Title
a. Approve and authorize the Director of Health Services or designee to retroactively execute a Grant Subcontract Agreement for a total of approximately $211,184 in funding from the Public Health Institute (PHI) from March 1, 2023 to April 15, 2024; and
b. Authorize the Director of Health Services or designee to execute up to three (3) future amendments to this Agreement where the amendments do not significantly alter the scope of the services; and
c. Amend the Health Department Fiscal Year 2023-2024 Adopted Budget to increase appropriations and increase estimated revenue by $211,184 in the Emergency Medical Services Bureau 001-4000-8109-HEA006, funded by the augmentation of grant revenues from the Department of Healthcare Services (DHCS) via the Public Health Institute (PHI) under the CA Bridge Program (4/5 vote required); and
d. Direct the Auditor-Controller and County Administrative Office to incorporate the changes in the Fiscal Year 2023-24 Health Department Adopted Budget 001-4000-8109-HEA006.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health Services or designee to retroactively execute a
Grant Subcontract Agreement for a total of approximately $211,184 in funding from the Public Health Institute (PHI) from March 1, 2023 to April 15, 2024; and
b. Authorize the Director of Health Services or designee to execute up to three (3) future amendments to this Agreement where the amendments do not significantly alter the scope of the services; and
c. Amend the Health Department Fiscal Year 2023-2024 Adopted Budget to increase appropriations and estimated revenue by $211,184 in the Emergency Medical Services Bureau 001-4000-8109-HEA006, funded by the augmentation of grant revenues from the Department of Healthcare Services (DHCS) via the Public Health Institute (PHI) under the CA Bridge Program (4/5 vote required); and
d. Direct the Auditor-Controller and County Administrative Office to incorporate the changes in the Fiscal Year 2023-24 Health Department Adopted Budget 001-4000-8109-HEA006.
SUMMARY/DISCUSSION:
Pursuant to California Health and Safety Code, Section 1797 et seq., the County of Monterey EMS Agency is responsible for EMS system coordination, medical oversight, and coordination of the delivery of EMS by provider organizations in Monterey County.
In 2022, the County of Monterey EMS Agency entered into a three-county collaborative with the County of Santa Cruz and the County of San Benito to support the ongoing efforts to address Substance Use Disorder (SUD) as a treatable emergency condition. Through the Buprenorphine program, paramedics responding to medical emergency calls will be able to identify and treat patients who may benefit from medication-assisted treatment (MAT).
In 2023, the Department of Health Care Services (DHCS) informed the three counties of funding available for this program. The total grant amount of $375,000 will be allocated among the participating three counties based on population percentage. This grant will support overall program and grant management costs related to the administration of buprenorphine to patients in opioid withdrawal or following a near-fatal opioid overdose and linking these patients to needed services.
The Monterey County Emergency Medical Care Committee (EMCC) and its Medical Advisory Subcommittee (MAC) endorsed this program in late 2022. Similarly, on December 14, 2022, the California State EMS Authority approved the tri-county Buprenorphine program as a Local Scope of Practice through December 31, 2025.
EMS is seeking approval retroactive to March 1, 2023, because the grant award documents were not received until August 2023, and time was needed to meet with the grantor to clarify grant requirements.
This work supports the Monterey County Health Department 2018-2022 Strategic Plan Goal 2 (Enhance public health and safety through prevention) and Goal 4 (Engage Health Department 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, (Monitor health status to identify and solve community health problems; Mobilize community partnerships and action to identify and solve health problems; and Link people to needed personal health services and assure the provision of health care when otherwise unavailable).
This report was presented to the Budget Committee at its October 25, 2023, meeting. Since the Budget Committee meeting, we have reallocated funds within the budget, but the overall agreement amount remains the same.
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. This report was presented to the Budget Committee at its October 25, 2023 meeting.
FINANCING:
Costs associated with this grant were not included in the EMS’ FY 2023-24 (HEA006, Unit 8109) Adopted Budget in accordance with the County’s General Financial Policies. In order to perform the tasks associated with this grant, the Bureau requires an increase in appropriations in the amount of $211,184 which will be funded by grant revenue.
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: Korina Moreno, Administrative Services Assistant, 755-6344
Approved by:
________________________________Date___________________
Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Agreement