DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger MPH, PhD
COUNCIL DISTRICTS IMPACTED: City Wide
SUBJECT:
Authorizing agreements associated with the 1115 Waiver Teen Pregnancy Prevention Program for a term commencing October 1, 2017 to September 30, 2018, with options to renew for two, one-year terms.
SUMMARY:
These Ordinances will authorize the following agreements for programs funded by the 1115 Medicaid Waiver:
(A) An Ordinance authorizing an agreement with the Bexar County Hospital District d/b/a University Health System (UHS) for adolescent health services to prevent teen pregnancy for the San Antonio Metropolitan Health District’s Teen Pregnancy Prevention Medicaid 1115 Waiver Program in an amount up to $325,000.00 for a term commencing October 1, 2017 to September 30, 2018, and further provides two, one-year renewal options.
(B) An Ordinance authorizing an agreement with Communities in Schools of San Antonio (CISSA) for adolescent health services to provide in-school behavioral and mental health counseling for the San Antonio Metropolitan Health District’s Teen Pregnancy Prevention Medicaid 1115 Waiver Program in an amount up to $216,000.00 for a term commencing October 1, 2017 to September 30, 2018, and further provides two, one-year renewal options.
BACKGROUND INFORMATION:
On January 31, 2013, City Council authorized the submission of six project proposals by Metro Health through the Regional Healthcare Partnership Anchor entity, University Health System for consideration and funding in the amount of $43,392,942.00 through the new Delivery System Reform Incentive Payment (DSRIP) arm of the “Texas Healthcare Transformation and Quality Improvement Program” or “Transformation Waiver.” Metro Health carefully selected projects in the following areas: diabetes prevention, children’s oral health services, HIV and Syphilis prevention, breastfeeding promotion, teen pregnancy prevention and neighborhood health promotion. All six project proposals are in alignment with Metro Health’s strategic plan and many community goals set forth by SA2020 and have the overall goal of improving health outcomes. The initial demonstration period came to an end on September 30, 2016. With a 15 month extension period approved by the Centers for Medicare and Medicaid Services set to expire December 31, 2017, HHSC has requested an additional 21 month renewal of the program that if approved, would extend the term of the 1115 Waiver through September 30, 2019.
In 2014, Metro Health reported 2,441 teen births. Of those 539 were repeat teen births. San Antonio’s birth rate for females ages 15-19 was 37.4 per 1,000 and was 55% higher than the national rate. According to the National Campaign to Prevent Teen and Unplanned Pregnancy, the 2014 cost of teen childbearing in San Antonio was $54.2 million in child welfare, healthcare, lost revenue and incarceration. By the year 2019, 111 kindergarten classes will be filled with the children of teen parents.
In 2012, the City of San Antonio conducted a Community Survey through the ETC Institute that included San Antonio residents from all ten City Council Districts. Teen pregnancy was ranked the highest concern among fifteen community issues and respondents felt that teen pregnancy was the most important issue for the City to address over the next two years. Metro Health’s 1115 Waiver projects include activities for the reduction of teen pregnancy in San Antonio which is consistent with the SA2020 community vision, the Bexar County Community Health Improvement Plan, and Metro Health strategic plan.
Authorization of the agreements will allow Metro Health to provide funding to UHS and CISSA for the implementation of an adolescent health services project for the prevention of teen pregnancy in San Antonio. These agreements are subject to and contingent upon continued Medicaid 1115 Waiver funding.
ISSUE:
Metro Health is requesting approval of the agreements with UHS and CISSA: Authorization of the agreement (A) UHS for adolescent health services to prevent teen pregnancies by provisioning Long Acting Reversible Contraceptive methods, and behavioral and mental health counseling for teenagers; Authorization of the agreement (B) CISSA for adolescent health services to provide in-school behavioral and mental health counseling to teen parents. Parental/guardian consent will be required for teenagers ages 17 and younger to receive services (A & B).
ALTERNATIVES:
Should the contract not be approved, Metro Health will be unable to move forward with its plan for October implementation of an adolescent health services project for the prevention of teen pregnancy in San Antonio and will be unable to meet deliverables set forth in the Medicaid 1115 Waiver Project.
FISCAL IMPACT:
These Ordinances authorize the City to enter into two agreements with:
(A) The Bexar County Hospital District d/b/a University Health System (UHS) in an amount up to $325,000.00 for adolescent health services to prevent teen pregnancy; and
(B) Communities in Schools of San Antonio (CISSA) in an amount up to $216,000.00 for adolescent health services to provide in-school behavioral and mental health counseling.
Both of these agreements are funded with Medicaid 1115 Waiver Program. There will be no impact to the General Fund.
RECOMMENDATION:
Staff recommends approval of agreements with (A) UHS and (B) CISSA with options to renew. Authorization of these agreements will allow Metro Health to move forward with the implementation of goals set forth in the Medicaid 1115 Waiver Teen Pregnancy Prevention project.