DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger MPH, PhD
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT:
Authorizing amendments with Jonathan Meyer and UT Health for the San Antonio Metropolitan Health District’s Healthy Start Program
SUMMARY:
This Ordinance amends two agreements related to the San Antonio Metropolitan Health District’s Healthy Start program with Jonathan Meyer and the University of Texas Health Science Center at San Antonio, d/b/a UT Health, to provide additional compensation and extend the term of each agreement for an additional one-year. The amendment with Jonathan Meyer is for the provision of grant evaluation services and will increase the total compensation by $23,501.00 for a total amount up to $48,500.00 for a term ending March 31, 2019. The amendment with UT Health is for the provision of fetal-infant and maternal mortality data abstraction and case review services and will increase the total compensation by $24,999.00 for a total amount up to $49,998.00 for a term ending March 31, 2019.
BACKGROUND INFORMATION:
Metro Health’s Healthy Start program is responsible for operating a Fetal Infant Mortality Review (FIMR) and/or a Maternal Mortality and Morbidity Review (MMMR). FIMR is a national collaborative effort between the American College of Obstetrics and Gynecology and the Maternal Child Health Bureau dating back to 1990. FIMR is based on a community-wide action-oriented process that examines fetal and infant deaths through clinical abstraction and maternal interviews, determines preventability, and engages communities to take action. FIMR had previously existed in San Antonio from 2008-2011and was reinstated in May 2015 by Metro Health’s Healthy Start program. Beginning in 2017, Healthy Start also instituted the Bexar County Maternal Morbidity and Mortality Task Force (MMMR). The Bexar County MMMR focuses on maternal death and disease at a more local level, and with a specific focus on the first year postpartum, compared to the state task force’s focus on the first 42 days postpartum.
Metro Health’s Healthy Start program is funded through the U.S. Department of Health and Human Services (DHHS) Healthy Start Program whose purpose is to engage communities in an effort to reduce infant mortality where rates are over one and a half times the national average through five strategic approaches. These five approaches are to improve women’s health before, during, and after pregnancy, promote quality services, strengthen family resilience, achieve collective impact, and increase accountability through quality improvement, performance monitoring, and evaluation. To conduct quality improvement, performance monitoring and evaluation with the utmost integrity, it is typical for Healthy Start programs to utilize external evaluators to meet the DHHS strategic approach of increasing accountability.
Historically, Metro Health contracted with external evaluators, Jonathan Meyer and UT Health to fulfill requirements related to the increasing accountability strategic approach. Healthy Start will be required to continue reporting its performance relating to the five strategic approaches twice annually, through a quantitative performance report and a narrative progress report where the work of these external evaluators is an essential component. The DHHS Healthy Start Grant now continues through March 31, 2019 and requires Metro Health to secure these continued services to meet grant requirements through the end of the grant period. Through amendments with Jonathan Meyer and UT Health, Metro Health’s Healthy Start Program will be able to meet the five strategic approaches and continue its efforts in reducing infant and maternal mortality rates in the San Antonio and Bexar County area.
ISSUE:
Metro Health is requesting approval of the amendments with Jonathan Meyer and UT Health to provide evaluation, monitoring and quality improvement services for the San Antonio Metropolitan Health District’s Healthy Start Program. The DHHS Healthy Start Program’s quality improvement and performance monitoring and evaluation strategy, one of the five DHHS strategic approaches, improves the accountability and integrity of Metro Health’s Healthy Start program by contracting with external evaluators.
ALTERNATIVES:
Should these amendments not be authorized, Metro Health will not be able to meet the evaluation and FIMR review requirements of the U.S. Department of Health and Human Services’ (DHHS) Healthy Start Program Grant funding. The Healthy Start Program would need to identify other professionals in the community that can provide similar services to the Healthy Start Program.
FISCAL IMPACT:
Metro Health is requesting City Council authorization of amendments with Jonathan Meyer and UT Health to extend the term for an additional one-year period ending March 31, 2019 and provide additional compensation increasing the cumulative total amount to $98,498.00. The amendment with Jonathan Meyer increases the compensation amount by $23,501.00 for a total amount up to $48,500.00. The amendment with UT Health increases the compensation amount by $24,999.00 for a total amount up to $49,998.00. Both of these amendments are funded by the DHHS Healthy Start Program Grant. There will be no impact to the General Fund.
RECOMMENDATION:
Staff recommends approval of an ordinance amending two agreements with Jonathan Meyer and UT Health to provide evaluation, monitoring and quality improvement services for the San Antonio Metropolitan Health District’s Healthy Start Program. Authorization of these amendments will allow Metro Health to move forward with meeting the requirements set forth by the DHHS Healthy Start Program Grant.