @ 2.5000% (30,248)
Subtotal Full-Time Staff (less sal. sav.) $1,179,653
Employee Benefits @ 27.1005%* $ 319,692
Bilingual Bonus 9 12 $ 80 8,640
Nurse Retention Bonus 8 12 $ 110 10,560
TOTAL PERSONNEL & EBS: $1,518,544
II. OPERATING EXPENSES
Mileage 24,753@ 0.26/mile $ 6,436
Travel 4,781
Patient Incentives 25,000
Equipment
TOTAL OPERATING EXPENSES: $ 36,217
III. ADMIN. OVERHEAD on Salaries & Wages @ 17.3265% $ 204,392
TOTAL PROJECT COST $1,759,153
LESS COUNTY COST ( 204,392)
TOTAL GRANT COST $1,554,761
*TB Control will revise the Employee Benefits rate to reflect the current rate.