HomeMy WebLinkAboutSTATE DPH-California Strengthening Public Health Initiative_A-23-225.pdf coj� County of Fresno Hall of Records, Room301
2281 Tulare Street
Fresno,California
Board of Supervisors 93721-2198
O� i856 O Telephone:(559)600-3529
-PR E`'� Minute Order Toll Free: 1-800-742-1011
www.co.fresno.ca.us
May 23, 2023
Present: 5- Supervisor Steve Brandau,Vice Chairman Nathan Magsig,Supervisor Buddy Mendes,
Supervisor Brian Pacheco, and Chairman Sal Quintero
Agenda No. 39. Public Health File ID: 23-0355
Re: Approve and authorize the Chairman to execute a retroactive California Strengthening Public Health
Initiative Award Agreement with California Department of Public Health,effective December 1, 2022
through November 30,2027($1,275,543); retroactively approve and 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 award documents, including submission of all future reports, claims,
certification forms and adjustments to subsequent California Strengthening Public Health Initiative work
plans and spend plans
APPROVED AS RECOMMENDED
Ayes: 5- Brandau, Magsig, Mendes, Pacheco,and Quintero
Agreement No. 23-225
County of Fresno Page 39
co
Board Agenda Item 39
0 18-)6�0
FRE`'
DATE: May 23, 2023
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director
SUBJECT: California Strengthening Public Health Initiative Award Agreement
RECOMMENDED ACTION(S):
1. Approve and authorize the Chairman to execute a retroactive California Strengthening
Public Health Initiative Award Agreement with California Department of Public Health,
effective December 1, 2022 through November 30, 2027 ($1,275,543).
2. Retroactively approve and 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 award documents, including submission of all future
reports, claims, certification forms and adjustments to subsequent California Strengthening
Public Health Initiative work plans and spend plans.
There is no additional Net County Cost associated with the recommended actions. Approval of the
recommended actions will provide the Department of Public Health (Department)with funding from the
California Department of Public Health (CDPH)to supplement existing levels of services provided by the
Department, referred to as California Strengthening Public Health Initiative (CASPHI)funding.The funding
will support hiring, training and retention of staff, as well as supplies and other related administrative costs.
It should be noted that the Department received the Acknowledgement of Allocation Letter on February 23,
2023. The letter was required by CDPH in advance of the Work Plan, Spend Plan and Certification Form
with the due date of April 7, 2023;therefore, the Department submitted the Letter with the Director of the
Department's signature on March 17, 2023, contingent upon the Board's approval.
The third recommended action will authorize the Director, or designee, to sign and submit required
documentation including the Acknowledgement of Allocation Letter, work plan, spend plan, invoices,
semi-annual reports and annual Certification form required yearly by CDPH. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended actions, the
Department would not be able to accept the CASPHI funding to supplement existing levels of services,
which would negatively impact public health services to the community. The Department would need to
submit a subsequent acknowledgement letter to CDPH rejecting the funds.
RETROACTIVE AGREEMENT:
The recommended allocation is retroactive to December 1, 2022, because the Allocation Letter was
County of Fresno Page 1 File Number.23-0355
File Number.23-0355
provided by CDPH to the Department on February 23, 2023. The recommended allocation is being brought
to your Board in accordance with the agenda item processing timelines.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. CDPH approved a
non-competitive CASPHI funding allocation of$1,275,543 to the County for FY 2022-23 to be expended
through November 30, 2027. A subsequent salary resolution will be presented to your Board as an
amendment once CDPH has approved the Work Plan and Spend Plan.
DISCUSSION:
On December 4, 2022, CDPH received a Notice of Award from the Centers for Disease Control and
Prevention (CDC)for$36,800,000 to be allocated to 50 of the 61 local health jurisdictions (LHJ) in California,
which included the Department. The remaining 11 LHJs will receive funding directly from the CDC and are
not part of this CASPHI allocation process.
As a condition to receive CASPHI funding, LHJs are required to have a minimum 1.0 full time equivalent
(FTE)equity staff position with roles and responsibilities dedicated to advancing health equity and/or
eliminating health disparities. Each LHJ will receive a base funding of$495,000 to cover the position, but if
the LHJ has funding allocated for this position under other funding sources, the base allocation can be
utilized for other workforce development activities. The remaining balance of the CASPHI appropriation is
allocated to each LHJ using three weighted inputs: population, poverty and demographic diversity. Based on
these factors, the Department has been allocated $1,275,543 in FY 2022-23 to be expended through
November 30, 2027.
The funding must be used to supplement, rather than supplant, existing levels of service, such as recruiting
and hiring new staff, including benefits, providing training and developmental opportunities, supporting
workplace well-being programs to promote staff retention, and strengthening human resources systems for
effective workforce management. The limitations of CASPHI funds are that they may not be expended for
research, clinical care, or purchase of equipment(defined as a single unit cost exceeding $5,000)or
furniture.
CASPHI also provides funding to strengthen the County's ability to provide a culturally and linguistically
responsive workforce with sufficient capacity to assess and respond to public health needs and crises.
Fresno County is a richly diverse community and approval of the recommended actions will allow the
Department to continue rendering quality services using a health equity focus that understands and
addresses the health disparities affecting disproportionately impacted populations that are higher risk and
underserved.
Like many organizations involved in public health, replenishment and retention of the workforce are pressing
issues for the Department. CASPHI funding will allow the Department to expand recruitment efforts, create
new positions, and introduce a paid student worker pipeline program. It will also provide for retention
incentives, create new promotional opportunities and offer career ladder education and worker upskilling.
CASPHI also includes support for the existing workforce members, including strengthening the
Department's Worksite Wellness Committee to address mental, emotional and physical well-being.
CDPH required submission of an Acknowledgment of Allocation Letter in advance of the Work Plan and
Spend Plan due date. The letter served to acknowledge the Department's receipt of the CASPHI Allocation
Letter and acceptance and agreement to use the funds as outlined. To meet the deadline, the Department
submitted the Acknowledgment of Allocation 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 of Allocation Letter and authorize the Director, or
designee, to submit all future reports, claims, certification forms and adjustments to subsequent CASPHI
County of Fresno page 2 File Number.23-0355
File Number:23-0355
work plans and spend plans.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk-Award Agreement with CDPH
CAO ANALYST:
Ron Alexander
County of Fresno Page 3 File Number:23.0355
Agreement No. 23-225
State of California—Health and Human Services Agency ���� rb,
California Department of Public Health __ .rz
I)COPH
-.
TOMAS J.ARAGbN,M.D.,Dr.P.H. GAVIN NEWSOM
Director and State Public Health Officer Governor
February 23, 2023
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
Re: California Strengthening Public Health Initiative LHJ Allocation Letter
Award Number: CASPH10010
County of Fresno
Dear Dr. Rais Vohra, David Luchini:
On December 4, 2022, CDPH received a Notice of Award (NOA) from CDC for the
California Strengthening Public Health Initiative (CASPHI). Please refer to the CDPH
CASPHI Funding Memo dated 2/14/23 for a broader description of that award to
California. CDPH is allocating funds to participating local health jurisdictions and this
letter specifies your LHJ's specific allocation amount below and the LHJ Allocation
Table (Attachment 1 CASPHI Allocation Table - Final). This allocation is for a full five
years.
Your allocation of the CASPHI funds is below:
Annual Award Amount $255,109.00
Full Award Amount (five years) $1,275,543.00
This letter provides submission requirements for the period of December 1, 2022 to
November 30, 2027.
Funding:
a. Any local health jurisdiction that did not apply for direct CDC funding will be
included in CDPH's allocation process. CDPH collaborated with the County Health
Executives Association of California (CHEAC), the California Conference of Local
Health Officers (CCLHO), and other stakeholders to finalize funding formulas for this
allocation.
The methodology for allocating these funds as set by statute are as follows:
.344 t.0 t.r Af i!,FI,A
CDPH Director's Office • P.O. Box 997377 • Sacramento, CA 95899-7377 .
(916)650-6416 9 (916)650-6420 FAX
Internet Address: www.cdph.ca.gov
4
a. The funding base of$495,000 has been set in order to cover a 1.0 FTE Equity Staff
position for approximately 3.3 years at $150,000 [with the first two years of equity
staffing previously funded as part of the California Equitable Recovery Initiative
(CERI), Future of Public Health (FoPH) or other funds]. Additional funding through the
formula-based allocation is available to support additional workforce development
activities including training, recruitment, and incentives.
NOTE: If LHJ has funding allocated for up to five years of 1 .0 FTE Equity Staffing under
other funding sources, the base allocation of$150,000 can be utilized for other
Workforce Development Activities.
b. The formula-based allocation is designed to emphasize a focus on equity based on
several factors. The formula-based allocation is using three weighted inputs:
Total Funding Base Percentage
Allocation (Weight)
Population 30%
Race/Ethnicity 35%
Poverty 35%
c. These inputs are calculated using hybrid weighting that incorporates the proportion
of the total statewide population (at 30%) and the percentage of the total LHJ
population (at 70%) for which these inputs apply.
d. In addition to the direct allocation of funds to the 50 participating LHJs, CDPH's
State Operations will also utilize the following funds to support all 61 local heath
jurisdictions with the following activities:
a. Hire a vendor to conduct a Local Public Health Workforce Assessment:
$2,000,000
i. Potential areas of focus for this assessment will include a compensation study
comparing salary rates across local public health agencies as well as private
sector and health care rates for similar positions, identifying recommended
staffing levels for foundational capabilities as well as expanded multisector
functions of public health, and workforce diversity.
b. Support Public Health Capacity Building: $1,010,404
2
i. Targeted local assistance contract funding for equity-focused community-
based organizations to provide capacity building support to local health
jurisdictions.
c. Community Health Assessment and Improvement Plan Support: $1,080,000
i. Four years of funding (yrs. 2-5) of statewide and targeted training and
technical assistance activities to support LHJs working to develop or update
CHA/CHIPS.
e. Allocations to Local Health Jurisdictions are included in Attachment 1: CASPHI
Allocation Table: Final.
Funding Requirements:
Non-Supplantation
a. 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.
b. 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. Please submit Attachment 5 by April 7, 2023. See
Attachment 5 Certification Form.
Required Staffing:
a. As a condition of receiving this funding, all recipients are required to have a
minimum of 1.0 FTE of staff capacity with roles and responsibilities dedicated to
advancing health equity and/or eliminating health disparities.
a. At the discretion of the LHJ, the 1 .0 FTE equity staffing threshold may be spread
over multiple positions, with a minimum of 0.5 fully dedicated FTE and the
remaining 0.5 FTE spread across additional positions.
b. LHJs may also demonstrate that they already have a 1 .0 FTE dedicated role for
this purpose through other funding sources.
b. A wide range of staff roles can fulfill this requirement, including leadership roles,
policy, program, data and community engagement functions. An equity focus
includes understanding and addressing health disparities affecting
disproportionately impacted populations that are higher risk and underserved,
including racial and ethnic groups, rural populations, those experiencing
socioeconomic disparities and other underserved communities. Activities related to
improving policies, systems and environments to more effectively serve communities
3
and address structural and social determinants of health would also address this
requirement. (Additional details and examples will be incorporated in the Funding
Reference Guide.) LHJs will determine the focus and position title based on local
needs.
c. The funding base of$495,000 has been set in order to cover a 1 .0 FTE Equity Staff
position for approximately 3.3 years at $150,000 [with the first two years of equity
staffing previously funded as part of the California Equitable Recovery Initiative
(CERI), Future of Public Health (FoPH) or other funds]. Additional funding through the
formula-based allocation is available to support additional workforce development
activities including training, recruitment, and incentives (additional details below).
d. Per CDC, all work under this funding initiative should be grounded in three key
principles:
a. The need for data and evidence to drive planning and implementation
b. The critical role that partnerships will play in success, and
c. The imperative to direct these resources in a way that supports health equity
CDC Funding Restrictions:
a. Recipients may not use funds for research.
b. Recipients may not use funds for clinical care except as allowed by law.
c. Generally, recipients may not use funds to purchase furniture or equipment.
d. Other than for normal and recognized executive-legislative relationships, no funds
may be used for:
a. Publicity or propaganda purposes, for the preparation, distribution, or use
of any material designed to support or defeat the enactment of
legislation before any legislative body
b. The salary or expenses of any contract recipient, or agent acting for such
recipient, related to any activity designed to influence the enactment of
legislation, appropriations, regulation, administrative action, or Executive
Order proposed or pending before any legislative body
Recipients may use funds only for reasonable program purposes, including personnel,
travel, supplies, and services.
4
See CDC's Fundinq Restrictions and Limitations for additional guidance and additional
guidance on lobbying for recipients.
Submission Requirements:
a. Complete and submit the Acknowledgement Letter on page 8 of this document by
March 3, 2023 and submit to CDPH at: CASPHILocalFundinq@cdph.ca.gov.
b. Complete and submit verification of information in the CDPH Form 9083 to
CASPHILocalFundinq@cdph.ca.gov (these documents will be emailed out in a
separate email with its own timeline).
c. Complete and submit a Workplan and Spend Plan by April 7, 2023, and submit to
CDPH at: CASPHILocalFundinq@cdph.ca.gov. See Attachment 2 CASPHI Work Plan
and Reporting and Attachment 3 CASPHI Spend Plan. Your Agency should consider
the following when developing your Workplan and Spend Plan:
a. Below is a list of sample activities that could be completed utilizing these CASPHI
funds:
i. Recruit and hire new public health staff. For example, this could include
expanding recruitment efforts, creating new positions, improving hiring
incentives, and creating new hiring mechanisms.
ii. Retain public health staff. For example, this could include strengthening
retention incentives, creating promotional opportunities, and transitioning
staff to other hiring mechanisms.
iii. Support and sustain the public health workforce. For example, this could
include strengthening workplace well-being programs and expanding
engagement with the workforce to address their mental, emotional, and
physical well-being.
iv. Train new and existing public health staff. For example, this could include
improving the quality and scope of training and professional development
opportunities for all staff.
v. Strengthen workforce planning, systems, processes, and policies. For
example, this could include maintaining and upgrading human resource
systems, identifying ways to better collect and use workforce data, and
identifying policies that could facilitate more efficient and effective
workforce development and management.
Reporting Requirements:
a. CDC requires semi-annual progress reporting from all recipients and subrecipients
(including CA LHJs). The report requires a hiring update in addition to progress on all
proposed activities in workplans and spend plans.
5
b. The initial progress report is tentatively projected to be due from CDPH to CDC by
the end of May 2023. Based upon this due date, please provide the first report by
May 26, 2023. Note, the dates in the below table may be adjusted based on CDC
submission requirements. We will notify you as soon as we know of any adjustments
to the below dates.
c. As a recipient of the California Strengthening Public Health Initiative funding, the
following reporting documents will be required:
a. Submit semi-annual progress reports on objective progress to CDPH following the
schedule below. Provide status of timelines, goals, and objectives outlined in your
workplan. 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. See Attachment 2 CASPHI Work Plan and Reporting.
Year/Quarter Reporting Period Due Date
Year 1/Re ort 1 December 1, 2022-April 30, 2023 May 26, 2023
Year 1/Re ort 2 May 1, 2023-October 31, 2023 November 21, 2023
Year 2/Report 1 November 1, 2023-April 30, 2024 May 24, 2024
Year 2/Report 2 May 1, 2024-October 31, 2024 November 26, 2024
Year 3/Report 1 November 1, 2024-April 30, 2025 May 30, 2025
Year 3/Report 2 May 1, 2025- October 31, 2025 November 25, 2025
Year 4/Report 1 November 1, 2025-April 30, 2026 May 29, 2026
Year 4/Report 2 May 1, 2026- October 31, 2026 November 24, 2026
Year 5/Report 1 November 1, 2026-April 30, 2027 May 28, 2027
Year 5/Report 2 May ], 2027- November 30, 2027 December 17, 2027
b. Submit semi-annual expenditure and hiring reports to CDPH following the
schedule below. Expenditure and hiring 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 3 CASPHI Spend Plan.
Year/Quarter Reporting Period Due Date
Year 1/Re ort 1 December 1, 2022-April 30, 2023 May 26, 2023
Year 1/Re ort 2 May 1, 2023- October 31, 2023 November 24, 2023
Year 2/Report 1 November 1, 2023-April 30, 2024 May 24, 2024
Year 2/Report 2 May 1, 2024- October 31, 2024 November 26, 2024
Year 3/Report 1 November 1, 2024-April 30, 2025 May 30, 2025
Year 3/Report 2 May 1, 2025-October 31, 2025 November 25, 2025
Year 4/Report 1 November 1, 2025-April 30, 2026 May 29, 2026
Year 4/Report 2 May 1, 2026-October 31, 2026 November 24, 2026
Year 5/Report 1 November 1, 2026-April 30, 2027 May 28, 2027
6
Year 5/Report 2 May 1, 2027- November 30, 2027 December 17, 2027
c. A CDPH representative will issue reminders as these dates get closer.
d. 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:
CASPHILocalFunding@cdph.ca.gov. See Attachment 4 Invoice.
a. First Payment: CDPH will issue a warrant (check) to your Agency for 25% of your total
allocation, this will be issued as an advance payment.
b. 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
Attachment 2 CASPHI Work Plan and Reporting and Attachment 3 CASPHI Spend
Plan following the due dates above within Reporting Requirements.
c. 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.
Thank you for the time your Agency has invested to strengthen our State's public health
infrastructure throughout our diverse communities. CDPH is hosting a webinar on March
20, 2023 from 4:00 PM- 5:00 PM to go over the requirements and activities of this
funding. A meeting notice will be sent through the CCLHO and CHEAC distribution lists .
If you have any questions or need further clarification, please reach out to
CASPHILocalFunding@cdph.ca.gov.
Sincerely,
Susan Fanelli
Chief Deputy Director
California Department of Public Health
7
Acknowledgement of Allocation Letter
Instructions: Please check one statement below, sign, and return to
CASPHILocalFundinq@cdph.ca.gov
LVCounty 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 understands that these funds cannot be delegated to another Agency.
OCounty of Fresno acknowledges receipt of this Allocation letter and does not accept
the funds. County of Fresno understands that CDPH will redistribute these funds.
Name of Local Health Jurr::.licfion designated signee(s):David Luchini, contingent upon approval
of the Board of Supervisors of the
Title/Role:Director of Public Health County of Fresno
:Signature of Local Health Jurisdiction desi nee s
9 g
Date:
Attachments
Attachment 1: CASPHI Allocation Table - Final
Attachment 2: CASPHI Work Plan and Reporting
Attachment 3: CASPHI Spend Plan
Attachment 4: Invoice
Attachment 5: Certification Form
8
LHJ SY AIIoc Annual
DRAFT
Total Funds $36,800,000 This allocation table is being provided to support LHJ planning.
Base $495,000 Formal allocation letters will be Issued to each LHJ.
FoPH CDC Public
pop weight Allocation Health 30'0%
r/e weight Annual, Infrastructure 35
.0%
povertywelght ongoing Grant 35.0%
Intracounty weight 70.0%
states share weight 30.0%
Alameda $6,537,374 N
Alpine $354,669 Y $583,129 $116,626
Amadar $487,482 Y $585,345 $117,069
Berkeley $912,213 y $650,928 $130,186
Butte $1,224,383 y $702,246 $140,449
Calaveras $515,889 Y $579,902 $115,980
Colusa $459,468 Y $671,895 $134,379
Contra Costa $4,844,667 y $1,099,733 $219,947
Del Norte $474,087 y $620,391 $124,078
El Dorado $1,015,644 Y $629,130 $125,826
Fresno $6,126,172 y $1,275,543 $255,109
Glenn $482,368 Y $655,654 $132,131
Humboldt $938,349 y $656,121 $131.224
Imperial $1,568,105 Y $863,102 $172,620
Inyo $423,621 Y $586,197 $117,239
Kern $5,381,815 Y $1,214,654 $242,931
Kings $1,175,930 Y $764,714 $152,943
Lake $641,433 y $639,437 $127,887
Lassen $481,278 Y $613,373 $122,675
Long Beach 52,807,624 N
Las Angeles $47,328,331 N
Madera $1,217,976 Y $774,736 $154,947
Marin $1,I41,952 y $662,487 $132,497
Mariposa $421,598 Y $583,092 $116,618
Mendocino $723,894 y $652,649 $130,530
Merced $1,882,112 y $857,180 $171,436
Modoc $394,124 y $600,891 $120,178
Mono $4O3,6Z9 y $600,701 $120,140
Monterey $2,563,477 y $909,993 $182,999
Napa $896,612 Y $659,137 $131,927
Nevada $690,079 y $599,133 $119,927
Orange $13,351,733 N
Pasadena 51,033,025 N
Placer $1,661,462 y $702,722 $140,544
Plumas $420,397 Y $567,056 $113,411
Riverside $11,792,061 N
Sacramento $7,072,450 N
San Benito $647,267 Y $675,929 $135,186
San Bernardino $11,294,416 N
San Diego $14,356,108 N
San Francisco $3,639,898 N
San Joaquin $4,031,505 Y $1,044,258 $208,852
San Luis Obispo $1,459,610 Y $705,237 $141,047
San Mateo $3,141,653 Y $895,310 $179,062
Santa Barbara $2,433,999 y $866,749 $173,350
Santa Clara $7,296,326 N
Santa Cruz $1,475,452 Y $741,903 $148,381
Shasta $1,031,190 Y $653,729 $130,746
Sierra $362,059 Y $574,667 $114,933
Siskiyou $538,801 Y $609,957 $121,991
Salano $2,196,187 y $815,435 $163,087
Sonoma $2,174,091 y $798,378 $159,676
Stanislaus $2,975,808 y $940,385 $188,077
Sutter $797,927 y $669,116 $133,023
Tehama $642,801 y $660,258 $132,052
Trinity $405,254 y $595,221 $119,13"
Tulare $3,085,604 Y $1,001,705 $200,341
Tuolumne $543,960 y $590,734 $119,147
Ventura $3,857,269 y $1,015,997 $203,199
Yolo $1,357,659 y $733,179 $146,636
Yuba $707,793 y $650,584 $130,117
Total(and N funded) s0 $36,800,000 $7,360,000
Highest Award $1,275,543
Lowest Award $567,056
p LHJ>$IM(SY) 6
Minimum Fund Le-1 $567,000
g LHJ above min,fund level(5Y) so
%above 10D%
Mini-m Fund Level Calculation
Per FTE Cost $ 150,000
%FTE Required 1.00
Years 3.3
Base Level to cover Equity5taffing $ 495,000
Formula based allocation Imin) 13%
Other Workforce Dev Activities oftotalaward $ 72,000
Minimum target fund level per LHJ $ 567,000
(staffing and additional activities
State of California—Health and Human Services Agency
K r.
R{ California Department of Public Health a„
COPH
TOMAS J.ARAGON,MD,DrPH GAVIN NEWSOM
Director and State Public Health Officer Governor
CALIFORNIA STRENGTHENING PUBLIC HEALTH
INITIATIVE FUNDING CERTIFICATION
The undersigned hereby affirms that they have read and agree with the funding
requirements specified in the California Strengthening Public Health Initiative
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.
Designee authorized to commit the Local Health Jurisdiction to this Agreement
Sa I Quintero Chairman of the Board of Supervisors of the County of Fresno
Name (Print) Title
sa " 5 a3 -23
Sign toe U Date
County of Fresno
Local Health Jurisdiction Name
CASPH 10010
Agreement Number
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of California
By Deputy
a\i[ALrk pr
CDPH Director's Office • P.O. Box 997377 • Sacramento, CA 95899-7377
(916) 650-6416 9 (916) 650-6420 FAX
Internet Address: www.cdph.ca.gov ° a
State of California—Health and Human Services Agency
California De artment of Public Health
!)COPH p a
Tomas Aragon,MD,DrPH GAVIN NEW50M
Director Governor
Date: February 14, 2023
To: California Local Health Jurisdictions (LHJs)
From: California Department of Public Health (CDPH)
Subject: Overview of Centers for Disease Control and Prevention (CDC) Strengthening
U.S. Public Health Infrastructure, Workforce, and Data Systems Grant Award
I. Purpose
This memo provides LHJs with an overview of the CDC award for the above-mentioned grant
funding, which is for a full five years. California's infrastructure funding is the California
Strengthening Public Health Initiative (CASPHI).
On December 4, 2022, CDPH received a Notice of Award (NOA) from CDC for CASPHI. CDPH
applied for funding in all three strategies (All Workforce, A2 Foundational Capabilities, and A3
Data Modernization) and was approved for all three strategies. However, the A3 Data
Modernization strategy funding is still pending and is currently unfunded by CDC. CDPH will
allocate funds to LHJs as part of the Al Workforce strategy.
II. CASPHI Grants
The grant award start date was December 1, 2022. The annual grant periods are below:
Year 1 December 1, 2022 — November 30, 2023
Year 2 December 1, 2023 — November 30, 2024
Year 3 December 1, 2024 — November 30, 2025
Year 4 December 1, 2025 — November 30, 2026
Year 5 December 1, 2026 — November 30, 2027
Funding: The California Strengthening Public Health Initiative (CASPHI) includes $36,822,154
million for direct allocation to participating local health jurisdictions.
Here is a link to the funding allocation spreadsheet which lists the amount of annual and five-
year total award amounts for each eligible and participating LHJ.
Required Staffing:
As a condition of receiving this funding, all recipients are required to have a minimum of 1.0 FTE
of staff capacity with roles and responsibilities dedicated advancing health equity and/or
eliminating health disparities.
Office of Policy and Planning ♦ MS 0514, P.O. Box 997377, Sacramento, CA 95899-7377
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A wide range of staff roles can fulfill this requirement, including leadership roles, policy, program,
data, and community engagement functions. An equity focus includes understanding and
addressing health disparities affecting disproportionately impacted populations that are higher
risk and underserved, including racial and ethnic groups, rural populations, those experiencing
socioeconomic disparities and other underserved communities. Activities related to improving
policies, systems and environments to more effectively serve communities and address
structural and social determinants of health would also address this requirement. (Additional
details and examples will be incorporated in the Funding Reference Guide.) LHJs will determine
the focus and position title based on local needs.
The funding base of $495,000 has been set in order to cover a 1.0 FTE Equity Staff position for
approximately 3.3 years at $150,000 [with the first two years of equity staffing previously funded
as part of the California Equitable Recovery Initiative (CERI), Future of Public Health (FoPH) or
other funds]. Additional funding through the formula-based allocation is available to support
additional workforce development activities including training, recruitment, and incentives
(additional details below).
Additional Details:
• At the discretion of the LHJ, the 1.0 FTE equity staffing threshold may be spread over
multiple positions, with a minimum of 0.5 fully dedicated FTE and the remaining 0.5 FTE
spread across additional positions.
• LHJs may also demonstrate that they already have a 1.0 FTE dedicated role for this purpose
through other funding sources.
• Per CDC, all work under this funding initiative should be grounded in three key principles:
• The need for data and evidence to drive planning and implementation
• The critical role that partnerships will play in success, and
• The imperative to direct these resources in a way that supports health equity
CDPH plans to issue a 25% advanced payment to eligible and participating LHJs. If an
LHJ wishes to decline the advance payment, please send an email to
CAS PHI Local Funding c-Dcdph.ca.gov stating "no advance payment". If an advance payment is
declined, the LHJ is still eligible to receive the full allocation and would follow CDPH invoicing
processes.
LHJ Eligibility Criteria: Any LHJ that did not receive direct CDC funding will be included in
CDPH's allocation process. CDPH collaborated with the County Health Executives Association
of California (CHEAC), the California Conference of Local Health Officers (CCLHO), and other
stakeholders to finalize funding formulas for this allocation. Per CDC, local governments
(includes county, city, and townships) serving a 1) a county population of 2,000,000 or more or
a city population of 400,000 or more were eligible to apply to the CDC for direct funding.
Number of LHJ allocation recipients: Effective FY 2022-23, $36,822,154 will be allocated to
fifty (50) of the sixty-one (61) LHJs in California. Eleven (1.1) LHJs are receiving funding directly
from the CDC and will not be part of this CDPH allocation process. Below are the LHJs
receiving direct funding from the CDC.
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Office of Policy and Planning ♦ MS 0514, P.O. Box 997377, Sacramento, CA 95899-7377
(916) 552-9800 ♦ FAX (916) 552-9810 ♦ Internet Address:www.cdph.ca.gov
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List of LHJs who will receive direct funding from CDC
1. Alameda County Health Department
2. County of Riverside Department of Public Health
3. County of San Diego Health and Human Services Agency
4. Long Beach Health Department
5. Los Angeles County Department of Public Health (Includes the City of Pasadena)
6. Orange County Health Care Agency
7. Sacramento County Health Department
8. San Bernardino County-Department of Public Health
9. San Francisco Department of Public Health
10. Santa Clara County Health Department
Timeline: CDPH anticipates issuing individual allocation letters and funding guidance to
LHJs by the end of February 2023. Work plan and spend plan templates will be provided with the
allocation package for LHJs to complete and return to CDPH.
In addition to the direct allocation of funds to the 50 participating LHJs, CDPH will also
coordinate the use of additional CASPHI grant funds for statewide activities to support all 61
local heath jurisdictions.
1. Hire a vendor to conduct a Local Public Health Workforce Assessment $2,000,000
Potential areas of focus for this assessment will include a compensation
study comparing salary rates across local public health agencies as well
as private sector and health care rates for similar positions, identifying
recommended staffing levels for foundational capabilities as well as
expanded multisector functions of public health, and workforce diversity.
2. Support Public Health Capacity Building $1,010,404
Targeted local assistance contract funding for equity-focused
community-based organizations to provide capacity building support to
local health jurisdictions.
3. Community Health Assessment and Improvement Plan Support $1,080,000
Four years of funding (YRs 2-5) of statewide and targeted training and
technical assistance activities support LHJs working to develop or
update CHA/CHIPs
CASPHI Informational Webinar: CDPH is planning to hold an informational webinar to
provide additional details once all allocation letters have been distributed. The date and time
of the webinar will be provided with individual LHJ allocation letters.
Contact Information: For questions related to this funding stream, please email
CAS PHI Local Funding(aD-cdph.ca.gov.
Office of Policy and Planning ♦ MS 0514, P.O. Box 997377, Sacramento, CA 95899-7377
(916) 552-9800 ♦ FAX (916) 552-9810 ♦ Internet Address:www.cdph.ca.gov
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III. Reporting Requirements
The CDC is requiring semi-annual progress reporting from all recipients and subrecipients
(including California LHJs). The report will require progress updates on all proposed activities
in workplans, and progress on expenditures identified in spend plans.
The initial progress report is tentatively projected to be due to from CDPH to the CDC by the
end of June 2023. Based upon this due date, CDPH anticipates requesting a hiring status
update from all participating LHJs by mid-May 2023. Additional information on progress
reporting dates and reporting templates will be provided in the individual allocation letters.
IV. Formula-Based Allocation Details
The formula-based allocation is designed to emphasize a focus on equity based on several
factors. The formula-based allocation is using three weighted inputs: 30% population, 35%
poverty, and 35% demographic diversity. These inputs are calculated using hybrid weighting
that incorporate the proportion of the total statewide population (at 30%) and the percentage
of the total LHJ population (at 70%) for which these inputs apply.
The overall allocation funding model has been developed to address the CDC grant focus on
strengthening public health infrastructure and advancing capacity to address equity.
Both the level of the base and the formula structure are set in order to provide a stable
funding level LHJs with smaller populations and a high percentage of residents experiencing
disadvantage, as well as to augment funding for LHJs which may represent a large
proportion of the statewide population experiencing disadvantage.
V. CDC Grants Sample Activities and Funding Restrictions
Below is a list of sample activities that could be completed utilizing these CASPHI grant funds:
1. Recruit and hire new public health staff. For example, this could include expanding
recruitment efforts, creating new positions, improving hiring incentives, and creating new
hiring mechanisms.
2. Retain public health staff. For example, this could include strengthening retention
incentives, creating promotional opportunities, and transitioning staff to other hiring
mechanisms.
3. Support and sustain the public health workforce. For example, this could include
strengthening workplace well-being programs and expanding engagement with the
workforce to address their mental, emotional, and physical well-being.
4. Train new and existing public health staff. For example, this could include improving the
quality and scope of training and professional development opportunities for all staff.
5. Strengthen workforce planning, systems, processes, and policies. For example, this
could include maintaining and upgrading human resource systems, identifying ways to
better collect and use workforce data, and identifying policies that could facilitate more
efficient and effective workforce development and management.
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Office of Policy and Planning ♦ MS 0514, P.O. Box 997377, Sacramento, CA 95899-7377
(916) 552-9800 ♦ FAX (916) 552-9810 ♦ Internet Address: www.cdph.ca.gov
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CDC Funding Restrictions
• Recipients may not use funds for research.
• Recipients may not use funds for clinical care except as allowed by law.
• Generally, recipients may not use funds to purchase furniture or equipment. (Equipment
is defined as a single unit cost exceeding $5,000.)
• Other than for normal and recognized executive-legislative relationships, no funds may
be used for:
Publicity or propaganda purposes, for the preparation, distribution, or use of any
material designed to support or defeat the enactment of legislation before any
legislative body
• The salary or expenses of any grant or contract recipient, or agent acting for such
recipient, related to any activity designed to influence the enactment of legislation,
appropriations, regulation, administrative action, or Executive order proposed or
pending before any legislative body
Recipients may use funds only for reasonable program purposes, including personnel,
travel, supplies, and services.
See CDC's Funding Restrictions and Limitations for additional guidance and additional guidance
on lobbying for recipients.
Office of Policy and Planning ♦ MS 0514, P.O. Box 997377, Sacramento, CA 95899-7377
(916) 552-9800 ♦ FAX (916) 552-9810 ♦ Internet Address:www.cdph.ca.gov