DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger, MPH, PhD
COUNCIL DISTRICTS IMPACTED: City Wide
SUBJECT:
An ordinance authorizing the submission of a grant application to Gilead, and acceptance of funds, if awarded, for the Frontlines of Communities in the United States (FOCUS) in an amount not to exceed $189,716.29 to be submitted September 30, 2017.
SUMMARY:
This ordinance authorizes the submission of a grant application to the Gilead’s Frontlines of Communities in the United States (FOCUS) grant program with a proposed award in the amount of $189,716.29 for a 12 month period beginning January 1, 2018 and ending December 31, 2018.
The above referenced request for funding includes a background; proposal narrative and reach; project framework, goals, sustainability and timeline; and a proposal budget.
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, 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:
In 2010 an estimated one in five HIV-positive Americans, or approximately 230,000 people, did not know that he or she was infected in the US. Gilead’s Frontlines of Communities in the United States (FOCUS) began a program to screen patients for HIV and AIDS. In 2013 screening was expanded to hepatitis B (HBV) and in 2015 was expanded again to include hepatitis C (HCV) at the recommendation of the Centers for Disease Control and Prevention (CDC) and the United States Preventive Services Task Force (USPSTF).
FOCUS partners with over 100 healthcare institutions, government agencies and community partners to:
• Make routine HIV, HCV, and HBV screening a standard of care for appropriate patient populations;
• Reduce the number of undiagnosed individuals, decrease the number of those who are diagnosed and ensure strong linkage to care and treatment;
• Expand stakeholder dialogue on these issues; and
• Change public perceptions and overcome stigma that may discourage testing.
Given that only acute cases of hepatitis B and C are reportable in Texas, it is not known what the true burden of these diseases are in our community; this project will provide us with data to determine that burden and provide the ability to link anyone positive to services for treatment.
The San Antonio Metropolitan Health District (Metro Health) was approached by Gilead to apply for funding that would enhance services by adding routine testing for HCV and HBV among individuals seen in the STD and TB clinics, including those for pre-exposure prophylaxis (PreP) and mobile outreach.
FOCUS is based on 4 pillars:
• Testing integrated into normal clinic flow (this would be done similar to the way we offer universal HIV testing to all persons seen at the clinic)
• EMR modification (if possible to make the change automatic)
• Systemic policy change (organizational commitment)
• Training, Feedback and Quality Improvement (ID best practices and motivate staff)
Within Metro Health, the funding will allow for universal screening for HBV and HCV in TB clinic and PReP clinic, universal screening for HCV in STD clinic, including the mobile outreach clinic, and targeted screening based on risk for HBV in STD clinics-those who are intravenous drug users, foreign-born, HCV positive, etc. Metro Health will also create MOUs with area providers for linkage to care for individuals that test positive for HCV and/or HBV-similar to the activities that are conducted for individuals that are HIV positive.
ISSUE:
In order to identify individuals with HBV and HCV, the funds from FOCUS will:
• Enhance our services by making routine HBV and HCV screening a standard of care for appropriate patient populations at our STD, TB and PReP clinics;
• Reduce the number of undiagnosed individuals, decrease the number of those who are diagnosed late and ensure strong linkage to care and treatment through memorandums of understanding with area providers;
• Expand stakeholder dialogue on these issues, and;
• Change public perceptions and overcome stigma that may discourage testing.
ALTERNATIVES:
Without these funds individuals with Hepatitis B (HBV) and Hepatitis C (HCV) may remain undiagnosed and not receive linkage to care and treatment.
FISCAL IMPACT:
Gilead’s FOCUS grant program awards the amount of $189,716.29 for a 12 month period beginning January 1, 2018 and ending December 31, 2018. Funds for this grant will be used to provide for the Hepatitis B (HBV) and Hepatitis C (HCV) testing, lab work, data collection, and will help link patients to care services.
RECOMMENDATION:
Staff recommends authorization to submit the application to Gilead’s FOCUS grants program and if awarded, the execution of the grant documents, acceptance of the funds and approval of the personnel complement.