DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger MPH, PhD
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT:
Authorizing an agreement with Communities in Schools of San Antonio for the San Antonio Metropolitan Health District’s Project Worth Teen Health program for a term ending September 30, 2021.
SUMMARY:
This Ordinance will authorize an agreement with Communities in Schools of San Antonio (CISSA) for adolescent health services to provide in-school behavioral and mental health counseling for the Teen Pregnancy Prevention Program, funded by the Medicaid 1115 Waiver Program in an amount not to exceed $217,000.00 for a term ending September 30, 2021 with the option to renew for one, one-year term for a total amount not to exceed $362,000.00 inclusive of the renewal.
BACKGROUND INFORMATION:
On January 31, 2013, City Council authorized the submission of six project proposals by Metro Health through the Regional Healthcare Partnership Anchor entity, University Health System for consideration and funding in the amount of $43,392,942.00 through the new Delivery System Reform Incentive Payment (DSRIP) arm of the “Texas Healthcare Transformation and Quality Improvement Program” or “Transformation Waiver.” Metro Health carefully selected projects in the following areas: diabetes prevention, children’s oral health services, HIV and Syphilis prevention, breastfeeding promotion, teen pregnancy prevention and neighborhood health promotion. All six project proposals were in alignment with Metro Health’s strategic plan and many community goals set forth by SA2020 and had the overall goal of improving health outcomes. The initial demonstration period came to an end on September 30, 2016. The Centers for Medicare and Medicaid Services approved an initial 15 month extension period and an additional 21 month renewal of the program that extended the term of the 1115 Waiver through September 30, 2019. Metro Health will continue to earn incentive payments through the Waiver Program from October 2019 - September 2021 and has additional Waiver funds to support these projects through 2023.
In 2016, Metro Health reported 2007 teen births. Of those 406 were repeat teen births. San Antonio’s birth rate for females ages 15-19 was 30.2 per 1,000 and was 49% higher than the national rate. According to the National Campaign to Prevent Teen and Unplanned Pregnancy, the 2016 cost of teen childbearing in San Antonio was $45.4 million in child welfare, healthcare, lost revenue and incarceration. In Texas, one of the biggest risk factors for future teen pregnancy is a prior teen pregnancy.
In September 2017, City Council Authorized an agreement with CISSA for adolescent health services to provide in-school behavioral and mental health counseling for Metro Health’s Teen Pregnancy Prevention Medicaid 1115 Waiver Program in an amount up to $216,000.00 for a term commencing October 1, 2017 through September 30, 2018, with options to renew for two, one-year terms. Furthermore, a one-year renewal was executed for the term October 1, 2018 through September 30, 2019. In February 2019, City Council authorized an amendment to the agreement with CISSA to increase the value up to $550,000.00 and extend the term through September 30, 2020. The amendment further expanded the scope of work required by CISSA to include telephone sessions in addition to individual and group counseling to teenage parents and expanded the target school districts to include a fifth district, Southwest Independent School District.
Authorization of the proposed agreement with CISSA will allow Metro Health to continue funding adolescent mental health counseling services to teens and teen parents.
ISSUE:
Metro Health is requesting City Council authorization of an agreement with CISSA for adolescent health services to provide in-school behavioral and mental health counseling to teen parents. In the event COVID19 dictates, CISSA clinicians are fully trained to provide tele-counseling services via HIPPA approved video conferencing and phone-based communication platforms. Parental/guardian consent will be required for teenagers ages 17 and younger to receive services.
ALTERNATIVES:
Should this contract not be authorized, Metro Health will be unable to move forward with plans for improving upon its adolescent health services project for the prevention of teen pregnancy in San Antonio and will be unable to meet deliverables set forth in the Medicaid 1115 Waiver Project.
FISCAL IMPACT:
This ordinance authorizes an agreement with Communities in Schools of San Antonio (CISSA) to provide behavioral mental health counseling for teens for a term ending September 30, 2021 for an amount of up to $217,000.00 and includes the option to renew for one, one-year term for an amount up to $362,000.00 inclusive of the renewal. Funding for the amendment with CISSA will be provided through the Medicaid 1115 Waiver. There will be no impact to the General Fund.
RECOMMENDATION:
Staff recommends City Council authorize the agreement with CISSA to support Metro Health’s teen pregnancy prevention efforts funded by the Medicaid 1115 Waiver Project.