Sacramento County Grand Jury • 2021-2022

Public Health Office Abandoned by County Board of Superviors in Covid-19 Crisis Drivers Line Up at Cal Expo for

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Findings and Recommendations 6 findings

F1
On March 19, 2020 the Sacramento County Public Health Officer issued a Public Health Order. Lack of coordinated emergency response and direction from the County Executive and the Board of Supervisors shifted all oversight of the planning and implementation to the Public Health Officer and the Office of Emergency Services.
Related Recommendations (1)
R1
The County Executive, Board of Supervisors, and OPH should develop and adopt a public health emergency response plan which recognizes, and plans for the immediate requirements of OPH to implement public health orders to best ensure public safety. The Board of Supervisors should finalize and approve the response plan by December 2022.
F2
In 2009, OPH experienced dramatic staffing and funding cutbacks, which have never been fully restored. As a result, OPH entered the 2020 pandemic with distinct deficits in areas, such as the field nursing unit, services for at-risk communities, and other programs that significantly impacted its ability to respond to the dynamic nature of the COVID-19 pandemic as it reached Sacramento in early 2020. These under-investments in Public Health presented significant challenges for OPH in meeting the immediate public health emergency response required in a pandemic.
Related Recommendations (1)
R2
The Board of Supervisors should immediately develop, formally approve and implement a direct and regular reporting process for the Public Health Officer. This process should require at least monthly reporting to the Board during public sessions. Whenever a community wide public health order has been declared, the Board of Supervisors should augment regular reporting by OPH with detailed reporting on the response to the public health emergency, including recommendations for needed services, programs and funding. These policies and processes should be adopted by the Board of Supervisors no later than June 2022.
F3
Sacramento County administrators adhered to a traditional budget process and calendar in response to emergency funding requests from OPH, despite the availability of $181 mil- lion in CARES Act funding. That rigid process absolutely stymied appropriate and timely disbursal of emergency funds requested by OPH for needed equipment, staffing and ser- vices. 6
Related Recommendations (1)
R3
Funding for OPH should be immediately reviewed and adequately increased to build and maintain a strong organizational infrastructure with sufficient staffing. Such funding is essential to ensure that OPH maintains the critical capacity to immediately implement all essential and emergency public health services. This funding assessment and increased funding levels should be included in the budget process for the 2022-2023 budget.
F4
Despite the gravity of the COVID-19 pandemic and its impact on Sacramento County residents, the Board of Supervisors did not request pandemic response reports directly from its Public Health Officer for nearly five months after the issuance of the first COVID-19 Public Health Order.
Related Recommendations (1)
R4
The County should develop and adopt a separate emergency budget allocation and approval process. This process would operate outside the regular fiscal year county budget process in order to expedite emergency funding requests from County departments. Such a process should include program staff training, as well as transparent allocation and expenditure reporting to the Board of Supervisors and County Executive staff. The Board of Supervisors should finalize and approve the emergency budget allocation process by December 2022.
F5
The Board of Supervisors does not have its own “Continuity of Operation” plan in place for the Board of Supervisors to use in the case of any type of public emergency which would prevent or adversely impact critical Board of Supervisors governance activities and responsibilities.
Related Recommendations (1)
R5
The Board of Supervisors should develop and adopt its own “Continuity of Operation” plan, with periodic updating as appropriate. The Board of Supervisors should finalize its “Continuity of Operation” plan by December 2022. 7
F6
Implementation of COVID-19 related Public Health Orders was hamstrung by a lack of enforcement support from the Sacramento County Board of Supervisors, the County Chief Executive, the County Sheriff and local law enforcement agencies.
Related Recommendations (1)
R6
The Board of Supervisors and OPH should immediately begin discussions with the County Sheriff and other County law enforcement entities. These discussions should result in a County ordinance directing local law enforcement to enforce public health emergency orders. The Board of Supervisors should enact this ordinance by December 2022