DEPARTMENT: Health
DEPARTMENT HEAD: Jennifer Herriott, MPH
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT:
Authorizing the acceptance of funds from the Texas Department of State Health Services (DSHS) for the EXHALE grant--Education on asthma self-management, eXtinguishing smoking and second hand smoke, Home visits for trigger reduction and asthma self-management, Achievement of guidelines-based medical assessment Linkages and coordination of care across settings, and Environmental policies or best practices to reduce asthma triggers from indoor, outdoor, and occupational sources (EXHALE).
SUMMARY:
This ordinance authorizes the acceptance of funds upon award in an amount not to exceed $215,000.00 for an initial term of approximately nine months for prevention activities and the delivery of services within the EXHALE grant and authorizes a personnel complement of two (2) full-time positions.
The funds will be used to: 1) work with community partners to expand access to asthma self-management education in schools and worksites; 2) expand delivery of home visits for asthma trigger reduction; 3) work with health systems partners to promote utilization of non-physician team members to identify patients with uncontrolled asthma in emergency departments and other clinical settings and navigate them to medical and self-management support; 4) provide technical assistance to employers to expand coverage of asthma self-management education for employees and their dependents; 5) promote anti-idling and clean diesel bus fleets among area school districts; 6) provide technical assistance to multi-unit housing and housing authorities to adopt tobacco-free policies; and, 7) work with established local tobacco prevention and control partners to reduce tobacco use and exposure to secondhand smoke through prevention/cessation education and policy, systems, and environmental change.
Furthermore, this ordinance authorizes the Director of Metro Health to initiate, negotiate, and execute any and all necessary documents and a grant contract to effectuate the acceptance of the referenced grant funds, and to execute contract amendments pertaining to this contract, to include a) carry-over funds, when ascertained and approved by the funding agency through a revised notice of award; b) line item budget revisions authorized by the funding agency; c) 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 intent of the grant; d) no cost extensions; e) amendments which will provide supplemental grant funds to the grant by the funding agency in an amount up to 20% of the total amount awarded to the grant; f) reimbursement increases of administrative funds for each participant served; g) amendments funding one time equipment purchases or defined program services; and h) changes in regulations mandated by the funding agency.
BACKGROUND INFORMATION:
The SA Kids BREATHE (SAKB) program was created with the South Texas Asthma Coalition and is funded by the City of San Antonio to address high hospitalization rates in children with asthma. The intended purpose of the program is to improve the lives of children with asthma by increasing school attendance and improving the management of asthma.
The program, a community-driven initiative, has an advisory council comprised of nearly a dozen community advisors from different fields.
The SAKB program is a free program whose primary goal is to improve quality of life for children diagnosed with asthma by teaching them and their family best practices to control asthma. The SAKB program will help keep kids out of the hospital, keep kids in school, keep parents at work, and save families and healthcare systems money. SAKB Community Health Workers serve children between the ages of 3 and 17 diagnosed with asthma and residing within the city of San Antonio limits.
The EXHALE Program aims to provide resources for education on asthma self-management and smoking and second hand smoke reduction, the use of home visits for trigger reduction and asthma self-management and education, to achieve guidelines-based medical assessment linkages and coordination of care across settings, and to promote environmental policies or best practices to reduce asthma triggers from indoor, outdoor, and occupational sources.
The Texas Department of State Health Services (DSHS) expressed interest in funding Metro Health to expand the work of SAKB. On September 13, 2019 DSHS sent Metro Health a draft Statement of Work, a Budget template and a Face Page to apply for $215,000.00 and begin the sub-recipient process. DSHS requested the documents be returned by September 26, 2019. The application was submitted on September 26, 2019 with authorization from a Special Category Grant Opportunity form. Metro Health applied for $215,000.00 to fund two full-time positions and for asthma case management software. The initial term of the grant contract for EXHALE is expected to be approximately nine (9) months for a term ending on August 31, 2020.
ISSUE:
The Texas Department of State Health Services (DSHS) is funding Metro Health to expand the work of SAKB through the EXHALE program for a period of five years. The EXHALE program funds will be used to complement the current activities of the SAKB program. Currently, SAKB focuses on recruiting new families for asthma home visits to identify asthma trigger reduction. The EXHALE program will focus on expanding asthma self-management education across the community by working with schools and work-sites and their health insurance plans to develop policies or procedures that provide for/allow this education for their children and adults with asthma. The funds will also be used to promote anti-idling and clean diesel bus fleets among area school districts and provide technical assistance to multi-unit housing and housing authorities to adopt tobacco-free policies. Multi-unit housing includes apartments and other facilities were people live in close proximity together. Finally, the funds will be used to work with established local tobacco prevention and control partners to reduce tobacco use and exposure to secondhand smoke through prevention/cessation education and policy, systems, and environmental change.
Metro Health requests City Council authorize the acceptance of funds upon award in an amount not to exceed $215,000.00 from DSHS for Year 1 of 5 of the EXHALE program. The funds will be used to improve the quality of the lives of children living with asthma by teaching them and their family best practices to control asthma.
ALTERNATIVES:
Should City Council not approve this ordinance, Metro Health will not be able to expand programs that target asthma for the SAKB Program.
FISCAL IMPACT:
An ordinance authorizing the acceptance of funds from the Department of State Health Services in an amount not to exceed $215,000.00 for a grant related to expanding access to asthma self-management education in schools, worksites and homes for a term ending August 31, 2020. This ordinance also authorizes a personnel complement of two (2) full-time positions for the initial period to end August 31, 2020. Metro Health will have the opportunity to apply for an additional four years of non-competitive funding. There is no impact on the General Fund in the form of a cash match. This is year one of the five-year EXHALE Program.
RECOMMENDATION:
Staff recommends City Council authorize an ordinance for the acceptance of grant funds upon award in an amount not to exceed $215,000.00 from DSHS for a term ending August 31, 2020 for the EXHALE Program, and for the authorization of two (2) full-time positions.