Inter-Departmental Correspondence

San Mateo Medical Center



October 28, 2002


November 5, 2002



Honorable Board of Supervisors


Nancy Steiger, Chief Executive Officer



Appropriation Transfer Request



Approve an Appropriation Transfer Request (ATR) Recognizing Unanticipated

Revenue for the Ryan White CARE Act Title III Early Intervention Planning Program, increasing Intergovernmental Revenues ($50,000), Personnel Expenses ($30,000) and Services and Supplies Expenses ($20,000) in the Community Health Clinics Enterprise Fund (6850B).



Since 1991, the County Health Services Agency has been providing primary medical care for people with HIV with funds provided by the federal government through CARE ("Ryan White") Title I and II legislation. These funds have been administered by the San Mateo County AIDS Program through an agreement with the San Francisco Department of Public Health, which receives the funding for the entire Eligible Metropolitan Area (San Francisco, San Mateo and Marin Counties) and allocates a portion to the other counties. This has enabled the AIDS Program to establish a high level of HIV medical care at its Edison Clinic at the San Mateo Medical Center, but has not been sufficient to cover the cost of supporting that level of care throughout the county, especially in the South County area. Current federal resources for HIV care received by the County are insufficient to meet the increasing medical care needs of a growing population living with HIV and AIDS countywide, especially among Latino and other minority communities.


During 2001-2002, HRSA awarded the Medical Center a one-year, $50,000 grant to begin planning HIV early intervention services for underserved people living with HIV/AIDS in the County, focusing on minority communities. During that year, an extensive needs assessment was undertaken and completed. In order to complete the planning process, the Medical Center submitted a continuation proposal in response to a "Request for Proposals" for the Ryan White CARE Act Title III HIV Planning and Capacity Building Grant Program, issued last spring by HRSA. On September 1, 2002, HRSA notified the County that the proposal had been favorably reviewed and the grant awarded. The County will receive an additional $50,000 for a second, one-year project.

This award will make it possible for the County to continue to develop a plan for outpatient HIV early intervention services for low-income, medically underserved people in the County's existing primary care system. It specifically will focus on serving the Latino community, but will incorporate the needs of people from other minority communities living with HIV in the south county area, as well. If this planning project is successful, the County will be eligible in the following year to apply for Title III funds from HRSA to implement a system of HIV Early Intervention Services (EIS) in south county.

The Medical Center intends to amend an existing contract with the South County Community Health Center, which was written into the grant as the collaborating partner, to provide them with some of this funding for community organizing and planning activities.


Vision Alignment

This ATR for the Ryan White Title III HIV Early Intervention Services Planning Program reflects the County's commitment to ensuring basic health and safety for all, along with goal number 8, helping vulnerable people achieve a better quality of life. The new funding contributes to this commitment and goal, as it will allocate $50,000 to the County Health Center, in collaboration with the South County Community Health Center, to plan for improved medical care and related services for disadvantaged people of color living with HIV in the southern part of the county.


Fiscal Impact

The attached ATR adds unanticipated revenue in the amount of $50,000 to the Medical Center's Community Clinics administrative budget (68110) for HIV services planning. There is no net county cost associated with this one-year planning grant.