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Local Assistance Funding

James Watt, MD, MPH

CTCA Fall Meeting 2010

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TB Funding Awards

• Objective: reduce tuberculosis in California– match funding to disease burden– match funding to disease complexity– provide funding for statewide initiatives that

benefit all LHJ

• CTCA request: support currently unfunded LHJ– funding– other support

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What Other Support Does TBCB Provide?

• Technical assistance– clinical– CI/outbreak

• Laboratory support– MGIT by mail– molecular beacons– DST– NAAT?

• Special needs funds• Case conferences• Training

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Current Local Assistance Funding Categories

• Base Award – federal/state– formula (20+ cases)– fixed award (6-19 cases)

• Housing/FSIE – state– housing personnel award– FSIE allotment– allocated based on applications submitted in 1997

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Funding BreakdownHousing,

Personnel, $1,207,611

FSIE, $758,398Federal Base, $3,581,176

State Base, $3,996,246

37%

13%

8%

42%

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Current Housing/FSIE Distribution

• Range $0-5400/case (median =$520)

• 18 LHJ with >0 cases/year received $0

• Unfunded LHJ had 0.5-64 cases/year (median = 1.5 cases)

• 7 LHJ receive only housing/FSIE

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Proposal

• Redistribute housing/FSIE distribution based on average case count• Expand formula to include all LHJ with 10+ cases• For LHJ with 10+ case, allocate housing/FSIE based on formula• Allocate proportion of all funds (base and housing/FSIE) to LHJ with <10

cases/year– 3.5% of cases– $318,000– $2500/case

• Reserve $83,000– training for RSHJ– laboratory support

MGIT by mail (benefits RSHJ) DST NAAT

– special needs

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Change

• 21 LHJ with 1-9 cases/year– 5 decrease (all 5 decrease >10%)– 16 increase – net $14,000 increase– 7 previously unfunded LHJs would receive funds (1-4

cases/year)• 24 LHJ with 10+ cases/year

– 14 decrease (7 decrease >10%)– 10 increase – net $96,000 decrease

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Change in LHJ Funding ($) by Case Group

<10 cases 10+ cases

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Change in LHJ Funding ($ and %) by Case Group

Funding Comparison:Total Dollars per Case

Current• 1-10 Cases

– mean: $1800– median: $1200– range: $0-7500

• 10+ cases– mean: $4700– median: $4600– range: $2900-5600

Proposed• 1-10 Cases

– mean: $2500– median: $2500

• 10+ cases– mean: $4500– median: $4400– range: $3500-5500

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Summary

• TBCB provides both financial and technical support

• Current housing funding based on outdated allocation

• Revision of allocation could enable– funding for LHJs with fewer cases– more equitable distribution of funds – new technical support resources

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Questions?

Discussion after lunch•Thoughts on the concept (reallocation of housing funds)•Thoughts on the proposal

– funding for LHJs with 0 cases– funding for LHJs with 1-10 cases– funding for LHJs with 10+ cases– funding for NAAT and emergency funds

•Next steps?13

Current Funding ($) per Case

• 1-10 Cases– mean: $1800

– median: $1200

– range: $0-7500

• 10+ cases– mean: $4700

– median: $4600

– range: $2900-5600

14<10 cases 10+ cases

Proposed Funding ($) per Case

• 1-10 Cases– mean: $2500

– median: $2500

• 10+ cases– mean: $4500

– median: $4400

– range: $3500-5500

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