Speaker 1: Thank you. Next item, please. Looks like it is 23.
Speaker 0: Communication from Health and Human Services. Recommendation to authorize city manager to receive and expend grant funding and an estimated amount of 25,200 to provide HIV program services citywide.
Speaker 1: Thank you. There's a motion and a second. Councilwoman Pryce.
Speaker 9: Is there a staff report?
Speaker 5: Why don't we get a staff report?
Speaker 4: Yes, there is. There's a staff report. We have Kelly Collopy and Dr. Davis, our health officer.
Speaker 3: Well. Am I on? Okay. Well, Silver.
Speaker 10: Good evening, honorable mayor and council members. Thank you for providing this opportunity to share about the HIV Pre-Exposure Prophylaxis Program, otherwise known as Prep. I wanted to take this time to highlight the importance of HIV Prep and the important work that's occurring in Long Beach to prevent HIV infection. In 2017, do you have the clicker? Okay.
Speaker 6: In 2017.
Speaker 10: There were 4520 people living with HIV in Long Beach. Most of these individuals resided in the 1908 or 292813 and 90804 zip codes. In 2017, there were 107 new HIV infections reported among Long Beach residents. The rate of HIV infection in Long Beach is higher than that of Los Angeles County in the state of California. We did see a 33% decrease between 2012 and 2016, but it's still at an unacceptable level. Next, HIV pre-exposure.
Speaker 1: Can I ask a question? I'm sorry, just one shot. I'm clear on that. Can you get back one side when you say that? I know that that HIV infection rate is larger in Long Beach per se, when you compare it comparatively to the county. When you say if there's a 33% decrease from 12 to 16. Mm hmm. So even though it's still it's still decreasing, though, right? So it's still larger, but it's continuing to decrease, is that correct?
Speaker 3: Right.
Speaker 10: Okay. So it's still larger, but it's decreasing the rate of HIV.
Speaker 3: Infection, the state of new infections. Yes. Thank you. Yeah.
Speaker 10: It's kind of stagnated or was like HIV, pre-exposure prophylaxis or prep is a way for people who do not have HIV, but who are at substantial risk of getting it to prevent HIV infection by taking one pill every day. The pill is called Truvada and was approved by the Federal Drug Administration to be used for HIV prep in 2012. When someone is exposed to HIV through sex or injection drug use, this pill can work to keep the virus from establishing a permanent infection. When taking consistently every day, Prep has been shown to reduce the risk of HIV infection by greater than 92%. Prep is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone.
Speaker 3: Next.
Speaker 10: Based on the Los Angeles County HIV AIDS strategy for 2020 and beyond, to reach our goal of reducing the number of new HIV infections in the county, it's estimated that 4543 Long Beach residents would need to be on prep consistently by the year 2020. As of 2017, approximately 430 people are on prep in Long Beach. This mirrors the national trend of less than 10% of the estimated 1.2 million people who could benefit from Prep actually getting it. We realize we have a ways to go to reach our 2020 goal, but are confident that working with our community and providers that we can reach it. Long Beach residents can receive prep at the Long Beach Health Department as well as several other locations. Next, patients who are taking prep are seen regularly by a medical provider and sexually transmitted disease testing and treatment is done at that time. Prep is usually covered by insurance, and Gilead, the maker of the drug, has a patient assistance program that can help defray the cost of the medication. Los Angeles County provided up to $300,000 to the health department to implement our HIV prep program. Other organizations serving Long Beach were funded as well. That funding is sunsetting in 2018, and the state of California has started providing financial assistance to local providers to cover the HIV prep costs for both insured and uninsured individuals.
Speaker 3: Next.
Speaker 10: The Long Beach HIV planning group has been meeting for many years. It's made up of partners and community members who are all committed to ending HIV in Long Beach, including health care providers, public health, substance abuse treatment and education professionals and community activists, among others. One of our primary goals is to increase the number of people on Prep in Long Beach. The HIV Planning Group Prep Committee is addressing the issues of making more high risk individuals and health care providers aware of the existence and benefit of HIV prep and eliminating barriers to starting and staying on prep, all of which have been shown to play a part in the current suboptimal use of the medication. Next IV share Pre-Exposure prophylaxis is a powerful tool to stop HIV infections. Another tool to prevent transmission of HIV is known as you equals you, which means undetectable equals and transmissible. If an HIV positive person's viral load is suppressed or undetectable, there is virtually no risk to transmit the virus to others. So by treating an HIV positive person to an undetectable level, not only are you enabling that person to live a full, healthy life, but you have the added benefit of preventing the spread of the virus to others. In early 2018, the Long Beach Health Department signed on to an international consensus statement supporting you equals to you. We, in conjunction with our partners, are committed to utilizing these tools to their fullest capacity to halt the spread of HIV. Thank you for your time tonight. That concludes my presentation and I'm.
Speaker 3: Available for questions.
Speaker 1: Thank you. Really, really great work. Councilwoman Price.
Speaker 9: Ditto. Excellent work. And it's just so impressive to me how much work you guys do with grant funding and what a great job you do with outreach. And I really appreciate your efforts to communicate on this issue and some of the citywide efforts that you've participated in in terms of outreach and education. Thank you very much.
Speaker 6: Thank you.
Speaker 3: Do I face more injuries?
Speaker 1: Yes.
Speaker 8: And again, I want to thank you so much for the work that you guys do put into this program. Thank you again.
Speaker 10: Oh, you're welcome. I just wanted to say that it is really a citywide effort that a lot of organizations in the.
Speaker 3: City have received the grant.
Speaker 10: Funding. And we're really working together.
Speaker 1: Thank you. And I just want to just interject real quick, similar and maybe I didn't get it in the presentation. Are we providing prep at the health department?
Speaker 10: Yes. So we are. When there was a slide, they had like I think seven or eight.
Speaker 1: Saw.
Speaker 10: The organizations. Those are all providing prep.
Speaker 1: And so so you can so we're providing prep through the health department. And what is that something that you that folks is there from from a cost perspective? How are we dealing with that?
Speaker 10: So you can we can bill your insurance. And then there was also a demonstration project funded by Los Angeles County. They got CDC funding and so they funded the testing, the meds and the navigator to help you kind of navigate the system. And that's sunsetting in September. And so now the state of California has allocated funds to help cover the cost of the medical provider and to help get you hooked up with the meds and the lab testing and the treatment for STDs, that part of.
Speaker 1: Things. So if you if you don't have insurance or if you are underinsured or are we just creating some kind of.
Speaker 10: State would be the best.
Speaker 1: The State would, but we would function as the actual organization that gives out the prep at the Health Department right now.
Speaker 3: Yeah, we are the providers. So a couple of years ago we brought forward to the council the initial jump into the into the service model. And we've been working with L.A. County to negotiate that. And now at this time for this item, it is the funding from the state to allow us to provide for those who are unfunded.
Speaker 1: This is really, really important work. So thank you for for all this. I know we've been talking about this and I hadn't realized that we had made so much progress already. So that's great. Thank you. Councilman Richardson.
Speaker 2: Thanks, Mr. Mayor. And thanks, Dr. Davis and Kelly for the presentation. And we've had conversations about this, and I just want to point out something and have a quick conversation. So I see the three zip codes where most cases are found or. 90802908090813 and 90804. But then when you look at the new cases, nine available for drops off the list, which is good news for 9004 but not a waiting five comes in. What is the narrative behind that difference? Is it traditionally been, you know, on the rise? And I 25 and on the on the way down and I know two four or I know that some of these ZIP codes I personally know that 980592103 and I know it or two or three zip codes that have have seen significant population growth. You know, 925 has grown four times higher than the city's pace and population growth. So is it is there folks moving or that we have a real problem in like 9 to 5 we need to address?
Speaker 3: Well.
Speaker 10: Like nationally, we're seeing one of the highest rates of getting HIV is in the African-American community. And so with 90805 having a large African-American community, I'm hypothesizing that that might be some of why 90805 is making on to the new HIV infection list.
Speaker 3: Like as a one of the zip codes. These are rates. So it's per population versus versus direct numbers.
Speaker 2: Sure. Yeah. I'd like to I'd like to dig into that more because to do that. So I just see the correlations at 9805 is now one of the youngest zip codes in the city is one of the growing zip codes in the city. And with that comes challenges that really haven't historically been a priority in that area that need to be, you know, started sort of become more of a priority and read it. The other thing I would say is the statistics here are great, but the narrative that I you know, I've been working with St Mary's and some of the, you know, other folks around this conversation. The narrative is that and tell me if I'm wrong, but the narrative is that Long Beach is number six and new HIV cases in the country is that are we way off? Because that's what's out there in the community?
Speaker 10: I don't think you're way off. I don't have the exact number, but it's somewhere like that.
Speaker 2: Number six across the country. I think we need to thank you for this work, but I think it needs, particularly if we know that communities of color and males of color are statistically higher here. And given just, frankly, the makeup of the city council, there's a number of males of color here. I think we need to talk about this more. I think we need to engage on this issue more. But thank you for this presentation and I think we need to continue this work.
Speaker 3: Thank you. I just did want to add that the way that the funding structures work is they're very significantly underfunded for outreach, testing and other things both around HIV and AIDS. TB, which I have shared. And in North London there are fewer providers than in other areas, and we are looking to address and how we could locate and bring services to that community.
Speaker 5: Well, if I could, I would.
Speaker 2: Add I think we need to bring that to the conversation that's happening around 925 with a plan, planning for future needs. I think health needs to really engage in that conversation.
Speaker 1: Thank you. Cancer appears.
Speaker 6: Yes. I also want to say what great work you guys have done. I know that in last year's budget this was a hot topic for us. And so I really want to appreciate all the efforts that have been done. Could you remind us I know you mentioned that African-Americans are one of the rising populations. Can you remind us of the other populations that are increasingly affected?
Speaker 10: In general? It's younger folks, men who have sex with men, people who use HIV drugs. And then we see a lot of homelessness and.
Speaker 3: Drug use and mental health issues that are.
Speaker 10: Contributing to this as.
Speaker 3: Well.
Speaker 6: So how is the health department working with our continuum of care around homelessness and Multi-Service Center?
Speaker 10: So we're reaching out a lot to test in that area and working with the MSE and homeless providers when we do have patients that we're trying to find to get them in because it is a tough poppy.
Speaker 3: Relation to, you know, get addresses.
Speaker 10: On and get in and get treated.
Speaker 3: And tested and what have you.
Speaker 6: Great.
Speaker 3: Go ahead and say part of the services that are partner services so someone is identified. And what we do is we work to find out who their partners are to help to help bring them in as well. So among the homeless population, that's a little more difficult, but we're working with the MSI to work through that.
Speaker 6: Great. I think that is a I'm sure it is a challenging job to try to track down partners and go through that process. And so I really am.
Speaker 3: Happy and.
Speaker 6: Happy that you guys have taken this on as not just getting the grants for, but I know it's something that we've got the work group. I know my staff attends. One other question that I wanted to ask is on the outreach. I know I recall last year in the budget we talked about a population that was, you know, maybe a diverse population that was using apps more and that that population was seeing a rise just in STDs in general, maybe not HIV, but kids in general and wondering what our outreach to that population of that community has been on education around STDs. Well, I know that.
Speaker 10: As far as reaching out on apps is being done primarily at the state level because they didn't want, like every jurisdiction to be reaching out to all the apps.
Speaker 3: But I think I think where you're taking that is that the time we're talking about how the access to apps and hooking up is increased as part of the increase we are seeing in a number of studies and so we are working on it. And where we're rising is that need at the state and federal level? Are there's much funding at all? I mean, I want to say our budget is under $100,000 for STDs. And so the funding is actually in HIV work. And we're trying to, while we're there, also be testing and working around STD prevention. So that is an area that we're really trying to work more closely and to generate, but it is severely under-resourced at all levels and it's an issue across the country.
Speaker 6: Wow. That's that's not a lot of funding. Well, just again, thank you so very much for all of your work in your effort on this. I look forward to hearing more about your efforts in the upcoming budget conversation. Thanks so much.
Speaker 3: Thank you.
Speaker 1: Thank you. Councilmember Councilmember Richardson.
Speaker 2: I know very little people are paying attention, but I have another question I forgot I got to ask. Well, I have the two of you here. So we talk about Prep now. I know Prep is in pill form. I know this conversation about getting to something you don't have to take daily like shots and stuff like that. You have no and then and then prep as well. So we're, you know, do you know about that? Are we going to be able to deploy that?
Speaker 10: So we do offer prep. So we offer.
Speaker 3: Yeah. So after you've been exposed, there's this a big time limit, so you have to get to people quickly.
Speaker 10: The shots, I'm not sure where we're at with that, but this not something follow.
Speaker 3: Up and think about.
Speaker 2: Thanks. Appreciate it.
Speaker 1: Thank you. Any public comment on this item? Seeing none. Oh, please. Looking straight ahead as this gentleman's hair is coming down. I just want to make sure that. We elevate this conversation a little bit. There's a lot of information that came to us that I think is really important for us to elevate. And I think we need to have a broader conversation around more of the data and and what is happening and why we are being impacted the way we are and what we need to do better. I know, obviously, you know, what we can do is limited, but I think we can do more than what we're doing, clearly . And so I'm just not sure what, you know, how we do that. I think we're going to will brainstorm some. I think we need to elevate this a little bit more to the broader community, because I know it's happening at the Health Department and I think you guys are having great conversation with it with our partners in the hospitals and and certainly a bunch of foundations as well as the center and others. But I think for this body, we need to elevate it and put a little bit more emphasis on it. So I just thank you for the presentation. Yes.
Speaker 4: Hi. My name is Michael Neutron. I am a second district resident. I'm also a prep navigator at St Mary Medical Center. I see about half the people in Long Beach on Prep in my office. I've seen a big change happen in HIV prevention over the past few years. We've gone into a biomedical model. This is something that's happened under the Obama administration, and I think we have the opportunity to move things forward and really bring down the HIV rate. We know, as we've heard, that people who are on medication and are undetectable aren't going to transmit the virus. And so we can reduce the rate of new HIV cases by testing as many people as possible. Getting those people who test positive on medications and stop the spread of the epidemic that way. I know at the program where I work, the clients who come in who do test positive, we have 90% of that, over 90% of them at undetectable. And these are very difficult to reach clients. A lot of our clients are homeless, active drug users. They're there, have access to our housing services, our food pantry, our dental clinic, mental health services. So one of the ways that testing can help the community at large is getting these people into social services. We have access to HIV, housing, money. So if we can get these people tested, we can get them into our programs and and start addressing these other issues that we have in the city. The same thing happens on my end for the high risk negatives that I'm working with. We're getting them in. We're testing them for STDs every three months. The people who have HIV are getting tested for SCD every three months. We've seen the rate of STDs go at 500% in the past five years. And by testing more people, getting them into treatment if they need it, getting them on prep, if they need that , we're doing a lot more testing for STDs and we can help to bring down the STD rate that way. So I think we have a lot of great things in place now. The trick is we need to expand them exponentially. On the federal level, they're looking to get about the same number of people with HIV. They want to see those, that same number on prep. L.A. County has similar numbers where they want to see Long Beach have about 4400 people. I think people on Prep, which is about equivalent to the number of people we have living with HIV. That would mean that I would need to enroll another thousand people. So we need I think it would be great if the city council could look at this further. I think we can become like places like San Francisco, Washington State, New York State, where they've made a priority of addressing HIV. Put a little of the general fund money in to address these kind of issues and and have some successes here. Thank you.
Speaker 1: Thank you.
Speaker 6: Mike.
Speaker 1: Thank you. Thank you very much.
Speaker 6: Councilmember Pearce. Yes. I just wanted to thank you for for staying late and for all of your efforts. I would love to be able to sit down with you before the 21st, which I think is when our health department brings our budget health department presentation the 27th.
Speaker 5: It's not on. It'll probably be on September 4th or before the.
Speaker 4: B or C if if it's necessary.
Speaker 6: I will make it a priority for you and I to sit down before that date. Okay. Thank you so much.
Speaker 1: Thank you. There's a motion to second. Please cast your votes.
Speaker 7: And he filed.
Speaker 3: A.
Speaker 0: Motion carries.
Recommendation to authorize City Manager, or designee, to execute an agreement, and any subsequent amendments, with the State of California Department of Public Health, to receive and expend grant funding in an estimated amount of $25,200, to provide HIV Pre-Exposure Prophylaxis Assistance Program services, for the period January 1, 2018 through December 31, 2021.  (Citywide)