DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger, MPH, PhD
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT:
Authorizing the submission of an application to and the acceptance of funds, if awarded, from the Centers for Disease Control and Prevention (CDC) for the Innovative State and Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke Grant
SUMMARY:
This ordinance authorizes the submission of an application to and acceptance of funds, if awarded, in an amount not to exceed $3,000,000.00 annually from the CDC for the delivery of services within the Innovative State and Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke grant for prevention activities and authorizes a personnel complement of three (3) Management Analyst positions. Following the initial 12 months of funding there will be four additional years of level funding available.
The funds will be used to support the goals and objectives of the San Antonio Diabetes Collaborative which utilizes the Collective Impact Model to prevent those at risk of developing diabetes from progressing to diabetes. The Diabetes Collaborative which is led by the San Antonio Metropolitan Health District (Metro Health) is a partnership of several organizations in San Antonio working together to align policies and systems to connect clinical health care to community based prevention programs. This funding opportunity will allow Metro Health to contract with sub-recipients from the San Antonio Diabetes Collaborative for the design, testing and evaluation of novel approaches to address evidence-based strategies aimed at reducing risks, complications, and barriers to prevent and control diabetes and cardiovascular disease (CVD) in high-burden populations. Metro Health plans to issue a Request for Proposal to sub-recipient(s) interested in providing the above work for (a) diabetes or (b) cardiovascular disease or both and to write an evaluation of the program(s) at the end of the project period.
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 inclusive of the amount accepted through this ordinance; 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:
Diabetes and obesity are complex health issues affecting San Antonio/Bexar County across socioeconomic and demographic boundaries. These complex chronic diseases are caused by unhealthy dietary patterns, lack of physical activity, stress, and an environment that does not support healthy behaviors. Higher rates of obesity and diabetes in our central urban core are interconnected to the socioeconomic status and environmental conditions of the neighborhoods. According to the Behavioral Risk Factor Surveillance System (BRFSS, 2016) in Bexar County 71% of adults are either overweight or obese, and nearly 11% of adults have been diagnosed with diabetes.
Every 40 seconds, someone in the U.S. has a stroke. It is the third leading cause of death in Texas and a leading cause of long-term disability. Nearly 28% of San Antonio area deaths each year are attributed to cardiovascular disease. Activities and programs to address heart disease and stroke are similar to those of diabetes: high blood pressure, high blood cholesterol, low physical activity, poor nutrition and tobacco use.
The Innovative State and Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke grant aims to reduce the impact of these chronic diseases in high-burden populations. This funding opportunity will provide up to five years of funding to Metro Health to support the goals and objectives of the San Antonio Diabetes Collaborative.
Metro Health plans to select sub-recipients from the San Antonio Diabetes Collaborative that will work together with Metro Health to meet the goals of the program by selecting from a menu of evidence-based strategies that focus in areas where they have capacity to achieve the greatest reach and impact. For diabetes, strategies include selection of six strategies that encompass prevention and management. Six strategies for CVD will also be pursued. Strategies will include tracking and monitoring clinical measures, implementing team-based care and linking community resources and clinical services. Both the diabetes and CVD strategies in this funding opportunity support the long term aim of the San Antonio Diabetes Collaborative to successfully connect clinical care to community based prevention programs.
ISSUE:
Metro Health has been the backbone for the San Antonio Diabetes Collaborative for the past two years. The Diabetes Collaborative has developed an implementation plan to extend the reach and impact of the strategies that they have outlined to reduce diabetes throughout San Antonio and Bexar County. The strategies outlined are in line with the goals of this grant and will provide the basis of the programs that the Diabetes Collaborative intends to implement. The members of the Diabetes Collaborative are also well positioned to implement the strategies outlined in the application to reduce heart disease in San Antonio.
Metro Health requests City Council authorize the submission of grant documents to the Centers for Disease Control and Prevention (CDC) and the acceptance of funds upon award in the amount of $3,000,000.00 for participation in the Innovative State and Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke grant for a 12-month term. The funds will be used to support the design, testing and evaluation of approaches to address evidence-base strategies for the prevention and control of diabetes and cardiovascular disease in high-burden populations throughout San Antonio and Bexar County.
ALTERNATIVES:
Should City Council choose not to authorize this ordinance, these diabetes and CVD strategies will remain unfunded and Metro Health will not be able to increase reach for diabetes and CVD in the community.
FISCAL IMPACT:
The Innovative State and Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke Grant aims to provide funding for diabetes and CVD strategies that will reduce the incidence of these health issues in high-burden populations in San Antonio for the period October 1, 2018 through September 30, 2019; and to fund a personnel complement of three Management Analyst positions. There is no impact on the General Fund in the form of a match requirement. If funded for the first year, Metro Health will have the opportunity to submit a non-competitive application for an additional four years of funding.
RECOMMENDATION:
Staff recommends City Council authorize an ordinance for the submission of an application to and the acceptance of funds, if awarded, in an amount not to exceed $3,000,000.00 annually from the CDC for the delivery of services within the Innovative State and Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke Grant for prevention activities and authorize three (3) full-time positions.