Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: John L. Maltbie, County Manager
Subject: Use of District-Specific Measure K Funds - Supervisorial District 1
RECOMMENDATION:
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Measure K: Adopt a resolution authorizing a one-time grant of district-specific Measure K funds, not to exceed $50,000, to San Francisco Hep B Free - Bay Area for the continued provision of community screenings, outreach, and education to increase awareness of hepatitis B in San Mateo County, and authorizing the County Manager, or his designee, to prepare and execute the grant agreement.
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BACKGROUND:
Measure K is the half-cent general sales tax initially approved by San Mateo County voters in November 2012 and extended in November 2016 for a total of thirty years. The Board of Supervisors (“Board”) and County staff have conducted study sessions and community outreach efforts to inform priorities for Measure K spending for FY2017-19.
On May 16, 2017, the Board approved the FY 2017-19 Measure K allocation plan in which the County anticipates Measure K receipts of approximately $81.6 million annually. The plan included $7 million in one-time loans or grants during FY 2017-19, divided equally among the five supervisorial districts, for district-specific needs and projects. District 1 has submitted a request to use its district-specific Measure K funds as shown below and described in the Project Summary section of this memorandum:
|
District/Project |
Amount |
|
District 1 (Supervisor Dave Pine) - SF Hep B Free - Bay Area: to continue the provision of hepatitis B screening, outreach, and education services |
$50,000 |
This item is consistent with the criteria for district-specific Measure K funds, which were developed during the initial round of district-specific allocations and approved by the Board in April 2015.
PROJECT SUMMARY:
This is a request to authorize a grant to San Francisco Hepatitis B - Bay Area (SFHBF-BA) and resulting grant agreement in an amount not to exceed $50,000, to continue the provision of hepatitis B screenings, outreach, and education services in San Mateo County. The County Manager’s office will administer and manage the proposed agreement.
Overview of the San Francisco Hep B Free - Bay Area Program
SFHBF-BA is a San Francisco-based non-profit organization founded in 2007 as a public/private collaboration between the San Francisco Department of Public Health, AsianWeek Foundation, and the Stanford Asian Liver Center at Stanford University. SFHBF-BA's mission is to:
1) Create awareness among healthcare providers and the public about the importance of testing and vaccinating for hepatitis B;
2) Promote routine hepatitis B testing and vaccination within the primary care medical community; and
3) Ensure linkage to care for chronically infected individuals.
Goals of the San Francisco Hep B Free - Bay Area Program
San Mateo County’s population, according to the U.S. Census Bureau, is over 765,000 people, with a population of 30.5% (233,325) Asian and Pacific Islanders, or approximately 19,400 Asian and Pacific Islanders living with chronic Hepatitis B, based on the assumed infection rate of 1 in 12.
In July 2017, your Board approved the allocation of $50,000 in Measure K funding to allow SFHBF-BA to create one FTE to coordinate hepatitis B screenings and events in San Mateo County. SFHBF-BA also received a $45,000 grant from Stanford Healthcare which helped to supplement some of the original costs of expansion. Additional funding has been received from the Peninsula Health Care District, Silicon Valley Lions Club, Lazarex Cancer Foundation, and Gilead Sciences. This funding has allowed SFHBF-BA to hold regular community and physician education sessions and to host table installations at health fairs, cultural celebrations, church gatherings, and other events.
In addition to organizing and hosting a range of community and professional outreach events, SFHBF-BA also offers free hepatitis B screenings to San Mateo County residents, with a goal of 250 residents screened by September 30, 2018. 223 screenings have been conducted as of August 7, 2018, and the organization is confident that the remaining screenings will be completed by the end of this month. Anonymized screening statistics are evaluated in more detail within the table below labelled “Results of Hepatitis B Screenings.”
So that they may continue to provide these services to residents of the County, SFHBF-BA is requesting a one-year grant of $50,000 in Measure K funding in order to fund a portion of the $122,700 in total anticipated expenditures described in the table below.
Cost Breakdown (estimated for FY2018-19)
|
Item: |
Approximate Spending: |
|
Staff salary |
$58,000 |
|
Staff health benefits |
$14,700 |
|
Grant Coverage |
|
|
Staff Salary |
$12,000 |
|
Lab services |
$15,000 |
|
Community Initiatives (CI) administration *As SF Hep B Free - Bay Area’s fiscal sponsor, CI takes 10-15% of funding received by SF Hep B Free to support administration and benefit management |
$15,000 |
|
Community education materials |
$2,000 |
|
Phlebotomy services |
$2,000 |
|
Programmatic supplies |
$2,000 |
|
Office supplies |
$1,000 |
|
Physician education materials |
$1,000 |
|
Total |
$122,700 |
Results of Hepatitis B Screenings
|
|
Chronically Infected |
Non-Immune |
Some Sort of Immunity |
Total Screened With Results |
Total Screened |
|
# of Residents |
1 |
92 |
103 |
196 |
223 |
|
% of Total |
0.5% |
46.9% |
52.6% |
100% |
N/A |
The chronic infection rate of 0.5% exhibited in SFHBF-BA’s screening results is far lower than the nationally published rate of about 8.3%. This is likely due to several factors, including the small sample size, a concentration of screenings from Chinese seniors, and San Mateo County’s high ranking in both health outcomes and socio-economic factors. To better reach a more representative community population, SFHBF-BA is piloting several new outreach initiatives for FY2018-2019, including education-based programs organized in partnership with the San Mateo Community College District and the Millbrae Elementary School District. By screening students and their families, SFHBF-BA should reach a younger subset of the population who are vulnerable to hepatitis B.
Expanding the available data pool will help indicate whether vaccination, screening, or linkage to care should be the predominant focuses of future efforts. Nearly 50% of all screened patients, while not chronically infected, were non-immune, suggesting that a large portion of the County population is vulnerable to the disease and would continue to benefit from the type of outreach and education that SFHBF-BA currently provides.
Total Measure K Request: Not to Exceed $50,000
The release of funds will be contingent on the execution of an agreement providing for the County’s confirmation of the expenditure of funds during FY 2018-19 for the purposes stated herein. The County will disburse the funds to the following organization for the purposes described above:
Contact Information:
Arcadi Kolchak, MPH
Executive Director
SF Hep B Free
101 Grove St. #406
San Francisco, CA 94102
Office: (415) 554-2638
Mobile: (408) 718-3084
www.sfhepbfree.org
PERFORMANCE MEASURES:
By the end of the contract period, September 30, 2018, SFHBF-BA will have met or exceeded all grant criteria under its initial grant. To build upon this success, increase screening and education, and begin improving linkage to care for vaccinations and treatment, SFHBF-BA is seeking a second round of funding.
Certain individual measures must be changed for FY2018-2019 to accommodate changing circumstances and data trends observed in FY2017-2018. These are detailed below:
• Large physician education events that were scheduled as Continuing Medical Education (CME) sessions for FY2017-2018 will be largely supplanted by academic detailing sessions for FY2018-2019, in which SFHBF-BA will present to multiple smaller offices of community primary care physicians.
• The Physician Honor Roll, a highly successful program first introduced in San Francisco, is a list of physicians published by local social and print media who have pledged to screen their patients for hepatitis B in accordance with Centers for Disease Control and Prevention (CDC) guidelines. The San Francisco implementation saw over 90% of the city’s primary care physicians sign the pledge after 4 to 5 years. SFHBF-BA plans to introduce this program in the County as an additional reminder and incentive to improve hepatitis B screening practices.
|
Description |
Target FY 2017-2018 |
Actual FY 2017-2018 (as of 8/7/2018) |
Target FY 2018-2019 |
|
San Mateo County residents screened |
250 |
223 |
400 |
|
Large physician education sessions |
2 |
2 |
N/A |
|
Academic detailing sessions |
N/A |
N/A |
20 |
|
% of registered primary care physicians who have signed honor roll |
N/A |
N/A |
35% |
|
Community education and/or screening events |
6 |
30 |
40 |
|
Residents directly educated |
N/A |
1,231 |
2,500 |
County Counsel has reviewed and approved the resolution as to form.
Funding for San Francisco Hep B free - Bay Area contributes to the Shared Vision 2025 outcome of building a healthy community by providing free hepatitis B screening, outreach, and education services to residents in the County.
FISCAL IMPACT:
There are sufficient Measure K funds for this specific FY 2018-2019 Measure K request. These funds are budgeted in the Non-Departmental Services FY 2018-19 Approved Recommended Budget.