Title
a. Receive an update on the expenditure report through June 30, 2021 (Attachment A) and the proposed right-sizing process for the Virus Integrated Distribution of Aid Project (VIDA) Project, formerly known as the Community Outreach and Education Pilot Project (“Pilot Project”); and
b. Approve a budget modification request submitted by the Community Foundation for Monterey County (CFMC) as highlighted in Attachment B, to move unspent allocated funds from one previously approved line item to another and from one budget category to another, to meet budget gaps as identified by the CFMC and VIDA Project partners; and
c. Approve and authorize the County Administrative Officer or Assistant County Administrative Officer to approve budget modification requests in accordance with the budget categories and line items previously approved by the Board on December 21, 2020, as outlined in Attachment B; and
d. Provide direction to staff as appropriate.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Receive an update on the expenditure report through June 30, 2021 (Attachment A) and the proposed right-sizing process for the Virus Integrated Distribution of Aid Project (VIDA) Project, formerly known as the Community Outreach and Education Pilot Project (“Pilot Project”); and
b. Approve a budget modification request submitted by the Community Foundation for Monterey County (CFMC) as highlighted in Attachment B, to move unspent allocated funds from one previously approved line item to another and from one budget category to another, to meet budget gaps as identified by the CFMC and VIDA Project partners; and
c. Approve and authorize the County Administrative Officer or Assistant County Administrative Officer to approve budget modification requests in accordance with the budget categories and line items previously approved by the Board on December 21, 2020, as outlined in Attachment B; and
d. Provide direction to staff as appropriate.
SUMMARY:
The Virus Integrated Distribution of Aid Project (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 model, the VIDA Project is implemented in collaboration with ten 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.
BACKGROUND/DISCUSSION:
At the start of the COVID-19 pandemic, community-based organizations and grassroots community groups leaped into action to help address critical and urgent needs that evidently affected low-income and Communities of Color throughout Monterey County. Underlying conditions such as overcrowded housing, misinformation, language barriers, fear and mistrust of government exacerbated the disparate impact of the COVID-19 pandemic. The County Administrative Office and Health Department built upon an established partnership with the Community Foundation for Monterey County (CFMC) to develop a grantmaking process and manage the implementation of a coordinated public health response effort, the Community Health Worker pilot project which would later become branded as the VIDA Project. Community partners who possessed the expertise in outreach and education and were trusted messengers with strong relationships in communities whose workforce predominantly consisted of essential workers such as agricultural farmworkers, hospitality, restaurant and grocery store workers.
On December 21, 2020, the Board of Supervisors approved a $4,989,651 contribution to support the expansion and implementation of the VIDA Project. The ten partner CBO’s receiving grants made possible by this contribution are: Building Healthy Communities (BHC), Mujeres en Acción, Center for Community Advocacy (CCA), Centro Binacional para el Desarrollo Indígena Oaxaqueño (CBDIO), California Rural Legal Assistance (CRLA), Lideres Campesinas, City of Gonzales, CHISPA, Pajaro Valley Prevention and Student Assistance (PVPSA) and The Village Project.
Budget Modification Request
On April 7, 2021, the Board of Supervisors approved a budget modification reallocating funds from budget line items within or across previously approved budget categories. The initial budget approved by the Board of Supervisors was drafted based on estimates in specific budget categories and budget line items. As expenditures continue, the need for budget modifications are to be expected. A need for another budget modification as outlined in Attachment B. To better and more expeditiously support the CFMC in efforts to meet community needs identified by partner CBOs, staff recommends that the Board of Supervisors approve and authorize the County Administrative Officer or his designee to receive, review and approve future budget modification requests, so long as they are in compliance with allowable expenses in budget line items and budget categories approved by the Board of Supervisors.
Expenditure Report
As of June 30, 2021, the total expenditures are $2,422,211 with a total of allocated funds remain at $1,399,774 projected to support most CBOs through September 30, 2021. A total of $957,344 remain unallocated. Attachment A includes a breakdown of expenditures by budget category and budget line items.
VIDA Project Organizational Structure
The CFMC coordinates a cross-sector COVID-19 collaborative which supports various strategies to address community impact, including the VIDA Project. The CFMC has secured funding from the Public Health Institute and Packard Foundation to support needs such as the design and development of communication and marketing tools, management of social media presence, the positions of a Community Initiatives Manager and Project Manager who work closely with the County Administrative Office and Health Department. The organizational structure with CFMC as the lead organization with subcontractors provides accountability, project management, streamlined invoicing and weekly check-ins with CHW Coordinators to provide resource and supports to CBO’s. The Health Department manages data collection and reporting, holding weekly check-ins with Data Analysts from all CBO’s to ensure data quality control and analysis.
Right-sizing Process
The VIDA Project has proven to be able to rapidly pivot strategies upon assessing community needs. Aside from focus on outreach with a consistent presence at various testing sites to provide quarantine and isolation support during the winter surges in COVID-19 case rates, CHWs focused on educating and informing the community about the vaccines strategically at workplace outreach with agricultural companies and contractors both for year-round employees and in anticipation of the return of the spring agricultural season. Additional outreach strategies include conducting door-to-door canvassing in HPI census tracts, hosting and supporting vaccine clinics, having continuous presence at grocery stores in The VIDA Project helped community members who experienced challenges in accessing or navigating the MyTurn registration process during the tiered vaccine roll out. As testing rates declined, the VIDA Project partnered with the California Department of Public Health Rapid Antigen Testing Program and CHWs were trained to directly provide antigen testing.
The right-sizing process has included the analysis of outcomes in outreach, isolation and quarantine support provided based on data reports submitted by each CBO, review of vaccination rates in each region of the county, asset mapping of CBO expertise and reach in specific populations and language capacity. At its full-sized capacity, the VIDA Project collectively employs 126 CHWs, of which 101 CHWs are full-time employees. Several CBOs have begun to release CHWs organically because of either budget expenditures, performance and service quality reviews or CHWs accepting opportunities for permanent positions elsewhere. The proposed right-sized project would take a phase out approach and initially include an overall 35% reduction, an elimination of 44.1 CHW positions, effective September 1, 2021. The next step would be to once again review the status of positive case rates and vaccination rates in the county at the end of September 2021 and determine the appropriate reduction.
In the second phase of the right-sizing process, other factors that will be taken into consideration include; the need to support community members who suffer from lingering effects of COVID-19, the potential need for boosters to the vaccines, the anticipated availability of vaccines for children under the age of 12, the potential reinstatement of mask mandates and increase in positive case rates due to surges from new COVID-19 variants, the potential need to continue to educate the community on the importance of continued practice of safety precautions such as wearing masks and social distancing although vaccinated. Such factors are nearly impossible to predict but not unlikely to present the need for having a solid team of CHWs trained and prepared to serve.
Lastly, a quality control review has identified opportunities for continued CHW training and reestablishing of performance standards that will continue to improve on the overall quality of service and support provided by all CHWs.
OTHER AGENCY INVOLVEMENT:
The VIDA Project is implemented in partnership with the County Administrative Office, 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), California Rural Legal Assistance (CRLA), Lideres Campesinas, City of Gonzales, CHISPA, Pajaro Valley Prevention and Student Assistance (PVPSA) and The Village Project. County Counsel reviewed and approved Board Report.
FINANCING:
Approval of this recommendation will not result in any financial impact.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Approval of this recommendation supports efforts to address the disparate impact of the COVID-19 pandemic.
Mark a check to the related Board of Supervisors Strategic Initiatives
X_ Economic Development
X_ Administration
X_ Health & Human Services
__ Infrastructure
__ Public Safety
Prepared by: Rosemary Soto, Management Analyst III, x5840
Approved by: Nick Chiulos, Assistant County Administrative Officer
Attachments:
Board Report
ATTACHMENT A
ATTACHMENT B