TITLE
Recommendation to authorize City Manager to execute all necessary documents, including but not limited to contracts, subcontracts and amendments, with the State Department of Health Services for funding the provision of HIV/AIDS preventive health services for an amount not to exceed $5,599,053 for a period of three years, to be appropriated on an annual basis; and increase appropriations in the Health Fund
(SR 130) and the Department of Health and Human Services (HE) by $216,342. (Citywide)
DISCUSSION
For the past 22 years, the State Department of Health Services (State) has contracted with the City to provide HIV/AIDS clinical services, education, outreach, and surveillance activities. The State provides funding for HIV Prevention, HIV Counseling and Testing, AIDS Surveillance, and the Early Intervention Program. The City will enter into a three-year agreement with the State for each of these programs. In addition, the City will enter into subcontract agreements with community agencies to conduct specialized services to augment the services provided by the City's Department of Health and Human Services (Health Department).
HIV Prevention Program
The amount allocated for the HIV Prevention program is $2,248,968 for three years.
The following grants comprise the HIV Prevention program:
HIV Education and Prevention
The overall purpose of the HIV Education and Prevention (E&P) program is to prevent HIV transmission; change individual attitudes about HIV and risk behaviors; promote the development of risk-reduction skills; and change community norms that may sanction unsafe sexual and drug-taking behaviors. The E&P program targets high-risk youth, women-at-sexual risk, men who have sex with men, HIV-positive individuals, high-risk negatives, and drug users. The E&P program puts great emphasis in reaching people of color under each target population. In addition, the E&P program provides technical assistance for community-based organizations to increase their organizational capacity to address the HIV/AIDS epidemic more effectively. Technical assistance is provided in grant writing, program planning and evaluation, data collection and interpretation, survey design and methodology, and training. The projected allocation for the E&P program is $644,656 annually.
Under the agreement, the City will subcontract with the following organizations to provide comprehensive HIV E&P services to the community:
Organization Amount District
Center for Behavioral Research and Services $156,000 6
St. Mary Medical Center Comprehensive AIDS
Research and Education (CARE) Program 103,000 6
Centro Community Hispanic Association 20,000 1
The Gay and Lesbian Center of Long Beach 58,320 2
Better World Advertising 25,00 N/A
$362,320
The remainder of the funds will be utilized to operate the Health Department's Teens Smart program, a community-based educational series on HIV prevention targeting high-risk youth (homeless, runaway, out of school youth, and adolescents with a history of probation). The remainder of the funds also supports the Mobile Youth Drop-In Center, a youth-friendly mobile van, which provides workshops, risk reduction materials, and peer counseling for teens at risk for contracting HIV and other sexually transmitted diseases.
Neighborhood Intervention Geared toward High-risk Testing (NIGHT) Program
The NIGHT program's goal is to reach high-risk individuals in order to assess their risk for HIV and, if appropriate, refer them to HIV testing, provide them with educational materials/condoms and referrals to other social support and/or medical services. This is accomplished by outreach in venues where clients live or frequent, e.g., bars, parks, feeding programs, etc. The identified high-risk populations served are substance users, sex workers, men who have sex with men, and presumptive Medi-Cal eligible women and their partners. The funding allocation of the NIGHT program is $105,000 annually.
HIV/HCV Counseling and Testing
The amount allocated for HIV/HCV Counseling and Testing activities is $857,685 for three years ($285,895 annually). The counseling and testing program consists of HIV counseling and testing and Hepatitis C virus testing programs. The HIV Counseling and Testing program offers anonymous and confidential HIV counseling and testing services and provides an assessment of client needs pertaining to HIV transmission, personal risk behaviors, client-centered prevention counseling or educational materials, risk reduction planning, and referral to other services (including medical referrals and partner counseling and referral services) for clients with a confirmed HIV positive test result. HCV (hepatitis C virus) testing services will be offered to injection drug users (IOU) in an effort to increase HIV testing within this population. The primary goal of providing HCV testing services is to increase the number of IDUs who receive HIV counseling and testing services by offering HCV screening in coordination with HIV counseling and testing. The secondary goals of providing HCV services are to integrate HCV testing into HIV counseling and testing and to increase the number of IDUs who know their HIV status, receive appropriate HCV prevention and treatment services.
HIV/AIDS Surveillance Program
The HIV/AIDS Surveillance Program yields epidemiologic data useful for policy and program development. This data is particularly effective when appropriately analyzed and interpreted, combined with other relevant data, and widely disseminated. For example, AIDS-related data are critical components of the federally funded HIV Prevention Community Planning Process. Community planning work groups use epidemiologic and behavioral data to assess the state's prevention needs and develop a statewide HIV prevention plan. Planning groups at the local level also use local data to establish prevention priorities for their areas. In addition, AIDS case data serves as the basis for allocating federal funds to California under Title II of the Comprehensive AIDS Resources Emergency (CARE) Act and for the state's allocation of these funds to local consortia. Further, AIDS case information has been used to estimate HIV prevalence, analyze HIV disease survival rates, and provide insight into diagnostic practices and access to care. The amount allocated for HIV/AIDS Surveillance is $720,000 for three years ($240,000 annually).
Early Intervention Program
The amount allocated for the Early Intervention Program is $1,772,400 for three years ($590,800 annually). The following grants are a part of the Early Intervention Program:
AIDS/HIV Early Intervention Program
The Early Intervention Program was established to provide quality of life enhancement to those infected with HIV and to prevent further transmission and acquisition of the virus to those persons at risk. The EIP Program includes medical services, treatment advocacy and health education, case management, risk reduction counseling, partner notification, and services which assist HIV infected individuals with overcoming barriers and assist them with linkages to transition into care and treatment.
AIDS/HIV Positive Changes Program
The HIV/AIDS Positive Changes Program is the part of the Early Intervention Program that provides one on one supportive risk reduction counseling for those persons contemplating behavior change to maintain wellness and prevent transmission of HIV.
This service assists high risk, HIV positive individuals to develop a treatment plan that will focus on reducing harm with realistic, agreed upon goals.
BRIDGE
The HIV/AIDS Bridge Program provides work with the community to link and transition newly diagnosed HIV infected patients into care and treatment. The Bridge Program also assists those HIV infected individuals who fall out of care to overcome barriers and get back into care.
This matter was reviewed by Deputy City Attorney Lori A. Conway on July 31, 2007 and by Budget and Performance Management Bureau Officer David Wodynski on August 6, 2007.
TIMING CONSIDERATIONS
Services have been provided under all of the programs related to the agreement since July 1, 2007 but the City will be unable to recover any of the related costs until the agreement is approved.
FISCAL IMPACT
The total amount of the agreement is $5,599,053 for a three-year period. The award amount will be appropriated on an annual basis. Funding for these programs in the amount of $1,794,237 is currently budgeted in the Health Fund (SR 130) and in the Department of Health and Human Services (HE) for the current fiscal year. An appropriation increase of $216,342 is included in the recommendation, and has no fiscal impact to the General Fund.
SUGGESTED ACTION
Approve recommendation.
Respectfully Submitted,
RONALD R. ARIAS
DIRECTOR HEALTH AND HUMAN SERVICES
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APPROVED: |
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ANTHONY W. BATTS |
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CITY MANAGER |