DEPARTMENT: Public Health
FILE TYPE: Consent Action
TITLE
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Authorization To Execute Joint Powers Agreement With Ramsey County For Tuberculosis Services
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PURPOSE/ACTION REQUESTED
Authorize execution of a joint powers agreement (JPA) with Ramsey County for tuberculosis services.
SUMMARY
Pursuant to Minn. Stat. § 375A.04, the Dakota County Board of Commissioners is, and performs the duties and exercises the powers of, a community health board under Minn. Stat. ch. 145A, including the responsibility to prevent disease and to promote and protect the public health of Dakota County residents.
Dakota County Public Health is mandated under Minn. Stat. ch. 145A to control communicable disease and therefore, ensure tuberculosis services are provided in the form of medical care and case management through the completion of treatment. Dakota County Public Health staff provides tuberculosis case management services to clients in the County with active tuberculosis, latent tuberculosis, and suspect tuberculosis. In addition, specialized clinical services for infectious disease are needed to determine tuberculosis disease treatment requirements to prevent the further spread of tuberculosis. Dakota County is responsible for the costs of tuberculosis clinical services for residents who are uninsured or underinsured.
Due to the lack of a clinic in Dakota County that provides infectious tuberculosis related services, Dakota County Public Health has joint powers agreements (JPA) with Hennepin County and Ramsey County to assist with this need.
By Resolution No. 23-572 (December 16, 2023), the Dakota County Board of Commissioners authorized the Community Services Director to enter into a JPA with Ramsey County for the delivery of tuberculosis services to Dakota County tuberculosis clients, in a total amount of up to $70,000 for the period of January 1, 2024 through December 31, 2025.
Dakota County Public Health has utilized Ramsey County tuberculosis services since 2010. Ramsey County operates a tuberculosis control program and is able to provide those program services to Dakota County under the terms of this JPA. The purpose of this JPA is to set out the respective duties and responsibilities of Dakota and Ramsey Counties for the provision of tuberculosis control services to those residents who have been referred to Ramsey County by Dakota County. The maximum amount to be paid by Dakota County pursuant to this Agreement shall not exceed $50,000. The maximum amount to be paid in the previous contract (2023-2025) was not to exceed $70,000. The maximum amount was decreased by $20,000 based on an average cost of $36,000 over a period of two years. The remaining $14,000 buffer allows for an unpredictable influx in clients or large-scale contact investigation service costs. Tuberculosis control service needs are unpredictable and can vary client to client due to diagnostic needs, diagnosis or disease type, treatment, and follow-up requirements.
Staff recommends a two-year term of the JPA to continue tuberculosis clinical services provided by Ramsey County through the Saint Paul-Ramsey County Tuberculosis Clinic to clients referred by Dakota County Public Health (Attachment: Joint Powers Agreement).
The vendor’s performance was previously successful as shown by the ability to receive all clients referred from Dakota County Public Health for diagnostic work, treatment, and follow-up thoroughly and as expected.
OUTCOMES
How Much? All residents with active tuberculosis or suspect tuberculosis are eligible to receive infectious disease medical care to ensure effective clinical treatment of disease.
How Well? Dakota County Public Health staff assists with case management services for all active tuberculosis clients. Clients are able to complete disease treatment regardless of insurance status.
Is Anyone Better Off? Dakota County Public Health protects the health of all through prevention of tuberculosis spread in our community.
RECOMMENDATION
recommendation
Staff recommends authorization to enter into a JPA with Ramsey County for tuberculosis services for the term of January 1, 2026 through December 31, 2027, in an amount not to exceed $50,000 based on an average of actual expenses in 2024-2025.
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EXPLANATION OF FISCAL/FTE IMPACTS
Funding for the JPA for the term of January 1, 2026 through December 31, 2027, is included in the 2026 County Manager’s Recommended Budget.
☐ None ☒ Current budget ☐ Other
☐ Amendment Requested ☐ New FTE(s) requested
RESOLUTION
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WHEREAS, pursuant to Minn. Stat. § 375A.04, the Dakota County Board of Commissioners is, and performs the duties and exercises the powers of, a community health board under Minn. Stat. ch. 145A, including the responsibility to prevent disease and to promote and protect the public health of Dakota County residents; and
WHEREAS, Dakota County Public Health is mandated under Minn. Stat. ch. 145A to control communicable disease and therefore, ensure tuberculosis services are provided in the form of medical care and case management through the completion of treatment; and
WHEREAS, Dakota County Public Health staff provides tuberculosis case management services to clients in the County with active tuberculosis, latent tuberculosis, and suspect tuberculosis; and
WHEREAS, in addition, specialized clinical services for infectious disease are needed to determine tuberculosis disease treatment requirements to prevent the further spread of tuberculosis; and
WHEREAS, Dakota County is responsible for the costs of tuberculosis clinical services for residents who are uninsured or underinsured; and
WHEREAS, due to the lack of a clinic in Dakota County that provides infectious tuberculosis related services, Dakota County Public Health has joint powers agreements (JPA) with Hennepin County and Ramsey County to assist with this need; and
WHEREAS, by Resolution No. 23-572 (December 16, 2023), the Dakota County Board of Commissioners authorized the Community Services Director to enter into a JPA with Ramsey County for the delivery of tuberculosis services to Dakota County tuberculosis clients, in a total amount of up to $70,000 for the period of January 1, 2024 through December 31, 2025; and
WHEREAS, Dakota County Public Health has utilized Ramsey County tuberculosis services since 2010; and
WHEREAS, Ramsey County operates a tuberculosis control program and is able to provide those program services to Dakota County under the terms of this JPA; and
WHEREAS, the purpose of this JPA is to set out the respective duties and responsibilities of Dakota and Ramsey Counties for the provision of tuberculosis control services to those residents who have been referred to Ramsey County by Dakota County; and
WHEREAS, the maximum amount to be paid by Dakota County pursuant to this Agreement shall not exceed $50,000; and
WHEREAS, the maximum amount to be paid in the previous contract (2023-2025) was not to exceed $70,000; and
WHEREAS, the maximum amount was decreased by $20,000 based on an average cost of $36,000 over a period of two years; and
WHEREAS, the remaining $14,000 buffer allows for an unpredictable influx in clients or large-scale contact investigation service costs; and
WHEREAS, tuberculosis control service needs are unpredictable and can vary client to client due to diagnostic needs, diagnosis or disease type, treatment, and follow-up requirements; and
WHEREAS, staff recommends a two-year JPA to continue tuberculosis clinical services provided by Ramsey County through the Saint Paul-Ramsey County Tuberculosis Clinic to clients referred by Dakota County Public Health (Attachment: Joint Powers Agreement); and
WHEREAS, the vendor’s performance was previously successful as shown by the ability to receive all clients referred from Dakota County Public Health for diagnostic work, treatment, and follow-up thoroughly and as expected.
NOW, THEREFORE, BE IT RESOLVED, That the Dakota County Board of Commissioners hereby authorizes the Community Services Director to enter into a joint powers agreement with Ramsey County for the delivery of tuberculosis services to Dakota County tuberculosis clients, in a total amount of up to $50,000 for the period of January 1, 2026 through December 31, 2027, subject to approval by the County Attorney’s Office as to form.
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PREVIOUS BOARD ACTION
23-572; 12/16/23
ATTACHMENTS
Attachment: Joint Powers Agreement
BOARD GOALS
☒ A Great Place to Live ☐ A Healthy Environment
☐ A Successful Place for Business and Jobs ☐ Excellence in Public Service
PUBLIC ENGAGEMENT LEVEL
☐ Inform and Listen ☐ Discuss ☐ Involve ☒ N/A
CONTACTS
Department Head: Gina Pistulka
Author: Gina Pistulka