LHD Maintenance ARPA SLFRF Quarterly Report (September 2022)

Summary

The LHD Maintenance ARPA SLFRF Quarterly Report for September 2022 from the Virginia Department of Health (VDH), dated 9/30/2022. It describes an initiative to address facility maintenance needs at Local Health Department (LHD) and other VDH facilities, and lists progress including delivery of vaccine cold storage equipment for LHD sites, workspace redesign work at the James Madison Building, and delivery of new camera equipment to 33 additional sites. The project budget table lists a total appropriation of $30,000,000, obligations to date of $2,584,500 and expenditures to date of $871,700.

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                         LHD MAINTENANCE
American Rescue Plan Act (ARPA) State and Local Fiscal Recovery Fund (SLFRF)




                                9/30/2022
LHD Maintenance
ARPA SLFRF Quarterly Report
September 2022
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Table of Contents
Report Mandate ............................................................................................................................................ 3
Context for ARPA Initiatives .......................................................................................................................... 3
Executive Summary....................................................................................................................................... 3
Objective(s) ................................................................................................................................................... 4
Overview of Quarterly Progress (July – September 2022)............................................................................ 4
Anticipated Next Quarter Activities (October – December 2022) ................................................................ 5
Risks and Risk Management ......................................................................................................................... 6
Change Management Considerations........................................................................................................... 7
Project Budget .............................................................................................................................................. 7
LHD Maintenance
ARPA SLFRF Quarterly Report
September 2022
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Report Mandate
Chapter 1 Enactment Clause 1, paragraph B.2.m.6., of the amended 2021 Acts of Assembly states, “The
department shall communicate a detailed plan and implementation schedule to the Governor, the Chairs
of the House Appropriations and Senate Finance and Appropriations Committees, and the Director of the
Department of Planning and Budget by September 30, 2021. Additionally, the department shall report
quarterly to the Governor, the Chairs of the House Appropriations and Senate Finance and Appropriations
Committees, and the Director of the Department of Planning and Budget on progress made, with the first
progress report to be delivered not later than December 31, 2021.”

Context for ARPA Initiatives
The Virginia Department of Health (VDH) is excited about the opportunity presented by the appropriation
of ARPA State Fiscal Funds in the August 2021 Special Session II of the General Assembly to improve public
health in Virginia. VDH views this investment as a once in a generation opportunity and will work tirelessly
to maximize use of funds to create and sustain these initiatives. Modifications to VDH’s plans will be
reflected in future quarterly reports.

Executive Summary
The VDH & Local Health Department (LHD) Maintenance initiative focuses on implementing solutions to
address facility maintenance needs that have impacted the Department’s ability to provide services that
address COVID-19’s impact across the Commonwealth of Virginia. The Commonwealth’s residents who
are served by the community-based clinics that are part of the public health system rely on the LHD
facilities. Lack of appropriate facility upgrades, such as touchless technology for doors and restrooms and
cold storage for vaccines, exacerbated the disproportionate impact of COVID-19 on populations that rely
on public health systems. This initiative focuses on employee safety and addresses maintenance needs in
the LHDs and other VDH facilities. It will enable locations to comply with distancing and ventilation
guidance to minimize the spread of COVID-19.

These projects will enable VDH to protect the health and promote the well-being of all people in Virginia,
while simultaneously ensuring VDH employees are able to work in a safe environment that enables social
distancing and COVID-19 prevention measures. The projects will support VDH’s employees, contractors,
and volunteers in furthering the agency’s mission of making Virginia the healthiest state in the nation.

The following is a summary of progress made over the last three months, with more details provided later
in this report:
     • Continued workspace redesign work at the James Madison Building and Office of Environmental
         Health Services Norfolk Field Office

    •   Received delivery of vaccine cold storage equipment for LHD sites

    •   Completed card reader access control and continued progress of security camera installation at
        the Office of Vital Records
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ARPA SLFRF Quarterly Report
September 2022
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    •   Completed installation of teleconferencing equipment at the James Madison Building and two
        LHD sites as part of a pilot program. Delivered new camera equipment to 33 additional sites for
        immediate setup and use

Objective(s)
The goal of this initiative is to make building upgrades to mitigate the impact of infrastructure challenges
hindering VDH’s ability to reach at-risk communities. The following are objectives to achieve this goal:
    •   Determine most-needed LHD infrastructure repairs and make upgrades in LHDs across the state
        in a systematic fashion, prioritizing the most outdated LHDs with the greatest number of needed
        updates. Infrastructure repairs include physical plant improvements to public hospitals and health
        clinics, or adaptations to public buildings to implement COVID-19 mitigation tactics.
    •   Procure and install adequate refrigeration units and generators to support storage of COVID-19
        vaccinations.
    •   Procure and install negative pressure ventilation to support ongoing efforts to combat COVID-19.
        Ventilation improvements may occur in congregate settings, health care settings, or other key
        locations.
    •   Upgrade building furniture and improve layout of offices to allow for adequate social distancing
        and cleaning measures to protect employees against COVID-19.
    •   Invest in hands free facility solutions that support ongoing efforts to combat COVID-19.
    •   Procure and install teleconferencing equipment to adapt to the modern digital workplace and
        provide robust telehealth services.

Overview of Quarterly Progress (July – September 2022)
Over the previous quarter, VDH has conducted numerous activities that have advanced the LHD
Maintenance Initiative, beginning upgrades at some sites while positioning VDH to begin upgrading LHD
and VDH facilities in the coming months. The key activities that have been accomplished to date are
summarized below:

Key Activities and Accomplishments

    •   James Madison Building (JMB)
           o Additional items were added at JMB to allow for VDH staff to return to in-person work.
               These items include sanitizing the building, disposal of documents left behind when VDH
               staff began working remotely due to COVID-19, and the installation of new automated
               external defibrillators (AEDs)

            o   A design firm has been selected to provide a conceptual redesign of the JMB interior
                spaces. Much of this work will fall outside of ARPA, but some activities will be aligned to
LHD Maintenance
ARPA SLFRF Quarterly Report
September 2022
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               utilize ARPA funding such as the installation of new touchless restroom fixtures and
               motion-activated light switches

   •   Local Health District (LHD) Upgrades
           o Sixty-three new cold storage freezers and refrigerators have been purchased for 45 LHD
               sites. Fifty-one units have been delivered to date

           o   The team kicked off installation of generators and the design work necessary to complete
               improved ventilation at LHDs. Twelve generator and HVAC sites will be improved during
               the first phase

           o   Selected a vendor to begin performing site assessments for new wireless access points at
               the 17 sites receiving improved internet connectivity as part of the Broadband initiative

   •   Office of Environmental Health Services (OEHS) Upgrades

           o   At the Norfolk Field Office, a firm has been selected and began re-designing workspaces.
               Once the design is complete, contractors will be solicited to install upgrades

           o   The Department of Real Estate Services (DRES) is presently negotiating a lease extension
               at the Accomac Field Office. Once this effort is complete, a similar design exercise will
               take place to the Norfolk Field Office

   •   Office of Vital Records (OVR) Upgrades
           o Completed the installation of card readers for enhanced access control at key doors

           o   Continued installation of video cameras for improved site security. Completion is pending
               the delivery of long lead-time devices that are experiencing supply chain disruptions

           o   Purchased movable panels to better separate public and VDH staff workspaces in an effort
               to mitigate the spread of contagious diseases

   •   Teleconferencing Upgrades
           o Kicked off pilot program, installing new cameras, televisions, and miscellaneous
              equipment at the James Madison Building and Ashland & Chesterfield Health Districts

           o   Upgraded teleconferencing software to activate newly installed equipment

           o   Renewed license and maintenance agreement with teleconferencing service provider
               (Vicom)

           o   Purchased and delivered new teleconferencing cameras to 33 LHD sites for immediate
               setup and activation

Anticipated Next Quarter Activities (October – December 2022)
The following outlines the activities and tasks planned from October through December 2022:
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ARPA SLFRF Quarterly Report
September 2022
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   •   James Madison Building (JMB)
          o Complete the conceptual redesign of JMB workspaces to allow for the competitive
              solicitation of design work from architectural firms

           o   Identify and complete building renovation tasks that do not require design work and are
               aligned to ARPA rules and regulations

   •   Local Health District (LHD) Upgrades
           o Complete delivery and installation of cold storage equipment

           o   Select vendors to complete generator installation and improved ventilation design. Begin
               generator installation and solicit quotes for improved ventilation installation

           o   Complete site assessments for wireless access points at the 17 Broadband pilot sites and
               place and order with Verizon to install new devices

   •   Office of Environmental Health Services (OEHS) Upgrades
           o Complete the redesign of workspaces at the Norfolk Field Office and solicit quotes from
               qualified small businesses to install upgrades

           o   Begin Accomac Field Office design work once an extended lease agreement is finalized

   •   Office of Vital Records (OVR) Upgrades
           o Complete installation of new security cameras

           o   Select a vendor to install lobby modifications. Most of this work is outside of ARPA and
               separately funded, but some tasks will be funded under ARPA where the rules and
               regulations allow

   •   Teleconferencing Upgrades
           o Complete pilot program at two JMB locations currently incomplete due to long lead-time
              equipment experiencing supply chain disruptions

           o   Begin implementation of the full program of upgrades across LHD sites

Risks and Risk Management
   •   Risk 1: If a long-term funding source is not identified for monthly router and wireless access point
       fees, then VDH will not be able to afford the upgraded broadband equipment that will be installed

           o   Mitigation Strategy: Develop a detailed operating expense budget using available
               Verizon/Virginia IT Agency (VITA) cost information for VDH to use in requesting additional
               funds from the General Assembly.

   •   Risk 2: If VDH does not provide instructional material to sites receiving teleconferencing upgrades,
       then they may not be able to effectively use the new equipment
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ARPA SLFRF Quarterly Report
September 2022
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           o     Mitigation Strategy: Teleconferencing vendor (Vicom) to provide instructional materials
                 for VDH to distribute and post in upgraded conference spaces.

    •   Risk 3: If LHDs are responsible for procuring and overseeing vendors, then they may not follow
        the correct procedures to document and confirm compliance with the ARPA rules and regulations

           o     Mitigation Strategy: Prepared guidance materials for the business managers or their
                 delegates to use when procuring vendors and will use a comprehensive tracker to make
                 sure all compliance items are documented prior to executing a purchase order.


Change Management Considerations
VDH understands that successful transformation initiatives rely on more than just the right technology,
processes, and resources. They also depend on effective change management, communications, and
engagement strategies to make sure stakeholders are properly equipped with the information and
guidance that they need to support the changes. For the LHD Maintenance initiative, the successful
implementation of critical upgrades will depend on ongoing two-way communication and engagement
with a variety of local contacts.

VDH has developed and implemented a communications strategy for the LHD Maintenance initiative that
identifies key internal and external stakeholders, determines how they may be impacted and/or their role
in supporting the effort, and establishes strong feedback loops and channels for regular information-
sharing. Key messages to build buy-in and support from stakeholders have included the goals of the
upcoming changes, their benefits, and guidance and steps to prepare. Feedback loops include an intranet
site to house content for internal stakeholders, an initiative-specific email inbox for two-way
communication, and regular briefings to Central Office and LHD stakeholders across a variety of VDH
forums.

Project Budget
Budget, Obligations, and Actuals as of September 2022



 Total                            Total                                 Total
                   $30,000,000    Obligations           $2,584,500      Expenditures          $871,700
 Appropriation
                                  (To Date)                             (To Date)


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