Title
Receive an updated written response to Board Referral No. 2022.06 seeking an increase in funding allocated to the Virus Integrated Distribution of Aid (VIDA) to maintain operations through December 31, 2022.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Receive an updated written response to Board Referral No. 2022.06 seeking an increase in funding allocated to the Virus Integrated Distribution of Aid (VIDA) to maintain operations through December 31, 2022.
SUMMARY:
This staff summary is an update to Board Referral No 2022.06, VIDA Project Extension, seeking an increase in funding allocated to the Virus Integrated Distribution of Aid (VIDA) Project to maintain operations through December 31, 2022. The VIDA Project, formerly known as the Community Outreach and Education Pilot Project (“Pilot Project”) is a partnership between the County of Monterey and the Community Foundation for Monterey County focused on addressing the disparate impact of the COVID-19 pandemic in low-income and Communities of Color. Using the community health worker (CHW) model, the VIDA Project is implemented in collaboration between Monterey County, the Community Foundation for Monterey County and with community-based organizations (CBO’s) focused on specific census tracts of the lowest quartile of the Healthy Places Index (HPI Census Tracts). The purpose of the VIDA Project is to raise community awareness and education and provide system navigation to help community members access resources for adequate isolation and quarantine, and COVID-19 testing and vaccines. The VIDA project began in December 2021 through a funding allocation of $4,989,651 from General Fund Reserve, and Cannabis Tax fund accounts by the Board of Supervisors to the County Administrative Office and the project has continued through several phases and additional funding in response to community needs during the pandemic. The effort currently employs 58 part and full time CHWs or 44 Full-Time Equivalent (FTE) CHWs across 8 CBOs, with a recent expansion of their outreach efforts to include providing Medi-Cal application assistance to residents and previously the Community Health Needs Assessment Survey.
DISCUSSION:
The project has gone through several phases as approved by the Board of Supervisors and in response to the COVID-19 pandemic and community needs, including: 1) approval by the Board on June 22, 2021 for continuation past the original end date of June 30, 2021 using unspent allocated funds ($559,000) but with a right-sized approach; 2) a return to the Board July 27, 2021 with the right-sized approach and a 35% reduction in overall CHW numbers from 126 to 80 CHWs; 3) a second approval by the Board on September 28, 2021 to continue the project for an additional six months through March 31, 2022 using already approved but unallocated funds ($957,344) with additional right-sizing; 4) acceptance on October 17th, 2021 of $3,952,437 in funding from the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Health which allowed the project leads to fund approximately 18-20 CHWs from July 1st, 2021 through June 30th, 2023 with a focus on COVID-19 health literacy; and 5) a continuation through December 31, 2022 approved by the Board on March 8, 2022 to support the remaining portion of CHWS not funded by the HHS grant and enable the project to continue at the March capacity of approximately 50 CHWs by using funding support of $1,570,011 from unspent ARPA funds. Through March 2022, VIDA supported the work of the CHWs across nine organizations. After March, one organization opted to return to pre-COVID-19 pandemic response activities. Some of their CHWs were subsequently hired by other VIDA organizations and as of the end of May 2022, there are 58 part and full time CHWs or 44 FTE CHWs.
Since March, VIDA CHWs continued to implement public awareness campaigns and community education strategies centered on culturally relevant messaging to influence social behaviors, normalizing and providing COVID-19 testing, use of face covering and social distancing, and addressing vaccine misinformation and supporting vaccine clinics in priority communities. In addition, CHWs were trained in and began supporting individuals with Medi-Cal applications as part of the state of California expansion of Medi-Cal eligibility to those 50 years old and older. This support will connect individuals that are more vulnerable to COVID-19 to needed medical resources. All strategies are community-specific and guided by CBO grass-roots community knowledge and supported by various sectors through the COVID-19 Collaborative of the Community Foundation of Monterey County.
From January through April, the VIDA Project had outreach interactions with over 24,000 individuals, providing COVID-19 prevention educational materials and resource connections. They also assisted 550 people with vaccinations at VIDA partner clinics, conducted over 6,700 and distributed over 6,900 rapid antigen test kits, and supported 517 individuals with basic needs and resources through COVID-19 isolation and quarantine support. Since March, CHWs have also received training in supporting individuals with Medi-Cal applications and began helping with applications June 1st. They also helped 195 individuals do complete the county-wide Community Health Needs Assessment.
The holistic and culturally relevant approach of the VIDA Project has been successful in its goal of addressing health equity and social justice needs of the residents of Monterey County during the COVID-19 pandemic, with CHW effort heavily concentrated in the lowest quartile Healthy Places Index ZIP Codes. In addition, VIDA has established process protocols; training modules and schedules for community outreach and engagement strategies; and communication tools and social media protocols to maximize reach to the populations of focus in the most culturally relevant and linguistically appropriate methods
Expenditure Report
County ARPA Funds
The total expenditures for VIDA from October 1, 2021 through March 30, 2022, were $875,419.95 which supported 27 FTE CHWs at seven organizations. Upon reconciliation of expenditures and issuance of final payment to contractor from the original County funded amount, remaining unspent funds will be returned to the County. The expenditures for April 2022 and May 2022 were $348,891 which covered 23 CHWs at six organizations, leaving a balance of $1,221,120 available for expenditure through December 31, 2022.
HHS Funds
The HHS grant funded expenditures from July 2021 through May 2022 total $946,188 which covered 21 FTE CHWs at two different organizations, administrative staffing, and evaluation for the HHS grant.
The tables below show the allocation period and amount, expenditures-to-date, remaining balance and current number of CHW FTEs for each of the two Health Department project funding sources.
VIDA Project - County ARPA Funds
Allocation Period: April 1, 2022 - December 31, 2022
|
Allocation Amount |
$1,570,011 |
|
Expenditures-to-Date (salaries, benefits, operational supplies) |
$348,891 |
|
Remaining Balance |
$1,221,120 |
|
Current Number of Funded CHWs |
23 |
VIDA Project - Federal Health Literacy Grant Award
Grant Period: July 1, 2021 - June 30, 2023 (2 Years)
|
FY 2021-22 Grant Amount |
$1,975,395 |
|
Expenditures-to-Date (contracted services, County staff salaries, benefits, operational supplies) |
$946,188 |
|
Remaining Balance |
$1,029,206 |
|
Current Number of Funded CHWs |
21 |
This work supports the Monterey County Health Department 2018-2022 Strategic Plan Goals: 1. Empower the community to improve health; 2. Enhance community health and safety through prevention; 3. Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services; and 4. Engage MCHD workforce and improve operational functions to meet current and developing population health needs. It also supports the following of the ten essential public health services, specifically: 1. Monitor health status to identify and solve community health problems; 3. Inform, educate, and empower people about health issues; 4. Mobilize community partnerships and action to identify and solve health problems; 7. Link people to needed personal health service and assure the provision of health care when otherwise unavailable; and 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
OTHER AGENCY INVOLVEMENT:
The VIDA Project is implemented in partnership with Monterey County Health Department, Community Foundation for Monterey County, Building Healthy Communities (BHC), Mujeres en Acción, Center for Community Advocacy (CCA), Centro Binacional para el Desarrollo Indígena Oaxaqueño (CBDIO), Lideres Campesinas, City of Gonzales, CHISPA, Pajaro Valley Prevention and Student Assistance (PVPSA) and The Village Project. The office of the County Counsel reviewed and approved Board Report.
FINANCING:
There is no financial impact from receiving this report.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
This recommendation supports all of the Board of Supervisors Strategic Initiatives. Community Health Workers are a critical and cost-effective, customer-responsive part of the county workforce. They are trustworthy individuals who come from the community they serve and as such are important contributors in our county in emerging stronger from the COVID-19 pandemic and with a focus on reducing historic social and health inequities. They can bolster public health with their efforts, while also addressing broader social and economic needs within their communities. Their continued COVID-19 outreach and education efforts and expansion into social supports not only promotes equitable opportunities for healthy choices, they reduce community stressors that can contribute to improved community safety and a more sustainable infrastructure, contributing to an improved quality of life and economic development.
Mark a check to the related Board of Supervisors Strategic Initiatives
X Economic Development
X Administration
X Health & Human Services
X Infrastructure
X Public Safety
Prepared by: Krista Hanni, MS, PhD, Public Health Program Manager, II, 755-4586
Approved by:
______________________________Date:_____________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Attachment:
Board Referral No. 2022.06