OLD BUSINESS  6.

COMMITTEE MEMORANDUM

HISTORY:

At the July 19, 2019 Finance & Citywide Projects Committee Meeting, during the discussion item on the Fiscal Year 2020 Proposed Operating Budget and Millage Rate, the Committee members requested an update on the status of the University of Miami  PrEP Mobile Wellness Clinic (UM Mobile Clinic). 

ANALYSIS:

Background

Through the FY 2017/18 budget process, the City Commission approved a $250,000 grant for the University of Miami ("UM") to provide public health services with the goal of reducing the rate of new human immunodeficiency virus ("HIV") infections in Miami Beach. 

UM encountered delays during the initial stages of program startup and implementation. Hiring and training new staff, coordination among UM divisions and with community organizations, securing  auxiliary resources  such  as  laboratory services,  securing  an  appropriate  parking location for the mobile unit and other logistical issues related to initiating a new project caused a delay to the program start date.   To accommodate these delays, the Administration wrote the grant contract with a 2-year term, allowing funding to be spent on the project from October 1, 2017 through September 30, 2019.   The City entered into a grant agreement with UM to provide pre-exposure prophylaxis ("PrEP")  and related services in a mobile clinic positioned outside the Hotel Gaythering (1409 Lincoln Rd, Miami Beach, FL 33139) on July 13, 2018 and UM initiated services to clients on September 24, 2018.

Grant Expenditures

The approved grant budget has two main categories: Salaries and Fringe Benefits in the amount of $206,402.20; and Operating Expenses in the amount of $43,598.  A copy of the current grant budget is attached (Attachment A).

Contractually, the University of Miami is required to provide a progress report to the City every quarter.  A synopsis of the reported and projected expenditures is as follows:  

1) Reported Expenditures as of June 30, 2019

2) Projected: Expenditures from July 1, 2019 through September 30, 2019 (Contract End Date)

UM has projected the expenditures from July 1, 2019 through September 30, 2019 to be $72,000.  This will include mainly salaries, and also supplies and lab costs.

3) Projected: Remaining Balance at September 30, 2019 (Contract End Date)

Program Metrics and Expected Outcomes

The goal of the project is for UM to enroll 250 candidates for PrEP services in its first year, with a target of keeping 200 individuals (80%) adherent to their PrEP medication schedule for six months after commencing treatment, and 175 individuals (70%) adherent to their PrEP medication schedule after a full year.  Adherence to the medication schedule is monitored by appointment compliance and number of prescriptions filled.  A synopsis of the accomplishments is as follows:

Areas Served

An analysis of the zip code data for clients seen at the mobile clinic as of June 24, 2019 indicates the following:

• Total Number of Clients: 134

• Miami Beach Residents: 34 (25% of total Clients)

Of the 34 Miami Beach Residents, the breakdown is as follows:

• South Beach Residents (Zip Code 33139): 29 clients

• Middle Beach Residents (Zip Code 33140): 0 clients

• North Beach Residents (Zip Code 33141): 5 clients

New Request for FY 2020 Budget Process

UM has requested funding for FY 2020 to continue current services at the Lincoln Road/Hotel Gaythering location and to expand to a second location for services in North Beach.  The FY 2020 budget also requests funds for a subcontract with Prevention305 for outreach, as well as in-person assistance with navigation to a PrEP appointment.  A copy of the detailed Request for Funding is attached to this item (Attachment B).

A summary of the FY 2020 Budget Request is as follows:

CONCLUSION:

The most recent report from UM for the existing $250,000 grant reflects expenses incurred through June 30, 2019 and indicates that $126,704 has been expended and a balance of $123,296 is available.  UM projects that an additional $72,000 will be spent by the contract end date of September 30, 2019.  UM has projected the remaining unspent balance to be $51,296 at contract end date.

An additional one-time request of $250,000 was discussed at the July 19, 2019 Finance and Citywide Projects Committee.  Additional information has been provided for further consideration of the additional $250,000 request for the FY 2020 budget process.