Title
a. Approve a request to use unexpended FY 2020-21 American Rescue Plan Act (ARPA) funds allocated to the Health Department in the amount of $590,000 to fund the Stipend Pilot through January 25, 2022; and
b. Approve and authorize the Director of Health or the Assistant Director of Health to sign Amendment No. 4 to Agreement No. A-15050 with United Way of Monterey County for providing one-time cash stipends to individuals with a positive COVID-19 test (Stipend Pilot), adding $586,761 to increase the amount of the Agreement from $644,129 to $1,230,890 to cover expenses incurred through January 25, 2022, for the Agreement term of December 1, 2020, through April 30, 2022; and
c. Provide direction to staff on next steps for Stipend Pilot.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve a request to use unexpended FY 2020-21 American Rescue Plan Act (ARPA) funds allocated to the Health Department in the amount of $590,000 to fund the Stipend Pilot through January 25, 2022; and
b. Approve and authorize the Director of Health or the Assistant Director of Health to sign Amendment No. 4 to Agreement No. A-15050 with United Way of Monterey County for providing one-time cash stipends to individuals with a positive COVID-19 test (Stipend Pilot), adding $586,761 to increase the amount of the Agreement from $644,129 to $1,230,890 to cover expenses incurred through January 25, 2022, for the Agreement term of December 1, 2020, through April 30, 2022; and
c. Provide direction to staff on next steps for Stipend Pilot.
SUMMARY/DISCUSSION:
On August 18, 2020, the Monterey County Board of Supervisors approved the County’s CARES Spending Plan. In that plan, the Health Department requested funds to expand the Great Plates Program to individuals in our County needing to self-isolate. On October 6, 2020, the Board of Supervisors received an update on CARES spending which showed an increase to the Health Department’s spending plan of $1.9 million and a corresponding reduction in the Department of Social Services’ spending plan. After further review, it was determined the County could better support these individuals by providing a cash stipend to encourage individuals to stay home and self-isolate, as many of our residents are not eligible for income replacement benefits if they were to become sick.
Accordingly, on December 1, 2020, the Health Department implemented a Stipend Pilot (Pilot) for individuals with COVID-19, providing a one-time $1,000 cash card stipend to adult residents (18 years of age and older) with a COVID-19 positive test result and who are not eligible for income replacement, to encourage them to comply with the 10-day self-isolation period or as directed by their medical/health provider. Based on the CARES funding available, the Health Department established agreements for administration of the program with the United Way of Monterey County, $644,129, Clinica de Salud del Valle, $30,000, and Soledad Community Health Care District, $10,000.
At the time, CARES funds had an expiration of December 30, 2020, and the County spent its full allocation by the December 30, 2020, deadline, which was before the first cash stipend was issued. As a result, the Pilot was subsequently funded with ARPA funds allocated directly to the County. In February of 2021, the Board allocated $350,000 of ARPA funds for the Stipend Pilot to be spent through the end of Fiscal Year (FY 2020-21). The actual amount spent by June 30, 2021, was $335,800.
In an effort to positively impact the County’s case rate, positivity rate, and equity metric, the priority has been to serve individuals in census tracts of the lowest quartile of the Healthy Places Index, areas with higher COVID-19 positivity rates than the countywide average. These areas include Salinas, our south county cities, several unincorporated areas, and pockets of Seaside and Marina. To implement the program the Health Department has partnered with United Way of Monterey County, Department of Social Services, and community health centers located in areas of interest, designated staff (Pilot Coordinators) at these locations submit a referral to United Way of Monterey County on behalf of individuals who test positive for COVID-19. Individuals qualify for the Pilot based on meeting specific eligibility criteria, including their Zip Code of residence, being early in their 10-day self-isolation period, and not be in receipt of unemployment insurance benefits or paid sick leave when the results are received.
At the launch of the State’s Home for the Harvest program in May 2021, the County’s Stipend Pilot was aligned and administered by the Department of Social Services to avoid duplication of efforts and assure those in need would be supported by the most appropriate Program/Pilot. The Pilot provided 668 stipends from inception through mid-December 2021. With the surge in COVID-19 cases due to the Omicron variant and awareness of the Pilot, the demand and need for the Pilot began to skyrocket in mid-December 2021. Since then and through January 25, 2022, an additional estimated 534 individuals were enrolled in the Pilot. The rapid uptick in demand and an administrative error resulted in an over expenditure of the Agreement with United Way of Monterey County. The Pilot was suspended on January 25, 2022, when staff realized the contract was over-expended, until further direction was received from your Board.
In addition to seeking approval to use unexpended Fiscal Year 2020-21 ARPA funds allocated to the Health Department to fund pilot expenditures incurred through January 25, 2022, staff also seek Board direction on next steps for the Pilot:
1. Permanently suspend Pilot acknowledging that the Pilot served over 1,200 Monterey County residents during this Pandemic, or
2. Relaunch Stipend Pilot with a monthly cap of 50 cash cards, from February 9,2022 through April 30, 2022, at an estimated monthly cost of $55,000 for a total of $165,000; or
3. Relaunch Stipend Pilot with modifications with a monthly cap of 50 cash cards, reducing the one-time cash card stipend from $1,000 to $500 to align with recent CDPH isolation guidelines, from February 9, 2022, through April 30, 2022, at an estimated monthly cost of $27,500 for a total of $82,500.
This work supports the Monterey County Health Department 2018-2022 Strategic Plan Initiatives: 1. Empower the community to improve health; and 2. Enhance community health and safety through prevention. It also supports the following of the ten essential public health services, specifically; 4. Mobilize community partnerships and action to identify and solve health problems; and 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
OTHER AGENCY INVOLVEMENT:
The Office of County Counsel and the Auditor-Controller have reviewed and approved this Agreement as to legal form, and fiscal provisions, respectively.
FINANCING:
This Agreement is funded by ARPA funds allocations previously approved by the Board of Supervisors for management of the COVID-19 pandemic to the Health Department. There are sufficient appropriations included in the Health Department’s (HEA014-8438) Fiscal Year (FY) 2021-22, Adopted Budget to cover amount of $586,761 proposed in Amendment No. 4 to Agreement with the United Way of Monterey County. The Health Department is requesting a total reallocation of $590,000 to fund Amendment No. 4 with United Way of Monterey County and expenses incurred by our community clinic partners through January 25, 2022. If the Board elects to relaunch the Pilot, the Health Department will require additional appropriations and a source of funding.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐ Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐ Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability, and transparency.
☒ Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐ Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐ Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Krista Hanni, Program Manager II, x4586
Approved by:
_____________________________Date:___________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Attachments:
Amendment No 4
Amendment No 3
Amendment No 2
Amendment No 1
Agreement