TITLE
Recommendation to authorize City Manager, or designee, to execute an agreement, and any subsequent amendments, with the State of California Department of Public Health, to receive and expend grant funding in an estimated amount of $25,200, to provide HIV Pre-Exposure Prophylaxis Assistance Program services, for the period January 1, 2018 through December 31, 2021. (Citywide)
DISCUSSION
In 2012, the first biomedical HIV prevention intervention for HIV negative individuals was implemented with the approval of the Food and Drug Administration (FDA) of the drug Truvada for use as Pre-Exposure Prophylaxis (PrEP). PrEP uses an HIV prevention prescription medication (Truvada) prescribed to people who do not have HIV, but are at substantial risk of contracting HIV. PrEP, as a biomedical prevention intervention, has been proven safe and effective in reducing HIV infection in people who are at high-risk of acquiring HIV by up to 92 percent when taken consistently.
The Department of Health and Human Services (Health Department) HIV Care Clinic’s medical providers have nearly five years of experience in providing biomedical HIV prevention services as co-investigators of a multi-year study led by the California Collaborative Treatment Group (CCTG), sponsored by the California Research Program (CHRP) and the Centers for Disease Control (CDC), as well as a previously executed contract to provide biomedical PrEP services through the County of Los Angeles Department of Public Health (LADPH).
The PrEP Assistance Program (PrEP-AP) is administered by the California Department of Public Health to subsidize certain costs of medication for the prevention of HIV infection and other related medical services for eligible individuals. The purpose of PrEP-AP is to help reduce new HIV infection among high-risk populations in California.
Through this agreement, the Health Department will participate as a clinical provider in the PrEP-AP Provider Network, to provide access to PrEP services for high-risk individuals to keep them HIV negative. As a provider, uninsured clients and those whose insurance does not cover Prep-AP-related medical co-pays, deductibles, and drug costs are eligible for PrEP-related services (i.e. medical visits, HIV testing, screening for STDs and lab tests).
The proposed agreement will allow the Health Department to submit reimbursement claims for the provision of PrEP-related services in accordance with Medicare fee schedules. The term of the agreement is January 1, 2018 through December 31, 2021.
This matter was reviewed by Deputy City Attorney Linda T. Vu on July 17, 2018 and by Revenue Management Officer Geraldine Alejo on July 19, 2018.
TIMING CONSIDERATIONS
City Council action is requested on August 14, 2018, for the Health Department to provide PrEP-AP services to individuals who are at risk for contracting HIV.
FISCAL IMPACT
The City will receive grant reimbursements based on the number of clients served. The annual anticipated reimbursement for this program is estimated at $25,200 based on the existing client population. Sufficient appropriation is available in the Health Fund (SR 130) in the Health and Human Services Department (HE). The grant has no required match or in-kind service mandate. There is no local job impact associated with this recommendation.
SUGGESTED ACTION
Approve recommendation.
Respectfully Submitted,
KELLY COLOPY, DIRECTOR
HEALTH AND HUMAN SERVICES
APPROVED:
PATRICK H. WEST
CITY MANAGER