This memo provides LHJs with an overview of the CDC award for the above-mentioned grant funding, which is for a full five years. California's infrastructure funding is the California Strengthening Public Health Initiative (CASPHI).
On December 4, 2022, CDPH received a Notice of Award (NOA) from CDC for CASPHI. CDPH applied for funding in all three strategies (A1 Workforce, A2 Foundational Capabilities, and A3 Data Modernization) and was approved for all three strategies. However, the A3 Data Modernization strategy funding is still pending and is currently unfunded by CDC. CDPH will allocate funds to LHJs as part of the A1 Workforce strategy.
II. CASPHI Grants
The grant award start date was December 1, 2022. The annual grant periods are below:
Year 1 December 1, 2022 – November 30, 2023
Year 2 December 1, 2023 – November 30, 2024
Year 3 December 1, 2024 – November 30, 2025
Year 4 December 1, 2025 – November 30, 2026
Year 5 December 1, 2026 – November 30, 2027
Funding: The California Strengthening Public Health Initiative (CASPHI) includes $36,822,154 million for direct allocation to participating local health jurisdictions.
The CASPHI funding allocation spreadsheet lists the amount of annual and five-year total award amounts for each eligible and participating LHJ.
As a condition of receiving this funding, all recipients are required to have a minimum of 1.0 FTE of staff capacity with roles and responsibilities dedicated advancing health equity and/or eliminating health disparities.
A wide range of staff roles can fulfill this requirement, including leadership roles, policy, program, data, and community engagement functions. An equity focus includes understanding and addressing health disparities affecting disproportionately impacted populations that are higher risk and underserved, including racial and ethnic groups, rural populations, those experiencing socioeconomic disparities and other underserved communities. Activities related to improving policies, systems and environments to more effectively serve communities and address structural and social determinants of health would also address this requirement. (Additional details and examples will be incorporated in the Funding Reference Guide.) LHJs will determine the focus and position title based on local needs.
The funding base of $495,000 has been set in order to cover a 1.0 FTE Equity Staff position for approximately 3.3 years at $150,000 [with the first two years of equity staffing previously funded as part of the California Equitable Recovery Initiative (CERI), Future of Public Health (FoPH) or other funds]. Additional funding through the formula-based allocation is available to support additional workforce development activities including training, recruitment, and incentives (additional details below).
- At the discretion of the LHJ, the 1.0 FTE equity staffing threshold may be spread over multiple positions, with a minimum of 0.5 fully dedicated FTE and the remaining 0.5 FTE spread across additional positions.
- LHJs may also demonstrate that they already have a 1.0 FTE dedicated role for this purpose through other funding sources.
- Per CDC, all work under this funding initiative should be grounded in three key principles:
- The need for data and evidence to drive planning and implementation
- The critical role that partnerships will play in success, and
- The imperative to direct these resources in a way that supports health equity
CDPH plans to issue a 25% advanced payment to eligible and participating LHJs. If an LHJ wishes to decline the advance payment, please send an email to CASPHILocalFunding@cdph.ca.gov stating "no advance payment". If an advance payment is declined, the LHJ is still eligible to receive the full allocation and would follow CDPH invoicing processes.
LHJ Eligibility Criteria: Any LHJ that did not receive direct CDC funding will be included in CDPH's allocation process. CDPH collaborated with the County Health Executives Association of California (CHEAC), the California Conference of Local Health Officers (CCLHO), and other stakeholders to finalize funding formulas for this allocation. Per CDC, local governments (includes county, city, and townships) serving a 1) a county population of 2,000,000 or more or a city population of 400,000 or more were eligible to apply to the CDC for direct funding.
Number of LHJ allocation recipients: Effective FY 2022-23, $36,822,154 will be allocated to fifty (50) of the sixty-one (61) LHJs in California. Eleven (11) LHJs are receiving funding directly from the CDC and will not be part of this CDPH allocation process. Below are the LHJs receiving direct funding from the CDC.
List of LHJs who will receive direct funding from CDC
- Alameda County Health Department
- County of Riverside Department of Public Health
- County of San Diego Health and Human Services Agency
- Long Beach Health Department
- Los Angeles County Department of Public Health (Includes the City of Pasadena)
- Orange County Health Care Agency
- Sacramento County Health Department
- San Bernardino County-Department of Public Health
- San Francisco Department of Public Health
- Santa Clara County Health Department
Timeline: CDPH anticipates issuing individual allocation letters and funding guidance to LHJs by the end of February 2023. Work plan and spend plan templates will be provided with the allocation package for LHJs to complete and return to CDPH.
In addition to the direct allocation of funds to the 50 participating LHJs, CDPH will also coordinate the use of additional CASPHI grant funds for statewide activities to support all 61 local heath jurisdictions.
- Hire a vendor to conduct a Local Public Health Workforce Assessment - $2,000,000
Potential areas of focus for this assessment will include a compensation study comparing salary rates across local public health agencies as well as private sector and health care rates for similar positions, identifying recommended staffing levels for foundational capabilities as well as expanded multisector functions of public health, and workforce diversity.
- Support Public Health Capacity Building - $1,010,404
Targeted local assistance contract funding for equity-focused community-based organizations to provide capacity building support to local health jurisdictions.
- Community Health Assessment and Improvement Plan Support - $1,080,000
Four years of funding (YRs 2-5) of statewide and targeted training and technical assistance activities support LHJs working to develop or update CHA/CHIPs
CASPHI Informational Webinar: CDPH is planning to hold an informational webinar to provide additional details once all allocation letters have been distributed. The date and time of the webinar will be provided with individual LHJ allocation letters.
Contact Information: For questions related to this funding stream, please email CASPHILocalFunding@cdph.ca.gov.
III. Reporting Requirements
The CDC is requiring semi-annual progress reporting from all recipients and subrecipients (including California LHJs). The report will require progress updates on all proposed activities in workplans, and progress on expenditures identified in spend plans.
The initial progress report is tentatively projected to be due to from CDPH to the CDC by the end of June 2023. Based upon this due date, CDPH anticipates requesting a hiring status update from all participating LHJs by mid-May 2023. Additional information on progress reporting dates and reporting templates will be provided in the individual allocation letters.
IV. Formula-Based Allocation Details
The formula-based allocation is designed to emphasize a focus on equity based on several factors. The formula-based allocation is using three weighted inputs: 30% population, 35% poverty, and 35% demographic diversity. These inputs are calculated using hybrid weighting that incorporate the proportion of the total statewide population (at 30%) and the percentage of the total LHJ population (at 70%) for which these inputs apply.
The overall allocation funding model has been developed to address the CDC grant focus on strengthening public health infrastructure and advancing capacity to address equity.
Both the level of the base and the formula structure are set in order to provide a stable funding level LHJs with smaller populations and a high percentage of residents experiencing disadvantage, as well as to augment funding for LHJs which may represent a large proportion of the statewide population experiencing disadvantage.
V. CDC Grants Sample Activities and Funding Restrictions
Below is a list of sample activities that could be completed utilizing these CASPHI grant funds:
- Recruit and hire new public health staff. For example, this could include expanding recruitment efforts, creating new positions, improving hiring incentives, and creating new hiring mechanisms.
- Retain public health staff. For example, this could include strengthening retention incentives, creating promotional opportunities, and transitioning staff to other hiring mechanisms.
- Support and sustain the public health workforce. For example, this could include strengthening workplace well-being programs and expanding engagement with the workforce to address their mental, emotional, and physical well-being.
- Train new and existing public health staff. For example, this could include improving the quality and scope of training and professional development opportunities for all staff.
- Strengthen workforce planning, systems, processes, and policies. For example, this could include maintaining and upgrading human resource systems, identifying ways to better collect and use workforce data, and identifying policies that could facilitate more efficient and effective workforce development and management.
CDC Funding Restrictions
- Recipients may not use funds for research.
- Recipients may not use funds for clinical care except as allowed by law.
- Generally, recipients may not use funds to purchase furniture or equipment. (Equipment is defined as a single unit cost exceeding $5,000.)
- Other than for normal and recognized executive-legislative relationships, no funds may be used for:
- Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body
- The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before any legislative body
Recipients may use funds only for reasonable program purposes, including personnel, travel, supplies, and services.
See CDC's Funding Restrictions and Limitations for additional guidance and additional guidance on lobbying for recipients.
Office of Policy and Planning
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