DEPARTMENT: Health
DEPARTMENT HEAD: Dawn Emerick, Ed.D
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT:
Authorizing agreements with the University of Texas Health Science Center at San Antonio for the San Antonio Metropolitan Health District’s Racial and Ethnic Approaches to Community Health (REACH) Healthy Neighborhoods Program for terms ending September 29, 2020.
SUMMARY:
This Ordinance will authorize an amendment to an agreement with the University of Texas Health Science Center at San Antonio (UTHSCSA) to implement tobacco prevention strategies, adding to the current scope of work for an amount of $5,670.00, for a total amount of up to $40,670.00 and authorizes an agreement with UTHSCSA to provide community-clinical linkage strategies in an amount up to $68,316.00 for the REACH Healthy Neighborhoods Program, funded by the REACH Healthy Neighborhoods CDC grant, both with terms ending September 29, 2020.
BACKGROUND INFORMATION:
On June 21, 2018, City Council authorized the application to accept funds from the Centers for Disease Control and Prevention (CDC) in an amount not to exceed $900,000.00 per year for up to 5 years for an award to improve health, prevent chronic diseases and reduce health disparities among certain racial and ethnic populations. In the funding application Metro Health proposed to implement culturally tailored interventions to address the preventable behaviors of tobacco use, poor nutrition and physical inactivity building on the success of the Healthy Neighborhoods Program and Office of Health Equity.
The REACH Healthy Neighborhoods Program expanded the existing Healthy Neighborhoods program utilizing the Community Health Worker model to address health disparities within the near East, South, and West sides of San Antonio. The Office of Health Equity is housed within Metro Health and provides training and technical assistance on cultural competence, cultural humility, and culturally appropriate evidence-based strategies for reaching African-Americans, Hispanic/Latino and Native American populations at large. The Healthy Neighborhoods Program and the Office of Health Equity will continue to collaborate to expand current place-based public health strategies to organize for community change and focus on addressing health disparities in priority populations, including tobacco-free living, food systems approaches, breastfeeding promotion, and enhancing the community-clinical linkage and referral systems.
The amendment with UTHSCSA seeks to address a barrier to collecting existing project data within the UT Health electronic medical record system. As part of the project’s first year activities, staff partnered with UTHSCSA to implement a tobacco-use screening and referral policy within one of the Robert B. Green clinics. The goal of this activity was to ensure that 100% of patients were screened for tobacco use and referred to a quitline or behavioral specialist if the patient indicated tobacco use and a desire to quit. During the project year, the data requested from the clinic was found to be difficult to extract due to coding issues. The amendment will allow the vendor to retrieve essential data from the EMR with assistance from the UT Health epidemiology team and to find a long-term solution to this data collection barrier for future grant years.
The agreement with UTHSCSA will support a referral system feasibility study to better understand the clinical to community referral system within a large health system, identifying gaps and proposed solutions to creating bi-directional feedback between clinical providers and Metro Health community programs and services. Through the agreement, UTHSCSA will: (1) coordinate community and clinical linkage efforts between Metro Health, UTHSCSA, and the Primary Care Clinics; (2) conduct a feasibility assessment for a referral communication system that includes a feedback loop of patient follow-up between the clinic and local program; and, (3) develop a planning/program proposal.
ISSUE:
Metro Health is requesting Council authorization to execute an amendment to an agreement with UTHSCSA to implement tobacco prevention strategies and authorization to execute an agreement with the Institute for Health Promotion Research to provide community-clinical linkage strategies and evaluate the use of these strategies in clinical settings for REACH Healthy Neighborhoods.
ALTERNATIVES:
Should these agreements not be authorized, Metro Health will be unable to move forward with the REACH Healthy Neighborhoods Program work plan as funded by the CDC; thus, failing to meet program deliverables as well as failing to improve health, prevent chronic diseases and reduce health disparities among racial and ethnic populations in San Antonio.
FISCAL IMPACT:
This ordinance authorizes an amendment to an agreement with the University of Texas Health Science Center at San Antonio for implementation of tobacco prevention and cessation strategies in an amount of $5,670, for a total amount of up to $40,670.00 and authorizes an agreement with UTHSCSA to coordinate community to clinical linkages in an amount up to $68,316.00 for the San Antonio Metropolitan Health District’s Racial and Ethnic Approaches to Community Health (REACH) Healthy Neighborhoods Program, each with terms ending September 29, 2020.
Funding for the agreements with UTHSCSA is authorized by the REACH Healthy Neighborhoods Grant, funded by the CDC. There will be no impact to the General Fund.
RECOMMENDATION:
Staff recommends City Council authorize the agreements with UTHSCSA to support Metro Health’s REACH Healthy Neighborhood Program.