DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger MPH, PhD
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT:
Annual State of Texas Grant Funding for FY 2020 and approving contracts with the Southwest Texas Regional Advisory Council and the University of Texas Health Science Center.
SUMMARY:
This ordinance authorizes the annual submission of 17 grant renewal applications and the acceptance of funds upon award in an estimated amount of $13,341,570.00 from the Texas Department of State Health Services (DSHS) for public health functions of the San Antonio Metropolitan Health District (Metro Health) for a period beginning July 1, 2019 through December 31, 2020. Metro Health’s participation in these 17 state grant programs serve a legitimate public purpose in that this funding will promote and provide needed public health functions throughout the community.
This action also authorizes the finalization of programmatic budgets, incidental expenditures for grant program participants, and a personnel complement of 155 grant funded positions for the maintenance and delivery of essential public health services within Metro Health as reflected in Attachment I. Temporary support is included in the current budget and will be redirected to personnel if approved by the grantor. In addition, this ordinance authorizes the Director of Metro Health to initiate, negotiate, and execute any and all necessary documents and grant contracts to effectuate the application and acceptance of the referenced grants, and to execute contract amendments pertaining to these contracts, 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 contracts 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 a grant by the funding agency in an amount up to 20% of the total amount initially 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 state regulations mandated by the funding agency.
Furthermore, this ordinance authorizes the execution of two agreements funded by two of these DSHS grant awards: (1) an agreement with Southwest Texas Regional Advisory Council (STRAC) for an amount up to $7,500.00 for a term commencing July 1, 2019 and ending June 30, 2020, and further provides four, one-year renewal options, funded by the Public Health Emergency Preparedness grant; and, (2) an agreement with the University of Texas Health Science Center at San Antonio (UTHSCSA) School of Dentistry for an amount up to $216,852.00 for a term commencing September 1, 2019 and ending August 31, 2020, funded by the Title V Dental - Oral Health grant.
BACKGROUND INFORMATION:
As the public health authority for Bexar County, Metro Health actively addresses the public health functions of policy development, health assessment, and health assurance. To carry out these responsibilities, Metro Health operates evidenced based programs in various settings throughout the County. These 17 DSHS grant awards support 155 grant-funded positions which will account for 35% of the total number of Metro Health staff (439 positions) as adopted through the City’s annual budget for FY 2019. The Department provides services to residents at public health settings and service locations located throughout the City and Bexar County. With State grant support, Metro Health provides preventive health services, community education, limited clinical services to prevent communicable diseases, emergency preparedness, disease control, supplemental nutrition programs, and dental health services.
Metro Health receives approximately 31% of its total budget support through these 17 contract and grant awards from the State of Texas in both direct funding and federal pass-through funding. Since 2007, this support has been authorized by City Council through a block submission of state grant applications and renewals, most recently on February 15, 2018 (Ordinance 2018-02-15-0106) as well as individual actions. Metro Health will request $13,341,570.00 in funding from DSHS through this ordinance.
Service delivery and personnel complement needs are anticipated to remain consistent with the adopted DSHS FY 2019 budgets for the following State and Federal pass through grants:
• Local Immunizations
• Federal STD
• HIV Surveillance
• HIV Prevention
• Federal TB
• State TB
• TB Waiver Project
• Surveillance Epidemiology
• WIC (2 awards)
• Triple O
• Title V Dental
• Public Health Emergency Preparedness (PHEP) Bioterrorism Preparedness
• PHEP Cities Readiness Initiative
• PHEP Lab
• State Milk Sample Lab Testing Program
• State Flu Surveillance
This action will authorize a total of 155 grant positions which aligns with the number of positions authorized by DSHS for FY 2020. Temporary support is included in the current budget and will be redirected to personnel if approved by the grantor. A list of the grantors, grant amounts and CFDA numbers is attached as Table 1.
The application amount authorized by this ordinance of $13,341,570.00 represents a $567,919.00 decrease over the current State and federal pass-through FY 2019 funding. Final amounts will be determined by State Agencies and may result in higher or lower amounts.
Additionally, the Department requests the authorization of two contracts funded with DSHS grant award monies. One is an agreement with STRAC, funded by the PHEP award, in the amount of $7,500.00 per year with four, one-year renewal options. The agreement with STRAC supports a multiagency (Metro Health, STRAC, DSHS and all regional hospitals) funded license for the EverBridge Software Notification System used to notify medical staff in an emergency event and maintenance of services related to public health emergency preparedness.
The second contract will be funded by Title V Dental - Oral Health grant in the amount of $216,852.00. Metro Health’s Oral Health Program works to provide preventive dental services such as sealants and fluoride treatments to school-aged children for the prevention of dental caries (tooth decay). Often, children served through Metro Health’s Oral Health program are identified as having significant untreated decay that requires extensive dental treatment beyond the scope of services provided by Metro Health’s Oral Health Program. The agreement with UTHSCSA School of Dentistry will be for the provision of direct patient care and will ensure pediatric patients identified by Metro Health, which are either uninsured or underinsured, have access to critical dental health services.
ISSUE:
Historically, the State of Texas has provided funding to the City of San Antonio for service delivery in health and disease prevention. Currently, this includes 17 program grants and contracts through the Texas Department of State Health Services.
State and federal funding opportunities are often presented in a time-sensitive manner, requiring the ability to initiate and execute grant submissions, amendments and subsequent awards within prescribed time constraints. Approval of this ordinance allows for a proactive and efficient process for the timely submission and execution of state/federal funding requests. This comprehensive approach maximizes Metro Health, City administration, and City Council resources; expedites the annual support process; coordinates Metro Health’s annual funding processes; and provides City Council with a concise illustration of grant support and Metro Health programs.
Acceptance of funds from the State of Texas continues the long-standing practice of utilizing grant funds to support some of the local public health programs of the City.
ALTERNATIVES:
Approval of this ordinance will facilitate the efficient application for and acceptance of ongoing grants from the State and leads to seamless continuity of Metro Health services.
Alternatively, each of the 17 grants and the two contracts could be submitted separately. This would require individual Council consideration, action, time and processing causing potential delays in funding, resources and service delivery. Alleviating inefficient processing delays allows personnel and City resources to be utilized proactively, effectively and efficiently to advance the public health efforts of the Department.
FISCAL IMPACT:
This ordinance authorizes the submission of 17 annual grant renewal applications with the State of Texas in an amount of $13,341,570.00 in funding and authorizes acceptance of any prior year carry-forward support, as allowed by the funding agency.
These 17 grant awards will support 155 grant-funded positions. The City will provide an estimated $296,410.00 of in-kind services from the General Fund to these grants.
This ordinance also authorizes the execution of two contracts funded by two of these DSHS grant awards: an agreement with STRAC funded by the PHEP grant in the amount of $7,500.00 per year with the options to renew for four, one-year terms up to a total amount of $37,500.00; and, an agreement with the UTHCSA School of Dentistry funded by the Title V Dental - Oral Health grant in an amount up to $216,852.00, for the term commencing September 1, 2019 and ending August 31, 2020.
RECOMMENDATION:
Staff recommends approval of an ordinance authorizing the submission of 17 annual grant renewal applications to the State of Texas totaling $13,341,570.00, acceptance of funds upon award, and execution of grant contracts and amendments and approval of two contracts; an agreement with STRAC in an amount of $7,500.00 per year with the option to renew for four, one-year terms, and an agreement with the UTHCSA School of Dentistry an amount up to $216,852.00.