HomeMy WebLinkAboutResolutions - 2017.10.26 - 23152MISCELLANEOUS RESOLUTION #.1:1a-a2 October 26, 2017
BY: Commissioner Christine Long, Chairperson, General Government Committee
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION — RYAN WHITE
HIV/AIDS TREATMENT EXTENSION ACT OF 2009 INTERGOVERNMENTAL AGREEMENT BETWEEN
THE COUNTY OF OAKLAND AND THE CITY OF DETROIT
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Ryan White HIV/AIDS Treatment Extension Act of 2009 requires that intergovernmental
agreements (IGA) be established between political subdivisions which have not less than 10% of the areas
reported AIDS cases and provide HIV/AIDS related services; and
WHEREAS the Detroit Health Department, as the lead agency for administering Ryan White Part A, HIV
Emergency Relief Grant funds, and the Southeastern Michigan HIV/AIDS Council (SEMHAC) facilitate an
ongoing needs assessment process; and
WHEREAS this needs assessment shows that Oakland County possesses 19% of HIV/AIDS cases in the
Eligible Metropolitan Area (EMA) Counties; and
WHEREAS the Detroit Health Department and SEMHAC directly allocated $2,200,919 of Ryan White Part A
funding to community agencies within Oakland County in FY 2016/17 for the provision of services to persons
living with HIV/AIDS; and
WHEREAS the purpose of the 1GA is to ensure eligible local governments provide maintenance of effort
expenditure information related to the Ryan White Extension Act; and
WHEREAS none of the provisions of the Agreement are intended to create any other relationship between the
County and the City of Detroit; and
WHEREAS this agreement has been reviewed in accordance with the Board of Commissioners Automatic
Direct Referral Procedures and is recommended for approval; and
WHEREAS acceptance of this intergovernmental agreement does not obligate the County to any future
cornmitment.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
the Intergovernmental Agreement between the County of Oakland and the City of Detroit.
BE IT FURTHER RESOLVED that the Board Chairperson is authorized to execute the agreement.
Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing
resolution.
Lc,CC
Commissioner Christine Long, DistrictA7
Chairperson, General Government C6nimittee
GENERAL GOVERNMENT COMMITTEE VOTE:
Motion carried unanimously on a roll call vote with Kowall and Kochenderfer absent.
ADR REVIEW SIGN OFF — Department of Health and Human Services
/Health Division
RESOLUTION TITLE: Ryan White HIV/AIDS Treatment Extension Act of 2009 Inter-Governmental
Agreement Between the County of Oakland and the City of Detroit
DEPARTMENT CONTACT PERSON: Rachel Shymkiw 2-2151
DATE: 10/3/2017
DEPARTMENT REVIEW
Department of Human Resources:
Approved (No Committee) - Heather Mason (9/22/2017)
Department of Management and Budget:
Approved — Lynn Sonkiss (9/22/2017)
Corporation Counsel:
Approved — Bradley Benn (10/3/2017)
CITY OF DETROIT
DETROIT HEALTH DEPARTMENT
August 29, 2017
3245 E. JEFFERSON, SUITE 100
DETRorr, MICHIGAN 48207
(313) 876-4000 TTY:711
WWW.DETROITMIGOV
Kathy Forzley, RS, MPA
Health Officer and Manager
Oakland County Health Department
1200 North Telegraph Road
Pontiac, MI 48341
Dear Ms. Forzley:
The City of Detroit Health Department (DHD), is the lead agency for the Detroit
Eligible Metropolitan Area (EMA) for the purposes of administering the Ryan White
Part A, HIV Emergency Relief Grant Program which includes the counties of Wayne,
Oakland, Macomb, St. Clair, Lapeer, and Monroe. Our staff is in the process of
developing the application for fiscal year 2018. As such I am writing to request your
signature on the attached Intergovernmental Agreement Form.
The Ryan White legislation requires Part A grantees to document intergovernmental
relationships with the Chief Elected Officials (or designee) of political jurisdictions that
provide HIV health services and account for at least ten percent of the reported AIDS
cases in the EMA. For the purposes of this grant, this includes the counties of Wayne
and Oakland.
Please return the attached intergovernmental agreement in the provided pre-addressed
envelope to the Detroit Health Department by Tuesday, October 10, 2017. Please feel
free to contact Leanne F. Savola, HIV/STI Programs Director at
SavolaL@detroitmi.gov or 313-870-0073 if you have any questions.
Also attached is a letter from the Southeastern Michigan HIV/AIDS Council inviting
you to participate in Ryan White planning activities.
Thank you in advance for your timely response.
Sincerely,
Joneigh S.4thaldun, MD MPH FACE?
Executive Director and Health Officer
Page 2
Enc: Table of Client Residence
Prevalence Table of Southeast Michigan
Intergovernmental Agreement Requirement (from Ryan White HIV/AIDS
Program Part A Manual)
2017-2018 Intergovernmental Agreement
SEMHAC Letter
cc: Timothy Lowther, MPH, MA, Chief of Staff
Leanne F. Savola, HIV/STI Programs Director
Shila Wu, HIV Care Manager
RYAN WHITE H1V/AIDS TREATMENT EXTENSION ACT OF 2009
INTERGOVERNMENTAL AGREEMENT BETWEEN THE
CITY OF DETROIT
AND
OAKLAND COUNTY
THIS AGREEMENT, entered into this day of , 2017, between the City of
Detroit, by and through its Health Department, hereinafter referred to as the "City", and the
County of Oakland, a body politic and. corporate, hereinafter referred to as the "County":
WHEREAS, the Ryan White HIV/AIDS Treatment Extension Act of 2009 requires that
intergovernmental agreements (IGA) be established between political subdivisions which have
not less than ten percent of the areas reported AIDS cases and provide HIV-related services;
WHEREAS, the purpose of the IGA is to lay out a framework for the relationship between
pertinent organizations;
WHEREAS, the City and the Southeastern Michigan HIV/AIDS Council (SEMHAC) facilitate
an ongoing needs assessment process. This document, with updated information and with
supplemental information regarding HIV needs and services in the remainder of the Eligible
Metropolitan Area (EMA) Counties will serve as a basis for determining service need;
WHEREAS, Oakland County possesses 19% of HIV/AIDS cases in the EMA and is a provider
of in-hospital and ambulatory care services to persons with HIV Disease. The County's
experience and expertise include direct health care, supportive care, and model care programs for
the medically indigent.
NOW, THEREFORE, in consideration of the above, the parties hereto agree in this
Intergovernmental Agreement as follows:
ARTICLE I. ADMINISTRATION
A. The City will be the grantee of the Ryan White Treatment Extension Act Part A funds.
ARTICLE II. HIV SERVICE PLANNING COUNCIL
A. The Council established to guide implementation of the Ryan White Treatment Extension
Act is known as the Southeastern Michigan HIV/AIDS Council (the "Council")
B. The duties of the Council include:
1. Developing a comprehensive plan for organizing and delivering HIV health and
support services that are compatible with existing federal, state and local plans
regarding the provision of HIV-related services; and
1
2. Recommendations for allocation of funds to service categories of greatest need.
ARTICLE III. FUNDING DECISIONS
A. The findings from ongoing needs assessment will be updated and supplemental
information will be reviewed by the Council in establishing funding priorities.
ARTICLE IV. TERMS OF AGREEMENT
A. This Agreement shall be deemed effective upon its acceptance by the City and the County
and upon the approval and release of funds by the United States Division of Inv
Services, Bureau of Health Resources and Services Administration, whichever is later.
B. The Project shall become operational upon award of funds under Part A of Title XXVI of
the Public Health Service Act as amended by the Ryan White HIV/AIDS Treatment
Extension Act of 2009.
C. Local governments shall comply with requests for expenditure information related to the
Ryan White Treatment Extension Act.
The Ryan White legislation requires Ryan White Part A grantees to maintain, as a
Condition of Award, EMA/TGA political subdivision expenditures for Ryan White core
medical services and support services at a level equal to the 1-year period preceding the
fiscal year (FY) for which the grantee is applying to receive a Ryan White Part A grant.
In order to receive a Ryan White Part A award, EMAs/TGAs must comply with
maintenance of level requirements, which include: a signed assurance that maintenance
of effort has been maintained, a description of a consistent data set of local government
expenditures for two previous years, and methodologies for calculating maintenance of
effort expenditures.
To demonstrate compliance with this provision, EMAs/TGAs must maintain adequate
systems for consistently tracking and reporting on expenditure data for core medical
services and support services from year-to-year. Grantees are accountable to ensure that
Federal funds do not supplant EMA/TGA spending but instead expand and enrich such
activities.
D. Each party to this Agreement has its own legal representative and agrees to bear its own
costs, including judgments, in any litigation which may arise from performance of this
contract, it is specifically understood and agreed that neither party will indemnify the
other party in such litigation.
E. If any provision in this Agreement is invalid for any reason, such invalid portion shall not
render invalid the remaining provisions of the agreement which can be given effect
without the invalid provision to carry out the intent of the parties as stated herein.
2
F. Neither party hereto may assign this Agreement in whole or in part without the written
consent of the other party.
G. The waiver by party or any breach or failure of the other party to perform any covenant
or obligation contained herein shall not constitute a waiver of a subsequent breach.
H. This Agreement represents the entire Agreement between parties and supersedes any and
all prior agreements, whether written or oral. Any modification of this Agreement shall
be valid only if in writing and signed by all parties hereto.
I. This Agreement shall be governed by and construed in accordance with the reauthorized
Ryan White Treatment Extension Act of 2009.
J. None of the provisions of the Agreement are intended to create nor shall be designed to
create any other relationship between the City and the County other than of independent
entities coordinating with each other hereunder solely for effecting the provisions of this
Agreement. Neither of the parties hereto nor any of their respective representatives shall
be construed to be the agent, the employer, or representative of the other. The City and
the County will maintain separate and independent managements and each has full
unrestricted authority and responsibility regarding its own organization and structure.
K. This Agreement is terminable at will by either party upon 10 days' notice.
3
AUTHORIZATION:
FOR THE CITY OF DETROIT: FOR THE COUNTY OF OAKLAND:
SIGNATURE SIGNATURE
Typed Name Typed Name
Title Government Unit Title Government Unit
Date Date
City of Detroit Health Department
Grantee for the Detroit Eligible Metropolitan Area (ENL4)
4
Section II: HIV Service Delivery System
IL Ch I. Overview
The largest component of the Federal AIDS budget is health care services and treatment for
PLWHA in the United States, totaling $15.6 billion in the FY 2013 budget request. This
represents a 6-percent increase over FY 2012, primarily due to increased mandatory spending for
Medicaid and Medicare, but also to increases in the Ryan White Program.
The Ryan White HIV/AIDS Program is the single largest Federal program designed specifically
for people with HIV in the United States, estimated to reach more than half a million people with
HIV each year, It is also the third largest source of domestic funding for HIV care.6 First enacted
in 1990, it provides care and support services to individuals and families affected by the disease,
functioning as the "payer of last resort" by filling the gaps for those who have no other source of
coverage or face coverage limits.
The Ryan White HIV/AIDS Program requires Eligible Metropolitan Areas (EMAs) and
Transitional Grant Areas (TGAs)—population centers that are the most severely affected by the
HIV/AIDS epidemic—to develop coordinated service delivery systems of care for PLWHA. A
comprehensive continuum of HIV/AIDS care requires grantees to develop collaborative,
partnering and coordinating relationships between multiple sources of HIV testing, treatment,
prevention and care service provider agencies on the State and local levels.
The Ryan White Part A Program grantees are expected to reflect these in their HIV
comprehensive plan and community-based needs assessment and planning processes. Ryan
White grantees must integrate the National HIV/AIDS Strategy (NHAS) goals and Early
Identification of Individuals living with H1V/AIDS (EIIHA) strategies in addressing the service
needs of newly affected and underserved populations.
Ch 2. Legislative Background
The Ryan White HIV/AID Program under Title XXVI of the Public Health Service (PHS) Act as
amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87,
October 2009) includes formula and supplemental grants to assist eligible metropolitan in
developing HIV/AIDS service delivery systems that reflect a comprehensive continuum of
HIV/AIDS care accessible to eligible PLWHA in the EMAJTGA. The system of care should
address the service needs of newly affected and underserved populations — including
disproportionately impacted communities of color and emerging populations,
Ryan White HIV/AIDS Program legislation, under Section 2604(c) of the Act, requires that
grantees funded under Part A use not less than 75 percent of grant funds, after Program
6 Ryan White Program Fact Sheet, November 2011, Kaiser Family Foundation,
bt10/www.kft:orgthivaitlsiuplotill5g2-06.pdf
10
Ryan White HIV/AIDS Program Part A Manual—Revised 2013
Administration and Quality Management reductions, for core medical services unless a waiver is
approved. Core medical services are identified under Section 2604(c) of the Act.
In addition, Ryan White Program funds may be used for essential supportive services, These are
described in Section 2604(d) of the Act as services "that are needed for individuals with
HIV/AIDS to achieve their medical outcomes (such as respite care for persons caring for
individuals with HIV/AIDS, outreach services, medical transportation, linguistic services, and
referrals for health care and support services)."
Section 2602(b)(2) of the Act requires the CEO to "establish or designate an HIV health services
planning council that shall reflect in its composition the demographics of the population of
individuals with HIV/AIDS in the eligible area involved, with particular consideration given to
disproportionately affected and historically underserved groups and subpopulations"
"(2) REPRESENTATION.—The HIV health services planning council shall include
representatives of—
(A) health care providers, including federally qualified health centers;
(B) community-based organizations serving affected populations and AIDS service
organizations;
(C) social service providers, including providers of housing and homeless services;
(D) mental health and substance abuse providers;
(E) local public health agencies;
(F) hospital planning agencies or health care planning agencies;
(G) affected communities, including people with HIV/AIDS, members of a Federally
recognized Indian tribe as represented in the population, individuals co-infected with
hepatitis B or C and historically underserved groups and subpopuiations;
(H) non-elected community leaders;
(I) State government (including the State Medicaid agency and the agency administering
the program under part B);
(I) grantees under subpart II of part C;
(K) grantees under section 2671, or, if none are operating in the area, representatives of
organizations with a history of serving children, youth, women, and families living with
HIV and operating in the area;
(L) grantees under other Federal HIV programs, including but not limited to providers of
HIV prevention services; and
(Iv!) representatives of individuals who formerly were Federal, State, or local prisoners,
were released from the custody of the penal system during the preceding 3 years, and had
HIV/AIDS as of the date on which the individuals were so released."
Section 2602(b)(4)(D) of the Public Health Service (PHS) Act describes the planning council
duty to develop a comprehensive plan for the organization and delivery of health and support
services, that includes a strategy to identify individuals who know their HIV status and are not
receiving such services; coordinates the provision of such services; is compatible with any State
or local HIV/AIDS plan; and includes a strategy to identify individuals who do not know their
HIV status, make them aware of their status, and refer them into care.
11
Ryan White HIV/AIDS Program Part A Manual—Revised 2013
In addition, Section 2602(b)(4)(F) of the PHS Act requires the planning council to participate in
the development of the Statewide Coordinated Statement of Need (SCSN) described under Part
B. Additionally, Sections 2602(b)(4)(G) and (H) of the PHS Act describe the planning council
role in assuring community input and in coordinating with Federal partners as follows:
"(F) participate in the development of the statewide coordinated statement of need
initiated by the State public health agency responsible for administering grants under part
B;
(G) establish methods for obtaining input on community needs and priorities which may
include public meetings (in accordance with paragraph (7)), conducting focus groups, and
convening ad-hoc panels; and
(H) coordinate with Federal grantees that provide HIV-related services within the eligible
area."
In addition, Sections2605(n)(2):and (3.).of the PHS Act speak to the important points of access
and components of a health care system for PLWHA by requiring%isuraticesadequate to ensure
.(2):that the. eligible area has an:14.1V health services planning council and has: entered
into intergovernmental agreements pursuant to section 2602, and has developed or will
develop the comprehensive plan in accordance with section -2602(b)(3)(B);
(3)..thatrentities within the eligible area that receive fonds under a grant under this subpart . . . Will maintain appropriate relationships with entities in the eligible area served that
constitute key pmts of access th.thehealth care system for individuals With HIV/AIDS
(including emergency rd./Oink substance abuse treatment programs, detoxification centers,
adult and juVenile detention facilities, sexually transmitted disease Clinics, HIV
counseling and sites, mental healtirixogioink and homeless shelters), and other
entitles Under section 2604(b)(3) ahd-2652(4,:for ..thepurposeof facilitating early
intervention for individuals newly .diagnosed with-HIVIAIDS -andindividuals
knowledgeable of their IRV status but not in care,"
II. Ch 3. Ryan White Core Medical Services
Introduction
As of 2006 Ryan White legislation requires that not less than 75 percent of the funds be used to
provide core medical services (including the co-occurring conditions of the individual) that are
needed in the eligible area for individuals with HIV/AIDS who are identified and eligible under
the Ryan White HIV/AIDS Program. The HIV care continuum and service delivery coordination
efforts are dependent on the availability of core services through Ryan White funding and other
payers. Core Services monitoring expectations are included in the National Monitoring
Standards.
12
Ryan White HIV/AIDS Program Part A Manual—Revised 2013
Section IX. Chief Elected Official Guide
LX. Ch 1. Overview
The Ryan White HIV/AIDS Program legislation provides Federal funding to metropolitan areas
known as EMAs/TGAs and States to fill gaps in care for PLWHA. Under two programs of the
Ryan White HIV/AIDS Program—Ryan White Part A (Metropolitan areas) and Part B (States)—
responsibility for managing these funds falls to chief elected officials (CEOs), such as mayors,
county executives and governors. In turn, CEOs often delegate implementation to staff within
their own offices or to agencies like health departments.
As the recipient of Ryan White Part A funds, the CEO spearheads the development of a
comprehensive HIV/A1DS service system. Ryan White awards include both formula grants
based on the number of HIV/AIDS cases and competitive supplemental funds for areas with
demonstrated need.
In using these resources, CEOs are required to work in partnership with communities to plan and
deliver HIV/AIDS services. CEO partners include the administrative agency designated by the
CEO to oversee the program (e.g., the health department), the planning body and its diverse
voices of expertise, and PLWHA. Other Ryan White partners include city or county finance or
grants offices that disburse and account for funds.
The CEO ensures that Ryan White partners meet their legislative requirements and submits
written assurances that requirements are being met. Assurances are submitted as part of the
annual funding application to HRSA/HAB's, Division of Metropolitan HIV/AIDS Programs.
This guide outlines CEO responsibilities as follows:
1. Assuring that grant funds are administered appropriately, and
2. Facilitating planning in partnership with planning bodies/community input processes to best
meet the needs of PLWHA.
This guide is to be used to orient staff of administrative agencies and planning bodies in working
with the CEO to implement Ryan White Part A programs.
IX. Ch 2. Legislative Background
The Ryan White Part A CEO has key responsibilities in a number of areas. Under Section
2602(a) of Title XXVI of the Public Health Service Act (42 U.S.C. § 300ff-42), (the PHS Act).
The CEO has the responsibilities to:
"(A) IN GENERAL—To receive assistance under section 2601(a), the chief elected
official of the eligible area involved shall-
75
Ryan White HIV/AIDS Program Part A Manual—Revised 2013
establish through jot.ergov,einlitiental::agreenienti :iivithrthe hief 0.10410.011kyils... of
political subdivisions decnbed in subparagraph (B), an administrative itigeft4TUS.M..to
41140titt tunds and services basedent
1(4,00:0.000.1,0:-.:Alps.,.:44,4. in ooji
(II) the seventy of need fot outpatient and'laMbitiatery:care::Servicesin:siieb ..Stibdivisions;
.and,
•::(111):::010 -:sheotkooi...00poort.SerViceapersOnnei needs of such subdivisions, and
(ii) establish an HIV :health ..O.V..ie ..i.l.:1.4tilitig..COttrieii.fin'ae0Ordanee .*ith...SObSectiOn ..(b)
Related to the HIV Planning Council, the CEO's responsibilities are clearly delineated under
Section 2602(b) of the PHS Act:
"(b) HIV HEALTH SERVICES PLANNING COUNCIL.—
(I) ESTABLISHMENT.—To be eligible for assistance under this subpart, the chief
elected official described in subsection (a)(1) shall establish or designate an HIV health
services planning council that shall reflect in its composition the demographics of the
population of individuals with HIV/AIDS in the eligible area involved, with particular
consideration given to disproportionately affected and historically underserved groups
and subpopulations."
Under Section 2603 the Chief Elected Official (CEO) or designee in the EMAITGA has
to meet the legislative requirements to disburse funds quickly, closely monitor their use,
and ensure that the Ryan White HIV/AIDS Program is the payer of last resort. In
addition, Section 2603 addresses the timely obligation of Ryan White HIV/AIDS
Program fund by the CEO which ensures that services can be provided as rapidly as
possible and decreases the possibility that unobligated funds will remain at the end of the
program year.
With respect to services, Section 2604 describes the CEO's responsibilities related to the
use of grant funds for the purpose of providing core medical services and support services
in accordance to priorities established the planning council, and taking into account
WICY provisions.
Section 2605 describes the key assurances that the CEO must make in receiving Ryan
White funds such as MOE, supplanting, maintenance of a continuum of care and
appropriate relationships with entities that constitute key points of access.
IX. Ch 3. Overview of the Ryan White HIV/AIDS Program
Introduction
The Ryan White HIV/AIDS Program is the largest Federal program focused exclusively on
HIV/AIDS care. The program is for individuals living with HIV/AIDS who have no health
insurance (public or private), have insufficient health care coverage, or lack financial resources
76
Ryan White HIV/AiDS Program Part A Manual—Revised 2013
Other administrative responsibilities of CEOs are as follows:
• Establishing the Administrative Mechanism
The Administrative Mechanism is how funds are disseminated locally. The CEO may
delegate administrative responsibility for the grant (usually to the health department) but
is responsible for ensuring that the program meets legislative mandates and that all Ryan
White partners work together to deliver quality care and services to PLWHA. CEOs must
ensure that funds are allocated fairly across the service area and target underserved
populations.
The planning council assesses the effectiveness of the fimding allocations process, but the
CEO helps make sure that funds get out to service providers in a timely manner. The
CEO should respond quickly to concerns regarding allocation of Ryan White funding and
make needed corrections.
• Establishing Intergovernmental Agreements
The CEO must establish Intergovernmental Agreements (IGAs) with the CEOs of those
political jut iklicticns that Provide .111V health services and include not less than 10
percent of the reported AIDS eases in the EMA.
Services to Women, Infants, Children, and Youth
The CEO must ensure that funding for services to women, infants, children, and youth is
proportionate to their representation among the EMA's/TGA's total HIV/AIDS Gases. A
waiver may be granted when an EMA/TGA can demonstrate that the needs of these
populations are being met through other sources, such as Medicaid, the Children's Health
Insurance Program (CHIP), or other Federal/State programs, including Ryan White
programs. Ryan White defines those populations as follows:
o Women —25 years and older
o Youth — 1,3-24 years old
o Children —2-12 years old
o Infants — less than 24 months old
• Filling. Gaps hi Care and Mainteriance:ofEffôrt ..........
CEOs must ototo 0044.4:Ar.histe ,f.tindi.are Care,:net:10::v4y:far. . . . SerVieekWieredliy.::nthet!:4VallaWhealtlt Care Alnding:sOUrCeS,.:::Stleh as Medicaid or
moacoo::-nraoto4iiiijst.:enSttre that eLwak are enrolled 16.0110..lieolth:re-prpgt4r.0
inr*.hia::they. ::ini.ther; CEOs *OS; assure that grot.poirlaitit.4ity-too.::PriPr : . . : . : . . . yeaeOleve1:0 spending for V0 service s peoviotseryices
regardless of an individual's ability to pay or his/her health : condition
• Clinical Quality Management Programs
The CEO assures that the grantee develops and implements CQM programs to ensure
both that PLWHA eligible for treatment and health-related services have access to those
services, and that the quality of those services meets certain criteria. CEOs must sign
assurances that CQM programs are in place and meet their objectives.
78
Ryan White H1V/AIDS Program Part A Manual—Revised 2013
• Choose someone with related knowledge and skills. Someone with a strong public health
background, knowledge/experience with the Ryan White HIV/AIDS Program, and direct
access to you and your office is best.
• Make sure administrative staff is competent knowledgeable, and diverse. Ensure staff
has strong HIV/AIDS experience and pertinent technical skills.
• Ensure clear lines of communication among all partners. Consider establishing a team of
people to conduct ongoing, regular activities to keep you informed.
• Require linkages among Ryan White programs, and between Ryan White and other
H1V/AIDS programs and activities. Consider a working group or task force comprised of
Ryan White Part A partners, Part B, HIV prevention providers, Medicaid, CHIP offices,
providers of homeless services, representatives of the incarcerated, State and/or local
AIDS entities, AIDS policy groups, etc.
• Be sure that Intergovernmental Agreements (MAO are monitored and followed.
• Require the administrative agency to build and maintain relationships with infected and
affected communities. Use methods such as community forums and hotlines to obtain
consumer and community input.
Making IGAs Meaningful
The Ryan White legislation requiresihat the CEO establish an IGA with any covered (as per
law) political subdivision(s) within the EIVIA/TGA. The 1GA must provide an administrative
mechanism to allocate fimds and services based on the
Number of H1V/AIDS cases in the eligible area,
Demonstrated need for services in the eligible area.
Health and support service needs of the eligible area
IGAs can be useful to promote access to CEOs in other jurisdictions that are part of emArrGA
and involve these elected officials in the Ryan White Part A process.
IGAs should also include the following:
Indicate a minimum number of seats on the planning council that will be set aside for
residents of the jurisdiction.
Specify how residentsof the jurisdiction can be nominated for planning council
membership..
Require Specific efforts to determine the unmet need for HIV-related health services in
these jurisdietions.
Establish periodic meetings between the Ryan White Part A CEO . and other CEOs of the
ether jurisdictions or their representatives;
Specify a periodic evaluation of how the IGA is working, in terms of services and
administration.
85
Ryan White HIV/AIDS Program Part A Manual—Revised 2013
FY16-17 Table of Client Residence FYI6-17 Expenditures $ 362,168.65 5 235,775.82 $ 149,945.70 Reported residence of clients peer Macomb Monroe Oakland St Clairl Wayne x x Minority AIDS Initiative Agency CareFirst Community Health Services, Inc. Comiiuiiity Health Awareness Group Part A $ 60,241.54 $ 1,045,637.70 Deaf Community Advocacy Network! Health Emergency Lifeline Programs klenry Ford Health System Matrix Human Services Oakland Integrated Health Network Oakland Livingston Human Services Agency Oakwood Healthcare Foundation 79.176.14 $ 1,726,649.14 $ 574,444.20 $ 275,887.42 $ 957,181.30 $ 252,133.93 . 172,000.00 .$ 702,111.59 St John Community Health Investment Corporation S 165,983,44 $ 82,075.55 , UNIVIED.1-111, Health and .1E;eyoncl(APM/Wellness Networkl $ 849,692.76 $ 131,094.22 Wayne County Neighborhood Legal Services 5 51,291.86 Wellness AIDS Services Wayne State University Adult HIV Program Wayne State University Horizons Project Wayne State University Hutzel Women's Hospital Wayne State University Sinai Grace $ 143.599.84 $ 70,649.95 $ 186,561,73 $ 43,457.27 Information retrieved from CareWARE and Agency reported FY16-17 expenditures
Prevalent AIDS Cases in Southeast Michigan According to Residence at
Diagnosis
Residence at Diagnosis Estimated
Prevalence
Reported
Prevalence Percent
Lapeer County 40 16 <1%
Macomb County 1,180 501 9%
Monroe County 100 47 1%
Oakland County 2,270 1,000 19%
St Clair County 110 43 1%
Wayne County 7,940 3,728 70%
Detroit 5,630 2,679 50%
Excluding Detroit 2,310 1,049 20%
Total 11,640 5,335 100%
Note: Prevalence estimate calculations are rounded to the nearest ten
Retrieved from PIDHIIS July 2015 Annual IIIV Surveillance Analysis: SOUTHEAST MICHIGAN on August 10, 2017
FISCAL NOTE (MISC. #17292)
October 26, 2017
BY: Commissioner Thomas Middleton, Chairperson, Finance Committee
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION — RYAN WHITE
HIV/AIDS TREATMENT EXTENSION ACT OF 2009 INTERGOVERNMENTAL AGREEMENT BETWEEN
THE COUNTY OF OAKLAND AND THE CITY OF DETROIT
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
resolution and finds:
1. The City of Detroit Health Department and Southeastern Michigan HIV/AIDS Council (SEMHAC)
directly allocated $2,200,919 of Ryan White Part A funding to community agencies within
Oakland County in FY 2016/2017 for the provision of services to persons with HIV/AIDS.
2. The intergovernmental agreement between Oakland County and the City of Detroit establishes
the framework to ensure that eligible local governments provide maintenance of effort
expenditure information related to the Ryan White Extension Act.
3. The Oakland County Health Division does not receive any funding from the Ryan White HIV/AIDS
Treatment Extension Act of 2009.
4. Article III of the agreement allows the Southeastern Michigan HIV/AIDS Council (SEMHAC) to
review all findings and supplemental information from the ongoing needs assessment to establish
funding priorities.
5. There is no fiscal impact on the County with thij_..4gr9,ement, a0—rits budget amindment is
required.
Corntriissioner Thomas Middleton, District #4
Chairperson, Finance Committee
FINANCE COMMITTEE VOTE:
Motion carried unanimously on a roll call vote with Woodward absent.
Resolution #17292 October 26, 2017
Moved by Kochenderfer supported by Jackson the resolutions (with fiscal notes attached) on the amended
Consent Agenda be adopted (with accompanying reports being accepted).
AYES: Crawford, Fleming, Gingell, Hoffman, Jackson, Kochenderfer, KowaII, Long, McGillivray,
Middleton, Quarles, Spisz, Taub, Tietz, Weipert, Woodward, Zack, Berman, Bowman. (19)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the amended Consent
Agenda were adopted (with accompanying reports being accepted).
- GERALD D. POISSON
CHIEF DEPUTY COUNTY EXECUTIVE ACTING PUR$04fsfT Tr) lvia 45,5S9A(71
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lisa Brown, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and
accurate copy of a resolution adopted by the Oakland County Board of Commissioners on October 26, 2017,
with the original record thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at Pontiac,
Michigan this 26th day of October, 2017.
Lisa Brown, Oakland County