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Placer to explore more sustainable models for public health laboratory services

December 12, 2017

Placer County will seek a more sustainable model for public health laboratory services, with a vote today by the Board of Supervisors allowing staff to move forward in exploring alternative options.

This decision comes after a thorough review by an outside consultant determined that the county’s public health laboratory in Auburn has faced a severe decline in demand for its services, which, coupled with advances in technology, mean that the lab is no longer cost effective.

County staff will now develop proposals for different lab service models, which could potentially include modifying the existing lab to lower costs and increase revenue, or closing the lab and contracting with other counties — such as the Sacramento County lab or the Napa-Solano-Yolo-Marin lab — to provide the same services through a regional model. Staff will return to the board in early 2018 to present more detailed proposals for each model.

The current public health lab in Auburn has been in operation since the 1950s, and its primary function is to test samples for infectious disease or other harmful agents. This could include testing animals for rabies; human blood for sexually transmitted diseases or lead; or water for bacteria. Placer also provides lab testing services to Yuba, Sutter and Nevada counties.

“I know that our public health lab staff take a lot of pride in what they do, and they do a tremendous job. As sitting elected officials we have to determine the best bang for the buck, and we're beholden to our constituents to utilize their tax dollars in the most efficient and effective way we can,” said District 1 Supervisor Jack Duran. “Sometimes, that means we have to make hard decisions. I'm not convinced yet that we have to take a different road, but it's my responsibility to take a look at the options.”

Many tests that were once performed by public health labs are now performed by private labs, due to shifting health insurance practices. Additionally, improved lab technology has allowed for batch processing of multiple tests at once, making smaller labs with a low volume of tests less practical. As a result of this changing landscape, Placer County went from conducting a high of 35,000 tests in 1998 to performing just 3,500 in 2016.

Placer County is not the only county to explore alternative lab models. Many others across California refer testing to the state lab or make arrangements with other counties. Placer currently has a higher ratio of staff to tests performed than other labs in the region, including Sacramento, and only generates approximately $45 in revenue for tests costing $250 — a significant financial demand on county resources. A regional model has the potential to expand lab capabilities, including more robust after-hours support, an improved ability to more broadly monitor the spread of disease across county lines and more staff for broader coverage.

In addition to proposals for a regional model, the board asked that staff develop detailed proposals for preserving a local model by reducing lab costs.

There are seven public health laboratory employees who could potentially be impacted by changes to the current lab structure. Should that happen the county would attempt to absorb as many positions as possible into other roles.

“Change must be done thoughtfully. This process has been careful and cautious,” said Dr. Craig Lindquist, the consultant who conducted the review of lab operations over the last several months. “We understand the importance of these services, and know it is vital that public health lab services continue to be available.”

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