HomeMy WebLinkAboutAgreement A-20-471 Acceptance of Award from CDPH for ELC.pdfACCEPTANCE OF AWARD
County of Fresno, Department of Public Health
Base Award: $11,672,782
Base Award Number: COVID-19ELC11
Strategy 1: $907,858
Strategy 2: $3,300,000
Strategy 3: $500,000
Strategy 4: $364,462
Strategy 5: 5,967,122
Strategy 6: $633,340
Funding Period: May 18, 2020 through November 17, 2022
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Agreement No. 20-471
I hereby accept this award . By accepting this award , I agree to the requirements as
described in the COVID-19 ELC Enhancing Detection Funding Direct Allocation
Letter and any other conditions stipulated by the California Department of Public
Health .
~E-::::::::::--~~-?--1.L A1..-,~~I ~~~~
Authorized Signature
Print Name
ATTEST:
BERNICE E. SEIDEL
Clerk of the Board of Supervisors
Cou~n of Fresno State of California
By -~1 • (\ ¾ B,,
puty
Date
~~~~~
Title 1
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1.The LHJ ELC Enhancing Detection Workplan is due on or before August 31, 2020 by COB
a. The workplan should be emailed to CDPHELC@cdph.ca.gov
b. Enter the name of the LHJ on the top of the page on each tab.
2.Progress reports are due quarterly.
a. Progress reports are due by the 30th of the month following the end of the quarter.
b. The progress report is entered on every tab of the spreadsheet beginning on Column F.
c. The progress report should be emailed by the due date to CDPHELC@cdph.ca.gov.
3.Strategy Tabs
a. There are 6 strategies in the CDC ELC Enhancing Detection.
b. Please enter the name of the LHJ at the top of the page on each tab.
c. Enter data into unshaded areas only.
d.Each Strategies Actions and Deliverables (in cell B7) must be addressed, but the LHJ can
define other activities and add a milestone. If the Strategies Actions and Deliverables do not
apply to the LHJ, please state "Not Applicable".
4.Performance Measures
a. CDC Epidemiology and Laboratory Capacity (ELC) Program will be developing Performance
Measures for the ELC Enhancing Detection strategies. The LHJ may be asked to submit
information/data to meet the requirements of Performance Measures during the course of the
funding period.
EPIDEMIOLOGY AND LABORATORY CAPACITY (ELC)
aycheck Protection Program and Health Care Enhancement Act of 202
Local Health Jurisdiction (LHJ)
INSTRUCTIONS
Workplan & Progress Report
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Local Health Jurisdiction Name:Fresno County
Grant Number:6 NU50CK000539‐01‐10
Strategy 1 Actions and Deliverables:
Strategy 1 ‐
Milestone 1
Planned Activity
(Provide a title for this milestone)
Onboard clerical staff to increase lab and epidemiology workflow productivity
Applicant capacity: What is the current
capacity to perform this milestone?
Management support and infrastructure needed to recruit and onboard positions
Expected achieve by date: December 2020
Expected Achieve By Date
(select from drop down)
Strategy 1 ‐
Milestone 2
Planned Activity
(Provide a title for this milestone)
CDC ‐ Epidemiology and Laboratory Capacity (ELC) Paycheck Protection Program and Health Care
Enhancement Act of 2020
Strategy 1 ‐ Enhance Laboratory, Surveillance, Informatics and other Workforce
Capacity
Implementation Plan
(Bulleted items or brief sentences)
Identify and train full time leads for Medical Investigation Team (MIT) and School
Settings Investigation Teams (SSIT). Review, adapt and create work processes for
A. Train and hire staff to improve laboratory workforce ability to address issues around laboratory safety, accessioning, testing
and reporting results.
B. Build expertise for healthcare and community outbreak response and infection prevention and control (IPC) among local
health departments.
C. Train and hire staff to improve the capacities of the epidemiology and informatics workforce to effectively conduct
surveillance and response of COVID‐19 (including contact tracing) and other conditions of public health significance.
D. Build expertise to support management of the COVID‐19 related activities within the jurisdiction and the integrate into the
broader ELC portfolio of activities (e.g., additional leadership, program and project managers, budget staff, etc.).
E. Increase capacity for timely data management, analysis, and reporting for COVID‐19 and other conditions of public health
significance.
Strategy 1: Enhance Laboratory, Surveillance, Informatics and other Workforce Capacity
Strategy 1: Enhance Laboratory, Surveillance, Informatics and other Workforce Capacity
Implementation Plan
(Bulleted items or brief sentences)
* Hire 8 Program Techicians to increase testing and reporting capacity
* Train new clerical staff on CalREDIE, RedCAP, LIMS and other information
management systems required to process lab and epi data to improve timeliness
of surveillance and response activities, including contact tracing
* Update existing training materials as needed
Build COVID response stucture for investigations of individual cases and those in high
risk settings including schools.
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Applicant capacity: What is the current
capacity to perform this milestone?
Currently 1 Communicable Disease Specialist will be trained as a lead for the SSIT
team. Additional support staff of 10 CDSs will be hired on in September.
Expected achieve by date: December 2020
Expected Achieve By Date
(select from drop down)
Strategy 1 ‐
Milestone 3
Planned Activity
(Provide a title for this milestone)
Increase management and support structure for COVID response to evaluate
program data and complete quality assurance measures
Applicant capacity: What is the current
capacity to perform this milestone?
At this time there are no leads identified for the case assignment team. 1 current
PT and PHN are training two new PTs to assist with this component of the
response.
Expected achieve by date: December 2020
Expected Achieve By Date
(select from drop down)
Strategy 1 ‐
Milestone 4
Planned Activity
(Provide a title for this milestone)
Strategy 1: Enhance Laboratory, Surveillance, Informatics and other Workforce Capacity
Implementation Plan
(Bulleted items or brief sentences)
MIT and SSIT teams. Hire 10 CDSs for SSIT to manage school outbreaks.
Implementation Plan
(Bulleted items or brief sentences)
Hire and train full time Program Technician lead for case assignment team and
data management, quality assurance components of COVID response. Due
October/November 2020
Strategy 1: Enhance Laboratory, Surveillance, Informatics and other Workforce Capacity
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Applicant capacity: What is the current
capacity to perform this milestone?
Expected Achieve By Date
(select from drop down)
Strategy 1 ‐
Milestone 5
Planned Activity
(Provide a title for this milestone)
Applicant capacity: What is the current
capacity to perform this milestone?
Expected Achieve By Date
(select from drop down)
Strategy 1: Enhance Laboratory, Surveillance, Informatics and other Workforce Capacity
Implementation Plan
(Bulleted items or brief sentences)
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Local Health Jurisdiction Name:Fresno County
Grant Number:6 NU50CK000539‐01‐10
Strategy 2 Actions and Deliverables:
Strategy 1 ‐
Milestone 1
Planned Strategy
(Provide a title for this milestone)
Improve capacity for testing in the laboratory up to 1,500 tests per day.
Applicant capacity: What is the current
capacity to perform this milestone?
Management of all milestones are effectively in place now.
Expected achieve by date: December 2020
Expected Achieve By Date
(select from drop down)
Strategy 1 ‐
Milestone 2
Planned Strategy
(Provide a title for this milestone)
Increase testing capacity with existing medical providers and provide testing outreach
mobile clinics to the vulnerable population within Fresno County.
Strategy 2 ‐ Strengthen Laboratory Testing
* Establish contracts with all FQHC's
* Establish contracts with all rural health clinics
* Establish contracts with community based organizations to provide health education
outreach, quarantine supports and testing locations.
* Ongoing management of FQHC contracts
CDC ‐ Epidemiology and Laboratory Capacity (ELC) Paycheck Protection Program and Health Care
Enhancement Act of 2020
Strategy 2 ‐ Strengthen Laboratory Testing
Strategy 2 ‐ Strengthen Laboratory Testing
Implementation Plan
(Bulleted items or brief sentences)
* Add 2 Microbiologists ‐ Train on Covid Protocols.
* Add 4 lab Technician Staff ‐ Train on Covid protocols.*
Complete new building lab construction by October 2020.*
Validate all Covid Testing Equipment
C. Enhance data management and analytic capacity in public health laboratories to help improve efficiencies in operations,
management, testing, and data sharing.
A. Establish or expand capacity to quickly, accurately and safely test for SARS‐CoV‐2/COVID‐19 (which may build capacity to test
for other pathogens with potential for broad community spread) among all symptomatic individuals, and secondarily expand
capacity to achieve community‐based surveillance, including testing of asymptomatic individuals.
B. Enhance laboratory testing capacity for SARS‐CoV‐2/COVID‐19 outside of public health laboratories
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Applicant capacity: What is the current
capacity to perform this milestone?
There is existing management capacity to facilitate this milestone
Expected achieve by date: November 2022
Expected Achieve By Date
(select from drop down)
Strategy 1 ‐
Milestone 3
Planned Strategy
(Provide a title for this milestone)
Enhance data management of testing results.
Applicant capacity: What is the current
capacity to perform this milestone?
LIMS purchased and workflows established
Expected achieve by date: December 2020
Expected Achieve By Date
(select from drop down)
Strategy 1 ‐
Milestone 4
Planned Strategy
(Provide a title for this milestone)
Applicant capacity: What is the current
capacity to perform this milestone?
Expected Achieve By Date
(select from drop down)
Strategy 2 ‐ Strengthen Laboratory Testing
Strategy 2 ‐ Strengthen Laboratory Testing
Implementation Plan
(Bulleted items or brief sentences)
Strategy 2 ‐ Strengthen Laboratory Testing
Implementation Plan
(Bulleted items or brief sentences)
*Continue to implement web‐based LIMS system with OrchardSoft Copia (lab ordering)
and Harvest (lab machine automatic reporting interface) (utilizing existing funding)
* Revise lab test ordering and reporting workflow as necessary to improve system
capability
* Onboard and train new lab staff on LIMS
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Strategy 1 ‐
Milestone 5
Planned Strategy
(Provide a title for this milestone)
Applicant capacity: What is the current
capacity to perform this milestone?
Expected Achieve By Date
(select from drop down)
Implementation Plan
(Bulleted items or brief sentences)
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Local Health Jurisdiction Name:Fresno County
Grant Number:6 NU50CK000539‐01‐10
Strategy 3 Actions and Deliverables
Strategy 3 ‐
Milestone 1
Planned Strategy
(Provide a title for this milestone)
Create database systems for CBO connections into local County contract tracing
database.
Applicant capacity: What is the current
capacity to perform this milestone?
Database system in place November 2020
Expected Achieve By Date
(select from drop down)
Strategy 3 ‐
Milestone 2
Planned Strategy
(Provide a title for this milestone)
Implement PrepMod pandemic response system
Applicant capacity: What is the current
capacity to perform this milestone?
In process of purchasing PrepMod system.
Expected achieve by date: December 2021
Implementation Plan
(Bulleted items or brief sentences)
* Tracking of isolation/Quarantine Supports and tracking of labor to document
compliance with COVID Equity Project scope of work categories *Make
available lab results to CBO partners to determine Iso/Quar Supports
* Management of Iso/Quar Supports database
CDC ‐ Epidemiology and Laboratory Capacity (ELC) Paycheck Protection Program and Health Care
Enhancement Act of 2020
Strategy 3 ‐ Advance Electronic Data Exchange at Public Health Labs
A. Enhance and expand laboratory information infrastructure, to improve jurisdictional visibility on laboratory data (tests
performed) from all testing sites and enable faster and more complete data exchange and reporting.
Strategy 3 ‐ Advance Electronic Data Exchange at Public Health Labs
Strategy 3 ‐ Advance Electronic Data Exchange at Public Health Labs
Implementation Plan
(Bulleted items or brief sentences)
* Purchase PrepMod pandemic response system from Multi‐State Partnership for
Prevention, including online patient consent form, clinic management system, and
automated social‐distancing and PPE/supply management (utilizing existing funding)
* Set‐up and customize interface, including translation to Spanish and Hmong
* Complete data transfer from existing electronic health information system(s)
* 2‐3 training webinars for staff and users
* Implement full system for patient scheduling, integration of lab testing/LIMS, and
online resulting to patients
* Upon vaccine availability, connect implemented system with CAIR/other IIS systems
to improve testing and vaccination reporting
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Expected Achieve By Date
(select from drop down)
Strategy 3 ‐
Milestone 3
Planned Strategy
(Provide a title for this milestone)
Applicant capacity: What is the current
capacity to perform this milestone?
Expected Achieve By Date
(select from drop down)
Strategy 3 ‐
Milestone 4
Planned Strategy
(Provide a title for this milestone)
Applicant capacity: What is the current
capacity to perform this milestone?
Expected Achieve By Date
(select from drop down)
Strategy 3 ‐
Milestone 5
Planned Strategy
(Provide a title for this milestone)
Strategy 3 ‐ Advance Electronic Data Exchange at Public Health Labs
Implementation Plan
(Bulleted items or brief sentences)
Strategy 3 ‐ Advance Electronic Data Exchange at Public Health Labs
Implementation Plan
(Bulleted items or brief sentences)
Strategy 3 ‐ Advance Electronic Data Exchange at Public Health Labs
Implementation Plan
(Bulleted items or brief sentences)
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Applicant capacity: What is the current
capacity to perform this milestone?
Expected Achieve By Date
(select from drop down)
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Local Health Jurisdiction Name:Fresno County
Grant Number:6 NU50CK000539‐01‐10
Strategy 4 Actions and Deliverables:
Strategy 4 ‐
Milestone 1
Planned Strategy
(Provide a title for this milestone)Increase Epidemiology capacity for data analysis
* Hire 1 Epidemiologist (25% FTE) to increase analysis capacity
* Train Epidemiologist on data collection systems and COVID‐19 data and processes
required for analysis
Applicant capacity: What is the current
capacity to perform this milestone?
Epidemiology Program established, management support, and infrastructure needed in
place to recruit and train position available.
Expected Achieve By Date
(select from drop down) Expected Achieve Date: 11‐01‐2020
Strategy 4 ‐
Milestone 2
Planned Strategy
(Provide a title for this milestone)Increase statistical software available for epidemiological analysis
* Purchase and install SAS software for new positions
* Train Epidemiologist software coding needed to conduct COVID‐19 analyses
Strategy 4 ‐ Improve Surveillance and Reporting of Electronic Health Data
Implementation Plan
(Bulleted items or brief sentences)
Strategy 4 ‐ Improve Surveillance and Reporting of Electronic Health Data
Implementation Plan
(Bulleted items or brief sentences)
D. Enhance systems for flexible data collection, reporting , analysis, and visualization.
E. Establish or improve systems to ensure complete, accurate and immediate (within 24 hrs) data transmission to a system and
open website available to local health officials and the public by county and zipcode, that allows for automated transmission of
data to the CDC in a machine readable format.
CDC ‐ Epidemiology and Laboratory Capacity (ELC) Paycheck Protection Program and Health Care
Enhancement Act of 2020
Strategy 4 ‐ Improve Surveillance and Reporting of Electronic Health Data
A. Establish complete, up‐to‐date, automated reporting of morbidity and mortality to CDC and others due to COVID‐19 and other
conditions of public health significance, with required associated data fields in a machine readable format.
B. Establish complete, up‐to‐date, timely, automated reporting of individual‐level data through electronic case
reporting to CDC and others in a machine‐readable format (ensuring LHD have access to data that is reported).
C. Improve understanding of capacity, resources, and patient impact at healthcare facilities through electronic reporting.
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Applicant capacity: What is the current
capacity to perform this milestone?
Epidemiology Program supervisor can conduct training required
Expected Achieve By Date
(select from drop down)Expected Achieve Date: 12‐01‐2020
Strategy 4 ‐
Milestone 3
Planned Strategy
(Provide a title for this milestone)Increase IT COVID‐19 Database support to assist with data collection
* Onboard IT staff and resources required to improve data collection and visualization
* Update resources as needed
Applicant capacity: What is the current
capacity to perform this milestone?
Infrastructure in place to develop additional resources
Expected Achieve By Date
(select from drop down)Expected Achieve Date: 01‐01‐2021
Strategy 4 ‐
Milestone 4
Planned Strategy
(Provide a title for this milestone)Increase statistical capacity for data analysis
Applicant capacity: What is the current
capacity to perform this milestone?
Epidemiology Program established to work with the biostatistician
Expected Achieve By Date
(select from drop down) Expected Achieve Date: 12‐1‐2021
Strategy 4 ‐ Improve Surveillance and Reporting of Electronic Health Data
Strategy 4 ‐ Improve Surveillance and Reporting of Electronic Health Data
Implementation Plan
(Bulleted items or brief sentences)
Strategy 4 ‐ Improve Surveillance and Reporting of Electronic Health Data
Implementation Plan
(Bulleted items or brief sentences)
Establish a contract with a biostatistician/biostatistician group to provide consulting
services for advanced statistical analysis associated with COVID‐19.
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Strategy 4 ‐
Milestone 5
Planned Strategy
(Provide a title for this milestone)
Applicant capacity: What is the current
capacity to perform this milestone?
Expected Achieve By Date
(select from drop down)
Implementation Plan
(Bulleted items or brief sentences)
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Local Health Jurisdiction Name:Fresno County
Grant Number:6 NU50CK000539‐01‐10
Strategy 5 Actions and Deliverables:
Strategy 5 ‐
Milestone 1
Planned Strategy
(Provide a title for this milestone)
Increase COVID‐19 containment capacity to manage high risk groups.
Applicant capacity: What is the current
capacity to perform this milestone?
Current capacity is 3 part time and 3 full time staff to manage the congregate senior
living facilities.
Expected Achieve date Nov 2020
Expected Achieve By Date
(select from drop down)
Strategy 5 ‐
Milestone 2
Planned Strategy
(Provide a title for this milestone)
Increase investigation and response capacity of COVID‐19 to manage high risk
populations including congregate settings and schools
Strategy 5 ‐ Use Laboratory Data to Enhance Investigation, Response and Prevention
Implementation Plan
(Bulleted items or brief sentences)
Increase staffing to include 10 full time Communicable Disease Specialists for the
Congregate Settings Medical Investigations Team (CSMIT). Add 10
Communicable Disease Specialists for the School Setting Investigation Team (SSIT).
Strategy 5 ‐ Use Laboratory Data to Enhance Investigation, Response and Prevention
Implementation Plan
(Bulleted items or brief sentences)
Increase staffing by 20 Communicable Disease Specialists to manage congregate and
other high risk populations. This team will focus on the congregate and school settings
with the ability to address issues in other vulnerable populations when needed.
CDC ‐ Epidemiology and Laboratory Capacity (ELC) Paycheck Protection Program and Health Care
Enhancement Act of 2020
Strategy 5 ‐ Use Laboratory Data to Enhance Investigation, Response and Prevention
A. Use laboratory data to initiate case investigations, conduct contact tracing and follow up, and implement containment
measures.
B. Identify cases and exposure to COVID‐19 in high‐risk settings or within vulnerable populations to target mitigation
strategies.
C. Implement prevention strategies in high‐risk settings or within vulnerable populations (including tribal nations) including
proactive monitoring for asymptomatic case detection.
Page 19 of 38
Applicant capacity: What is the current
capacity to perform this milestone?
Current capacity is 7 part time and reassigned staff for CSMIT team plus 1 lead.
Current capacity for SSIT is 1 lead position. Reassigned staff will returning to their
regular work location when other staff are hired and trained.
Expected Achieve date Nov 2020
Expected Achieve By Date
(select from drop down)
Strategy 5 ‐
Milestone 3
Planned Strategy
(Provide a title for this milestone)
Strategic surveillance testing in vulnerable populations
Applicant capacity: What is the current
capacity to perform this milestone?
Department has 2 new extra help physicians to assist with determining need in
community for testing in high risk populations.
Expected Aheive date Nov 2020
Expected Achieve By Date
(select from drop down)
Strategy 5 ‐
Milestone 4
Planned Strategy
(Provide a title for this milestone)
Increase investigation, response, case management, and prevention capacity of
Communicable Disease Investigation Program
Applicant capacity: What is the current
capacity to perform this milestone?
Reallocate assets within department starting end of 2021
Expected achieve by date: 11/17/2022
Expected Achieve By Date
(select from drop down)
Strategy 5 ‐ Use Laboratory Data to Enhance Investigation, Response and Prevention
Implementation Plan
(Bulleted items or brief sentences)
Utilize Public Health physicians in identifying areas of need related to surveillance
testing in vulnerable populations including homeless and congregate setttings.
Strategy 5 ‐ Use Laboratory Data to Enhance Investigation, Response and Prevention
Implementation Plan
(Bulleted items or brief sentences)
* Add 1 Program Technician
* Add 4 Communicable Disease Specialists
* Add 3 Public Health Nurses
* Update & train staff on policies and procedures
* Utilize laboratory data to initiate case investigation,follow‐up,& containment *
Establish/enhance investigation & case management electronic data system *
Identify high‐risk cases & settings for targeted case management
*Implement education & prevention strategies within vulnerable populations *Partner
with CBOs in identifying & addressing needs of high‐risk population
Strategy 5 ‐ Use Laboratory Data to Enhance Investigation, Response and Prevention
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Strategy 5 ‐
Milestone 5
Planned Strategy
(Provide a title for this milestone)
Applicant capacity: What is the current
capacity to perform this milestone?
Expected Achieve By Date
(select from drop down)
Implementation Plan
(Bulleted items or brief sentences)
Page 21 of 38
Local Health Jurisdiction Name:Fresno County
Grant Number:6 NU50CK000539‐01‐10
Strategy 6 Actions and Deliverables
Strategy 6 ‐
Milestone 1
Planned Strategy
(Provide a title for this milestone)
Building COVID‐19 Testing Capacity for Federally Qualified Community Health Centers
(FQHCs).
Applicant capacity: What is the current
capacity to perform this milestone?
FCDPH is well positioned to work with its FQHCs partners to build enhanced testing
capacity throughout its jurisdiction. FCDPH will support FQHC partners with staffing
needs, testing kits, PPE, transportation acquisition, and equipment to ensure testing
barriers are reduced and/or eliminated and needs are met in a timely fashion.
Expected Achieve by date including ongoing contract management of developed
agreements: June 30, 2021
Expected Achieve By Date
(select from drop down)
Strategy 6 ‐
Milestone 2
Planned Strategy
(Provide a title for this milestone)Partner with FQHCs and Community‐Based Organizations (CBOs) to host testing events
in Fresno County.
Implementation Plan
(Bulleted items or brief sentences)
Implement an equitable and targeted COVID‐19 response by working strategically with
a network of diverse community‐based organizations and FQHCs to target vulnerable
communities for enhanced COVID‐19 testing, in conjunction with prevention
education, and isolation and quarantine support (e.g. rental and utility assistance, food
assistance, wage replacement, respite care, childcare among other assistance).
Address the unique hardships of diverse cultural and linguistic mono‐lingual speakers.
In partnership with CBOs, develop authentic educational materials to meet the needs
of the target population. Provide guidance on isolation and quarantine, masking,
social distancing and good hand hygiene among other educational supports.
CDC ‐ Epidemiology and Laboratory Capacity (ELC) Paycheck Protection Program and Health Care
Enhancement Act of 2020
Strategy 6 ‐ Coordinate and Engage with Partners
A. Partner with LHDs to establish or enhance testing for COVID‐19/SARS‐CoV‐2.
B. Partner with local, regional, or national organizations or academic institutions to enhance capacity for infection
control and prevention of COVID‐19/SARS‐CoV‐2.
Strategy 6 ‐ Coordinate and Engage with Partners
Strategy 6 ‐ Coordinate and Engage with Partners
Implementation Plan
(Bulleted items or brief sentences)
Develop a Mini‐Grant/Request for Application (RFA) Proposal to increase capacity and
access to COVID‐19 testing within Fresno County in particular, rural/unincorporated
and high need areas of metropolitan Fresno. Through the RFA, target all five (5) FQHCs
in Fresno County. FQHCs serve the largest safety net providers, reaching some of the
most vulnerable and disproportionately impacted individuals. Accept, review and
informally score each application for selection. Notify FQHCs of selection award.
Develop and fully execute agreements with each FQHC, and provide ongoing contract
management throughout the term.
Page 22 of 38
Applicant capacity: What is the current
capacity to perform this milestone?
FCDPH is making significant strides towards this second milestone as evidenced by its
ability to collaborate, coordinate, and execute contracts with various community
partners. A master calendar of all scheduled testing events is being developed and will
be shared with all partners to keep clear communication on when and where testing
events will occur, and which FQHC and CBO partner will take the lead.
Expected Achieve by date including ongoing contract management of developed
agreements: June 30, 2021
Expected Achieve By Date
(select from drop down)
Strategy 6 ‐
Milestone 3
Planned Strategy
(Provide a title for this milestone)
Partnership with the Economic Opportunities Commission (EOC) to expand testing and
wrap‐around services for agricultural and food processing workers.
Applicant capacity: What is the current
capacity to perform this milestone?FCDPH is poised to support, coordinate and manage the EOC Harvest Proposal efforts
in partnership with other COVID‐19 Equity partners and FQHCs.
Expected Achieve by date including ongoing contract management of developed
agreement: June 30, 2021
Expected Achieve By Date
(select from drop down)
Strategy 6 ‐
Milestone 4
Planned Strategy
(Provide a title for this milestone)
Expand COVID‐19 Equity Project efforts to include the vulnerable and disabled
population with special needs.
Applicant capacity: What is the current
capacity to perform this milestone?
FCDPH has the capacity needed to engage other CBOs such as the ones working with
the disabled and special needs population to ensure an integrated and comprehensive
COVID‐19 Equity Project response.
Expected Achieve by date including ongoing contract management of developed
agreement: June 30, 2021
Expected Achieve By Date
(select from drop down)
Strategy 6 ‐ Coordinate and Engage with Partners
Implementation Plan
(Bulleted items or brief sentences)
Review, coordinate and execute a formal agreement with the Exceptional Parenting
Unlimited as the lead agency subcontracting with at least six other organizations to
target the population with special needs (e.g., hard of hearing, blind, down syndrome,
autistic). This includes providing specialized supports related to outreach and
education, medical investigation and contact tracing, and quarantine to remain safe
while meeting their essential daily needs. Plan ongoing strategic calls and supports
with the broader COVID‐19 Equity Project.
Strategy 6 ‐ Coordinate and Engage with Partners
Implementation Plan
(Bulleted items or brief sentences)
Co‐sponsor a Healthy Harvest Proposal with EOC to improve COVID‐19 testing,
specifically targeting the farmworker population working in the agricultural fields,
packing houses and food processing industry. Coordinate and Integrate Harvest
Proposal testing needs and referrals in the community, as well as wrap‐around services
such as transportation, food, and housing.
Page 23 of 38
Strategy 6 ‐
Milestone 5
Planned Strategy
(Provide a title for this milestone)Medical Case Investigation and Contact Tracing conducted by clinical partners.
Applicant capacity: What is the current
capacity to perform this milestone?
Through its newly formed COVID‐19 Division, FCDPH has been conducting Medical
Case Investigation and Contact Tracing using standardized workflow processes. FCDPH
is working diligently to increase capacity for its training team as demand for Medical
Case Investigation and Contact Tracing continually grows, particularly, given the rise in
case counts in recent months and the preparedness of schools slow re‐opening.
Expected Achieve by date including ongoing contract management of developed
agreement: June 30, 2021
Expected Achieve By Date
(select from drop down)
Strategy 6 ‐
Milestone 6
Planned Strategy
(Provide a title for this milestone)Increase infectious disease prevention and capacity through enhanced partnerships
and staffing.
Applicant capacity: What is the current
capacity to perform this milestone?
FCDPH is building its infection control infrasture and response mechanisms through the
focused efforts of 1.5 Medical Providers and other key clinical suppprt staff
experienced in public health and communicable diseases.
Expected Achieve by date including ongoing contract management of developed
agreement: June 30, 2021
Expected Achieve By Date
(select from drop down)
Strategy 6 ‐ Coordinate and Engage with Partners
Implementation Plan
(Bulleted items or brief sentences)
Develop, review and coordinate a Master Agreement with FQHCs and hospital partners
to initiate and conduct Medical Case Investigation and Contact Tracing services for
their patient population served. Fully execute the Master Agreement contracts.
Provide training to FQHCs and Hospital partners on county workflow processes,
database tracking systems and train on HIPAA prior to implementation of any medical
case investigation and contact tracing efforts. Establish bi‐weekly ongoing calls with
FQHC and Hospital partners to ensure areas of concerns are addressed in a timely
fashion.
Strategy 6 ‐ Coordinate and Engage with Partners
Implementation Plan
(Bulleted items or brief sentences)
Hire 1.5 FTE Providers to focus on Infection Control. Develop workplace protocols,
staff training, and appropriate infection control measures in partnership with state and
national partners (e.g., California Department of Public Health, Cal‐OSHA, and Center's
for Disease Control).
Page 24 of 38
County Name:
Position Title* Annual Salary FTE % Strategy 1 Strategy 2 Strategy 3 Strategy 4 Strategy 5 Strategy 6 COMBINED TOTAL
Program Technician I $38,863 2$ 100%$72,868 72,868$
Program Technician I $38,863 2$ 100%$72,868 72,868$
Program Technician I $38,863 2$ 100%$72,868 72,868$
Program Technician I (EH)$38,863 2$ 100%$72,868 72,868$
Program Technician I (EH)$38,863 2$ 100%$72,868 72,868$
Program Technician I (EH)$38,863 2$ 100%$72,868 72,868$
Program Technician I (EH)$38,863 1$ 100%$43,574 43,574$
Program Technician I (EH)$38,863 2$ 100%$16,360 $56,508 72,868$
Program Technician I (EH)$38,863 2$ 100%$72,868 72,868$
Program Technician I (EH)$38,863 2$ 100%$72,868 72,868$
Program Technician I (EH)$38,863 2$ 100%$72,868 72,868$
Sr. Microbiologist $92,055 2$ 50%$86,301 86,301$
Microbiologist $68,095 2$ 100%$127,678 127,678$
Microbiologist $68,095 2$ 50%$63,839 63,839$
PH Chemist II $63,266 2$ 100%$118,625 118,625$
Lab Intern $41,708 2$ 100%$78,202 78,202$
Lab Intern $41,708 2$ 100%$78,202 78,202$
Lab Intern $41,708 2$ 100%$78,202 78,202$
LVN I $35,287 2$ 100%$66,164 66,164$
LVN I $35,287 2$ 100%$66,164 66,164$
Spvsg PHN $95,187 1$ 100%$95,187 95,187$
Epidemiologist $64,885 2$ 25%$30,415 30,415$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I $41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Communicable Disease Spec I (EH)$41,864 2$ 100%$78,496 78,496$
Public Health Nurse I $71,749 2$ 100%$134,529 134,529$
Public Health Nurse I $71,749 2$ 100%$134,529 134,529$
Public Health Nurse I $71,749 2$ 100%$134,529 134,529$
Physician $187,998 2$ 50%$140,999 140,999$
Physician (EH)$187,998 1$ 100%$205,817 205,817$
Physician (EH)$187,998 2$ 100%$352,497 352,497$
Physician (EH)$187,998 2$ 100%$352,497 352,497$
-$
-$
Fringe 49%242,915$ 419,514$ -$14,861$ 1,596,620$ 169,462$ 2,443,372$
Total Personnel 740,057$ 1,278,076$ -$ 45,276$ 4,864,211$ 516,279$ 7,443,899$
Supplies 191,667.00$ 191,667$
Total Supplies -$ 191,667$ -$ -$ -$ -$ 191,667$
Travel
In-State -$
Out-of-State -$
Total Travel -$ -$ -$ -$ -$ -$ -$
Equipment -$
Total Equipment -$ -$ -$ -$ -$ -$ -$
Other -$
COVID-19 ELC Enhancing Detection
Spend Plan
Fresno
Elizabeth Tello:
22.5 months
(1/1/21 -11/17/22)
Page 25 of 38
Total Other -$ -$ -$ -$ -$ -$ -$
200,000.00$ 200,000$
500,000.00$ 500,000$
1,540,466.00$ 1,540,466$
83,920.00$ 83,920$
25,000.00$ 25,000$
-$
-$
-$
-$
-$
Total Subcontracts -$ 1,540,466$ 500,000$ 308,920$ -$ -$ 2,349,386$
Indirect Cost 23%167,800.53$ 289,791.01$ -$10,265.87$ 1,102,911.23$ 117,060.99$ 1,687,830$
Total Indirect 167,801$ 289,791$ -$ 10,266$ 1,102,911$ 117,061$ 1,687,830$
TOTAL 907,858$ 3,300,000$ 500,000$ 364,462$ 5,967,122$ 633,340$ 11,672,782$
907,858$ 3,300,000$ 500,000$ 364,462$ 5,967,122$ 633,340$ 11,672,782$
0$(0)$-$ 0$ (0)$0$0$
*Personnel supported with this funding should not duplicate efforts across other federal grants; exceed 1.0 FTE across all funding sources; and salary is kept below $197k as required by the
funder.
Allocation
Balance
CBO's
Central Valley Health Policy Institute (Fresno State)
SAS Epidemiology Software
Subcontracts:
Biostatistician
Database for management of patients and partners
Page 26 of 38
Attachment XX
California Department of Public Health Date:
Emergency Preparedness Office
Email Scanned Copy to: CDPHELC@cdph.ca.gov County Name/Address (to send warrant)
[ ] Check if remittance address changed
#REF! since last Invoice
Telephone:
FI$Cal ID #:
Approved Expenditures Remaining
Allocation This Period Balance
Strategy 1 100,000$ 25,000$ 75,000$
Strategy 2 200,000$ 50,000$ 150,000$
Strategy 3 300,000$ 75,000$ 225,000$
Strategy 4 400,000$ 100,000$ 300,000$
Strategy 5 500,000$ 125,000$ 375,000$
Strategy 6 600,000$ 150,000$ 450,000$
2,100,000$ 525,000$ 1,575,000$
Printed Name and Title of Authorized Representative
Signature and Date of Authorized Representative
EPO Use Only
Service Location:Please Pay:
525,000.00$
Signature
Melissa Relles, Assistant Deputy Director
Emergency Preparedness Office
California Department of Public Health
State Certification: I hereby certify that the above referenced local health department has met all
requirements for submission of its application, related documents, and certifications and is eligible to receive
this payment. The application, related documents, approvals, and requests for payment are maintained by
CDPH, Emergency Preparedness Office, for five (5) years for audit purposes as required by the State Controller's
Office.
ELC ENHANCING DETECTION
INVOICE
I certify that this claim is in all respects true, correct, supportable by
available documentation, and in compliance with all terms/conditions,
laws, and regulations governing its payment.
Contract Number:
Contract Term:
Billing Period:
EPO Invoice Number:
Page 27 of 38
ELC ENHANCING DETECTION
Emerging Issues (E) Project: Funding for the Enhanced
Detection, Response, Surveillance, and Prevention of COVID-19
Supported through the Paycheck Protection Program and Health
Care Enhancement Act of 2020
Attachment 5
Page 28 of 38
ELC ENHANCING DETECTION
1 | Page
CONTENTS
Background and purpose .......................................................................................................................................... 1
Funding strategy ....................................................................................................................................................... 2
Process for workplan and budget submission ......................................................................................................... 3
Activities .................................................................................................................................................................... 5
Performance measures and reporting ..................................................................................................................... 9
ELC ENHANCING DETECTION
EMERGING ISSUES (E) PROJECT
BACKGROUND AND PURPOSE
Over the past 25 years, the Centers for Disease Control and Prevention’s (CDC) Epidemiology and Laboratory
Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) cooperative agreement has enhanced
the capacity of each of our recipient jurisdictions’ public health capacity to cohesively and comprehensively
address infectious disease needs. In addition to foundational support for epidemiology, laboratory, and health
information systems, the ELC also supports disease-specific program areas (e.g., respiratory diseases; healthcare
associated infections). The portfolio of ELC-supported activities at each jurisdiction is overseen by an ELC
Governance Team with representation from epidemiology, laboratory, and health information systems. This
structure has been successfully utilized by ELC recipients to manage activities and funding from special
appropriations provided in response to a number of infectious disease emergencies (e.g., H1N1, Ebola, and Zika).
As part of the “Paycheck Protection Program and Health Care Enhancement Act of 2020 (P.L. 116-139, Title I)”, the
ELC is awarding a total of $10.25 billion dollars to our recipient base in a program-initiated component funding
under the Emerging Issues (E) Project of CK19-1904, henceforth, ”ELC Enhancing Detection” supplement. These
funds are broadly intended to provide critical resources to state, local, and territorial health departments in
support of a broad range of COVID-19/SARS-CoV-2 testing and epidemiologic surveillance related activities. Direct
recipients are limited to existing jurisdictions covered under CK19-1904 1. These resources should complement,
not duplicate, existing funding provided to jurisdictions, including the ELC Community-based Surveillance and ELC
CARES Act supplements. Additionally, recipients should leverage and build upon existing ELC infrastructure that
emphasizes the coordination and critical integration of laboratory with epidemiology and health information
systems in order to maximize the public health impact of available resources. Ongoing monitoring of milestones
and performance measures will be utilized to gauge progress toward successful completion of priority activities
supported with these funds.
Resources provided via this award mechanism should support necessary expenses to implement and oversee
expanded testing capacity for COVID-19/SARS-CoV-2, including the ability to process, manage, analyze, use, and
report the increased data produced. Recipients will establish a robust SARS-CoV-2 testing program that ensures
adequate testing is made available according to CDC priorities, including but not limited to: diagnostic tests, tests
1 Only current ELC recipients are eligible to receive awards associated with the supplement described in this
guidance. While tribal nations are not included in these awards, other federal support is provided in the Paycheck
Protection Program and Health Care Enhancement Act of 2020.
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ELC ENHANCING DETECTION
2 | Page
for contact tracing, and surveillance of asymptomatic persons to determine community spread. Recipients should
assure that provisions are in place to meet future surge capacity testing needs including point of care or other
rapid result testing for local outbreaks. Plans should include plans for testing at non-traditional sites (e.g., retail
sites, community centers, residential medical facilities, or pharmacies); testing of at risk populations including
elderly, disabled, those in congregate living facilities including prisons, racial and ethnic minorities, and other
groups at risk due to high frequency of occupational or nonoccupational contacts; and should also address any
essential partnerships with academic, commercial, and hospital laboratories to successfully meet testing demand.
Plans should explicitly detail how a minimum of 2% of the state’s population will be tested each month beginning
immediately; as well as plans to increase that number by Fall 2020. Plans should include a list of established and
proposed laboratories that will be testing for SARS-CoV-2 in each state along with each laboratory’s available
platforms and throughput, that are used for testing and indicate per laboratory, testing projections by month
through December 31st, 2020.
In conjunction with optimizing testing and increasing test volumes for COVID-19/SARS-CoV-2, resources will
support the establishment of modernized public health surveillance systems. These systems will support the public
health response to COVID-19 and lay the foundation for the future of public health surveillance. Establishing
systems and processes to report the data categories described in this document on a daily, automated basis to
state and federal health systems is a requirement of accepting these funds, if such systems are not already in
place. These systems must be transparent and visible to communities through an open website. For each data
category, minimum required data elements will be specified by CDC for each reportable condition at a later date.
These surveillance and data reporting systems must:
•Ensure that real-time, at least daily, complete and accurate test orders and results can be exchanged
within the healthcare/public health system and simultaneously reported to CDC and others via automated
systems in a machine-readable format. These systems must support reporting of test results at the county
or zipcode level with additional data fields as specified by CDC. This includes not only testing for the
presence of virus (nucleic acid or antigen testing), but also serological testing documenting past infection.
•Ensure real-time, at least daily, complete, automated reporting in a machine-readable format for the
following data categories: case, hospitalization and death reporting; emergency department syndromic
surveillance; and capacity, resources, and patient impact at healthcare facilities through electronic
reporting.
•Support the display of up-to-date, critical public health information relating to COVID-19 and future
outbreaks at the county or zipcode level in visual dashboards on county or state websites, including case
data and syndromic surveillance data.
Enhancements to epidemiologic activities resulting from additional test data are also fundamental to controlling
the spread of COVID-19. Recipients must accelerate efforts to conduct robust contact tracing and then identify
and isolate new cases of COVID-19 among symptomatic or asymptomatic individuals. This information should be
further utilized to understand COVID-19/SARS-CoV-2 exposure within a community and determine appropriate
mitigation strategies.
FUNDING STRATEGY
Funding by jurisdiction will be based on population and number of cases of COVID-19/SARS-CoV-2, as further
provided in the legislative language for the Paycheck Protection Program and Health Care Enhancement Act of
2020 (https://www.congress.gov/bill/116th-congress/house-bill/266/). Direct Assistance is authorized under
CK19-1904 2; however, should opportunities for direct assistance be made available, these will be shared broadly
with our recipient base and options for providing direct assistance in lieu of financial assistance may be discussed
and coordinated with the ELC and the CDC Office of Grant Services (OGS).
2Legislative Authority for CK19-1904: Sections 301 and 317 of the Public Health Service Act (PHS Act), 42 USC, 241
and 247b as amended; and Funding is appropriated under Affordable Care Act (PL 111-148), Title IV, Section 4002
(Prevention and Public Health Fund), Title IV, Section 4002
Page 30 of 38
ELC ENHANCING DETECTION
3 | Page
Recipients should consider requesting the following when developing budgets, in furtherance of award activities:
•Personnel (term, temporary, students, overtime, contract staff, etc.)
•Laboratory equipment and necessary maintenance contracts
•Collection supplies, test kits, reagents, consumables and other necessary supplies for existing testing or
onboarding new platforms
•Courier service contracts (new or expansion of existing agreements)
•Hardware and software necessary for robust implementation of electronic laboratory and surveillance data
exchange between recipient and other entities, including healthcare entities, jurisdictional public health and
CDC
•Tools that assist in the rapid identification, electronic reporting, monitoring, analysis, and evaluation of control
measures to reduce the spread of disease (e.g. GIS software, visualization dashboards, cloud services)
•Reporting and/or enrollment incentives
•Contracts with academic institutions, private laboratories, and/or commercial entities
•Laboratory renovations and minor construction (may be considered for unique cases where conditions do not
currently allow for safe or effective testing)
The above list is as an example and does not represent a full list of allowable costs. Any questions about specific
budget items should be directed to the OGS and the ELC Project Officer.
Support to Local Health Departments (LHD):
Recipients should work with their LHDs to determine how local needs can be addressed with the overall available
resources. Direct ELC recipients may provide financial resources to LHDs within their jurisdiction by way of a
contract or other mechanism(s) as available through their Health Department. In addition to financial resources,
ELC direct recipients may provide support to LHDs through offering non-financial resources (personnel, supplies,
etc.) to address COVID-19/SARS-CoV-2 surveillance, case detection, reporting, response, and prevention needs at
the local level.
Supporting Management of Activities and Resources:
The ELC recommends that jurisdictions ensure ELC leadership staff at the recipient level are adequate for the
management of this award and its integration with the recipient’s overall portfolio of ELC funded activities. A
minimum of 1 program manager and 1 budget staff (or equivalents) is suggested for the effective management
and implementation of the recipients’ proposed activities.
P ROCESS FOR WORKPLAN AND BUDGET SUBMISSION
This funding should support ELC Health Care Enhancement activities and the necessary reporting for Budget Period
1 under CK19-1904; however, recipients are reminded that expanded authority3 applies, and activities are likely to
take 30 months for completion due to the nature of COVID-19/SARS-CoV-2. Within 30 days of receipt of the Notice
of Award (NOA), the recipient is required to submit a workplan and budget describing its proposed activities.
Upon submission, budgets and workplans will be reviewed by CDC and feedback will be provided and discussed
with the recipient. Any necessary or recommended changes may be agreed upon between the jurisdiction and
CDC and documented in REDCap and/or GrantSolutions as necessary.
To appropriately document workplans, budgets, and facilitate recipients meeting the 30-day requirement:
3 Expanded Authority is provided to recipients through 45 CFR Part 75.308 which allows recipients to incur project
costs 90 days prior to award, initiate one-time extension to project period, and carryover unobligated balances to
subsequent budget periods.
Page 31 of 38
ELC ENHANCING DETECTION
4 | Page
1. Workplan entries will be completed in the ‘ELC Enhanced Detection’ portal, under ‘ELC COVID-19 Projects’, in
REDCap; and
2. Revised budgets will be completed by using the template provided via GrantSolutions Grant Notes at time of
NOA issuance.
a. Funds will be awarded under the ‘Other’ cost category;
b. Recipients will adjust the cost category allocations of awarded funds to reflect the areas where
financial assistance is needed; and
c. Recipients will upload the revised budget into GrantSolutions via a redirection amendment, with a
courtesy copy into REDCap ‘ELC Enhanced Detection’ portal, by the 30-day post award deadline.
d. ELC and OGS will process the redirection amendment in GrantSolutions and the recipient will receive
a revised NOA reflecting the requested cost category allocations.
3. A letter, indicating that all ELC Governance Team members have both contributed to and agreed upon the
workplan and budget submitted, must be signed by all Governance Team Members (hard copy or digital
signature) and submitted with the documents in the REDCap portal.
Workplan detail
Additional workplan guidance will be provided to recipients post-award; they will be required to provide a clear
and concise description of the time bound strategies and activities they will use to achieve the project’s outcomes,
including:
1. Description of how ‘ELC Enhanced Detection’ funding will be used in coordination with funding from CDC’s
Crisis COVID-19 Notice of Funding Opportunity (NOFO) and ELC CARES.
2. Specify the distinct new or enhanced activities made possible by ‘ELC Enhanced Detection’.
3. Plans for how the ELC recipient will work with local jurisdictions to meet local needs that support the entire
jurisdiction. These plans must include: description of activities to be supported at the local level, identification
of local partners and localities to be supported, methods to assess local needs, and description of funding
mechanisms to support local entities.
4. Description of expected mechanisms and frequency of interactions between the health department and/or
public health laboratory with academic/hospital and commercial laboratories.
5. Description of testing plan, including populations and institutional settings. Plans should align to your
jurisdictional testing plans for COVID-19 per legislation 4. Plans for May – June must be submitted by May 30,
2020. Plans for July – December must be submitted by June 15, 2020. Details about testing plan submission
will be shared with recipients via the ELC Program office.
6. Description of use of electronic health systems for surveillance, reporting, and public health action.
Of note: In a cooperative agreement, CDC staff is substantially involved in the program activities, above and
beyond routine grant monitoring.
CDC responsibilities include but are not limited to:
1. Provide ongoing guidance, programmatic support (including guidance on evaluation, performance
measurement, and workplan changes), technical assistance and subject matter expertise to the activities
outlined in this supplemental funding announcement guidance.
2. Convene trainings, meetings, conference calls, and site visits with recipients.
3. Share best practices identified and provide national coordination of activities, where appropriate.
4. Coordinate with the HHS Testing Team as needed, for subject matter expertise and technical assistance to
support States testing strategies.
In addition to the programmatic activities noted below in further detail, recipient responsibilities include but are
not limited to:
4 https://www.congress.gov/bill/116th-congress/house-bill/266/
Page 32 of 38
ELC ENHANCING DETECTION
5 | Page
1.Regular participation in calls with CDC/HHS for technical assistance and monitoring of activities supported
through this cooperative agreement.
2.On-time submission of all requisite reporting. This may include but is not limited to reporting of performance
measures and progress on milestones within REDCap or provision of financial updates.
3. Documentation of any necessary budget change/reallocation through REDCap and, as necessary,
GrantSolutions.
Both CDC and recipients should appropriately coordinate with points of contact in relevant stakeholder
organizations to maximize the impact of federal dollars (e.g., tribal nations, Health Resources and Services
Administration (HRSA), HHS testing team, etc.).
ACTIVITIES
Data collected as a part of the Activities supported with these funds shall be reported to CDC in a form and fashion
to be determined and communicated at a later date. Recipients are required to establish electronic reporting
systems to support comprehensive, timely, automated reporting of these data to LHD, CDC and others, at a
frequency to be determined and communicated at a later date, if such systems are not already in place. Such
systems must support reporting for COVID-19, other conditions of public health significance.
Activities supported by these funds include but are not limited to the following:
Enhance Laboratory, Surveillance, Informatics and other Workforce Capacity
1.Train and hire staff to improve laboratory workforce ability to address issues around laboratory safety,
accessioning, testing and reporting results.
2. Build expertise for healthcare and community outbreak response and infection prevention and control (IPC)
among local health departments.
3.Train and hire staff to improve the capacities of the epidemiology and informatics workforce to effectively
conduct surveillance and response of COVID-19 (including contact tracing) and other conditions of public
health significance.
4. Build expertise to support management of the COVID-19 related activities within the jurisdiction and the
integrate into the broader ELC portfolio of activities (e.g., additional leadership, program and project
managers, budget staff, etc.).
5.Increase capacity for timely data management, analysis, and reporting for COVID-19 and other conditions of
public health significance.
Strengthen Laboratory Testing
1.Establish or expand capacity to quickly, accurately and safely test for SARS-CoV-2/COVID-19 (which may build
capacity to test for other pathogens with potential for broad community spread) among all symptomatic
individuals, and secondarily expand capacity to achieve community-based surveillance, including testing of
asymptomatic individuals.
a.Develop systems to improve speed and efficiency of specimen submission to clinical and reference
laboratories.
b.Strengthen ability to quickly scale testing as necessary to ensure that optimal utilization of existing
and new testing platforms can be supported to help meet increases in testing demand in a timely
manner.
c.Perform serology testing with an FDA EUA authorized serological assay in order to conduct
surveillance for past infection and monitor community exposure.
d.Work with LHDs to build local capacity for testing of COVID-19/SARS-CoV-2 including within high-risk
settings or in vulnerable populations that reside in their communities.
Page 33 of 38
ELC ENHANCING DETECTION
6 | Page
e.Apply laboratory safety methods to ensure worker safety when managing and testing samples that
may contain SARS-CoV-2/COVID-19.
2. Enhance laboratory testing capacity for SARS-CoV-2/COVID-19 outside of public health laboratories
a.Establish or expand capacity to coordinate with public/private laboratory testing providers, including
those that assist with surge and with testing for high-risk environments.
b.Secure and/or utilize mobile laboratory units, or other methods to provide POC testing at public
health-led clinics or non-traditional test sites (e.g., homeless shelters, food processing plants,
prisons, Long Term Care Facilities (LTCF), etc.).
3.Enhance data management and analytic capacity in public health laboratories to help improve efficiencies in
operations, management, testing, and data sharing.
a.Improve efficiencies in laboratory operations and management using data from throughput, staffing,
billing, supplies, and orders. Ensure ability to track inventory of testing reagents by device/platform,
among other things.
b.Improve the capacity to analyze laboratory data to help understand and make informed decisions
about issues such as gaps in testing and community mitigation efforts. Data elements such as tests
ordered and completed (including by device/platform), rates of positivity, source of samples,
specimen collection sites, and test type will be used to create data visualizations that will be shared
with the public, local health departments, and federal partners.
Advance Electronic Data Exchange at Public Health Labs
1.Enhance and expand laboratory information infrastructure, to improve jurisdictional visibility on laboratory
data (tests performed) from all testing sites and enable faster and more complete data exchange and
reporting.
a.Employ a well-functioning Laboratory Information Management System (LIMS) system to support
efficient data flows within the PHL and its partners. This includes expanding existing capacity of the
current LIMS to improve data exchange and increase data flows through LIMS maintenance, new
configurations/modules, and enhancements. Implement new/replacement LIMS where needed.
b.Ensure ability to administer LIMS. Ensure the ability to configure all tests that are in LIMS, including
new tests, EUAs, etc., in a timely manner. Ensure expanding needs for administration and
management of LIMS system are covered through dedicated staff.
c.Interface diagnostic equipment to directly report laboratory results into LIMS
d.Put a web portal in place to support online ordering and reporting. Integrate the web portal into the
LIMS.
e.Enhance laboratory test ordering and reporting capability.
i.Implement or improve capacity to consume and produce electronic HL7 test orders and
result reporting (ETOR) to allow laboratories and healthcare providers to directly exchange
standardized test orders and results across different facilities and electronic information
systems using agreed upon standards.
ii.100% of results must be reported with key demographic variables including age/gender/race
iii.Report all testing to the health department and CDC using HL7 ELR.
Improve Surveillance and Reporting of Electronic Health Data
Conducting the activities in this section to enable comprehensive, automated, daily reporting to the CDC and
others in a machine-readable format, for data elements to be determined at a later date, is a requirement of
accepting these funds.
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ELC ENHANCING DETECTION
7 | Page
1. Establish complete, up-to-date, automated reporting of morbidity and mortality to CDC and
others due to COVID-19 and other conditions of public health significance, with required associated
data fields in a machine readable format, by:
a. Establishing or enhancing community-based surveillance, including surveillance of vulnerable
populations, individuals without severe illness, those with recent travel to high-risk
locations, or who are contacts to known cases.
b. Monitoring changes to daily incidence rates of COVID-19 and other conditions of public
health significance at the county or zipcode level to inform community mitigation strategies.
2. Establish complete, up-to-date, timely, automated reporting of individual-level data through
electronic case reporting to CDC and others in a machine-readable format (ensuring LHD have access
to data that is reported):
a. At the health department, enhance capacity to work with testing facilities to onboard and
improve electronic laboratory reporting (ELR), including to receive data from new or non-
traditional testing settings. Use alternative data flows and file formats (e.g., CSV or XLS) to
help automate where appropriate. In addition to other reportable results, this should
include all COVID-19/SARS-CoV-2-related testing data (i.e., tests to detect SAR-CoV-2
including serology testing).
b. Automate receiving EHR data, including eCR and FHIR-base eCR Now, to generate initial case
report as specified by CDC for the reportable disease within 24 hours and to update over
time within 24 hours of a change in information contained in the CDC-directed case
report, including death. Utilize eCR data to ensure data completeness, establish
comprehensive morbidity and mortality surveillance, and help monitor the health of the
community and inform decisions for the delivery of public health services.
c. Increase connectivity with laboratory and healthcare feeds for epidemiologic analysis
(including using automated single CSV files).
d. Expand eCR etc to include all conditions of public health significance
3. Improve understanding of capacity, resources, and patient impact at healthcare facilities through
electronic reporting.
a. Required expansion of reporting facility capacity, resources, and patient impact information,
such as patients admitted and hospitalized, in an electronic, machine-readable, as well as
human-readable visual, and tabular manner, to achieve 100% coverage in jurisdiction and
include daily data from all acute care, long-term care, and ambulatory care settings. Use
these data to monitor facilities with confirmed cases of COVID-19/SARS-CoV-2 infection or
with COVID-like illness among staff or residents and facilities at high risk of acquiring COVID-
19/SARS-CoV-2 cases and COVID-like illness among staff or residents.
b. Increase ADT messaging and use to achieve comprehensive surveillance of emergency room
visits, hospital admissions, facility and department transfers, and discharges to provide an
early warning signal, to monitor the impact on hospitals, and to understand the growth of
serious cases requiring admission.
4. Enhance systems for flexible data collection, reporting , analysis, and visualization.
a. Implement new/replacement systems where needed. Ensure systems are interoperable and
that data are able to be linked across systems, including adding the capacity for lab data and
other data to be used by the software/tools that are being deployed for contact tracing.
b. Data must be made available at the local, state, and federal level.
c. Make data on case, syndromic, laboratory tests, hospitalization, and healthcare capacity
available on health department websites at the county/zip code level in a visual and tabular
manner.
5. Establish or improve systems to ensure complete, accurate and immediate (within 24 hrs) data
transmission to a system and open website available to local health officials and the public by county
Page 35 of 38
ELC ENHANCING DETECTION
8 | Page
and zipcode, that allows for automated transmission of data to the CDC in a machine readable
format.
a.Track and send 100% of emergency department and outpatient visits for COVID-like illness, as
well as other syndromes/illnesses, to CDC.
b.Submit comprehensive syndromic surveillance data for all facilities in the jurisdiction.
c.Send deidentified copies of all admit, discharge, and transfer (ADT) messages to the CDC
d. Submit all case reports in an immediate, automated way to CDC for COVID-19/SARS-CoV-2 and
other conditions of public health significance with associated required data fields in a machine-
readable format.
e.Provide accurate accounting of COVID-19/SARS-CoV-2 associated deaths. Establish electronic,
automated, immediate death reporting to CDC with associated required data fields in a
machine-readable format.
f.Report requested COVID-19/SARS-CoV-2-related data, including line level testing data
(negatives, positives, indeterminants, serology, antigen, nucleic acid) daily by county or zipcode
to the CDC-designated system.
g.Establish these systems in such a manner that they may be used on an ongoing basis for
surveillance of, and reporting on, other threats to the public health and conditions of public
health significance.
Use Laboratory Data to Enhance Investigation, Response and Prevention
1.Use laboratory data to initiate case investigations, conduct contact tracing and follow up, and implement
containment measures.
a.Conduct necessary contact tracing including contact elicitation/identification, contact notification,
and contact follow-up. Activities could include traditional contact tracing and/or proximity/location-
based methods, as well as methods adapted for healthcare-specific and congregate settings.
b.Utilize tools (e.g., geographic information systems and methods) that assist in the rapid mapping and
tracking of disease cases for timely and effective epidemic monitoring and response, incorporating
laboratory testing results and other data sources.
2.Identify cases and exposure to COVID-19 in high-risk settings or within vulnerable populations to target
mitigation strategies.
a.Assess and monitor infections in healthcare workers across the healthcare spectrum.
b.Monitor cases and exposure to COVID-19 to identify need for targeted mitigation strategies to isolate
and prevent further spread within high-risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer
clinics, nursing homes, and other long-term care facilities, etc.).
c.Monitor cases and exposure to COVID-19 to identify need for targeted mitigation strategies to isolate
and prevent further spread within high-risk employment settings (e.g., meat processing facilities), and
congregate living settings (e.g., prisons, youth homes, shelters).
d.Work with LHDs to build local capacity for reporting, rapid containment and prevention of COVID-
19/SARS-CoV-2 within high-risk settings or in vulnerable populations that reside in their communities.
3.Implement prevention strategies in high-risk settings or within vulnerable populations (including tribal
nations) including proactive monitoring for asymptomatic case detection.
a.Build capacity for infection prevention and control in LTCFs (e.g., at least one Infection Preventionist
(IP) for every facility) and outpatient settings.
i. Build capacity to safely house and isolate infected and exposed residents of LTCFs and other
congregate settings.
ii.Develop interoperable patient safety information exchange systems.
iii.Assist with enrollment of all LTCFs into NHSN and provision of related user support.
b.Increase Infection Prevention and Control (IPC) assessment capacity onsite using tele-ICAR.
c.Perform preparedness assessment to ensure interventions are in place to protect high-risk
populations.
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ELC ENHANCING DETECTION
9 | Page
a. Coordinate as appropriate with federally funded entities responsible for providing health services to
vulnerable populations (e.g., tribal nations and federally qualified health centers)
Coordinate and Engage with Partners
1.Partner with LHDs to establish or enhance testing for COVID-19/SARS-CoV-2.
a.Support appropriate LHDs with acquiring equipment and staffing to conduct testing for COVID-
19/SARS-CoV-2.
b.Support LHDs to conduct appropriate specimen collection and/or testing within their jurisdictions.
2.Partner with local, regional, or national organizations or academic institutions to enhance capacity for
infection control and prevention of COVID-19/SARS-CoV-2.
a.Build infection prevention and control and healthcare outbreak response expertise in LHDs.
b.Partner with academic medical centers and schools of public health to develop regional centers for
IPC consultation and support services
PERFORMANCE MEASURES AND REPORTING
Performance Measures: In addition to the metrics and deliverable indicated above, performance measures specific
to COVID-19-related activities will be finalized and provided to recipients within 21 days of award. The ELC will
utilize existing data sources whenever possible to reduce the reporting burden on recipients and, where
appropriate, existing ELC performance measures may be used. While more frequent reporting may be employed
within the first year of this supplement, these requirements may be adjusted as circumstances allow. Where it is
possible, reporting will be aligned to current performance measure reporting timelines.
Consistent with current ELC practice, progress on Milestones will be reported on a quarterly basis utilizing REDCap.
Recipients will be provided 2 weeks to update their progress and note any challenges encountered since the
previous update. Financial reporting requirements shall be noted and, as necessary, updated in the Terms and
Conditions of the award. The ELC will work with OGS to limit the administrative burden on recipients.
Summary of Reporting Requirements:
1.Quarterly progress reports on milestones in approved workplans via REDCap.
2.Monthly fiscal reports (beginning 60 days after NOAs are issued).
3.Performance measure data.
4.CDC may require recipients to develop annual progress reports (APRs). CDC will provide APR guidance and
optional templates should they be required.
Please also note: Data collected as a part of the activities supported with these funds shall be reported to CDC in a
form and fashion to be determined and communicated at a later date.
Page 37 of 38
Local Health Department Population Strategy 1
38M
$400K Base
+ Population
Strategy 2
Lab
$38M
Strategy 3
Lab
$10M
Strategy 4
$20M
$325K Base
+ Population
Strategy 5
$150M
$400K Base
+ Population,
Poverty &
Race/Ethnicity
Strategy 6
$30M
$400K Base
+ Population
TOTAL
ALAMEDA (minus Berkeley)1,545,973 1,171,069$ 1,900,000$ 500,000$ 384,914$ 6,359,647$ 754,275$ 11,069,906$
ALPINE 1,162 400,580$ 325,045$ 404,444$ 400,266$ 1,530,335$
AMADOR 38,294 419,100$ 326,484$ 539,104$ 408,775$ 1,693,463$
BERKELEY 123,328 461,511$ 329,780$ 939,488$ 428,262$ 2,159,040$
BUTTE 226,466 512,952$ 700,000$ 500,000$ 333,777$ 1,310,148$ 451,897$ 3,808,774$
CALAVERAS 45,117 422,503$ 326,749$ 556,788$ 410,339$ 1,716,378$
COLUSA 22,117 411,031$ 325,857$ 505,712$ 405,068$ 1,647,669$
CONTRA COSTA 1,155,879 976,506$ 1,300,000$ 300,000$ 369,796$ 4,716,633$ 664,881$ 8,327,816$
DEL NORTE 27,401 413,667$ 326,062$ 524,401$ 406,279$ 1,670,409$
EL DORADO 191,848 495,686$ 332,435$ 1,017,846$ 443,964$ 2,289,931$
FRESNO 1,018,241 907,858$ 3,300,000$ 500,000$ 364,462$ 5,967,122$ 633,340$ 11,672,782$
GLENN 29,132 414,530$ 326,129$ 533,613$ 406,676$ 1,680,948$
HUMBOLDT 135,333 467,499$ 700,000$ 300,000$ 330,245$ 974,142$ 431,013$ 3,202,898$
IMPERIAL 190,266 494,897$ 700,000$ 500,000$ 332,374$ 1,575,482$ 443,601$ 4,046,354$
INYO 18,593 409,273$ 325,721$ 470,923$ 404,261$ 1,610,178$
KERN 916,464 857,095$ 500,000$ 250,000$ 360,518$ 5,355,721$ 610,017$ 7,933,351$
KINGS 153,710 476,664$ 500,000$ 330,957$ 1,229,611$ 435,224$ 2,972,457$
LAKE 65,071 432,455$ 327,522$ 679,914$ 414,912$ 1,854,802$
LASSEN 30,150 415,038$ 326,168$ 526,950$ 406,909$ 1,675,065$
MADERA 159,536 479,570$ 1,800,000$ 500,000$ 331,183$ 1,268,710$ 436,559$ 4,816,022$
MARIN 262,879 531,113$ 335,188$ 1,251,562$ 460,241$ 2,578,105$
MARIPOSA 18,068 409,012$ 325,700$ 467,320$ 404,140$ 1,606,172$
MENDOCINO 89,009 444,394$ 328,450$ 785,443$ 420,397$ 1,978,684$
MERCED 282,928 541,113$ 500,000$ 250,000$ 335,965$ 1,966,291$ 464,836$ 4,058,205$
MODOC 9,602 404,789$ 325,372$ 440,618$ 402,200$ 1,572,980$
MONO 13,616 406,791$ 325,528$ 452,000$ 403,120$ 1,587,439$
MONTEREY 445,414 622,155$ 800,000$ 500,000$ 342,262$ 2,586,808$ 502,071$ 5,353,296$
NAPA 140,779 470,215$ 330,456$ 946,731$ 432,261$ 2,179,663$
NEVADA 98,904 449,329$ 328,833$ 732,388$ 422,665$ 1,933,215$
ORANGE 3,222,498 2,007,253$ 2,400,000$ 300,000$ 449,888$ 13,252,732$ 1,138,467$ 19,548,340$
PLACER 396,691 597,854$ 340,374$ 1,654,835$ 490,906$ 3,083,968$
PLUMAS 19,779 409,865$ 325,767$ 467,320$ 404,533$ 1,607,484$
RIVERSIDE 2,440,124 1,617,036$ 1,700,000$ 300,000$ 419,567$ 11,673,131$ 959,179$ 16,668,913$
SACRAMENTO 1,546,174 1,171,170$ 2,500,000$ 300,000$ 384,922$ 6,998,908$ 754,321$ 12,109,321$
SAN BENITO 62,296 431,071$ 327,414$ 677,589$ 414,276$ 1,850,350$
SAN BERNARDINO 2,192,203 1,493,383$ 1,600,000$ 500,000$ 409,959$ 11,296,877$ 902,365$ 16,202,584$
SAN DIEGO 3,351,786 2,071,736$ 2,000,000$ 300,000$ 454,898$ 14,182,952$ 1,168,095$ 20,177,682$
SAN FRANCISCO 883,869 840,838$ 900,000$ 300,000$ 359,254$ 3,538,061$ 602,547$ 6,540,701$
SAN JOAQUIN 770,385 784,237$ 1,400,000$ 300,000$ 354,856$ 3,956,783$ 576,541$ 7,372,418$
SAN LUIS OBISPO 280,393 539,849$ 800,000$ 300,000$ 335,867$ 1,490,230$ 464,255$ 3,930,200$
SAN MATEO 774,485 786,282$ 1,100,000$ 300,000$ 355,015$ 3,129,513$ 577,481$ 6,248,291$
SANTA BARBARA 454,593 626,733$ 1,900,000$ 300,000$ 342,618$ 2,439,009$ 504,175$ 6,112,534$
SANTA CLARA 1,954,286 1,374,719$ 2,500,000$ 300,000$ 400,738$ 7,268,562$ 847,844$ 12,691,864$
SANTA CRUZ 274,871 537,095$ 335,653$ 1,531,541$ 462,989$ 2,867,278$
SHASTA 178,773 489,165$ 800,000$ 500,000$ 331,928$ 1,070,867$ 440,968$ 3,632,928$
SIERRA 3,213 401,603$ 325,125$ 411,559$ 400,736$ 1,539,022$
SISKIYOU 44,584 422,237$ 326,728$ 577,208$ 410,217$ 1,736,389$
SOLANO 441,307 620,106$ 1,000,000$ 300,000$ 342,103$ 2,130,588$ 501,130$ 4,893,927$
SONOMA 500,675 649,717$ 900,000$ 300,000$ 344,404$ 2,287,496$ 514,735$ 4,996,351$
STANISLAUS 558,972 678,793$ 346,663$ 3,053,787$ 528,094$ 4,607,337$
SUTTER 97,490 448,624$ 328,778$ 833,552$ 422,341$ 2,033,295$
TEHAMA 64,387 432,114$ 327,495$ 681,334$ 414,755$ 1,855,698$
TRINITY 13,688 406,827$ 325,530$ 458,084$ 403,137$ 1,593,578$
TULARE 479,112 638,962$ 2,900,000$ 1,000,000$ 343,568$ 3,155,745$ 509,793$ 8,548,068$
TUOLUMNE 54,590 427,227$ 327,116$ 589,231$ 412,510$ 1,756,084$
VENTURA 856,598 827,237$ 900,000$ 300,000$ 358,197$ 3,894,187$ 596,298$ 6,875,919$
YOLO 222,581 511,014$ 333,626$ 1,462,971$ 451,007$ 2,758,618$
YUBA 77,916 438,861$ 328,020$ 749,788$ 417,855$ 1,934,524$
TOTALS 29,673,599 $ 38,000,000 $ 38,000,000 $ 10,000,000 $ 20,000,000 $ 150,000,000 $ 30,000,000 $ 286,000,000
Paycheck Protection Program and Health Care Enhancement Act
ELC Enhancing Detection
Attachment 5
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