1 Local Assistance Funding James Watt, MD, MPH CTCA Fall Meeting 2010

2 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

3 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

4 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

5 Funding Breakdown 37% 13% 8% 42%

6 Current Housing/FSIE Distribution Range $0-5400/case (median =$520) 18 LHJ with >0 cases/year received $0 Unfunded LHJ had cases/year (median = 1.5 cases) 7 LHJ receive only housing/FSIE

7 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

8 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

9 Change in LHJ Funding ($) by Case Group <10 cases 10+ cases

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

Funding Comparison: Total Dollars per Case Current 1-10 Cases –mean: $1800 –median: $1200 –range: $ cases –mean: $4700 –median: $4600 –range: $ Proposed 1-10 Cases –mean: $2500 –median: $ cases –mean: $4500 –median: $4400 –range: $

Summary TBCB provides both financial and technical support Current housing funding based on outdated allocation Revision of allocation could enable –funding for LHJs with fewer cases –more equitable distribution of funds –new technical support resources 12

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: $ cases –mean: $4700 –median: $4600 –range: $ <10 cases 10+ cases

Proposed Funding ($) per Case 1-10 Cases –mean: $2500 –median: $ cases –mean: $4500 –median: $4400 –range: $