BOARD MEETING DATE: January 21, 2000
AGENDA NO. 14

PROPOSAL: 

Recognize Revenues from California Department of Health Services for the Development of a Mobile Asthma Unit and Implementation of a One-Year Asthma Outreach Program

SYNOPSIS: 

In January 1999, the Board adopted the Children's Air Quality Agenda, which included ten action items to protect children from adverse health effects of air pollution. Action Item No. 5 sought to "Seek federal and state funding for additional lung and asthma testing of children through a mobile unit traveling to school and sports league sites." The AQMD is scheduled to receive $200,000 in appropriated funds in the California Department of Health Services Medi-Cal budget for FY1999-00, which resulted from Assemblyman Marco Firebaugh’s legislative request. These funds will be used to implement an asthma van project. The AQMD plans to provide $100,000 in co-funding toward the $300,000 that is required to manufacture, operate, maintain, and staff the mobile asthma unit for one year.

COMMITTEE: 

Administrative, December 17, 1999, Recommended for Approval

RECOMMENDED ACTION:

1. Recognize upon receipt $200,000 from California DHS for the acquisition of a mobile asthma unit and implementation of a one-year asthma outreach program.
   
   
2. Appropriate the above recognized $200,000 from the Undesignated Fund Balance to the Professional and Specialized Services account in Public Affairs/Transportation Programs for the mobile asthma unit project.
   
   
3. Designate $100,000 from a Supplemental Environmental Project through the AQMD’s Prosecutor’s Office for the mobile asthma unit project.
   
   
4. Authorize the Chairman to execute a sole source contract for $200,000 with the Asthma and Allergy Foundation of America, Southern California Chapter to procure, operate and maintain the mobile asthma unit and implement the asthma outreach program for one year.

Barry R. Wallerstein, D.Env.
Executive Officer

Background

This project involves the acquisition and deployment of a mobile unit to augment health services for children with asthma in underserved Southern California areas. Many underserved populations do not have access to adequate transportation, thus limiting their ability to participate in health care programs. Additionally, asthma has been identified as the leading reason for school absences and is the leading cause of childhood visits to the emergency room. The mobile health unit would travel to schools, Head Start and health centers within our basin. Barriers to health care, including language barriers and fear of authority figures, would be minimized by sending medical staff with appropriate language skills to community-based facilities.

The funds (up to $312,000) would be used to manufacture, equip, insure and maintain the mobile unit for one year. The unit would be staffed by appropriate bilingual medical and patient service worker personnel. It would be made available to provide asthma and respiratory health screening and treatment to children and families in designated areas of our basin. Additionally, the mobile unit would serve as a point of distribution for air pollution and health-related information.

Proposal

Staff is recommending that the Board authorize the Chairman to enter into a sole source contract with the Asthma and Allergy Foundation of America (AAFA), Southern California Chapter, a non-profit health agency, to develop, implement, and operate the mobile asthma unit for the initial year of the program. AAFA has over five years of experience operating the Breathmobile Program, an asthma clinic on wheels that provides diagnosis, treatment and education to high-risk, disadvantaged children at their schools. The program currently has three mobile units (Breathmobiles) serving schools in Los Angeles County and is staffed and operated by medical personnel from Los Angeles County-USC Medical Center. Medical services provided by specialists on the Breathmobile include diagnosis, physical examinations, patient histories, pharmacological therapy, free medications, spirometry, as well as peak flow meter testing.

The following outlines the specific steps to get this program started.

• AQMD executes a contract with AAFA for the development and implementation of a mobile asthma unit, which includes acquisition and operations (including all required registrations, insurances, etc.) and implementation of the mobile asthma project for the initial year.
  
  
• AQMD program staff will identify schools and community and health-based partners to join in this pilot program.
  
  
• AQMD program staff will identify an organization to continue the future ongoing operation of the asthma unit. The mobile unit would be provided free of charge. The responsible organization would be expected to assume all costs associated with operating, staffing and maintaining the mobile unit after the first year. (For example, currently the Asthma and Allergy Foundation operates three mobile asthma units with Los Angeles County-USC Medical Center, and after the first year of operation units are operated by LAC-USC with regular reports to the Foundation).
  
  
• At the completion of the one-year pilot, LAC-USC has expressed a willingness to include this additional unit in the fleet they currently operate, although other options would be considered.

Staff is recommending that the Board authorize the Chairman to recognize $200,000 in revenue from California DHS when it is received, appropriate $200,000 from the Fiscal Year 1999-00 Undesignated Fund Balance, and seek $100,000 from a Supplemental Environmental Project through the AQMD’s Prosecutor’s Office for the acquisition and operation of a mobile asthma unit and implementation of a one-year asthma outreach program.

Sole Source Justification

Section VIII (B) of the Procurement Policy Procedure identifies four major provisions under which a sole source award may be justified. This request for sole source award is made under provision B.2.c(1), the unique experience and capabilities of the proposed contractor or contractor team. The AAFA, Southern California Chapter has over five years of experience operating mobile asthma programs in Los Angeles County. They currently operate a fleet of three mobile vans, and are the only health-based organization in our region that provides comprehensive asthma screening and treatment to children at their school site.

Project Budget

The asthma van project draft program budget of $312,000 includes $12,000 that AQMD’s Public Affairs office has budgeted for use and addresses the costs associated with building, equipping, staffing, operating and insuring the mobile unit for one year. Recurring annual costs are expected to range from $300,000 to $400,000, depending on fuel costs and salaries. The recurring annual budget will depend on the cost for ongoing medical supplies (estimated at $25,000 per year); the cost of mobile unit operation, insurance, and maintenance (estimated at $11,540 per year, although the cost could be as much as $85,000 per year based on the size and type of vehicle chosen) and cost for employee compensation (estimated at approximately $300,000 per year). These costs would be assumed by LAC-USC or other operators.

Reports and Program Evaluation

Once the program is initiated, staff will provide the Board with quarterly reports on the progress of the program, including number of children screened and schools/facilities served. After a full year of operation, staff will prepare a program evaluation that will include recommendations for future operation.

Fiscal Impacts

These grant funds are a supplement to the FY 1999-00 Budget, and as such have no negative impact on the budget. Since the receipt of funds by the AQMD constitutes a budget supplement within the definition of Health and Safety Code Section 40720(j), public notice of this proposed supplement was published in the Los Angeles Daily Journal, Riverside Press Enterprise, Orange County Register, San Bernardino Sun, and the Inland Valley Daily Bulletin.

Associated outreach funds for this program have been budgeted in the Public Affairs/Transportation Programs budget under Children’s Air Quality Agenda.

Attachment

Estimated One-Year Mobile Unit Budget

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