HEALTH MANAGEMENT ASSOCIATES, INC.

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Feasibility and Fiscal Evaluation Services for a Municipal Public Health Agency fully quantifiable. These may include certifications that the OCHCA may hold that provide opportunities for additional funds or eligibility for certain grant awards Based on reviewing the County's workload data, HMA will propose a potential geographic catchment area for consideration under the proposed regional health models. This proposal will consider both the potential boundaries and the functions that may be possible under a regional health model. This work stream will also include a summative review of the County's COVID-19 response specifically focusing to what degree the County's approach addressed issues unique to Santa Ana and/or engaged representatives from the City of Santa Ana. This will be based on a review of published reports by OCHCA and interviews with key stakeholders. Deliverables: Summary memo/presentation of current service level, cost and revenue; summative review of OCHCA COVID-19 response 4. Comparative The final element of the analysis will be to capture data from comparative Analysis and cities on their operation of a municipal public health development to Forecasting provide the basis for the City of Santa Ana cost, staffing, and revenue projections. Three cities in Southern California provide examples: Pasadena and Long Beach, which operate mandated functions, and Vernon, which operates a limited scale public health department. Pasadena and Long Beach directly provide services and contract with the County, nonprofits, and other partners in fulfilling their public health responsibilities. Comparative data from all three cities will be captured to the degree available to understand: ■ Cost and staffing levels and ratio ■ Revenue streams ■ Benefits and challenges of the municipal health department The comparative analysis will capture both quantitative and qualitative data. Quantitative data will be used to capture staffing and revenue estimates such as the number of inspections, permits, and related revenue. Qualitative data captured through interviews with key city staff in Long Beach and Pasadena will help identify and elevate key considerations for the City of Santa Ana. Using the data gathered from the County and comparable municipalities, HMA will create a forecasting model to project the staffing, costs, and revenue related for the three models: full service; limited service, and regional health model. This forecasting model will rely on assumptions based on the experience of other municipalities such as ratio of staffing to inspections, frequency of inspections, fees associated with inspections, staffing required for core functions, and potential grant funding. The model will provide the basis for the projections included in the draft and final model. IIE.ALTII MA\AGLMEN'r ASSOCIATES 18