Travis County Commissioners Court
March 20, 2007
Item 9
Due to technical difficulties some caption files may be incomplete.
9. Consider and take appropriate action regarding recommendation from health and human services and veterans service department to approve $67,000 in emergency one-time funding for the wright house wellness center's client advocacy program.
>> good morning.
>> good morning.
>> good morning, judge, Commissioners, sherri flemming, executive manager for health and human services and veterans service. Staff do have a brief presentation related to this request. We also want to acknowledge the staff and board members of the wright house who are present today. Executive director here susan wills.
>> would you introduce --
>> this is huey houston the president of the wright house wellness center.
>> welcome.
>> and as we get our presentation set up, staff will be recommending approval of this request as funds are currently available within the approved health and human services budget. However, due to a change in strategy, at the
>> funding has been around, a federal initiative to assist communities in aiding persons living with hiv disease and aids. Our funding for '07 is at 2. 2.3 million. We also have local funds from both the city and county in '05 totaled about $1 million and we believe our tally for '06 will be about 1.. Prior to this year we have been able to leverage about 3 million in federal fund for these service. The administrative agent for these declares is the Austin Travis County health and human services department at the city. The maintenance of effort dollars are also there to ensure that communities don't supplant these dollars and that they continue to invest in these services locally. The changes in the ryan white grant basically are that Austin Travis County is no longer considered an eligible metropolitan area, which means basically that we have 2,000 aids cases reported in the last five years and 3,000 persons living with aids in our community. Right now our designation has been change to a transitional grant area, which means that a community has at least 1,000 aids case cases in the last five years years. Even though that is our current designation, locally we already know that we don't meet that definition. And so, the future of funding related to this definition is somewhat uncertain because, as I said we don't meet that definition as well. And the major impact has come in to our minority aids funding. Austin Travis County did not receive the minority aids initiative funding, thank you. I was hoping to have it up there. Great. Wonderful. 75 percent of the graft funds now must go to core medical service. Those services include pharmaceutical assistance, outpatient, health services, home healthcare, hospice, , services that you would traditionally think of. Our locally providers have been using the match dollars that we have included for supportive services that we all know are critical for quality of life and also ensure a higher or better quality of life for folks living with this disease. So the current status of your investment, the Travis County investment, is that that are hiv social service contracts for nearly 400,000 and then the white house wellness center for a little over 75,000. By coincidence, the items on the agenda are the actual renewals of your investment today. We entered into agreements with these two providers for efficiency in March of 2002 with aids services of Austin and then in March of 2004 with the wright house. The minority aids initiative resulted from the realization that there was a disparate impact to communities of color to persons living with hiv disease and aids. At the end of the 1990s, between nate between the congressional black cause cuss faught for additional funding to address the issues of kiss--disparate impact to minimum orts. Locally we are experiencing the same impact. The disproportion all ty exists in the number of african american and latino folks represented in the population. They are a much higher percentage of the population of persons lig with this disease--living with this disease. And onned slide you say the rate of infection among african american males is nearly three time higher than that of white males. Also the prevalence rate among african american females is 12 and a half times higher than among white white females. For 2005, the largest increase in the prevalence of hiv infection has among latinos. The services that were purchased through the minority aids initiative funding included client out outreach, advocacy, assessment of individual needs, the provision of advice and assistance in obtaining medical, social, community, legal, financial, and other needed services. These services reach out to high need clients and those who are hardest to reach within our community. The minority aids initiative funding was also designed to strengthen the ability of community-based providers to improve the quality of hiv services. So client advocacy became a natural direction and key component of the process. So our immediate challenge with the loss of this funding and the funding ended effective March 1, is that contractors who serve these populations are forced with securesing additional funding in 30 days or shutting down these critical programs.
>> the $67,000 is associated this particular item, item 9 is actually the the emergency funding necessary to make it whole.
>> for the some very significant numbers per 100,000 . Of course, the thing actually projected I think according to the statesman had about 3020 20--302 for white, 100,000 population. According to the graph in the chart, among hispanics, a little more than 500 to 1 1,000. Backing down to 2005 for hundred thousand population it also indicated the significant cutback as far as funding and suggested that 385 cuts, tor getting the services that they need, would be cut from receiving those services because of the cutback at the federal level of funding. My question is what we're doing here today, this may also tie in to something else that I pulled, not pulled, but asked for it to be discussed, and we haven't gotten into it yet, which is item 19, is the fact that, does this actually stop gap measure where by we will be ail to continue the level of service for the persons in the community having to deal with hiv aids conditions? What we are doing here today.
>> yes, Commissioner. This level of funding if approved today will continue services through the remainder of the fiscal year year. Health and human services will be working with the community, with wright house and other providers to assess the full impact of this funding not being renewed. The funding going into a rfp process, so we anticipate that the community will have the opportunity to apply. However, the definitions that we talked about earlier in the presentation may impact either the amount of funding that we receive or whether or not we will even be considered for funding once the rfp process begins. So, we are anticipating a budget request for fiscal year 2008 because we just won't know during the budget process what our federal allocation would be should we be funded.
>> I understand.
>> yes.
>> does this also take into account the educational out outreach, I think that is very, very critical, as far as educating persons to let them understand this issue, hiv, and also the aids setting, the outreach into the community, is that also a part of what we are doing here today? Because education I think is very key, and I really don't know the full aspects of how adventures are into the community to make sure that folks are really made aware that this is really, really tough situation. It even can lead into deaths in some case. But my concern is with the community being impacted by this, my concern is what are we doing proactively to offset educationalwise to deal with some of these numbers ?
>> allow me to talk about what wright house does. In items of Travis County's investment, interlocal agreement with the city of Austin for public house services includes outreach and prevention activities. So your investment in public health includes that piece. Susan, can you speak to that that?
>> yes, we have some people from the from wright house wellness centers that go into the neighborhood centers, the clubs at night, into some of the different schools.
>> schools? Y yourself I'm with the wright house center.
>> okay.
>> we have a prevention team that goes into the different neighborhoods, Travis County housing developments, go into the bars, and we are actually contracting with the city of Austin that once we go into the neighborhoods we are going to also offer testing. So we do have a preventive, where we go out and talk about hiv, talk about the transmission and the risk behaviors of disease. So yeah.
>> do we know where the federal government got its definition ?
>> I'm a planner with health and human services research and planning division. As far as medical core services and minority aids initiative and support services, those are all defined by the federal government looking at what can they use their dollars for and what they expect the local communities to provide for funding for. Unfortunately, what they are looking at ing is the majority of funding going to medical core services. They have expanded the definition of medical core services but they have lost the concept of the wrap around program where the social support services ensure good medical support services. And so that's going more and more, as sherry said, to the accounts and and--to the counties and cities to pick up that funding. They have expanded hospice and medical case management definitions to encompass more of what we do. Unfortunately, wright house wellness and aids service of Austin would have to look at redesigning their client advocacy and outreach to really make it a medical case management rather than a social successful are those that have wrap around services of the brazilian model, going into the clubs and the communities, is most .the sprea.
>> the federal government is saying basically, they will spend federal money on core medical service. They expect local governmental ent the tis to pick up prevention.
>> more and more. As a matter of fact, you can see the incidence and privilege lens rate is increasing in our community and federal funding is decreasing on fined is probably better word, from the federal government. What position have they taken since then ?
>> I'm not aware of their position but you feel pretty safe in saying there has been tremendous outrage in terms of the impact of the changes in this funding as it relates to minority populations, in light of the fact that we are continuing to see increases in percent unt next time.
>> (applause)
The Closed Caption log for this Commissioners Court agenda item is provided by Travis County Internet Services. Since this file is derived from the Closed Captions created during live cablecasts, there are occasional spelling and grammatical errors. This Closed Caption log is not an official record the Commissioners Court Meeting and cannot be relied on for official purposes. For official records please contact the County Clerk at (512) 854-4722.
Last Modified:
Wednesday, March 21, 2007 8:00 AM