DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger, MPH, PhD
COUNCIL DISTRICTS IMPACTED: City-Wide
SUBJECT:
Authorizing Agreements with El Centro de Barrio d/b/a CentroMed and the San Antonio AIDS Foundation related to the Medicaid 1115 Waiver TB Project
SUMMARY:
This Ordinance authorizes agreements with El Centro del Barrio d/b/a CentroMed and the San Antonio AIDS Foundation (SAAF) related to the San Antonio Metropolitan Health District’s (Metro Health's) participation in the Texas Department of State Health Services’ Region 8 Medicaid 1115 Waiver Tuberculosis (TB) Identification and Treatment Project. CentroMed and SAAF will provide certain laboratory and medical consultation services which will contribute to the early intervention of TB infection or disease for a term beginning October 1, 2016 and ending September 30, 2018. This Ordinance will also authorize the option to renew each agreement for an additional one year term.
BACKGROUND INFORMATION:
Metro Health’s TB Prevention and Control Program (TB Program) provides examination, diagnosis and treatment for individuals suspected or confirmed with active tuberculosis disease. The TB Program also provides screening and preventive medicine for those with a known exposure to TB or those from high risk populations. Additional services offered include case management, contact investigation and community intervention with prevention measures in order to reduce the rates and control the spread of TB disease.
On June 19, 2014, City Council authorized the acceptance of funding from the Texas Department of State Health (DSHS) for Metro Health’s participation in the Tuberculosis Identification and Treatment Project (TB Project) under the Texas Medicaid 1115 Waiver. This project focuses on targeted testing and treatment for latent tuberculosis infection (LTBI) in high risk populations to prevent these cases from evolving into active TB cases. The DSHS TB Project will include increased targeted testing and treatment for high risk populations such as refugees and persons living in congregate settings such as homeless shelters and drug rehabilitation centers. In addition, individuals living with HIV and diabetes will be targeted.
CentroMed has been providing healthcare to homeless persons since 1989 and works with various partnering agencies to ensure that homeless persons have access to healthcare services. CentroMed provides integrated mental health and primary care for homeless individuals accessing services at CentroMed’s Sarah E. Davidson Clinic on the Haven for Hope campus.
SAAF has a dual mission of providing compassionate medical care and social services to people with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), and helping prevent the spread of HIV through education, counseling and testing. SAAF supports the provision of services without discrimination on any basis, including but not limited to race, ethnicity, age, sex, gender, sexual orientation, marital status, religion, handicap, immigrant status, national origin, drug use, and criminal background.
CentroMed’s homeless population has higher rates of both infectious and chronic disease, including TB, HIV, pneumonia, chronic obstructive lung disease, and cardiovascular disease. Through the proposed agreement, CentroMed will provide certain laboratory and medical consultation services, including phlebotomy services for collecting blood samples for T-SPOT®.TB (T-Spot) screening in high risk populations which will contribute to the early intervention of Tuberculosis infection or disease.
ISSUE:
TB continues to be a significant and expensive public health problem in Texas. In 2015, there were 1,334 cases of TB disease reported in Texas, a rate of 4.9 per 100,000 population. TB can strike anyone, but is more likely to be found in those born in a foreign country, people with diabetes, people with HIV/AIDS, the homeless, and those that work in health care. Many individuals in this population also are uninsured and lack access to appropriate treatment and care.
Metro Health seeks authorization of two agreements, one with CentroMed and one with SAAF to increase targeted testing and treatment for high risk populations as part of the Metro Health’s participation in the DSHS TB Project under the Texas Medicaid 1115Waiver.
ALTERNATIVES:
If these agreements are not authorized, Metro Health will need to identify alternative mechanisms to meet the goals of the DSHS TB Project which is to increase targeted testing and treatment for LTBI in high risk populations in order to prevent these cases from evolving into active TB cases.
FISCAL IMPACT:
Metro Health is requesting authorization to execute Memorandums of Agreement with CentroMed and SAAF for a term beginning October 1, 2016 through September 30, 2018. Supported by funding from the DSHS TB Project under the Texas Medicaid 1115 Waiver, Metro Health will provide supplies for T-Spot blood collection, professional courier pick-up and delivery services for T-Spot specimens collected under this project, and will cover the cost of T-Spot Tests in-house. DSHS TB Project funding is budgeted under the Texas Medicaid 1115 Waiver. This agreement will have no impact on the General Fund.
RECOMMENDATION:
Staff recommends approval of an Ordinance authorizing agreements with CentroMed and the San Antonio AIDS Foundation for certain laboratory and medical consultation services which will contribute to the early intervention of TB infection or disease for a term beginning October 1, 2016 and ending September 30, 2018; and authorizing the renewal of each agreement for an additional one year term.