DEPARTMENT: Health
DEPARTMENT HEAD: Vincent R. Nathan, PhD, MPH
COUNCIL DISTRICTS IMPACTED: City Wide
SUBJECT:
Annual State of Texas Grant Funding for FY 2018
SUMMARY:
This ordinance authorizes the annual submission of 17 state grant renewal applications and the acceptance of funds upon award in an estimated amount of $13,918,939.00 from the Texas Department of State Health Services (DSHS) through direct funding and federal pass-through grants and contracts for public health functions of the San Antonio Metropolitan Health District (Metro Health) for a period beginning July 1, 2017 through December 31, 2018. Metro Health’s participation in these 17 state grant programs serve a legitimate public purpose in that this funding will promote and provide needed public health functions throughout the community.
This action also authorizes the finalization of programmatic budgets, incidental expenditures for grant program participants and a personnel complement of 170 grant funded positions for the maintenance and delivery of essential public health services within Metro Health as reflected in Attachment I. Temporary support is included in the current budget and will be redirected to personnel if approved by the grantor.
Furthermore, this ordinance authorizes the Director of Metro Health to initiate, negotiate, and execute any and all necessary documents and grant contracts to effectuate the application and acceptance of the referenced grants, and to execute contract amendments pertaining to these contracts, 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 contracts 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 a grant by the funding agency in an amount up to 20% of the total amount initially 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 state regulations mandated by the funding agency.
BACKGROUND INFORMATION:
As the public health authority for Bexar County, Metro Health actively addresses the public health functions of policy development, health assessment, and health assurance. To carry out these responsibilities, Metro Health operates evidenced based programs in various settings throughout the County. These 17 annual awards support 170 grant funded positions which will account for 43% of the total number of Metro Health staff (393 positions) for FY 2018. The department provides services to residents at public health settings and service locations throughout the city and Bexar County. With state grant support, Metro Health provides preventive health services, community education, limited clinical services to prevent communicable disease, emergency preparedness, disease control, supplemental nutrition programs, and dental health services.
Metro Health receives approximately 67% of its total budget support through contract and grant awards from the State of Texas in both direct funding and federal pass-through funding. Since 2007, this support has been authorized by City Council through a block submission of state grant applications and renewals, most recently on March 3, 2016 (Ordinance 2016-03-03-0161) as well as individual actions. Metro Health will request approximately $13,918,939.00 in funding from DSHS through this ordinance.
Service delivery and personnel complement needs are anticipated to remain consistent with adopted FY 2017 resources for the following State and Federal pass through grants:
• Local Immunizations
• Federal STD
• HIV Surveillance
• HIV Prevention
• Federal TB
• State TB
• TB Waiver Project
• Surveillance Epidemiology Ebola
• Surveillance Epidemiology
• WIC
• Triple O
• Title V Dental
• Public Health Emergency Preparedness (PHEP) Bioterrorism Preparedness
• PHEP Cities Readiness Initiative
• PHEP Lab
• State Milk Sample Lab Testing Program
• State Flu Surveillance
This action will authorize a total of 170 grant positions which represents an increase of one position from FY 2017. Temporary support is included in the current budget and will be redirected to personnel if approved by the grantor.
The application amount authorized by this ordinance of $13,918,939.00 represents a 13% increase over the current FY 2017 funding. Final amounts will be determined by Federal and/or State Agencies and may result in higher or lower amounts.
ISSUE:
Historically, the State of Texas has provided funding to the City of San Antonio for service delivery in health and disease prevention. Currently, this includes 17 program grants and contracts through the Texas Department of State Health Services.
State funding opportunities are often presented in a time-sensitive manner, requiring the ability to initiate and execute grant submissions, amendments and subsequent awards within prescribed time constraints. Approval of this ordinance allows for a proactive and efficient process for the timely submission and execution of annual state funding requests. This comprehensive approach maximizes Metro Health, City administration, and City Council resources; expedites the annual support process; coordinates Metro Health annual funding processes; and provides City Council with a concise illustration of state grant support and Metro Health programs.
Acceptance of annual support from the State of Texas continues the long-standing practice of utilizing State aid to support local public health programs of the City.
ALTERNATIVES:
Approval of this ordinance will facilitate the efficient application for and acceptance of ongoing grants from the state and lead to seamless continuity of Metro Health services.
Alternatively, each of the 17 grants could be submitted separately. This would require individual Council consideration, action, time and processing causing potential delays in funding, resources and service delivery. Alleviating inefficient processing delays allows personnel and City resources to be utilized proactively, effectively and efficiently to advance the public health efforts of the Department.
FISCAL IMPACT:
This ordinance authorizes the submission of 17 annual state grants in an amount not to exceed $13,918,939.00 in funding and authorizes acceptance of any prior year carry-forward support, as allowed by the funding agency.
These 17 grant awards will support 170 grant funded positions. The City will provide an estimated $296,410.00 in in-kind services from the General Fund to these grants.
RECOMMENDATION:
Staff recommends approval of an ordinance authorizing the submission of 17 annual grant renewals to the State of Texas, acceptance of funds upon award, and execution of grant contracts and amendments.