DEPARTMENT: Health
DEPARTMENT HEAD: Dr. Thomas L. Schlenker
COUNCIL DISTRICTS IMPACTED: City Wide
SUBJECT:
Approving Grant Application Submission to the U.S. Department of Health and Human Services and Authorizing Acceptance of Funds upon Award
SUMMARY:
This Ordinance approves the submission of a grant application to the U.S. Department of Health and Human Services (HHS), Health Resources & Services Administration (HRSA), by the San Antonio Metropolitan Health District (Metro Health) for bridge funding in an amount up to $180,750.00 for the Healthy Start Initiative grant for the three-month period beginning June 1, 2014 through August 31, 2014; and authorizes a proposed program budget, the acceptance of funds upon award, the acceptance of any carryover funds from the previous fiscal year budget and approves a personnel complement of 9 full-time positions.
In addition, this Ordinance authorizes the Director of Metro Health to initiate, negotiate and execute any and all necessary documents and grant contracts to effectuate the acceptance of funds for the above referenced grant, and to execute any contract amendments pertaining to this grant in the following circumstances: a) line item budget revisions authorized by the funding agency; b) modifications to the performance measures authorized by the funding agency and listed in the contract so long as the terms of the amendment stay within the general parameters of the grant's intention; c) changes in state or federal regulations mandated by the funding agency; and d) carry-over funds, when ascertained and approved by the funding agency through a revised notice of award.
BACKGROUND INFORMATION:
The San Antonio Healthy Start Initiative brings together community leaders and various medical and social service agencies to identify and address issues associated with perinatal health disparities in Bexar County. The project provides outreach and recruitment, case management intervention, and health education to at-risk women and families within 13 targeted zip codes in San Antonio (78154, 78202, 78203, 78205, 78207, 78210, 78217, 78218, 78219, 78220, 78229, 78239, and 78244). In order to promote longer inter-conceptional periods (time between pregnancies) and to prevent relapses of risky behaviors, project services are extended for mother and infant up to the child's second birthday. The objectives for the Healthy Start Initiative were chosen based on maternal health indicators, the needs of the targeted communities, and the capacity of community organizations to affect perinatal health behavior change. Program goals within the target community include:
· Reducing the overall infant mortality rate;
· Increasing the proportion of pregnant women who receive prenatal care in the first trimester; and
· Ensuring that every woman participating in the Healthy Start Initiative is screened for perinatal depression and receives postpartum/inter-conceptional care.
In 2012, the San Antonio Healthy Start Initiative provided services to 245 pregnant and post-partum women and 146 children. Additionally, from 2005 to 2011, the infant mortality rate for program participants is 5.1 deaths in 1,000 live births, compared to the 2011 national average of 6.01/1000 live births. Since 2008, San Antonio Healthy Start Initiative has reached over 28,781 individuals in the community through outreach, health education, and case management.
As authorized by City Council on January 16, 2014, Metro Health has applied for grant funds from HRSA to provide Enhanced Services Healthy Start Program (ESHSP) activities. Healthy Start program activities listed under will support the implementation of essential Healthy Start program activities needed to achieve five approaches of the Healthy Start Model which are to: 1) improve women's health, 2) promote quality services, 3) strengthen family resilience, 4) achieve collective impact, and 5) increase accountability through quality improvement, performance monitoring, and evaluation. In addition, this program will engage in additional activities, such as stimulating community collaboration to develop a common agenda, sharing measurement approach, coordinating resources, and conducting performance measurement through Fetal Infant Mortality Review, Perinatal Periods of Risk, and/or Maternal Mortality and Morbidity Review. This program will be accountable to reach the entire community, thereby driving collective impact and supporting community change.
ISSUE:
Since 2001, Metro Health has received Healthy Start grant funding which has been renewed at each funding cycle without interruption. However, this year there will be a gap in the time frame that the current grant will end and the new grant will begin, if awarded. The current Healthy Start grant end date is May 31, 2014 and the ESHSP grant begins on September 1, 2014. HRSA is allowing current grantees who applied for the ESHSP grant to continue to provide limited Healthy Start services from June 1, 2014 until applicants are notified of the outcome of the ESHSP application in August 2014.
Metro Health requests City Council authorization to accept bridge funds upon award in an amount not to exceed $180,750.00 from HRSA to continue the Healthy Start Initiative grant. Authorization of this Ordinance will allow Metro Health to provide limited services to continue the important work of providing outreach, case management, and health education to underserved pregnant and inter-conceptional women and families in San Antonio and Bexar County.
ALTERNATIVES:
If the acceptance of funds is not approved, these funds will be re-distributed to other Healthy Start programs in the country. As a result, outreach, case management, and health education services to address infant mortality among women and families in Bexar County will be eliminated and Metro Health will be reduced by 9 staff members who currently provide services to pregnant and inter-conceptional women and their families.
FISCAL IMPACT:
This grant award will provide Metro Health an amount up to $180,750.00 to continue to provide limited Healthy Start services from June 1, 2014 until applicants are notified of the outcome of the ESHSP application in August 2014.
RECOMMENDATION:
Staff recommends that City Council approve the submission of a grant application to the U.S. Department of Health and Human Services, Health Resources & Services Administration and authorize the acceptance of funds upon award in an amount up to $180,750.00 for a three-month period beginning June 1, 2014 through August 31, 2014.