Fiscal Note
Funding is included in the 2013 Public Health Operating Budget. There is no anticipated impact on cost controls or the tax levy.
Title
Authorization for the Board of Health for Madison and Dane County to enter into a contract for the purchase of services with the Board of Regents for the University of Wisconsin for the Provision of Services for the Diagnosis and Treatment of Sexually-Transmitted Infections.
Body
Preamble:
Public Health-Madison and Dane County (PHMDC) is mandated to assure that services are provided for residents that may have a sexually-transmitted infection (STI). For more than 10 years, these services have been provided by University Health Services (UHS) and Access Community Health Centers (ACHC). The 2012 Public Health Adopted Operating Budget included $97,000 for STI services for these two contractors, although ACHC provided about 85 percent of the STI services.
ACHC is shifting their practice to a wrap-around model that makes it difficult to integrate STI clients and has decided that it will no longer provide services for Public Health clients after the end of this year.
The initial intent was to replicate these services using a different provider, issuing a Request for Proposal. Contacting other providers and health departments raised the possibility of other service models. The model that seems most effective is where a contractor is used to do the diagnosis and treatment, but PHMDC staff run the clinic and do all the follow-up. This is expected to be a more efficient use of our staff, since they will be able to work with clients face-to-face while they are at the clinic and not need to do all follow-up by telephone.
In surveying service providers, PHMDC staff learned of the possibility of an unlikely provider-the School of Nursing of the University of Wisconsin-Madison. The School of Nursing initiated a new program for the Doctor of Nursing Practice two years ago and has built a staff that includes several seasoned nurse practitioners. Moving from a physician-based model of services to one that is built around a nurse practitioner provides the services needed at a lower cost.
The School of Nursing has agreed to provide a nurse practitioner for STI services. Clinics will be held in current PHMDC clinic space. PHMDC staff would run the clinics with the contracted nurse practitioner providing diagnosis and treatment. The 2013 Adopted Operating Budget for Public Health adds 0.5 FTE to help manage the clinic. Even with the salary and expenses of adding 0.5 FTE, the combined cost of providing STI services and running HIV clinics using the new model will drop expenses by about $9,000, while providing more capacity. The budget retains funding of $12,000 for STI services through UHS.
Community Pharmacy has agreed to provide medication at a reduced cost for low-income clients.
In the first year of this contract, the School of Nursing will be reimbursed $230 per four-hour clinic session (three per week). The cap on the contract with the School of Nursing is $37,000 per year. PHMDC will be invoiced monthly.
The Public Health merger allowed additional staff to be dedicated to STI and HIV services.This has led to a level of staff expertise that makes this new clinic model possible.
The Inter-Governmental Agreement that created Public Health-Madison and Dane County requires that the department follow City of Madison purchasing guidelines. MGO 4.26 requires a request for proposal (RFP) process for contracts over $25,000, although it allows exceptions to sole source a contract with approval of Common Council. With this resolution, Common Council is being asked to authorize a contract with the UW-Madison School of Nursing for the services of a nurse practitioner.
Body:
WHEREAS Public Health-Madison and Dane County is a local health department that is required by the State of Wisconsin to assure the provision of services to clients with sexually-transmitted infection;
WHEREAS a current contractor will not be providing these services as of December 31, 2012;
WHEREAS it has been determined in consultation with other health departments and local providers that offering STI services at Public Health clinics using a contractor for the diagnosis and treatment of sexually-transmitted infection is a more effective model and will provide additional capacity.
WHEREAS the Inter-Governmental Agreement that created Public Health-Madison and Dane County requires that the department follow City of Madison purchasing guidelines, and MGO 4.26 allows exceptions to the request-for-proposal process with approval of the Common Council; and
WHEREAS the University of Wisconsin-School of Nursing is uniquely qualified to provide services for the diagnosis and treatment of sexually-transmitted infections using a nurse practitioner and Public Health-Madison and Dane County believes that a contract with the University of Wisconsin-School of Nursing is in the best interest of the City of Madison and Dane County to provide effective and efficient services for the diagnosis and treatment of sexually-transmitted infection;
NOW THEREFORE BE IT RESOLVED THAT the Board of Health for Madison and Dane County on behalf of Public Health-Madison and Dane County is authorized to enter into a contact for the reasons described above with the Board of Regents for the University of Wisconsin on behalf of the University of Wisconsin-Madison School of Nursing for up to $37,000 for the provision of clinic services to provide the treatment and diagnosis of sexually transmitted infections and the Director of Public Health-Madison and Dane County is authorized to sign the agreement.
BE IT FURTHER RESOLVED that the one-year contract includes the possibility of two one-year renewals if funding is appropriated by the City of Madison Common Council and the Dane County Board of Supervisors through the budget process.
BE IT FINALLY RESOLVED that Community Pharmacy is recognized for its assistance in the provision of medication for the essential service of the treatment of sexually-transmitted infection.