Report 2014-113 All Recommendation Responses

Report 2014-113: California Department of Public Health: Even With a Recent Increase in Federal Funding, Its Efforts to Prevent Diabetes Are Focused on a Limited Number of Counties (Release Date: January 2015)

Recommendation for Legislative Action

If state lawmakers desire Public Health to increase its efforts to address diabetes, they should consider providing state funding to aid in those efforts. For instance, the Legislature could provide funding to establish a grants specialist position to identify and apply for federal and other grants.

Description of Legislative Action

As of January 2020, the Legislature has not taken action to address this specific recommendation.

California State Auditor's Assessment of Annual Follow-Up Status: No Action Taken

Description of Legislative Action

The Legislature has not taken any action to address this specific recommendation.

California State Auditor's Assessment of Annual Follow-Up Status: No Action Taken

Description of Legislative Action

Assembly Bill 1532 (Bloom) was introduced on February 17, 2017, and would require the Department of Public Health to establish a grant specialist who shall identify and apply for grants related to the prevention and management of diabetes. This bill is pending in the Senate.

California State Auditor's Assessment of Annual Follow-Up Status: Legislation Introduced

Description of Legislative Action

Legislation has not been introduced to address this recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation #2 To: Public Health, Department of

To increase its efforts to prevent and control diabetes, Public Health should develop a process for identifying and applying for federal funding opportunities, including routinely and proactively searching for grants. In addition, Public Health should seek funding for a grants specialist position to identify and apply for federal and other grants.

Annual Follow-Up Agency Response From October 2021

Public Health staff within the Center for Healthy Communities actively search and track grant funding opportunities that address diabetes as workload allows by accessing websites which post grant opportunities, such as the Centers for Disease Control and Prevention (CDC), Grants.Gov, Centers for Medicare and Medicaid Services, National Association Chronic Disease Directors, and other public and private organizations. Searches to identify grant opportunities are performed on a weekly basis as staffing is available. In 2018, the California Department of Public Health's (CDPH) Chronic Disease Control Branch (CDCB) was awarded a five-year grant (October 2018 through June 2023) by the Centers for Disease Control and Prevention (CDC) "Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke" (CDC RFA-DP18-1815PPHF18), known in California as Prevention Forward. The purpose of the grant is to work with CDPH chronic disease prevention programs and stakeholders to implement diabetes management and Type 2 diabetes prevention, heart disease, high cholesterol, and stroke prevention and management strategies. The selected strategies are implemented in the counties of Fresno, Los Angeles, Madera, Merced, Monterey, Sacramento, and Solano in high burden areas and communities to ensure work on these strategies are mutually reinforcing across all community settings, and health system organizations. CDPH is using a multi-level coordinated approach with a health equity focus interwoven throughout all strategies and interventions. This approach allows Prevention Forward activities to be supported by public private partnerships between state and local government, health systems, and community stakeholders.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

Public Health indicates that it performs weekly searches of grant opportunities, as staffing is available. However, they do not indicate how often staff are available to perform this review. Further, they provide an example of a grant they obtained; however, the point of this recommendation is to make sure California is not missing out on grant opportunities. Obtaining one particular grant, as positive as that achievement might be, is not evidence the Public Health has processes to make sure it is not missing out on others.

Annual Follow-Up Agency Response From July 2018

Public Health staff within the Chronic Disease and Injury Control Division actively search and track grant funding opportunities that address diabetes by accessing websites with post grant opportunities, such as the Centers for Disease Control and Prevention (CDC), Grants.Gov, Centers for Medicare and Medicaid Services, National Association Chronic Disease Directors, and other public and private organizations. Searches to identify grant opportunities are performed on a weekly basis. In 2017, staff identified a funding opportunity and collaborated with a local health department to apply, but did not receive a funding award. To date, no funding has been available to pursue a grant specialist dedicated to identifying, analyzing, and applying for federal grants related to diabetes prevention and management. CDPH receives two federal CDC grants to address diabetes prevention and management: "State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health" and "State and Local Public Health Actions to Prevent Obesity, Diabetes, Heart Disease and Stroke." These grants end by September 2018. CDPH plans to apply for future CDC funding opportunities as soon as the notice of funding opportunities are released.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

Annual Follow-Up Agency Response From November 2016

Public Health staff within the Chronic Disease and Injury Control Division continues to search for grant funding opportunities that address diabetes and has not identified any that would be suitable for our public health mission or capacity (e.g., non-research focused). Staff monitor various Centers for Disease Control and Prevention notifications and belong to a variety of communication networks that provide information on federal funding. Additionally, no funding has been available to pursue a specific grant specialist dedicated to identifying, analyzing and applying for federal grants related to diabetes. If a suitable funding opportunity became available, Public Health management would determine the most appropriate staff to develop an application, likely the staff currently dedicated to working on federally funded diabetes programs.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

1-Year Agency Response

Public Health staff within the Chronic Disease and Injury Control Division continues to search for grant funding opportunities that address diabetes and has not identified any that would be suitable for our public health mission or capacity (e.g., non-research focused). Staff monitor various Centers for Disease Control and Prevention notifications and belong to a variety of communication networks that provide information on federal funding. Additionally, no funding has been available to pursue a specific grant specialist dedicated to identifying, analyzing and applying for federal grants related to diabetes. If a suitable funding opportunity became available, Public Health management would determine the most appropriate staff to develop an application, likely the staff currently dedicated to working on federally funded diabetes programs

California State Auditor's Assessment of 1-Year Status: Will Not Implement

Based on its response, the California Department of Public Health does not plan to implement this recommendation. Although Public Health stated in its response that its staff searches for grant funding opportunities, it has not developed a process to identify and apply for diabetes-related grants. Additionally, Public Health has not sought state funding for a grants specialist position.

6-Month Agency Response

The program continues to search for additional funding. However since the 60-day response there has been no grant opportunity available that would allow CDPH to specifically fund a grants specialist.

California State Auditor's Assessment of 6-Month Status: Will Not Implement

Based on its response, the California Department of Public Health does not plan to implement this recommendation.

60-Day Agency Response

The program is fully committed to obtain additional funding from all available resources. Also CDPH would welcome having additional staff to help with the acquiring and applying for grants. Along this line, CDPH recognizes the value of a grant specialist who is committed solely for the purpose of acquiring federal or other awards to help address the growing and urgent public health needs associated with diabetes. To this end, CDPH will continue to search for additional funding which will allow CDPH to fund a grants specialist. However, there is no certainty that additional funding can be found or will be available in the near or distant future that can be solely dedicated entirely for that purpose. In addition, we have to weigh this recommendation for an administrative position against a number of other needs within CDPH that may be more pressing or urgent from a health and safety standpoint. Therefore, CDPH cannot state, at this time, that it can or will be able implement this recommendation now or going forward.

California State Auditor's Assessment of 60-Day Status: Will Not Implement

Based on its response, the California Department of Public Health does not plan to implement this recommendation.

Recommendation #3 To: Public Health, Department of

To ensure that staff responsible for diabetes prevention have adequate knowledge and skills, Public Health should ensure that it follows its recently developed process to track training related to diabetes prevention for all employees participating in this effort.

6-Month Agency Response

Since the 60-day response, staff, including managers, send diabetes (and related) training announcements to the Training and Technical Assistance Coordinator (Coordinator). The Coordinator prints out the announcement and adds it to the training binder under the Current Trainings tab. Following the training, staff complete the attendance sheet and place it in the Coordinator's Diabetes Training Inbox. The attendance sheet and the training announcement is filed under the tab Attended Trainings. Approximately, twice a month, the Diabetes Tracking Log is updated, which lists all of the trainings attended by staff.

The Coordinator sends out a weekly reminder to diabetes-funded staff to ensure that they attend trainings and fill out the Attendance Sheet for tracking purposes. Included in the reminder is the attendance sheet and the procedures for tracking training attendance. At the end of each week, the Program Manager and Coordinator review the training opportunities and attendance to ensure that staff are attending trainings and review which trainings to promote for the upcoming week.

California State Auditor's Assessment of 6-Month Status: Fully Implemented

60-Day Agency Response

The Diabetes program established a training tracking system in January 2015 and is monitoring on-going staff training. In addition, a process is in place where new staff will be oriented and trained with regard to the training tracking system. The Diabetes program will continue to monitor staff trainings to demonstrate a sustained use of this new process and will update the program's progress in future updates.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

All Recommendations in 2014-113

Agency responses received are posted verbatim.