The Allocations Committee met via conference call on February 21, 2006 to review the reallocation request for the Waco HSDA.
CTHPC Members present: Eric Todd*, Cynthia Juniper, Bobby Holtman, Rita Castro, David Cooper, Janet Cates, Parker Willson, Janis Willis
BVCOG Staff present: Christopher Hamilton, Crystal Crowell
The meeting came to order at 10:10 a.m.
Mr. Hamilton gave an overview of the reallocation request, the changes from the previous request, and the process.
There was a question about the purchase of vitamins. A provider cannot purchase and dispense without written direction from a physician due to legal requirements in dispensing medication as well as funding restrictions. The provider notes in this request that Boost and vitamins will only be dispensed under physician direction. A concern was shared over the provider having a large number of vitamins on hand.
A question was asked about the Health Education Risk Reduction (HERR) reallocation. The provider does have a Prevention Case Management program in place, and the provider notes that the grant for that program does not cover the entire salary of the PCM program manager, and that the City of Waco must contribute money. It was asked why this reallocation would be used to pay a salary when it is already being paid elsewhere. The reallocation is only to purchase materials for the program, not to replace the salary being paid. The provider included that information to demonstrate that there are not sufficient funds in the program through their PCM grant.
A Council member from the Temple - Killeen HSDA noted that in the past, unexpended funds would be turned back to the State to be used in the ADAP program. The idea was proposed that this same action could be taken in the Waco HSDA.
The committee began to look at each of the line items in the request, starting with HERR. Many members thought the amount of $10,000 was too much, and alternative amounts were offered. The committee came to consensus on $2,500.
Next, the committee looked at Ambulatory/Outpatient Medical Care line item. The committee was in consensus on the requested amount of adding $5,000.
Emergency Financial Assistance: Some concerns were raised about putting $10,000 into this category. Other questions were raised about the amount in Food Bank, and why clients are not using the nutritional counseling service. It was noted that this amount would be used for food cards and boost for when clients are discharged from the hospital or released from incarceration. The Food Bank category supplies the normal allotment of food cards to the regular client case load, this EFA amount would be used for the emergency situations. Also, EFA money would be used for utility payments. The provider does have a HOPWA grant, however, they are having to adjust funds within that grant. Funds are moving from the HOPWA short term (utility assistance) to the long term (rental assistance). The gap in service left by reduced funds in short term HOPWA will be met with EFA utility assistance. Mr. Hamilton reminded the committee that they are able to allocate at a sub-level for EFA among medications, utility assistance, and food. The committee was in consensus on the requested amount of $10,000 without allocating at the sub-level.
Food Bank: it was noted by a Council member of the HSDA that food card amounts are from $15 to $25, which is not enough to buy a month's worth of food. Another member noted that the food cards are designed to be a supplement, not to meet all food needs. It was explained that a provider may not 'stock up' on cards, because they have to be used within the contract period, ending March 31, 2006, unless they are purchasing to replenish an inventory they already have, in which case they can only purchase up to their inventory amount. Mr. Hamilton noted that the provider does not maintain an inventory above $5,000. The committee was in consensus with the amount requested.
Nutritional Services: the provider has worked with BVCOG and made an effort towards enrolling clients in this service. Despite the effort, clients will not use the service. Therefore it was requested that $2,349 be moved to the Transportation category. The committee was in consensus on moving funds from this category.
Oral Health: There was a question as to why the funds were not already spent down if there is such a high need for this service. Ms. Crowell noted that they kept some funds in case the reallocation request was not approved. There is a high need among clients and a waiting list. The committee would like more clarification on the waiting list and projected cost before making a final decision. The committee made an initial allocation of $6,000 to this category and will send to the Council with this amount along with information from the provider about the waiting list. The Council, considering the additional information from the provider, may increase the amount or stay with the $6,000 reallocation. Some concern was expressed on whether or not the full $12,000 could be spent within the remaining months.
Transportation: the committee was in consensus on reallocating the requested amount to this category.
The question was asked as to why there is so much unspent in the Drug Reimbursement category that would allow so much to be moved to other service categories. Ms. Crowell noted that the allocation amount was based on a previous year when there were fewer staff and enrollment of clients into the ADAP or other patient assistance programs took a longer time. Now that staffing levels are up, the provider is more efficient in enrolling clients in those aforementioned programs. Since the committee changed the allocated amounts for the HERR and Oral Health categories from the requested amount, the difference, $13,500, will not be taken from the Drug Reimbursement category. The original request was to take $42,000 out of Drug Reimbursement and spread it among the categories. Instead, $28,500 will be taken from Drug Reimbursement and placed in the other categories.
The committee was in consensus in the above noted amounts. The new allocation will be sent to the Planning Council along with information from the provider about waiting list and projected cost for Oral Health service. The Council, at the time of its decision, may add additional funds to the Oral Health category from the Drug Reimbursement category. Also, expenditures as of January will be added in.
Members of the Waco HSDA abstained from voting and decision making.
The meeting adjourned at 11 a.m.
