COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

April 4, 2003

BOARD MEETING DATE:

April 22, 2003

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

Brian Zamora, Director, Public Health and Environmental Protection

SUBJECT:

Agreement with the State Department of Health Services for HIV-1 Viral Load Testing

Recommendation

Adopt a Resolution authorizing the President of the Board to execute an agreement with the State Department of Health Services for HIV-1 Viral Load Testing.

Background

For the past five years, San Mateo County has received viral load testing (VLT) vouchers from the California State Office of AIDS (OA) for use in decreasing the county's cost for testing clients who are ineligible for Medi-Cal. During this period, the County has been performing the viral load tests. The Public Health Laboratory's infrastructure was upgraded several years ago in order to be able to perform these HIV-1 viral load tests with no additional staff requirements.

Discussion

As one of fourteen participating viral load test laboratories in California, the Public Health Laboratory provides HIV-1 VLT services for AIDS Drug Assistance (ADAP)-eligible clients from Early Intervention Program (EIP) sites and Local Health Jurisdiction (LHJ) sites. In order to qualify for reimbursement, the County must follow a detailed protocol outlined by the State OA. Designated EIP staff and individuals authorized by LHJ sites shall determine client eligibility and complete a VLT voucher for each sample submitted for analysis and subsequent reimbursement.

The client's medical provider will determine the number of tests per individual and the frequency of testing. Staff estimates that it will perform up to 550 of these reimbursable tests annually. Based on this projection, the maximum number of client viral load tests performed by staff is not to exceed 550 (550 tests x $100 per test = $55,000) per year, the cost of which will be reimbursed under this agreement.

The term of the contract is July 1, 2002 through June 30, 2005. This contract is a late submission to your Board due to a delay in receipt of the contract from the State Department of Health Services.

Vision Alignment

The agreement with the State Department of Health Services keeps the commitment of ensuring basic health and safety for all and goal number 5: "Residents have access to healthcare and preventative care." The agreement contributes to this commitment and goal since local testing reduces the amount of time to obtain test results and supports patient care.

Fiscal Impact

The term of the agreement is July 1, 2002 through June 30, 2005. This agreement was delayed because the contract was received from the State late. The total amount of the agreement is $165,000: $55,000 has been included in the approved FY 2002-03 budget, and $55,000 per year will be included in the recommended FY 2003-04 and FY 2004-5 budgets. There is no net County cost.