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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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Health Department
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DATE:
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December 19, 2006
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BOARD MEETING DATE:
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January 9, 2007
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Charlene A. Silva, Director, Health Department
Brian J. Zamora, Director, Public Health and Environmental Protection Division
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SUBJECT:
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Grant Award from the State Department of Health Services for the Tuberculosis Prevention and Control Program
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RECOMMENDATION
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Adopt a resolution authorizing acceptance of a grant award from the State Department of Health Services for Tuberculosis (TB) prevention and control activities for the term of July 1, 2006 through June 30, 2007, in the amount of $281,028.
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VISION ALIGNMENT
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Commitment: Ensure basic health and safety for all.
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Goal 5: Residents have access to health care and preventive care.
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The TB award contributes to this commitment and goal by providing funds to identify patients with TB and appropriately treat them to prevent spread of the disease.
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Performance Measure:
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Measure
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FY 2005-06
Actual
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FY 2006-07
Estimated
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Number of TB investigations conducted to ensure that secondary cases are identified.
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107
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150
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BACKGROUND
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According to the Healthy San Mateo 2010 Report, like most other urban/suburban regions in the United States, San Mateo County experienced a resurgence of TB in the early 1990s. Nationally, this increase was attributable to several factors: increased immigration from regions where TB is highly endemic, association with HIV transmission, increased transmission among homeless populations, increased transmission in congregate settings such as prisons and jails, and general reduction in the national public health infrastructure supporting TB control activities.
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In 2002 the local rate in San Mateo County was 9.4 per 1,000, which is similar to that of California (9 per 1,000), but greater than the national rate of 5.6. This rate is higher than the Healthy People 2010 target of 3.5.
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DISCUSSION
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The State Department of Health Services provides funding for tuberculosis control activities and incentive funds that can be used for housing and food. Control activities include funding for investigation of potential cases as well as for administration of the directly observed therapy program (DOT). One of the major concerns with TB cases is the rise in the multi-drug resistant strains of the disease. This occurs when treatment is started and not completed. If patients are noncompliant with their treatment, staff will work with the patients to directly observe their medication usage. If this fails, the Health Officer has the authority to detain patients in facilities to ensure treatment compliance and protect the health of the community.
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Many patients diagnosed with TB may also have challenges, such as stable housing or appropriate nutrition, which can interfere with treatment. The State recognizes these obstacles and provides funding for these needs. These funds are used to enhance adherence of treatment protocols, prevent homelessness and allow the use of less restrictive alternatives that decrease or obviate the need for detention. Examples of incentives include vouchers for transportation, food and rent assistance.
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This award notice was received from the State in late September, and staffing changes within Public Health resulted in a longer processing time.
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County Counsel has reviewed and approved the resolution.
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FISCAL IMPACT
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The term of the agreement is July 1, 2006 through June 30, 2007. The total amount is $281,028, of which $29,444 can be used for incentives. There are no required matching funds included in this award, resulting in no Net County Cost. The revenue and expenditures are included in the Adopted FY 2006-07 Budget.
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