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
Grant Line Item
|
Approved Grant Budget
|
Total Expenditures Reported as of June 30, 2019
|
Remaining Balance as of June 30, 2019
|
Remaining %
|
Salaries & Benefits
|
$ 206,402.20
|
$ 122,902.22
|
$ 83,499.98
|
40%
|
Operating Expenses
|
$ 43,598.00
|
$ 3,801.87
|
$ 39,796.13
|
91%
|
Total Grant Funds
|
$ 250,000.20
|
$ 126,704.09
|
$ 123,296.11
|
49%
|
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)
Reported Expenditures through 6/30/2019 |
$126,704 |
Projected expenditures 7/1/2019 - 9/30/2019 (Contract End Date) |
$72,000 |
Projected Total Expenditures |
$198,704 |
Grant Award |
$250,000 |
Projected Balance Remaining from Grant at 9/30/2019 |
$51,296 |
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:
Metric |
Target |
July 1, 2018 - September 30, 2018 |
Oct. 1 - Dec. 31, 2018 |
Jan. 1, 2018 - March 31, 2019 |
April 1, 2018 - June 30, 2019 |
Total |
Percentage of Target |
Number of candidates enrolled for PrEP services |
250 |
1 |
48 |
43 |
42 |
134 |
54% |
% of patients adherent to PrEP medication schedule 6 months after commencing |
200 (80%) patients adherent 6 months after commencing treatment |
1 |
2 |
6 |
42 |
51 |
38% |
% of patients adherent to PrEP medication schedule 1 year after commencing |
175 (70%) patients adherent 1 year after commencing |
Achievement of 1 Year goals will be reported September 2019 |
% of PrEP patients not contracting HIV within first year |
100% |
Achievement of 1 Year goals will be reported September 2019 |
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:
University of Miami Salaries and Fringe |
$170,796 |
University of Miami Supplies |
$ 8,579 |
University of Miami Lab Tests |
$ 14,025 |
Total University of Miami |
$193,400 |
|
|
Prevention305 Salaries and Fringe |
$ 47,000 |
Prevention305 Client Transportation |
$ 8,000 |
Prevention305 Communications |
$ 1,200 |
Prevention305 Parking |
$ 400 |
Total Prevention305 |
$ 56,600 |
|
|
Total Funds Requested |
$250,000 |
| | |