DATE:

DATE: 08/19/02	SUBJECT: FINAL READING ORDINANCE NO. 2002-O-184 Authorizing the City Manager to accept and execute all documentation by increasing revenues and expenditures in the amount of $1,350,586 in direct funds and $227,690 in program income from the Texas Department of Health for nine grants: La Familia Health Care Program, Tuberculosis Elimination Program, Immunization Action Plan Project, Office of Public Health Practice, Hepatitis C Screening Project, Maternal and Child (and Dental) Health Program, Family Planning Services, and the Laredo Obesity Prevention and Control Project of the City of Laredo Health Department for the period beginning September 1, 2002, through September 30, 2002, by amending the City of Laredo FY 2001-2002 budget in the amount of $112,548 respectively; and October 1, 2002, through August 31, 2003, in the amount of $1,238,037.
INITIATED BY: STAFF SOURCE: Cynthia Collazo Hector F. Gonzalez, M.D., M.P.H. Asst. City Manager Health Director
PREVIOUS COUNCIL ACTION: On August 5, 2002, Council held public hearing introducing ordinance and instructed staff to proceed with final reading.
BACKGROUND: The Texas Department of Health has contracted with the City of Laredo to provide public health services to residents of Laredo and Webb County through the City of Laredo Health Department. The City of Laredo FY 2001-2002 budget will be amended by 1/12 of the grant budget, and the remaining 11/12 budget will be part of the FY 2002-2003 budget. #1 The Health Department’s **La Familia Health Care Program provides comprehensive health services targeted at the family unit, which is considered to be more effective than an individual patient approach. The program focuses on the provision of direct medical and preventive health services through intensive case management of the family or family member at risk of three of the leading chronic diseases our area - diabetes, hypertension and heart disease. Laredo and Webb County statistics attest to the fact of the high prevalence of these chronic diseases in the community’s 94% Hispanic population. During this fiscal year, 60% of the diabetic clients and 90% of the hypertensive clients enrolled in this project maintained control of their disease at medically acceptable levels. CONTINUED ON NEXT PAGE**
FINANCIAL: The City of Laredo will receive $1,350,586 in direct funds and $227,690 in program income for the City of Laredo Health Department.
RECOMMENDATION		STAFF: Recommends that Council approve ordinance.

BUDGET

#2 The Tuberculosis Elimination Program provides services for tuberculosis prevention and control consistent with the policies of the American Thoracic Society and Centers for Disease Control Joint Statements for tuberculosis prevention and control. These services include: A) administrative and professional direction of the tuberculosis control program in accordance with local and state policies; B) maintenance of records documenting program services; C) development and carrying out expanded outreach services to individuals of identified sub-groups who have tuberculosis or are at high risk of developing tuberculosis; D) testing appropriate individuals for tuberculosis; E) providing clinical diagnosis and treatment services; F) providing directly observed therapy (DOT) to non-compliant patients; G) evaluating progress of therapy on 90% of patients monthly; H) locating and investigating persons suspected of being exposed to tuberculosis; and I) maintaining a tuberculosis register. These public health services are provided to residents of Laredo and Webb County.

BUDGET

#3 The Immunization Action Plan Project was developed to meet requirements of the Texas Department of Health. It details a community-based strategy for the prevention of future epidemics of measles or other vaccine-preventable diseases. The Immunization Action Plan incorporates traditional and non-traditional systematic approaches designed to eliminate barriers, expand immunization delivery, and establish a coordinated effort to appropriately immunize preschool-aged children. The City of Laredo Health Department will endeavor to achieve and maintain 90% immunization levels for preschool-age children and to eradicate vaccine-preventable diseases. The Health Department will also assess immunization levels in the clinical records of preschool children using the CDC Clinic Assessment Software Application (CASA).

The City of Laredo Health Department must adhere to both the spirit and intent of the “Standards for Pediatric Immunization Practices,” as recommended by the National Vaccine Advisory Committee, approved by the U.S.P.H.S., and endorsed by the American Academy of Pediatrics. The Health Department plans to provide immunization services two or more evenings per week and on weekends as needed to insure barrier free access to immunization clinics. Residency requirements for vaccine recipients are not applicable to receive services. The Health Department cannot deny vaccine to a recipient because they do not reside within this jurisdiction nor for the inability to pay the approved $4.00 fee.

Included in this amendment are funds in the amount of $47,352 in direct assistance for two state-funded positions assigned to the City of Laredo Health Department. This brings the total state support for the Immunization Action Project to $178,852 in direct funds and $55,000 in program income.

BUDGET

#4 The purpose of the Office of Public Health Practice (formerly the Community Health Services Program) is to deliver one or more of the essential public health services:

Monitor the health status of individuals in the community to identify community health problems;
Diagnose and investigate community health problems and community health hazards;
Inform, educate, and empower the community with respect to health issues;
Mobilize community partnerships to identify and solve community health problems;
Develop policies and plans that support individual and community efforts to improve health;
Enforce laws and rules that protect the public health and ensure safety in accordance with those laws and rules;
Link individuals who have a need for a community and personal health services to appropriate community and private providers;
Ensure a competent workforce for the provision of essential public health services;
Research for new insights and innovative solutions to community health problems; and
Evaluate the effectiveness, accessibility and quality of personal and population based health services in a community.

BUDGET

#5 The City of Laredo Health department’s HIV/AIDS Program has been awarded $13,333 to conduct Hepatitis C Screening Project. The purpose of the study is to determine the prevalence of Hepatitis C in our local high-risk population. The term of this contract is for September 1, 2002, through December 31, 2002.

Hepatitis C (HCV) is one type of virus that can damage the liver, a vital organ that has many functions. About 30% to 40% of new Hepatitis C infections develop symptoms. Symptoms may include fatigue, mild fever, flu-like illness, nausea and vomiting, stomachache, and loss of appetite. Up to 70% of those newly infected with HCV will be asymptomatic and not know that they are infected. Amongst those infected with HCV, 20% will develop chronic liver disease and suffer serious liver damage as a result of their Cirrhosis (scarring of the liver). The remaining 70% who develop chronic liver damage will not develop serious liver problems. Moreover, 5% of those people with HCV will die from liver failure or liver cancer, and 15% will naturally resolve the infection on their own.

Hepatitis C is the most common bloodborne infection in the United States. Severe liver disease from Hepatitis C accounts for one quarter to one third of all liver transplants in the nation. There are currently no vaccines or immune globulin products to prevent HCV. A person infected with either acute or chronic HCV may infect other people, especially if no safety measures are taken. The virus is found in blood and is usually spread by direct contact with blood products. The highest risk of getting infected with HCV comes from sharing needles with an infected person, i.e. for illegal drug usage, injecting steroids, tattoos, etc.

BUDGET

#6& #7 The Maternal and Child Health (MCH-Title V) Program provides, at a minimum, the following services to eligible women and children: prenatal, preventive, and primary child health, genetics, and dysplasia. The program will bill Title V or Medicaid for all Medicaid eligible services; will ensure that all program income generated through Medicaid be used to expand and enhance women and children’s health services. Included in this contract are funds in the amount of $48,000 for the Dental Health Services Division, which is part of the Title V entitlement. This amount is included in the personnel line item. The grant period begins on September 1, 2002, through August 31, 2003.

BUDGET

#8 The Family Planning Services will assure the provision of family planning services for Title V eligible clients.

BUDGET

#9 The Laredo Obesity Prevention and Control Project (LOPAC) provides public health preventive services to women, children, and their families in order to address local health needs; to build the local public health infrastructure; and to improve the health status of women, children, and families. The grant period begins on September 1, 2002, through August 31, 2003

BUDGET

ORDINANCE 2002-O-184

Authorizing the City Manager to accept and execute all documentation BY INCREASING REVENUES AND EXPENDITURES in the amount of $1,350,586 in direct funds and $227,690 in program income from the Texas Department of Health for NINE grants: La Familia Health Care Program, Tuberculosis Elimination Program, Immunization Action Plan Project, Office of Public Health Practice, Hepatitis C Screening Project, Maternal and Child (AND DENTAL) Health Program, FAMILY PLANNING SERVICES, and the Laredo Obesity Prevention and Control Project of the City of Laredo Health Department for the period beginning September 1, 2002, through September 30, 2002, by amending the City of Laredo FY 2001-2002 budget in the amount of $112,548 respectively; and October 1, 2002, through August 31, 2003, in the amount of $1,238,037.

WHEREAS, the Texas Department of Health (TDH) is contracting with the City of Laredo to provide public health services to residents of Laredo and Webb County through the City of Laredo Health Department; and

WHEREAS, the City of Laredo FY 2001-2002 budget will be amended by 1/12 of the grant budget, and the remaining 11/12 budget will be part of the FY 2002-2003 budget; and

WHEREAS, the Health Department’s La Familia Health Care Program provides comprehensive health services targeted at the family unit, which is considered to be more effective than an individual patient approach. The program focuses on the provision of direct medical and preventive health services through intensive case management of the family or family member at risk of three of the leading chronic diseases our area - diabetes, hypertension and heart disease. Laredo and Webb County statistics attest to the fact of the high prevalence of these chronic diseases in the community’s 94% Hispanic population. During this fiscal year, 60% of the diabetic clients and 90% of the hypertensive clients enrolled in this project maintained control of their disease at medically acceptable levels; and

WHEREAS, the Tuberculosis Elimination Program provides services for tuberculosis prevention and control consistent with the policies of the American Thoracic Society and Centers for Disease Control Joint Statements for tuberculosis prevention and control. These services include: A) administrative and professional direction of the tuberculosis control program in accordance with local and state policies; B) maintenance of records documenting program services; C) development and carrying out expanded outreach services to individuals of identified sub-groups who have tuberculosis or are at high risk of developing tuberculosis; D) testing appropriate individuals for tuberculosis; E) providing clinical diagnosis and treatment services; F) providing directly observed therapy (DOT) to non-compliant patients; G) evaluating progress of therapy on 90% of patients monthly; H) locating and investigating persons suspected of being exposed to tuberculosis; and I) maintaining a tuberculosis register. These public health services are provided to residents of Laredo and Webb County; and

WHEREAS , the Immunization Action Plan Project was developed to meet requirements of the Texas Department of Health. It details a community-based strategy for the prevention of future epidemics of measles or other vaccine-preventable diseases. The Immunization Action Plan incorporates traditional and non-traditional systematic approaches designed to eliminate barriers, expand immunization delivery, and establish a coordinated effort to appropriately immunize preschool-aged children. The City of Laredo Health Department will endeavor to achieve and maintain 90% immunization levels for preschool-age children and to eradicate vaccine-preventable diseases. The Health Department will also assess immunization levels in the clinical records of preschool children using the CDC Clinic Assessment Software Application (CASA).

WHEREAS, the purpose of the Office of Public Health Practice (formerly the Community Health Services Program) is to deliver one or more of the essential public health services:

· Monitor the health status of individuals in the community to identify community health problems;

· Diagnose and investigate community health problems and community health hazards;

· Inform, educate, and empower the community with respect to health issues;

· Mobilize community partnerships to identify and solve community health problems;

· Develop policies and plans that support individual and community efforts to improve health;

· Enforce laws and rules that protect the public health and ensure safety in accordance with those laws and rules;

· Link individuals who have a need for a community and personal health services to appropriate community and private providers;

· Ensure a competent workforce for the provision of essential public health services;

· Research for new insights and innovative solutions to community health problems; and

· Evaluate the effectiveness, accessibility and quality of personal and population based health services in a community; and

WHEREAS, the City of Laredo Health department’s HIV/AIDS Program has been awarded $13,333 to conduct Hepatitis C Screening Project. The purpose of the study is to determine the prevalence of Hepatitis C in our local high-risk population. The term of this contract is for September 1, 2002, through December 31, 2002.

WHEREAS, the Maternal and Child Health (MCH-Title V) Program provides, at a minimum, the following services to eligible women and children: prenatal, preventive, and primary child health, genetics, and dysplasia. The program will bill Title V or Medicaid for all Medicaid eligible services; will ensure that all program income generated through Medicaid be used to expand and enhance women and children’s health services. Included in this contract are funds in the amount of $48,000 for the Dental Health Services Division, which is part of the Title V entitlement. This amount is included in the personnel line item. The grant period begins on September 1, 2002, through August 31, 2003; and

WHEREAS, the Family Planning Services will assure the provision of family planning services for Title V eligible clients; and.

WHEREAS, the Laredo Obesity Prevention and Control Project (LOPAC) provides public health preventive services to women, children, and their families in order to address local health needs; to build the local public health infrastructure; and to improve the health status of women, children, and families. The grant period begins on September 1, 2002, through August 31, 2003

NOW, THEREFORE BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF LAREDO THAT:

Section 1: The City Manager is hereby authorized to execute the contract and accept the grants and their provisions as set forth by the Texas Department of Health.

Section 2: The City of Laredo accepts funds in the amount of $1,350,586 in funds for nine grants of the City of Laredo Health Department.

Section 3: The City Manager is hereby authorized to accept additional funds from the Texas Department of Health in support of the activities funded by these grants.

Section 4: Revenue line item 226-0000-323-4036 be increased from $0 to $181,000; 226-0000-323-4042 from $0 to $208,928; 226-0000-323-4056 from $0 to $196,500; 226-0000-323-4033 from $0 to $435,703; 226-0000-323-4085 from $0 to $13,333; 226-0000-323-4034 from $0 to $377,557; 226-0000-323-4047 from $0 to $48,000; 226-0000-323-4034 from $0 to $93,550; and 226-0000-323-4069 from $0 to $24,605;

Section 5: Expenditure line item 226-6083 be increased from $0 to $181,000; 226-6085 from $0 to $208,928; 226-6086 from $0 to $196,500; 226-6088 from $0 to $435,703; 226-6074 from $0 to $13,333; 226-6079 from $0 to $377,557; 226-6080 from $0 to $93,550; 226-6081 from $0 to $48,000; and 226-6087 from $0 to $24,605.

Section 6: The City Manager is hereby authorized to make transfers within the budget as allowable under the General Provisions of the existing general contract with the Texas Department of Health to meet the necessary costs to accomplish the scope of work for the project.

PASSED BY THE CITY COUNCIL AND APPROVED BY THE MAYOR

ON THIS _________________ DAY OF ________________________, 2002.

__________________________

ELIZABETH G. FLORES

MAYOR

ATTEST:

__________________________

GUSTAVO GUEVARA, JR.

CITY SECRETARY

APPROVED AS TO FORM:

__________________________

JAIME FLORES

CITY ATTORNEY