HomeMy WebLinkAbout29166Board Agenda Item 36
DATE:January 31, 2017
TO:Board of Supervisors
SUBMITTED BY:David Pomaville, Director, Department of Public Health
SUBJECT:Revenue Agreement with the California Department of Public Health
RECOMMENDED ACTION(S):
Approve and authorize the Chairman to execute a revenue Agreement with the California Department of
Public Health, for Core Sexually Transmitted Disease Program Management, effective January 31, 2017
through June 30, 2019 ($153,666).
Approval of the recommended action will provide one-time funding from the California Department of Public
Health (CDPH), Sexually Transmitted Disease (STD) Control Branch to support STD prevention activities.
These funds will enhance efforts to address syphilis in the County by funding one (1) Office Assistant position
and the associated indirect costs. The Agreement allows indirect cost recovery for salaries and benefits, with no
increase in Net County Cost.
ALTERNATIVE ACTION(S):
No viable options are available. Should your Board not approve the recommended action, the Department
would be unable to further enhance STD services for County residents.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum
compensation for FY 2016-17 is $26,200; $153,666 for the term of the agreement. The funds will cover the
salary and benefits for one (1) Office Assistant position, which is currently offset by Health Realignment.
Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2016-17
adopted budget and will be requested in subsequent budgets. The Agreement allows indirect cost recovery for
salaries and benefits of 15%; the Department’s current indirect rate is 15.873%, the remaining .873% ($1,351)
will be offset by Health Realignment.
DISCUSSION:
STDs are the most common communicable diseases reported annually in the County. Gonorrhea, chlamydia,
and syphilis represent 77% of the total 12,133 reportable communicable diseases in the County. The proposed
agreement for one-time funding is being focused in response to the syphilis epidemic as referenced in the Board
Briefing Report entitled “California Department of Public Health Sexually Transmitted Disease Control Branch
and Center for Disease Control and Prevention Assistance in Addressing Syphilis in Fresno County”, dated
February 26, 2016. The rate of syphilis cases continued to rise in 2016 (Attachment A). The proposed funding
will support response to the syphilis epidemic data entry activities conducted by State assigned staff through
December 2016, allowing the Department to assess at the end of the proposed agreement term whether the
resource is necessary to continue supporting Core STD Program Management.
Page 1 County of Fresno File Number: 16-1615
File Number: 16-1615
On October 13, 2015 your Board approved Agreement No. 15-524 a four-year agreement with the STD Control
Branch which supports prevention, treatment and intervention activities. The recommended agreement will
provide additional funding to ensure accurate and timely data entry into the State’s web-based California
Reportable Disease Information Exchange (CalREDIE) system. The CalREDIE system captures
demographical, laboratory, clinical and case investigation information for reporting purposes.
The agreement includes language that if the State identifies a conflict of interest, the County will have five
working days to respond. Following the five days, the State may either grant additional time to resolve the
conflict or terminate the agreement. The Agreement contains non-standard County general indemnification and
intellectual property indemnification provisions, which require the County to indemnify and defend the State.
The agreement may be cancelled or terminated without cause by the State with 30 calendar days advance
written notice. The State may cancel immediately for cause. The County may cancel only if the State fails to
perform its responsibilities.
REFERENCE MATERIAL:
BBR - February 26, 2016
BAI #49, October 13, 2015, Agreement No. 15-524 with CDPH
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Attachment A
On file with Clerk - Agreement with CDPH
CAO ANALYST:
Sonia De La Rosa
Page 2 County of Fresno File Number: 16-1615
Syphilis: Annual and Secular Trends with Demographic Descriptive Statistics 2007-2015
Attachment A
Table 1: Number of cases and incidence rates of Primary and Secondary Syphilis, 2015.
Primary & Secondary Congenital
Cases Rate Cases Rate
Fresno County 268 27.3 40 243.4
State of California 4,890 9.9 142 28.2
*Data provided by CDPH
Table 2: Race/Ethnicity Distribution of Primary and Secondary Syphilis Cases, 2015.
Gender** Age
Cases Rate* %Male %Female Mean Std. Dev. Min Max
American Indian/Alaskan Native 2 30.6 100 0 40 --*** --*** --***
Asian/Pacific Islander 7 7.4 100 0 27 9.9 19 47
Black/African American 36 75.3 61 39 35 13.3 16 65
Hispanic/Latino 116 22.8 64 36 33 11.2 15 69
White 84 27.6 52 48 35 11.7 19 78
Other 23 128.3 74 26 35 12.4 20 60
Total 268 27.3 62 38 34 11.8 15 78
*Annual incidence rate per 100,000 population based on 2014 population figures.
**Figures may not add up to 100% remainders were either of unknown gender or transgendered.
***Data was supressed to protect
identities.
0
5
10
15
20
25
30
35
Number of CasesMonth
Figure 1: Primary & Secondary Syphilis by Month, Fresno County,
2015.
1 2.8 2.6 1.5 3
5.8
10.4
12.3
27.3
5.7 5.9 5.5 5.5 6.5
7.9
9.3 9.9
12.5
0
5
10
15
20
25
30
2007 2008 2009 2010 2011 2012 2013 2014 2015Annual Incidence Rate(per 100,000 population) Years
Figure 2: Primary and Secondary Syphilis: Annual Trends
2007 -2015*.
Primary & Secondary Fresno County Rate Primary & Secondary State Rate
*Data from CDPH
Syphilis: Annual and Secular Trends with Demographic Descriptive Statistics 2007-2015
Attachment A
0
2
4
6
8
10
12
Number of CasesMonth
Figure 3: Congenital Syphilis by Month, Fresno County, 2015.
30.7
18.4 12.4 12.5
89
114
243.4
12.5 15 12.1 11.6 9.2 6.6 11.7 20.3 28.2
0
50
100
150
200
250
2007 2008 2009 2010 2011 2012 2013 2014 2015Annual Incidence Rate (per 100,000 population)Year
Figure 4: Congenital Syphilis: Annual Trends 2007-2015*.
Congenital Fresno County Rate Congenital State Rate