COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health System

DATE:

April 10, 2009

BOARD MEETING DATE:

May 5, 2009

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Jean S. Fraser, Chief, Health System
Brian Zamora, Director, Community Health

SUBJECT:

Amendment A02 to the Agreement with the California Department of Public Health

RECOMMENDATION:

Adopt a Resolution authorizing the President of the Board to execute Amendment A02 to Agreement No. 07-65080 with the California Department of Public Health for the term of July 1, 2007 through June 30, 2010, reducing the contract amount by $170,122, decreasing the maximum obligation from $5,119,734 to $4,949,612.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goal 5: Residents have access to healthcare and preventive care.

The Agreement contributes to the commitment and goal by providing education, outreach, and testing services to individuals at high-risk of contracting HIV; providing case management to individuals affected by HIV/AIDS; and by generating information to develop specific strategies to best meet the AIDS program clients’ needs.

Performance Measure

Measure

FY 2007-08
Actual

FY 2008-09
Projected

Percentage of street outreach and group level HIV prevention education contacts who received HIV testing

58%

65%

BACKGROUND:

Since 1993 the California Department of Public Health (CDPH) has provided
funding to the San Mateo County Health System Public Health STD/HIV Program (SMCAP) for a continuum of services that includes AIDS case management, counseling and testing, an early intervention program, education and prevention, and HIV/AIDS surveillance. On October 16, 2007, your Board approved Agreement No. 07-65080 with CDPH for $4,321,653, to fund the above-mentioned services for the term July 1, 2007 through June 30, 2010. Subsequently, on April 11, 2008, your Board approved Amendment A01, increasing funding for the case management, early intervention and HIV prevention programs by $798,081 for a new contract amount of $5,119,734.

DISCUSSION:

Amendment A02, which was received by SMCAP from CDPH at the end of March 2009, decreases funding for years two and three of the Agreement.

Case management funding was decreased by $14,500 for the two-year period, bringing the total program amount from $644,460 to $629,960. Funding for the early intervention program has been decreased by $5,400 for the two-year period, changing the total program amount from $1,669,875 to $1,664,475. HIV/AIDS Surveillance funds were decreased by $9,408 for the two-year period, decreasing the total program amount from $403,200 to $393,792. The programs impacted by these changes have reduced operating expenses.

Funding for the HIV Counseling and Testing Program decreased by $140,814 for the two-year period, bringing the total program amount from $534,048 to $393,234. The reduction in funding for this program is due to the introduction of oral quick testing. A regular HIV blood test requires two counseling sessions, must be sent to a laboratory, is more expensive and takes two weeks to come back from the laboratory, resulting in a lower number of clients who return to pick up their test results. Oral quick testing is more cost effective because it is administered in one session and clients receive test results in twenty minutes, which has resulted in a greater number of clients obtaining their test results, lower use of more expensive conventional laboratory testing, and a decrease in operating expenses. There are no changes necessary to accommodate the reduction in funding because of the decrease in operating expenses produced by the new method utilized to perform testing.

County Counsel has reviewed and approved the Amendment and Resolution as to form and content.

FISCAL IMPACT:

The term of the Agreement remains July 1, 2007 through June 30, 2010. The original amount of the Agreement was $4,321,653. Amendment A01 increased funds by $798,081, and Amendment A02 decreases funding by $170,122, bringing the total amount of the Agreement from $5,119,734 to $4,949,612. A reduction in funding in the amount of $85,061 was included in the Public Health FY 2008-09 Adopted Budget. A funding decrease in the amount of $85,061 has been included in the Public Health FY 2009-10 Recommended Budget. There is no Net County Cost associated with this Amendment.