HomeMy WebLinkAboutSTATE DPH-Future of Public Health Funding Award_A-22-398.pdf tiCOtj� County of Fresno Hall of Records,Room301
2281 Tulare Street
J �, Fresno,California
Board of Supervisors 93721-2198
O� 1856 _ Telephone:(559)600-3529
-PR Minute Minute Order Toll Free: 1-800-742-1011
www.co.fresno.ca.us
September 6, 2022
Present: 5- Supervisor Steve Brandau, Supervisor Nathan Magsig, Supervisor Buddy Mendes,
Chairman Brian Pacheco, and Vice Chairman Sal Quintero
Agenda No. 37. Public Health File ID: 22-0875
Re: Approve and authorize the Chairman to execute a retroactive Future of Public Health Award Agreement
with California Department of Public Health, effective July 1,2022 through June 30, 2023,with the
allocated funds to be available for encumbrance or expenditure until June 30, 2024($6,126,172); and
retroactively authorize the Director of Public Health's previous submittal of the Acknowledgement of
Allocation Letter acknowledging receipt of the letter and accepting the funds to be used as outlined
under the submission requirements; and approve and authorize the Director of Public Health,or
designee, as signatory on behalf of the Board of Supervisors on associated grant documents, including
submission of all future reports, claims, and adjustments to subsequent Future of Public Health
Funding work plans and spend plans, as well as the Annual Certification form
APPROVED AS RECOMMENDED
Ayes: 5- Brandau, Magsig, Mendes, Pacheco,and Quintero
Agreement No. 22-398
County of Fresno Page 40
co
Board Agenda Item 37
0 18s6 0
DATE: September 6, 2022
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director
SUBJECT: Future of Public Health Funding Award Agreement
RECOMMENDED ACTION(S):
1. Approve and authorize the Chairman to execute a retroactive Future of Public Health Award
Agreement with California Department of Public Health, effective July 1, 2022 through June
30, 2023,with the allocated funds to be available for encumbrance or expenditure until June
30, 2024 ($6,126,172).
2. Retroactively authorize the Director of Public Health's previous submittal of the
Acknowledgement of Allocation Letter acknowledging receipt of the letter and accepting the
funds to be used as outlined under the submission requirements.
3. Approve and authorize the Director of Public Health, or designee, as signatory on behalf of
the Board of Supervisors on associated grant documents, including submission of all future
reports, claims, and adjustments to subsequent Future of Public Health Funding work plans
and spend plans, as well as the Annual Certification form.
There is no additional Net County Cost associated with the recommended actions. Approval of the
recommended actions will provide the Department of Public Health with funding from the California
Department of Public Health (CDPH)for public health workforce and infrastructure, referred to as Future of
Public Health (FoPH)funding. The funding will support hiring and retention of permanent staff, equipment,
supplies and other related administrative costs.
It should be noted that the Department received the Acknowledgement of Allocation letter on June 30, 2022.
The letter was required by CDPH in advance of the Work Plan and Spend Plan due date of September 15,
2022; therefore, the Department submitted the letter on July 27, 2022 contingent upon the Board's approval.
The third recommended action will authorize the Director of Public Health, or designee, to sign and submit
required documentation including the Acknowledgement of Allocation letter, work plans, spend plans,
invoices, reports, and Annual Certification form. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, the
Department would not be able to accept the FoPH funding to improve public health workforce and
infrastructure, which will impact much needed public health services to the community. The Department
would need to submit an additional acknowledgement letter to CDPH rejecting the funds.
RETROACTIVE AGREEMENT:
The recommended allocation is retroactive to July 1, 2022 and was received from CDPH on June 30, 2022.
County of Fresno page I File Number:22.0875
File Number:22-0875
The time required to prepare CDPH's requested documents for the recommended allocation, including the
work and spend plan attachments, did not allow presentation to your Board at an earlier date.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. CDPH approved a
non-competitive FoPH funding allocation ($6,126,172)to the County for public health workforce and
infrastructure in FY 2022-23. These funds are considered ongoing funds and part of the ongoing baseline
state budget thus additional annual allocations similar to FY 2022-23 are expected. Funds allocated for this
initial 12-month period allowed for encumbrance or expenditure through the following year, June 30, 2024. At
least 70% of the funding ($4,288,320) must be dedicated to support hiring permanent staff, including
benefits, training and activities that support the recruitment and retention of public health staff. No more than
30% ($1,837,852) may be used for equipment, supplies and other administrative purposes such as facility
space, furnishings, and travel. Subsequent budget and salary resolutions will be presented to your Board
once CDPH has approved the Work Plan and Spend Plan submitted.
DISCUSSION:
Effective July 1, 2022, the State of California Budget Act of 2022 provides $200,400,000 annually to local
health jurisdictions (LHJ)to support public health workforce and infrastructure. Each LHJ will receive a base
funding amount of$350,000 per year. The remaining balance of the appropriation will be allocated to each
LHJ based on most recent population data, poverty data, and the share of the LHJ's population that is
Black/African American/Latinx/or Native Hawaiian/Pacific Islander. Based on the factors mentioned above,
the Department has been allocated $6,126,172, as the first year allocation, of which at least 70% must be
dedicated to support hiring permanent staff, including benefits, training and activities that support the
recruitment and retention of public health staff. No more than 30% may be used for equipment, supplies and
other administrative costs such as facility space, furnishings, and travel. Funding provided under the
recommended agreement shall be used to supplement and not supplant all other specific local county
funds.
The FoPH funding offers a unique opportunity to strengthen and expand local public health workforce,
particularly to fill staffing gaps identified during the COVID-19 pandemic. In FY 2020-21, your Board
approved the Department's addition of 36 positions to address COVID-19 response, using State and Federal
sources which are expected to expire in 2024. FoPH funding recipients are encouraged to transition
limited-term positions previously funded through limited-term federal funding into permanent positions for the
LHJs. Reallocating these positions into new permanent duties with the FoPH funding will eliminate the need
to request creation of additional positions.
FoPH funding allows the County to continue work towards being agile, adaptive, and responsive to the
increasingly complex and emerging public health challenges facing its diverse communities. Approval of the
recommended actions will allow the Department to use the FoPH funding to improve workforce recruitment
and retention, local health access to disadvantaged communities, surveillance and detection of
communicable diseases, and overall population health through evaluation of policies and systems in place.
The Department's Workforce Development team will evaluate training strategies, increase employee
communication strategies with Department Administration, and coordinate with the County Administrative
Office and County Human Resources Department to strategically address the high vacancy rates in specific
classifications to improve recruitment and retention rates. FoPH funding will also allow the Department's
Workplace Wellness Committee to implement various wellness activities throughout the Department to
improve employee health and well-being.
California's Healthy Places Index and Fresno County's Health Priority Index will be utilized to assess overall
population health and guide work plan activities. The FoPH funding will allow the Department to establish
infrastructure to expand the community health worker network with local community-based organizations
that provide culturally competent and linguistically appropriate services to connect our disadvantage
County of Fresno Page 2 File Number:22-0875
File Number:22-0875
neighborhoods to healthcare. A rural mobile health program will be developed in collaboration with local
medical providers. Additionally, approval of the recommended agreement will:
• increase the Public Health Nursing division's capacity in targeted geographic areas;
• add support to improve epidemiology capabilities;
• increase staff support for communicable disease investigation and contact tracing,
• increase public health laboratory personnel and equipment to expand existing testing capacity;
• support the Health Policy and Wellness division's activities to evaluate local health policies and
general policies for potential improvement in addressing local health disparities;
• increase the Environmental Health division's capacity to evaluate and address illegal dumping,
housing, identification of new Certified Unified Program Agencies (CUPA)facilities, tobacco retail
inspections, pool inspections, rabies control, and water well program resources;
• allow the Emergency Services division to better support all the functions of the division in emergency
preparedness, Office of Emergency Services, Public Health Emergency Preparedness, and
management of the Central California Emergency Medical Services Agency and support lease costs
for a new facility location that can consolidate all services.
CDPH required submission of an Acknowledgment of Allocation Letter in advance of the Work Plan and
Spend Plan due date. The signed letter served to acknowledge receipt of the FoPH Allocation Letter and
acceptance and agreement to use the funds as outlined under the Submission Requirements section of the
letter. To meet the deadline, the Department submitted the acknowledgement letter signed by the Director
of Public Health contingent upon approval by your Board. Approval of the recommended actions would
retroactively authorize the Director of Public Health's submission of the acknowledgment letter and authorize
the Director, or designee, to submit all future reports, claims, and adjustments to subsequent FoPH funding
work plans and spend plans, as well as the Annual Certification form.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk- Future of Public Health Funding Award Agreement FoPH-011
CAO ANALYST:
Ron Alexander
County of Fresno Page 3 File Number:22-0875
A-22-398
State of California—Health and Human Services Agency
California Department of Public Health ._
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I)COPH
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TOMAS J.ARAG6N,M.D.,Dr.P.H. GAVIN NEWSOM
Director and State Public Health Officer Governor
June 30, 2022
Dr. Rais Vohra, Health Officer David Luchini, Health Director
County of Fresno County of Fresno
1221 Fulton Street, 6th Floor 1221 Fulton Mall
Fresno, CA 93721 Fresno, CA 93721
Future of Public Health Funding
Award Number FoPH-011
County of Fresno
Authority:
Budget Act of 2022 for budget year 2022-2023, H&S Code 101321, 101320.3 and 101320.5
Dear Dr. Rais Vohra, David Luchini:
The Budget Act of 2022 for budget year 2022-2023 [Health and Safety Code 101320,
101320.3, and 101320.5] provides $200,400,000 annually to local health jurisdictions for
public health workforce and infrastructure, referred to in this letter as the Future of
Public Health Funding. These funds are considered ongoing funds and part of the
ongoing baseline state budget. The California Department of Public Health (CDPH) is
allocating $6,126,172 to County of Fresno.
As a condition of the funding, each local health jurisdiction shall, by Dec 30, 2023 and
every three years thereafter, be required to submit a public health plan to CDPH
pursuant to the requirements.
This letter provides submission requirements for the period of July 1, 2022 to June 30,
2023. Funds allocated for this period are available for encumbrance or expenditure
until June 30, 2024 to support local health jurisdictions and strengthen local
infrastructure.
Funding:
For the period of July 1, 2022 to June 30, 2023. CDPH will evaluate spending at the local
level in January 2023. CDPH, in consultation with the California Conference of Local
Health Officers, the California Health Executives Association of California, and the
o NEri u,�
CDPH Director's Office • P.O. Box 997377 • Sacramento, CA 95899-7377
(916) 650-6416 • (916) 650-6420 FAX <`
Internet Address: www.cdph.ca.gov
i
Service Employees International Union (SEIU), will consider options for possible
redirection of funds at that time.
The methodology for allocating these funds as set by statute are as follows:
1. Each Local Health Jurisdiction will receive a base funding amount of $350,000
per year.
2. The remaining balance of the appropriation will be provided to Local Health
Jurisdiction proportionally as follows:
a. 50 percent based on 2019, or most recent, population data
b. 25 percent based on 2019, or most recent, poverty data
C. 25 percent based on 2019, or most recent, the share of the population
that is Black/African-American/Latinx/or Native Hawaiian/Pacific Islander.
Allocations to Local Health Jurisdictions are included in Attachment 1 .
Funding Requirement:
Non-Supplantation
The funds allocated to each Local Health Jurisdiction may only be used to supplement,
rather than supplant, existing levels of services provided by the Local Health Jurisdiction.
Each Local Health Jurisdiction receiving funds shall annually certify to the department
that its portion of this funding shall be used to supplement and not supplant all other
specific local city, county, or city and county funds including, but not limited to, 1991
health local realignment and city, county, or city and county general fund resources
utilized for Local Health Jurisdiction purposes, and excluding federal funds in this
determination. See Attachment 2 for certification form.
Required Use of Funding
1 . Each Local Health Jurisdiction must dedicate at least 70 percent of funds to support
the hiring of permanent city or county staff, including benefits and training.
2. Remaining funds, not to exceed 30 percent, may be used for equipment, supplies,
and other administrative purposes such as facility space, furnishings, and travel.
Workplan/Spend Plan Requirements
1. Each Workplan should be informed by a Community Health Assessment, Community
Health Improvement Plan, and/or local Strategic Plan.
2. If a current Community Health Assessment and Community Health Improvement
Plan has not yet been completed by your Local Health Jurisdiction, the state fiscal
year 2022-2023 Workplan should describe how the Local Health Jurisdiction will
identify and address relevant community health issues and provide a plan and
target date for completion of a Community Health Assessment and Community
Health Improvement Plan. A Community Health Assessment and Community Health
Plan should be completed by December 30, 2023. Local Health Jurisdictions should
2
describe in the Workplan and Spend Plan what positions your Agency plans to hire
and how it will support your local objectives in which you have direct influence in
achieving.
3. The Workplan should include an evaluation plan and metrics.
4. All Local Health Jurisdictions will be required to measure and evaluate the process
and outcome of hiring permanent staff.
Redirection of Funding
A Local Health Jurisdiction may direct a portion of their funds to another local health
jurisdiction in support of regional capacity. The Local Health Jurisdiction should submit a
letter of support to CDPH from the Local Health Jurisdiction in which these funds are
directed to, along with a description of the regional capacity the funds will support. The
letter should be included as an additional attachment to the submission package.
Submission Requirements:
1. Complete a Workplan and Spend Plan by September 15, 2022 and submit to CDPH
at: FoPHfundinq@cdph.ca.aov. See Attachments 3 and 4. Your Agency should
consider the following when developing your Workplan and Spend Plan:
• It is recommended that your Agency fund an administrative position to ensure
fiscal accountability and reporting requirements of the various Future of Public
Health funds. At least seventy (70%) percent of your Agency funds must go
towards the hiring of permanent city or county staff. Your agency must
complete the table in Attachment 3 (Workplan and Reporting) to indicate how
many positions in each type of classification across the listed public health
areas your Agency plans to hire.
• Your Agency may dedicate up to 30% of the allocated funding to fund
partners and/or contractors, or used for equipment, supplies and other
administrative purposes such as current staff compensation, staff development,
facility space, furnishings, and travel.
• Your Agency is encouraged to recruit and give hiring preference to
unemployed workers, underemployed workers, and a diversity of applicants
from local communities who are qualified to perform the work. In addition, you
are encouraged to work with applicants from your community.
• Your Agency is encouraged to explore transitioning limited-term or contracted
staff/positions previously funded through limited term federal funding into
permanent positions for the city; county; or city and county
• If your Agency will be dedicating a portion of your funds to another Local
Health Jurisdiction to increase regional capacity, your Agency should submit a
letter of support from the Local Health Jurisdiction receiving those funds.
Adjustments should be reflected in the workplan and spend plan that is
3
submitted to CDPH for review and approval. The letter should be included as
an additional attachment to the submission package.
2. Your Agency must also meet the following minimum requirements for these funds
and include descriptions in your Agency's Workplan:
i. A description of how your Agency will achieve 24/7 health officer coverage.
ii. A description of how your Agency will meet your Community Health
Assessment (CHA)/Community Health Improvement plan (CHIP) and/or local
Strategic plan goals. How do you plan to measure/evaluate the impact of
these funds? Please either attach a copy or provide links to your CHA, CHIP,
and Strategic Plan or provide a date when these will become available.
iii. A description of how your Agency will use these funds to meet your local
Health Jurisdiction equity goals.
iv. A description of how your Agency will use these funds to become or sustain
capacity as a learning organization including continuous quality
improvement and Results-Based Accountability/evaluation.
V. Commit to Health Officer and Health Director participation in Regional Public
Health Office monthly or quarterly meetings as determined by the Region
and CDPH
3. In advance of the Workplan and Spend Plan due date, your Agency should
respond to CDPH acknowledging that you accept the allocation funds outlined in
this letter.
Reporting Requirements:
As a recipient of the Future of Public Health Funding, the following reporting documents
will be required:
For your convenience, your Contract Manager will issue reminders as these dates get
closer.
1. Submit quarterly progress reports on hiring progress to CDPH following the schedule
below. Starting with the quarter 2 progress report, provide status of timelines, goals,
and objectives outlined in your workplan. See Attachment 3. Note, if your workplan
is under review by CDPH and has not been approved by the progress report due
date, you are still required to submit your progress report to CDPH.
4
Year/Quarter Reporting Period Due Date
Year 1/Q 1 July 1, 2022-September 30, 2022 October 30, 2022
Year 1/Q2 October 1, 2022- December 31, 2022 January 30, 2023
Year 1/Q3 January 1, 2023- March 31, 2023 April 30, 2023
Final April 1, 2023- June 30, 2023 July 30, 2023
2. Submit quarterly expenditure reports to CDPH following the schedule below.
Expenditure reporting should be completed within your Spend Plan. Note, if your
spend plan is under review by CDPH and has not been approved by the reporting
due date, you are still required to submit your expenditure report to CDPH. See
Attachment 4.
Year/Quarter Reporting Period Due Date
Year 1/Q 1 July 1, 2022-September 30, 2022 October 30, 2022
Year 1/Q2 October 1, 2022- December 31, 2022 January 30, 2023
Year 1/Q3 January 1, 2023- March 31, 2023 April 30, 2023
Final April 1, 2023- June 30, 2023 July 30, 2023
3. CDPH will provide a template to use to facilitate the reporting of these data metrics.
Reimbursement/Invoicing:
CDPH will reimburse your Agency upon receipt of invoice. In order to receive your
reimbursements, please complete and submit your invoice(s) to:
FoPHfundincl@cdph.ca. _ov. See Attachment 5.
1. First Quarter Payment: CDPH will issue a warrant (check) to your Agency for 25% of
your total allocation, this will be issued as an advance payment.
2. Future payments will be based on reimbursement of expenditures once the 25%
advance payment has been fully expended. In order to receive future payments,
your Agency must complete and submit reporting documentation within
Attachments 3 and 4 following the due dates above within Reporting Requirements.
3. Your Agency must maintain supporting documentation for any expenditures
invoiced to CDPH against this source of funding. Documentation should be readily
available in the event of an audit or upon request from CDPH. Documentation
should be maintained onsite for five years.
5
Thank you for the time your Agency has invested to strengthen public health capacity
and preparedness to respond to future emergencies throughout California
communities. We are hopeful that this funding will collectively achieve the goal of
developing and strengthening California's public health workforce. CDPH is hosting a
webinar on July 14, 2022 from 11:00 AM - 12:00 PM to go over the requirements and
activities of this funding. If you have any questions or need further clarification, please
reach out to FoPHfundina@cdph.ca.gov.
Sincerely,
�1�%VAI
Susan Fanelli
Chief Deputy Director
California Department of Public Health
6
Acknowledgement of Allocation Letter
Instruction: Please check one statement below, sign, and return to
FoPHfundinq@cdph.ca.aov
❑✓ County of Fresno acknowledges receipt of this Allocation letter and accepts the
funds to be used as outlined under the Submission Requirements section.
❑County of Fresno acknowledges receipt of this Allocation letter and does not
accept the funds. County of Fresno understands that these funds cannot be delegated
to another Agency and CDPH will redistribute funds.
Name of Local Health Jurisdiction designated signee(s): David Luchini, contingent upon approval
by the Board of Supervisors of the
ritle/Role: Director of Public Health County of Fresno
Signature of Local Health Jurisdiction designee:
Date.-72 0 ZZ
Attachments
Attachment 1: Local Allocations Table
Attachment 2: Certification Form
Attachment 3: Workplan and Reporting
Attachment 4: Spend Plan
Attachment 5: Invoice
7
Attachment 1 FoPH Allocation - FY 2022-23
Local Health Jursidiction (LHJ) funding distribution for the FoPH
Population, Poverty and Race/Ethnicity
Description of funding formula:Each California LHJ, including Los Angeles, Long Beach, and Pasadena, is awarded a base
amount of$350,000. The balance of funds are distributed based on the proportion each LHJ contributes to the 2020
population (50%of allocation),the proportion each LHJ contributes to the 2019 population in poverty(25%of
allocation),and the proportion each LHJ contributes to the population that is Black/African American, Latinx,or Native
Hawaiian/Pacific Islander(25%of allocation). Population and race/ethnicity data are from the Department of Finance;
and population in poverty are calculated using 2019 Census Estimates.
LHJ $350,000 Base
Alameda HD1 6,537,374
Alpine 354,669
Amador 487,482
Berkeley 912,213
Butte 1,224,383
Calaveras 515,889
Colusa 459,468
Contra Costa 4,844,667
Del Norte 474,087
El Dorado 1,015,644
Fresno 6,126,172
Glenn 482,368
Humboldt 938,349
Imperial 1,568,105
I nyo 423,621
Kern 5,381,815
Kings 1,175,830
Lake 641,433
Lassen 481,278
Long Beach 2,807,624
Los Angeles HD 47,328,331
Madera 1,217,976
Marin 1,241,952
Mariposa 421,598
Mendocino 723,894
Merced 1,882,112
Modoc 394,124
Mono 403,629
Monterey 2,563,477
Napa 896,612
Nevada 690,079
Orange 13,351,733
Pasadena 1,033,025
Placer 1,661,462
Plumas 420,397
Page 1 of 2
Attachment 1 FoPH Allocation - FY 2022-23
Local Health Jursidiction (LHJ) funding distribution for the FoPH
Population, Poverty and Race/Ethnicity
Description of funding formula:Each California LHJ, including Los Angeles, Long Beach, and Pasadena, is awarded a base
amount of$350,000. The balance of funds are distributed based on the proportion each LHJ contributes to the 2020
population (50%of allocation),the proportion each LHJ contributes to the 2019 population in poverty(25%of
allocation), and the proportion each LHJ contributes to the population that is Black/African American, Latinx,or Native
Hawaiian/Pacific Islander(25%of allocation). Population and race/ethnicity data are from the Department of Finance;
and population in poverty are calculated using 2019 Census Estimates.
Riverside 11,782,061
Sacramento 7,072,450
San Benito 647,267
San Bernardino 11,284,416
San Diego 14,356,108
San Francisco 3,639,888
San Joaquin 4,031,505
San Luis Obispo 1,459,610
San Mateo 3,141,653
Santa Barbara 2,433,999
Santa Clara 7,296,326
Santa Cruz 1,475,452
Shasta 1,031,180
Sierra 362,059
Siskiyou 538,801
Solano 2,186,187
Sonoma 2,174,091
Stanislaus 2,975,808
Sutter 787,927
Tehama 642,801
Trinity 405,254
Tulare 3,085,604
Tuolumne 543,960
Ventura 3,857,269
Yolo 1,397,659
Yuba 707,793
Total 200,400,000
Miniumum Award: 354,669
aximum Award: 47,328,331
1 -Alameda Health Department (HD) excludes City of Berkeley
2 - Los Angeles HD excludes Cities of Long Beach and Pasadena
Page 2 of 2
Attachment 2 Agreement No. 22-398
\• i • State of California—Health and Human Services Agency
California Department of Public Health
I)COPH
f �
TOMAS J.ARAG6N,MD,DrPH GAVIN NEWSOM
Director and State Public Health Officer Governor
FUTURE OF PUBLIC HEALTH FUNDING
ANNUAL CERTIFICATION
The undersigned hereby affirms that they have read and agree with the funding
requirements specified in the Future of Public Health Funding Award Agreement.
The undersigned certifies:
1. That the funding provided under this agreement shall be used to supplement
and not supplant all other specific local county funds.
2. That at least 70 percent of funds to support the hiring of permanent city; county;
or city and county staff, including benefits and training.
3. Remaining funds, not to exceed 30 percent, may be used for equipment,
supplies, and other administrative purposes such as facility space, furnishings,
travel.
Designee authorized to commit the Local Health Jurisdiction to this Agreement
Brian Pacheco Chairman of the Board of Supervisors of the County of Fresno
Nia e ( runt) Title
0j, q-& - 62
aoa
Signature Date
County of Fresno
Local Health Jurisdiction Name
FoPH-011
Agreement Number
ATTEST:
BERNICE E. SEIDEL
Clerk of the Board of Supervisors
County of Fresno,state
of California
By /16c/�
Deputy
CDPH Director's Office • P.O. Box 997377 • Sacramento, CA 95899-7377 /o WALTPr l orp �
(916) 650-6416 . (916)650-6420 FAX
Internet Address: www.cdph.ca,4ov
Attachment 3
CDPHFuture ofPublic Health (FoPH)Funding
IocaIObjectives&Qua rterly Progress Report
Local Health Jurisdiction Name:County of Fresno
Agreement Number:I FoPH-011
Local Objective#1
Objective(SMART Objective) Improve recruitment and retention of LHYs workforce.
Implementation Plan Workforce Development team to improve training,onboarding&increased employee communication with LHJ administration.Propose to the
(Bulleted items or brief sentences) County's Human Resources(HR)department to conduct a classification study to increase salaries of all LHJ positions while prioritizing the
higher vacancy positions.Evaluate additional compensation opportunities to LHJ positions in collaboration with the County Administrative
Office and County HR.Implement wellness activities throughout the County Department of Public Health(DPH)to improve employee morale.
Evaluation Plan:How will LHJ measure and Decrease DPH vacancy rate in future fiscal years from the current FY 2021-22 vacancy rate of over 20%.Evaluate vacancy rate within certain
track this objective? classifications and divisions.Establish a baseline measure through the Workforce Development subcommittee for documentation and
tracking of employee communication on improving recruitment and retention.Increase the number of exit interviews completed from the
current rate of 68%and analyze results collected in order to accurately understand reasons for leaving.Evaluate a tracking system on the
length of retention of LHJ employees.Evaluate wellness activities conducted throughout DPH,collecting participation rate and post-activity
satisfaction surveys.
Issue Area Issue Area 1 Other Core LHJ Infrastructure
(select from drop down)
Issue Area 2 Prevention and Health Promotion
Issue Area 3 Mental and Behavioral Health
Issue Area 4
Issue Area 5
Specify if"other"Selected
Strategy Area Strategy Area 1 Build and support a diverse and skilled public health workforce
(select from drop down)
Strategy Area 2 Build and maintain a strong organizational infrastructure for public health
Strategy Area 3 Create,champion and implement policies,plans and laws that impact health
Strategy Area 4
Strategy Area 5
Specify additional Strategy Area
Expected Achieve By Date
(select from drop down)
Local Objective#2
Objective(SMART Objective) Improve health access to local disadvantaged communities.
Implementation Plan Coordinate and support local university in a physician residency program.Evaluate Emergency Medical Services(EMS)division for new location
(Bulleted items or brief sentences) to better support all division functions including but not limited to training new Emergency Medical Technicians(EMT)servicing the entire
central valley.Create a new paramedic stipend program to address the existing shortage of paramedics in the EMS system.Continue to
improve on Fresno's Health Priority Index(HPI)in identifying the most health burden areas that will benefit from additional health and
economic mobility infrastructure being built in those areas.Continue to develop and expand the community health worker(CHW)network
with local community-based organizations that provide culturally competent and linguistically appropriate services to connect our
disadvantaged neighborhoods to healthcare.Improve community awareness of California Children's Services(CCS)program and utilization of
services through targeted outreach to healthcare providers and disadvantaged communities.Increase Public Health Nursing(PHN)division's
capacity in targeted geographic areas to improve access to health care,health literacy,and address social determinants of health that prevent
access to health care.Develop rural mobile health program in collaboration with local medical providers.
Evaluation Plan:How will LHJ measure and Establishment of a residency program with local university.Utilize EMS evaluation in planning and acquisition of new EMS lease.Track EMT
track this objective? training participants completion rate and recruitment outreach efforts.Conduct trainings to local stakeholders on Fresno's HPI,track
number of training participants,and track adoption of HPI in any infrastructure criteria decision making process.Establishment of the
infrastructure to manage the CHW network,track the amount of services provided by the network,track outcomes provided by the
network,and cost/benefit analysis.Track the additional CCS applications received annually compared to prior year.Identify CCS
applications in HPI Q1 area compared to prior year.Track the number and location of PHN visits.Implement rural mobile health program.
Issue Area Issue Area 1 Access,Availability and Utilization of Health Services
(select from drop down)
Page 1 of 7
Attachment 3
Issue Area 2 Accessible Built Environment
Issue Area 3 Prevention and Health Promotion
Issue Area 4 High Quality,Patient-Centered Care
Issue Area 5 Other Core LHJ Infrastructure
Specify if"other"Selected
Strategy Area Strategy Area 1 Assess and monitor population health status,factors that influence health,and
(select from drop down) community needs and assets
Strategy Area 2 Assure an effective system that enables equitable access to the individual services
and care needed to be healthy
Strategy Area 3 Build and maintain a strong organizational infrastructure for public health
Strategy Area 4 Communicate effectively to inform and educate people about health,factors that
influence it,and how to improve it
Strategy Area 5 Strengthen,support and mobilize communities and partnerships to improve health
Specify additional Strategy Area
Expected Achieve By Date
(select from drop down)
Local Objective#3
Objective(SMART Objective) Improve local surveillance and detection of communicable diseases.
Implementation Plan Add support to improve epidemiology capabilities including but not limited to increased access to local health data.Increase the amount of
(Bulleted items or brief sentences) FTE support for communicable disease(CD)investigation and contact tracing.Increase public health laboratory personnel and equipment to
expand existing testing capacity.Assist the County in development of a County integrated data system that will support County departments
and provide backbone IT infrastructure or a community information exchange.
Evaluation Plan:How will LHJ measure and Identify local health data that is currently available to the LHJ and note any additional local health data infrastructure being added(e.g.
track this objective? syndromic surveillance,health information exchange).Increase the amount of epidemiology reports.Increase the amount of CDs
investigated by the local LHJ.Decrease vacancy rate for CD investigators,increase cross-training of multiple CDs,increase phlebotomy
certified investigators.Develop a public health microbiologist trainee program.Evaluate laboratory equipment that can conduct a diverse
panel of testing for CDs.
Issue Area Issue Area 1 Other Core LHJ Infrastructure
(select from drop down)
Issue Area 2 Prevention and Health Promotion:STD
Issue Area 3 Prevention and Health Promotion:COVID-19
Issue Area 4
Issue Area 5
Specify if"other'Selected
Strategy Area Strategy Area 1 Assess and monitor population health status,factors that influence health,and
(select from drop down) community needs and assets
Strategy Area 2 Investigate,diagnose,and address health problems and hazards affecting the
population
Strategy Area 3 Assure an effective system that enables equitable access to the individual services
and care needed to be healthy
Strategy Area 4 Build and support a diverse and skilled public health workforce
Strategy Area 5 Build and maintain a strong organizational infrastructure for public health
Specify additional Strategy Area
Expected Achieve By Date
(select from drop down)
Page 2 of 7
Attachment 3
Local Objective#4
Objective(SMART Objective) Improve overall population health through evaluation of policies and systems in place.
Implementation Plan Utilize the Healthy Places Index and Fresno County Health Priority Index to assess overall population health.Health Policy and Wellness(HPW)
(Bulleted items or brief sentences) division will focus activities on evaluating local health and general policies for potential improvement in addressing local health disparities.
Environmental Health(EH)division will increase capacity to evaluate and address illegal dumping,housing,identification of new CUPA facilities,
tobacco retail inspections,pool inspections,and water well program resources.Evaluate existing environmental data and assess impact to
population health.
Evaluation Plan:How will U-U measure and Evaluate the amount of County population categorized in HPI Q1 from year to year.Epidemiology team will annually report on studies
track this objective? and/or publications completed with local,state,and federal stakeholders on assessing environmental impacts to Fresno County population.
Increase the number of inspections,outreach,and other activities completed by the EH division.HPW division will track the amount of local
policies evaluated annually and the number of recommended changes adopted by the jurisdictions/organizations.
Issue Area Issue Area 1 Equitable Outcomes
(select from drop down)
Issue Area 2 Environmental Quality and Climate Change
Issue Area 3 Neighborhood Safety and Collective Efficacy
Issue Area 4 Prevention and Health Promotion:Tobacco Use
Issue Area 5
Specify if"other"Selected
Strategy Area Strategy Area 1 Assess and monitor population health status,factors that influence health,and
(select from drop down) community needs and assets
Strategy Area 2 Investigate,diagnose,and address health problems and hazards affecting the
population
Strategy Area 3 Strengthen,support and mobilize communities and partnerships to improve health
Strategy Area 4 Create,champion and implement policies,plans and laws that impact health
Strategy Area 5
Specify additional Strategy Area
Expected Achieve By Date
(select from drop down)
Page 3 of 7
Attachment 3
C DPH Future o f Public Health (FoPH) Funding
Minimum Requirements
Local Health Jurisdiction Name: County of Fresno
Agreement Number: FoPH-011
Future of Public Health (FoPH) Minimum LHJ Response
Requirements
1.Describe how your local health jurisdiction achieves 24/7 health The County currently has an Interim Health Officer and a Deputy Health Officer
officer coverage. Include backup plans for times when the health position filled.In addition the County has an agreement with UC Merced for
officer is unavailable,such as Deputy Health Officer positions,contracts, emergency coverage when the Deputy Health Officer is also not available.
or regional coverage agreements.
2.Describe how these new funds will assist your jurisdiction in meeting Fresno County Community Health Needs Assessment 2020:
your community health assessment/community health improvement https://www.co.fresno.ca.us/home/showpublisheddocument/44681/637273059
plan and strategic plan goals. How do you plan to measure/evaluate 301000000
the impact of these funds? Please either attach a copy or provide links Ensure Implementation and Evaluation Plans selected allow for relevant
to your CHA,CHIP and Strategic Plan or provide a date when these will measurement of the impact of these funds consistent with population health
become available. metrics,along with programmatic goals.These funds will be utilized to directly
support updating the Fresno County Department of Public Health's Strategic Plan
(2008)and the development of the CHIP.
3.Describe how these new funds will assist your jurisdiction in meeting Funds will help improve Fresno's Health Priority Index(HPI)in identifying the
equity goals. most health burden areas that will benefit from additional health and economic
mobility infrastructure being built in those areas.FCDPH will fund a Health Equity
4.Describe efforts your jurisdiction will take in becoming or sustaining FCDPH will start building the infrastructure for accreditation that builds the
capacity as a learning organization including continuous quality foundation for continuous quality improvement.FCDPH Administration will start
improvement and results-based accountability/evaluation. with this process to establish the infrastructure each division will need to mirror
and align with its quality improvement.FoPH initial investment will support the
foundation and then it will become a new"operating system"for FCDPH so that
shifts from other funding sources may be done systematically to ensure
inrnrnnratinn and nnanina fiinrlina is availably fnr rnntini ini is imnrnvamant
5.Commit to Health Officer and Health Director participation in the Yes
Regional Public Office monthly/quarterly meetings as determined by
the Region and CDPH.(Select from dropdown)
Page 4 of 7
Attachment 3
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timeframe.For Quarter I,please provide progress updates timefame. timefame. timefame.
related to sreffing and hiring,if appfmble to this objective.
Otherwise,indicate"Not Applicable."
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Mefty describe progressto date and Challenges that might Brieflydescdb,progress m date and thallenges that might Briefly describe progressto date and Challenges that might Mefly d—fib,progress to date and Challenges that might
affect Your ability to Complete Mis objectiveM the expected afedYourahility M Complete Mis objectiveM the expected a&a Your ability to Complete M M is objective in the expected a&a Your ability M Complete Mis objective in the expeCMd
timeframe.For Quarter 1,Please provide progress updates tm 7 me. thr fame. timeframe.
related re sreffing and hiring,if opplitable m this objective.
Otherwise,indicate"Not Applicable."
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eff—your ability re romplere this objectiveM Me expected eff—your abiliry re romplere Mis objectiveM Me expected affect your ability m romplete this objectiveM Me expected az your abty re zeplete this objectiveM the expected
timeframe.For Quarter 1,please provide progress updates timeframe. timeframe. timeframe.
related to sreJfmB and hiring,if applimble to this objective.
Otherwise,indicate"Not Applicable."
Page 5 of 7
Attachment 3
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,Dace Your ability h,rompiete this objective in the expected pfita Your ability h,rompiete this objective in the expected Ilea Your ability.rompiete this objective in the expeced fct Your ability.rompiete this objective in the expected
timeft—t.For Quarter 1,Please provide progress updates timflame. ti—n... timflame.
reI.Wd.staffing and hiring,if pplitobi.to this objective.
Otherwise,indimte"Not Applicable."
Page 6 of 7
Attachment 3
CDPH Future of Public Health(Fo PH)Funding
Staffing Plan
Local Health Jurisdiction Name:County of Fresno
Agreement Number.FOPH-011
WorkplanStaffing LHJ Response Progress YRS/Q11`1191e1Update(July1,2022-September30,2022) YR3/Q2Prog—,Update(0—iid,1,2022—Decemher31,20221 YR1/Q3Pmg—,Updatet—a,1,2023—March 31,2023) YRI/Q4 Progress Update(April 1,2023—kne30,2023)
Considerations Report*
List any anticipated challenges and/or Recruitment and retention will be challenging based on our exit interviews with staff and potential Briefly descri be progress
barriers to h iring and/or technical applicants turning down positions due to salary and parking.The departments'classifications can to date and challenges
assistance needs from CDPH. improve from increased salaries to become competitive with other local agencies on your proposed
staffing plan
Ifappliwble,descrlbeypurstrateglesto CollaboaatewrthCounry Human Resources Department to evaluate contracting wrth a consultant to
rcome potential hiring barriers pnduct salary survey,.Coordinate wdhCounty Administratwe Officer on evaluating parking
solutions.
Public Health Topics
Type of P—t,,n/Classdiwtioo I nfecbous Diseases Chronic Diseases/ Family Health Environmental Health Public Health Lab Emergency Communications Vital Records IT pot Positions(Total FTE) Notes
Community Health Pre.redness
1 Professional or di—I staff,including
public health physicians and nurses(not
Public Health Nurses,but Registered
Nurses working in clinical capanty at a There are 39 positions
public health clinic);mental or behavioral 1.18]5 043J5 1.5 o.18J5 3.3125 but the column notes
health sp—ahsts to support workforce and Total HE so we
umoy resilience;sonal service completed the table
specali-;vacnnators; based on total HE of
29.
2.Public Health Nurses 1.5 1.5
3 Research,evaluation,and surveillanre
specialists and scientists such as
population Health and Disease
ertigatian staff,epidemiologists, 3.75 0.75 0.75 5.25
rvmllance spenahsts,program
evaluators,case investigators;contact
or d—a intervention sp..al,ts;
data se management and informatics staff,
4 laboratory d-tirta or techninans 0.75 0.75
S.Program development and
Implementation staff,mcl,ding program
onagers,health program specialists,
(cations and policy staff;
t.ndho.n and tmns-adaptaUon serves;
training development staff,tanners or
health educators;or other commundy 2.625 3.375 1.5 7.5
health workers,emergency preparedness
and response coordinators to support
plannmg,exercises,and response and
identify lessons learned to help prepare for
possible future disease outbreaks,health
e4udy officers or teams,
6.Environmental Health lnvesagators O.JS 3 3.75
]Adminirtrative staff,Including human
o es personnel;fiscal or grant
pagers,grant writers,dericA staff;or
[hers needed to ensure rapid hiring and
tot goods and servicesand 11 1.125 075 2625 0.75 6
other administrative services associated
with successfully managing multiple
funding streams that have been leveraged
and/or braided across multiple programs
B.Other positions that support strategic
alignment,coordination,wllaboration or
fadlitatlon of cross-cutting programmatic 0
work in your lurktlldlon,particularly
.or..public health programs
9 Polity Development 0.75 01875 0.9375
Total 29 9.8125 6.4375 6 3.1875 0 0 2.8125 0 0.7
Page 7 of 7
Attachment 4
Future of Public Health (FoPH)
Spend Plan
Local Health Jurisdiction Name: County of Fresno
Position Title* Annual Salary Budgeted Months FTE% Total Salary Benefit Rate Total Benefits Combined Salary
(1-12) Months) and Benefits
Program Technician I - Filled (ADMIN) $ 44,166.00 9.00 75% $ 33,124.50 80.71% $ 26,735.25 $ 59,859.75
Staff Analyst I - Filled (ADMIN) $ 61,930.00 9.00 75% $ 46,447.50 87.88% $ 40,820.25 $ 87,267.75
Administrative Assistant I-C- Filled (ADMIN) $ 51,199.00 9.00 75% $ 38,399.25 91.41% $ 35,102.25 $ 73,501.50
Health Educator- Filled (ADMIN) $ 63,710.00 9.00 75% $ 47,782.50 72.96% $ 34,863.75 $ 82,646.25
Deputy Public Health Officer- Filled (ADMIN) $ 226,779.00 9.00 75% $ 170,084.25 60.65% $ 103,161.75 $ 273,246.00
Staff Analyst I -Vacant(ADMIN) $ 55,370.00 9.00 75% $ 41,527.50 75.86% $ 31,502.25 $ 73,029.75
Business Systems Analyst I -Vacant(ADMIN) $ 52,193.00 9.00 75% $ 39,144.75 77.09% $ 30,177.00 $ 69,321.75
Public Health Physician-Vacant(ADMIN) $ 192,884.00 6.00 50% $ 96,442.00 64.85% $ 62,540.00 $ 158,982.00
Health Education Specialist-Vacant(HPW) $ 52,348.00 9.00 75% $ 39,261.00 76.76% $ 30,138.00 $ 69,399.00
Health Educator- Filled (HPW) $ 63,710.00 9.00 75% $ 47,782.50 72.96% $ 34,863.75 $ 82,646.25
Public Health Program Manager- Filled (HPW) $ 100,536.00 9.00 75% $ 75,402.00 66.98% $ 50,500.50 $ 125,902.50
Health Education Specialist-Vacant(HPW) $ 52,348.00 9.00 75% $ 39,261.00 76.76% $ 30,138.00 $ 69,399.00
Health Education Specialist-Vacant(HPW) $ 52,348.00 9.00 75% $ 39,261.00 76.76% $ 30,138.00 $ 69,399.00
Program Technician -Vacant(CMS) $ 54,470.00 9.00 75% $ 40,852.50 75.93% $ 31,020.00 $ 71,872.50
Staff Nurse-Vacant(CMS) $ 66,554.00 9.00 75% $ 49,915.50 72.22% $ 36,047.25 $ 85,962.75
Senior Administrative Case Worker-Vacant(CMS) $ 54,696.00 9.00 75% $ 41,022.00 75.85% $ 31,114.50 $ 72,136.50
Public Health Nurse-Vacant(PHN) $ 105,019.00 9.00 75% $ 78,764.25 86.55% $ 68,172.75 $ 146,937.00
Public Health Nurse-Vacant(PHN) $ 105,019.00 9.00 75% $ 78,764.25 86.55% $ 68,172.75 $ 146,937.00
Medical Social Worker-Vacant(PHN) $ 78,661.00 9.00 75% $ 58,995.75 80.79% $ 47,661.00 $ 106,656.75
Health Education Assistant-Vacant(PHN) $ 42,607.00 9.00 75% $ 31,955.25 81.63% $ 26,086.50 $ 58,041.75
Health Education Assistant-Vacant (PHN) $ 42,607.00 9.00 75% $ 31,955.25 81.63% $ 26,086.50 $ 58,041.75
Program Technician -Vacant(CH) $ 54,470.00 9.00 75% $ 40,852.50 75.93% $ 31,020.00 $ 71,872.50
Program Technician -Vacant(CH) $ 54,470.00 9.00 75% $ 40,852.50 75.93% $ 31,020.00 $ 71,872.50
Health Education Specialist-Vacant(CH) $ 52,348.00 9.00 75% $ 39,261.00 76.76% $ 30,138.00 $ 69,399.00
Health Education Specialist-Vacant(CH) $ 52,348.00 9.00 75% $ 39,261.00 76.76% $ 30,138.00 $ 69,399.00
Licensed Vocational Nurse-Vacant(CH) $ 42,497.00 9.00 75% $ 31,872.75 81.70% $ 26,040.00 $ 57,912.75
Communicable Disease Specialist-Vacant(CH) $ 58,675.00 9.00 75% $ 44,006.25 88.64% $ 39,005.25 $ 83,011.50
Communicable Disease Specialist-Vacant(CH) $ 58,675.00 9.00 75% $ 44,006.25 88.64% $ 39,005.25 $ 83,011.50
Supervising Communicable Disease Specialist-Vacan $ 63,868.00 9.00 75% $ 47,901.00 87.09% $ 41,717.25 $ 89,618.25
Division Manager- Public Health Services(ESDM) -V $ 111,852.00 9.00 75% $ 83,889.00 65.83% $ 55,220.25 $ 139,109.25
Epidemiologist- Filled (ESDM) $ 80,664.00 9.00 75% $ 60,498.00 69.29% $ 41,916.75 $ 102,414.75
Program Technician II - Filled (ESDM) $ 47,185.00 9.00 75% $ 35,388.75 85.18% $ 30,143.25 $ 65,532.00
Office Assistant II -Vacant(ESDM) $ 36,748.00 9.00 75% 1 $ 27,561.00 85.81% $ 23,649.00 $ 51,210.00
Public Health Microbiologist Trainee- Filled (ESDM) $ 53,805.33 9.00 75% 1 $ 40,354.00 76.19% $ 30,744.00 $ 71,098.00
Page 1 of 4
Attachment 4
Environmental Health Aide- Filled (EH) $ 46,333.00 9.00 75% $ 34,749.75 79.53% $ 27,636.00 $ 62,385.75
Environmental Health Aide-Vacant(EH) $ 46,333.00 9.00 75% $ 34,749.75 79.53% $ 27,636.00 $ 62,385.75
Environmental Health Aide-Vacant(EH) $ 46,333.00 9.00 75% $ 34,749.75 79.53% $ 27,636.00 $ 62,385.75
Environmental Health Aide-Vacant(EH) $ 46,333.00 9.00 75% $ 34,749.75 79.53% $ 27,636.00 $ 62,385.75
Environmental Health Aide-Vacant(EH) $ 46,333.00 9.00 75% $ 34,749.75 79.53% $ 27,636.00 $ 62,385.75
0% $ - $ - $ -
0% $ - $ - $ -
0% $ - $ - $ -
0% $ - $ - $ -
0% $ - $ - $ -
0% $ - $ - $ -
0% $ - $ - $ -
0% $ - $ - $ -
0% $ - $ - $ -
0% $ - $ - $ -
0% $ - $ - $ -
Total Personnel $ 1,915,597.25 $1,462,978.98 $ 3,378,576.23
Supplies
Safety Equipment Chairs, one for each floor of Brix (6) $ 20,000.00
Total Supplies $ 20,000.00
Travel
In-State $ -
Out-of-State $ -
Total Travel $ -
Equipment
Lap Equipment-Vitek Machine $ 275,000.00
$ -
Page 2 of 4
Attachment 4
Total Equipmentl $ 275,000.00
Other
Emergency Medical Services Lease- location to better support all EMS division functions servicing the entire central valley, including training $ 250,000.00
UCSF Resident Program -coordination of physician residency program with local university $ 75,000.00
Building Maintenance-maintenance and repairs costs for aging Brix Building $ 50,000.00
Handicap Access-costs for improvements to handicap access in the Brix Building $ 100,000.00
Elevator Maintenance- maintenace and repair costs for aging Brix Building elevator $ 100,000.00
Employee Wellness Activities-costs for coordinated physical, mental and emotional well-being activities to promote a positive wellness culture for $ 5,000.00
Office Upgrades- reconfiguration of existing space to adjust for additional staff and workstations, and allow for safe spacing with existing staff $ 675,266.87
Paramedic Stipend (2) - Paramedic Scholarships for 2 students per year,to assist Paramedic program candidates with required program fees $ 22,000.00
Annual Employee Parking-costs of daily parking fees for employees to park in the vicinity of the Brix Building $ 239,616.00
Total Otherl $ 1,516,882.87
Subcontracts:
Medi-Cal Claims Unit-TBD; processing Medi-Cal claims submitted as payment for public health services $ 100,000.00
General Non-Grant Funded Media -JP Marketing; creating/coordinating public awareness campaigns on various public health topics $ 100,000.00
Salary Survey-TBD; consultant to conduct salary survey $ 100,000.00
Page 3 of 4
Attachment 4
Total Subcontracts $ 300,000.00
Total Direct Costsl $ 5,490,459.10
Indirect Cost(%of Total Personnel or Total Direct Costs)
CDPH approved ICR is 18.818%of total Personnel Costs $ 3,378,576.23 1 19% $ 635,712.90
Total Indirect $ 635,712.90
TOTAL BUDGET $ 6,126,172.00
*Personnel supported with this funding should not duplicate efforts across grants,exceed 1.0 FTE across all funding sources.
Page 4 of 4
Attachment 5
C DPH Future o f Pu b lic Health (Fo PH) Fu n d in g
California DepartmentofPublic Health Datc:
Email Invoice to:FoPHfunding*dph.ca.gov
LHJ Namc/Address (to send warrant)
Contract Number:
Contract Term: July 1,2022to June 30,2023 Check ifremittance addresschanged
Billing Period: since last lnvoice
Invoice Number:
County Invoice #: Telephone #:
SupplierID#: Only
Budget Expenditures
line-Item 'Ili is Period
Personnel
Supplies
Travel
Equipment
Other
Sub c o ntra c is
Indirect
Total $
State Certification: Ihereby certify that the above referenced localhealth department has met all
re quire m e nts fo r sub m ission o f its a p p lic a tio n,re la te d d o c ume nts,a nd c e rtific a tions a nd iseligible to
receive this payment. ]he application,related documents,approvals,and requests forpayment are
maintained byCDPH,forfive (5)ye a rs fo r a ud it p urp o se s a s re quire d b y the State C o ntro He r's 0 ffic e.
CDPHUse Only
Scrvicc Location: 1PIcase Pay:
_MD 1 $-
Sig n a to re
Caroline Kurtz,Program Director