LHD Maintenance ARPA SLFRF Quarterly Report (December 2022)

Summary

The LHD Maintenance ARPA SLFRF Quarterly Report for December 2022 from the Virginia Department of Health (VDH), dated 12/31/2022. Its key activities include items added at the James Madison Building to allow VDH staff to return to in-person work, the selection of a design firm for a conceptual redesign of the building's interior spaces, and Local Health District upgrades. The project budget table, as of December 2022, lists a total appropriation of $30,000,000, commitments/obligations to date of $3,031,000 and expenditures to date of $1,258,000.

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




                                12/31/2022
LHD Maintenance
ARPA SLFRF Quarterly Report
December 2022
Page 2 of 7


Table of Contents
Report Mandate ............................................................................................................................................ 3
Context for ARPA Initiatives .......................................................................................................................... 3
Executive Summary....................................................................................................................................... 3
Objective(s) ................................................................................................................................................... 4
Overview of Quarterly Progress (October – December 2022)...................................................................... 4
Anticipated Next Quarter Activities (January – March 2023) ....................................................................... 5
Risks and Risk Management ......................................................................................................................... 6
Change Management Considerations........................................................................................................... 6
Project Budget .............................................................................................................................................. 7
LHD Maintenance
ARPA SLFRF Quarterly Report
December 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 District (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
December 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 four 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 security measures, both electronic and physical, at LHD sites to better separate public
        and VDH spaces and allow for safer operations
    •   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 (October – December 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 to prevent the spread of COVID-19 were added at JMB to allow for VDH
                staff to return to in-person work. The installation of one water bottle fill station is
                complete, the second one has been ordered. A partial shipment of new automated
                external defibrillators (AEDs) has been received
            o A design firm has been selected to provide a conceptual redesign of the JMB interior
                spaces. This design effort is outside ARPA but upgrades such as touchless fixtures and
                redesigned workspaces will be funded with ARPA dollars
    •   Local Health District (LHD) Upgrades:
            o Sixty-three new cold storage freezers and refrigerators have been purchased and
                delivered for 45 LHD sites.
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ARPA SLFRF Quarterly Report
December 2022
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           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 A design firm was selected to perform site assessments for new wireless access points at
               the first 17 sites receiving improved internet connectivity as part of the Broadband
               initiative
           o LHD sites were surveyed to determine the need for increased security measures such as
               video cameras, badge readers, and new doors. These sites were then prioritized using
               Social Vulnerability Index (SVI) for implementation
           o LHD sites were surveyed to determine the scale of desktop and laptop computers that
               cannot connect to the Commonwealth’s secure network. These devices will be replaced
               to enhance secure digital operations
   •   Office of Environmental Health Services (OEHS) Upgrades:
           o At the Norfolk Field Office, a design of the new workspaces has been received. 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 Accomack 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 Continued installation of video cameras for improved site security. Completion is pending
               the delivery of a new server mount rack
           o Purchased and received movable panels to better separate public and VDH staff
               workspaces to mitigate the spread of contagious diseases
   •   Teleconferencing Upgrades:
           o Completed the pilot program installation at Ashland and Chesterfield Health Departments
           o Purchased and delivered new teleconferencing cameras to four LHD sites for setup and
               activation

Anticipated Next Quarter Activities (January – March 2023)
The following outlines the activities and tasks planned from January through March 2023:

   •   James Madison Building (JMB):
           o Receive the remaining AED equipment and second water bottle fill station for installation
           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 Select vendors to complete generator installation and improved ventilation design. Begin
               generator installation and solicit quotes for improved ventilation installation
           o Ensure Verizon device availability for wireless access point upgrades. Complete site
               assessments for wireless access points at the 17 Broadband pilot sites and place and order
               with Verizon to install new equipment
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ARPA SLFRF Quarterly Report
December 2022
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            o   Distribute vendor procurement guidelines and to site selected to receive site security
                upgrades and begin vendor outreach.
    •   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 Accomack Field Office design work once an extended lease agreement is finalized
    •   Office of Vital Records (OVR) Upgrades:
            o Complete installation of new security cameras by installing a new server rack
    •   Teleconferencing Upgrades:
            o Complete pilot program at JMB by installing command control equipment at the central
                office locations
            o Complete installation at locations not requiring site assessments
            o Conduct site assessments at remaining LHD sites to finalize equipment purchase. Begin
                installing equipment
            o Complete a design for the elevator lobby screens

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 LHDs are overburdened, they may not promptly procure vendors to meet obligation
        deadlines

            o   Mitigation Strategy: Continue to follow up with LHD contacts, assisting with scopes of
                work and vendor identification where possible to drive progress


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
LHD Maintenance
ARPA SLFRF Quarterly Report
December 2022
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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 December 2022



                                 Total
 Total                                                              Total
                 $30,000,000     Commitments/          $3,031,000                        $1,258,000
 Appropriation                                                      Expenditures
                                 Obligations                        (To Date)
                                 (To Date)


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