DEPARTMENT: Health
DEPARTMENT HEAD: Jennifer Herriott, MPH
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT:
Authorizing agreements associated with the San Antonio Metropolitan Health District’s participation in the Texas Department of State Health Services’ Medicaid 1115 Waiver Tuberculosis Identification and Treatment Project with terms ending August 31, 2021; and, authorizing the option to renew the agreements for an additional one-year term.
SUMMARY:
This Ordinance will authorize an agreement with El Centro del Barrio d/b/a Centro Med and an agreement with the San Antonio Aids Foundation for TB services; each agreement is for a term ending August 31, 2021, includes an option to renew for an additional one-year term, and includes a Business Associate Agreement.
BACKGROUND INFORMATION:
The San Antonio Metropolitan Health District’s (Metro Health’s) TB Prevention and Control Program (TB Program) provides examination, diagnosis and treatment for individuals suspected or confirmed with active tuberculosis disease. The TB Program also provides screening and preventive medicine for those with a known exposure to TB or those from high risk populations. Additional services offered include case management, contact investigation and community intervention with prevention measures in order to reduce the rates and control the spread of TB disease.
On June 19, 2014, City Council authorized the acceptance of funding from the Texas Department of State Health (DSHS) for Metro Health’s participation in the Tuberculosis Identification and Treatment Project (TB Project) under the Texas Medicaid 1115 Waiver. This project focuses on targeted testing and treatment for latent tuberculosis infection (LTBI) in high risk populations to prevent these cases from evolving into active TB cases. The DSHS TB Project includes increased targeted testing and treatment for high risk populations including refugees and persons living in congregate settings such as homeless shelters and drug rehabilitation centers. In addition, individuals living with HIV and diabetes will be targeted for testing and treatment.
CentroMed has been providing healthcare to homeless persons since 1989 and works with various partnering agencies to ensure that homeless persons have access to healthcare services. CentroMed provides integrated mental health and primary care for homeless individuals accessing services at CentroMed’s Sarah E. Davidson Clinic on the Haven for Hope campus.
The San Antonio AIDS Foundation (SAAF) has a dual mission of providing compassionate medical care and social services to people with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), and helping prevent the spread of HIV through education, counseling and testing. SAAF supports the provision of services without discrimination on any basis, including but not limited to race, ethnicity, age, sex, gender, sexual orientation, marital status, religion, handicap, immigrant status, national origin, drug use, and criminal background.
CentroMed’s homeless population and SAAF’s HIV/AIDS population have higher rates of both infectious and chronic disease, including TB, HIV, pneumonia, chronic obstructive lung disease, and cardiovascular disease. Through the proposed agreements, CentroMed and SAAF will provide certain laboratory and medical consultation services, including phlebotomy services for collecting blood samples for T-SPOT®.TB (T-Spot) screening, in high risk populations which will contribute to the early intervention of Tuberculosis infection or disease.
ISSUE:
TB continues to be a significant and expensive public health problem in Texas. TB can strike anyone, but is more likely to be found in those born in a foreign country, people with diabetes, people with HIV/AIDS, the homeless, and those that work in health care. Many individuals in this population also are uninsured and lack access to appropriate treatment and care.
Metro Health seeks authorization of agreements with CentroMed and SAAF to increase targeted testing and treatment for high risk populations as part of Metro Health’s participation in the DSHS TB Project under the Texas Medicaid 1115 Waiver with terms ending August 31, 2021.
ALTERNATIVES:
If these agreements are not authorized, Metro Health will need to identify alternative mechanisms to meet the goals of the DSHS TB Project which is to increase targeted testing and treatment for LTBI in high risk populations in order to prevent these cases from evolving into active TB cases.
FISCAL IMPACT:
This ordinance authorizes two agreements with El Centro de Barrio d/b/a CentroMed and the San Antonio AIDS Foundation related to the San Antonio Metropolitan Health District’s participation in the Texas Department of State Health Services’ Medicaid 1115 Waiver Tuberculosis Identification and Treatment Project with terms ending August 31, 2021; and, authorizes the option to renew the agreements for an additional one year term. There is no fiscal impact associated with either agreement. These agreements will have no impact to the City’s General Fund.
RECOMMENDATION:
Staff recommends approval of the Ordinance authorizing execution of the agreements with El Centro del Barrio d/b/a Centro Med and the San Antonio Aids Foundation, with terms ending August 31, 2021, to support Metro TB Program.