COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

November 5,2004

BOARD MEETING DATE:

December 7, 2004

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Four-fifths vote

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer, San Mateo Medical Center

SUBJECT:

Acceptance of a Grant Award from the Universitywide AIDS Research

Program (UARP)

Recommendation

1.

Adopt a resolution accepting a grant from the Universitywide AIDS Research Program in the amount of $207,920 to conduct Universitywide AIDS Research Program (UARP)-funded research project entitled “Integrated Pain Management for HIV Patients”.

2.

Adopt an amendment to the Salary Ordinance to add one unclassified Psychologist I.

3.

Approve an Appropriation Transfer Request (ATR) to accept unanticipated revenue ($103,960) for 2004-05 and appropriate new revenue to Salaries and Benefits ($98,960) and to Professional Independent Contractor ($5,000).

Vision Alignment

Commitment: Basic Health and Safety for All
Goal 8: Help vulnerable people – the aged, disabled, mentally ill, at-risk youth and others – achieve a better quality of life.

The study contributes to the goal by giving San Mateo Medical Center an opportunity to implement and evaluate a pain management program for people living with HIV

Outcome Objectives

The following outcome objectives related to this project will be measured in 2005-2006 using an Evaluation Work Plan included in the grant proposal:

Outcome Measures

(at end of first year)

2004-2005

Objectives

Percentage of project client goal (100 persons) recruited and assessed for Integrated Pain Management Study

75%

Education of Health Care Professionals in HIV/AIDS clinics regarding the availability of needed capacity for pain management.

100%

Background

The Clinical Trials and Research Unit of the San Mateo Medical Center (SMMC) was established by in 2000 in order to provide a mechanism and infrastructure for clinical treatment trials and medical research projects for the benefit of the individuals and community of San Mateo County. Chronic Pain is a problem that affects many patients with HIV, for which few effective health treatments are available.

Discussion

The Clinical Trials and Research Unit submitted a proposal regarding Integrated Pain Management for HIV Patients in response to a “Request for Proposals” for Community Collaborative Research Projects involving people with HIV. Dr. Dennis Israelski is the Principal Investigator for this study. On October 6, 2004, the Universitywide AIDS Research Program notified the county that the proposal had been favorably received and the award granted. The County will receive $103,960 for fiscal year 2004-2005 and $103,960 for FY 2005-2006, for a total amount of $207, 920 over a two-year period.

The primary purpose of this study is to implement and evaluate a pain management program for people living with HIV. Treatment of pain is a serious problem in HIV positive patents with 60-75% of patients reporting problems with pain. Pain is responsible for increased distress, disability, and health care use and decreased quality of life in persons living with HIV/AIDS. Reasons for lack of adequate pain management in HIV positive patients include problems with complications of mental health and substance abuse disorders, co-morbid liver disease, adverse medication effects, lack of knowledge among HIV treating clinicians regarding best practices in pain management, and lack of patient access to pain treatment.

SMMC proposes to incorporate a promising treatment into patient’s current HIV treatment programs, thus increasing patients’ access to care and HIV treatment clinicians’ exposure to a pain specialist. This study proposes to test the acceptability and effectiveness of integrating cognitive-behavioral/relaxation-based group therapy for pain management into primary care clinics for people with HIV/AIDS. It will examine whether this pain management program is acceptable and effective for people living with HIV and AIDS with problems such as substance abuse, mental health disorders and homelessness.

The resolution will allow the County to accept the grant award and appropriate the funds that will pay the salary and benefits of the Clinical Psychologist and cover other administrative expenses associated with this study.

Fiscal Impact

The term of this grant award is from November 1, 2004 through November 30, 2006.

The maximum amount of the award is $207,920. San Mateo Medical Center will receive $103,960 for FY2004-05 and $103,960 for FY2005-06. Administrative oversight, technical assistance, and project monitoring will be provided by existing Clinical Trials and Research staff. There is no net county cost associated with this project.