DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger MPH, PhD
COUNCIL DISTRICTS IMPACTED: City Wide
SUBJECT:
Authorization of an amendment to an Agreement with the University of Texas Health Science Center at Tyler.
SUMMARY:
This ordinance authorizes an amendment to a Professional Services Agreement (PSA) with the University of Texas Health Science Center at Tyler (UTHSCT) for tuberculosis (TB) physician services related to the treatment of patients with Latent TB Infection (LTBI) as part of the San Antonio Metropolitan Health District’s (Metro Health) participation in the Texas Department of State Health Services Tuberculosis Identification and Treatment Project (DSHS TB Project), a project of the Texas Medicaid 1115 Waiver, to extend the term of the PSA through December 31, 2017.
BACKGROUND INFORMATION:
As the local health department for the City of San Antonio and Bexar County, Metro Health’s TB Clinic operations comprises of patient care for active and latent TB patients. The UTHSCT Heartland National TB Center is one of five Regional Training and Medical Consultation Centers (RTMCCs) in the United States, and is the only one in Texas funded by the Center for Disease Control and Prevention’s Division of TB Elimination, to provide medical and technical consultation services related to various aspects of TB control. As such, the UTHSCT is the only entity with this level of expertise available within the state to provide these services. On September 29, 2016, City Council authorized an agreement with UTHSCT for TB physician services for high risk individuals identified as having LTBI through increased targeted TB testing for a term ending on September 30, 2017. Increased testing and treatment focuses on persons at higher risk for contracting TB such as refugees and foreign born individuals, persons living in congregate settings such as homeless shelters and drug rehabilitation centers, and individuals living with HIV and diabetes.
In addition, on March 3, 2016 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 LTBI in high risk populations to prevent these infections from evolving into active TB cases. This project was implemented in partnership with DSHS Region 8, The Texas Center for Infectious Disease (TCID), University Health System, UT Health and the UTHSCT and has been extended through December 31, 2017.
ISSUE:
TB continues to be a significant and expensive public health problem in Texas. 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, incarcerated and those that work in health care. Many individuals in this population also are uninsured and lack access to appropriate treatment and care.
The amendment of the agreement with the University of Texas Health Science Center at Tyler will allow Metro Health to continue facilitating better treatment for individuals with latent tuberculosis infection (LTBI).
ALTERNATIVES:
If the amendment to the agreement is not authorized, Metro Health will need to identify alternative mechanisms to provide expert TB physician services for patients identified in the community with LTBI TB disease. In addition, Metro Health will be unable to meet the goals of the DSHS TB Project which aims to increase targeted testing and treatment for LTBI in high risk populations.
FISCAL IMPACT:
Metro Health is requesting City Council authorization for an amendment to extend the term of an agreement with the University of Texas Health Science Center at Tyler through December 31, 2017. The amendment will not increase the total compensation paid to UTHSCT. Funding for this agreement will continue to be supported through the DSHS TB Project grant funded through the Texas Medicaid 1115 Waiver for an amount not to exceed $198,735.00.
RECOMMENDATION:
Staff recommends approval of the Ordinance authorizing the amendment of an agreement with the University of Texas Health Science Center at Tyler for expert TB physician services related to the treatment of patients with Latent TB Infection (LTBI).