Report 2018-116 Recommendation 5 Responses

Report 2018-116: San Diego's Hepatitis A Outbreak: By Acting More Quickly, the County and City of San Diego Might Have Reduced the Spread of the Disease (Release Date: December 2018)

Recommendation #5 To: San Diego, County of

To ensure that it takes appropriate action to protect the public health of the residents of the city, the county should enter into an agreement—such as a memorandum of understanding—with the city or should negotiate revisions in its contract with the city by March 31, 2019, to clarify each entity's roles and responsibilities over public health matters, and to include city leadership in coordinating response efforts when public health matters, such as disease outbreaks, affect the city's residents.

6-Month Agency Response

The County and City of San Diego have developed and executed a memorandum of understanding to define the roles and responsibilities of each party and ensure appropriate representation in policy decisions during outbreaks of communicable disease and other public health concerns affecting both jurisdictions. This memorandum was fully executed on March 28, 2019.

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


60-Day Agency Response

The County and City met on February 5, 2019 to discuss the memorandum of agreement and a framework for the agreement was agreed upon. The County drafted and sent the draft agreement to the City on February 15, 2018 for the City to review. The County and City have scheduled a meeting on February 28, 2019 to review the agreement language. The intent of both the City and the County is to execute the agreement by March 31, 2019.

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


All Recommendations in 2018-116

Agency responses received are posted verbatim.