Primary Department: Public Health Services
Primary Department Head/Elected Official: Leah Barton, Interim Executive Director
Managing Department: Public Health Services
Managing Department Head/Elected Official: Leah Barton, Interim Executive Director
Regular or Supplemental RCA: Regular RCA
Type of Request: Investment Memo
Investment Memo Type: Final Investment Memo
Project Name: Mobile Health Expansion - Mammography Unit
Project ID (if applicable): TBD
Vendor Legal Name (if applicable): N/A
MWBE Contracted Goal (if applicable): N/A
MWBE Current Achievement (if applicable): N/A
Justification for 0% MWDBE Participation Goal: N/A - Goal not applicable to request
Grant Indirect Costs Rate (if applicable): N/A
Justification for 0% Grant Indirect Costs Rate (if applicable): N/A - Not a grant item
Incremental Authorization Requested: $1,308,439
Total Estimated Project Cost: $1,308,469
Request Summary:
title
Request for approval of the Final Investment Memo for the Mobile Health Expansion - Mammography Unit project for an amount of $1,308,469 and commercial paper funding in the amount of $1,310,000.
end
Project Description:
The Mobile Mammography Unit Project includes acquiring a fully equipped mobile mammography unit to deliver breast cancer screening services directly to underserved and hard-to-reach communities across Harris County. Equipped with advanced imaging technology and integrated with Harris County Public Health's (HCPH) existing health systems, this mobile unit will address barriers to preventive care, including geographic isolation, lack of transportation, and disparities in healthcare access.
The project is estimated to cost $1,308,469and is anticipated to be completed within 15 months of initiation. Upon completion, the mobile unit will increase access to life-saving breast cancer screenings, improve early detection rates, and reduce breast cancer disparities in high-need areas, ultimately contributing to better health outcomes for Harris County residents.
The key tasks include:
1. Purchasing 1 mobile mammography unit
2. Delivery of the unit
The desired end state of the project is a fully operational Mobile Mammography Unit integrated into the HCPH Mobile Health program, actively providing routine breast cancer screening services across Harris County. The anticipated benefits include increased access to breast cancer screening for underserved communities, improved early detection rates, enabling timely intervention and better treatment outcomes, and reduced healthcare disparities in access to breast cancer screening.
Anticipated Project Expenditures and Timeline:
|
Project Scope Breakdown |
Estimated Cost |
Estimated Completion |
|
Purchase of the Mobile Unit |
$1,304,384 |
Q4 2025 |
|
Unit Delivery |
$4,085 |
Q3 2026 |
|
Total |
$1,308,469 |
Q3 2026 |
Justification & Alternatives:
Breast cancer remains one of the leading causes of cancer-related deaths among women, and regular mammography screenings are critical for early detection and improved survival rates. According to the HCPH Chronic Disease Report, significant disparities persist in breast cancer screening rates across Harris County, particularly in communities experiencing geographic isolation and healthcare deserts, lack of reliable transportation, and limited availability of screening facilities.
This project supports the following Priority Outcomes and/or Goal Areas:
• Preventive Health Services: Expanding access to essential breast cancer screening services.
• Access to Care: Reducing geographic and logistical barriers to healthcare.
• Health Equity: Addressing disparities in healthcare access and outcomes.
The success of the project can be measured by the number of breast cancer screenings conducted.
The Mobile Mammography Unit provides a cost-effective, scalable, and flexible solution for delivering breast cancer screening services directly to communities that need them the most. This approach eliminates barriers such as transportation and access to care without healthcare coverage while maximizing the impact on community health. Alternate solutions include relying on the limited capacity of community partners or a fixed site offering mammography services, limiting reach to communities in healthcare deserts.
Delaying this project could result in continued obstacles to early breast cancer detection for vulnerable populations. This may lead to more late-stage cancer diagnoses, which are associated with poorer health outcomes and higher long-term healthcare costs due to the need for advanced care.
The stakeholders affected by this project include community members and healthcare providers. Engagement plans involve consultations with these groups to ensure that the mobile unit addresses community needs and integrates smoothly with existing health services, thereby ensuring continuity of care and follow-up services.
Anticipated Impact on Other Funds (If Applicable):
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Fund Code |
Description |
Estimated Cost |
Funding Method (Existing or Future Budget Request Required) |
Estimated Date of Needs |
|
2117 |
Labor |
$553,823 |
Existing |
N/A |
|
2117 |
Non-Labor |
$617,418 |
Existing |
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Total |
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$1,171,241 |
|
- |
County Strategic Plan Goal: 4. Improve physical and mental health outcomes across all communities.
County Strategic Plan Objective: O: Increase access to quality health care, including preventive and behavioral health.
Justice/Safety Initiative (Goal 1): N/A
Infrastructure Initiative (Goal 2): N/A
Economy Initiative (Goal 3): N/A
Health Initiative (Goal 4): O4: Increase community health care capacity.
Climate/Resilience Initiative (Goal 5): N/A
Housing Initiative (Goal 6): N/A
Decision Analysis Matrix Score (rubric on last page): 20
Previous Court Action:
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Fiscal and Personnel Summary |
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Total Current Budget |
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Additional Budget Request |
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Commercial Paper |
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$1,310,000 |
$1,310,000 |
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Total Additional Budget Request |
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$1,310,000 |
$1,310,000 |
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Total Funding Request |
$ |
$1,310,000 |
$1,310,000 |
$ |
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Personnel (Fill out section only if requesting new PCNs) |
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Current Position Count for Service |
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Additional Positions Request |
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Total Personnel |
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Anticipated Court Date: 4/10/2025
Anticipated Implementation Date (if different from Court date): Click or tap to enter a date.
Emergency/Disaster Recovery Note: Not an emergency, disaster, or COVID-19 related item
Legal funding compliance confirmed by: Paige Abernathy, Assistant County Attorney, 3/12/2025
Department Approval by: Alexey Gruber, Director of Operations & Technology Services
OMB CIP Team Approval by: Wanwei Tang, Analyst - Capital Projects and Infrastructure, 3/28/25
Commercial Paper Request (For OMB use only):
Receiving Department: N/A
Project PeopleSoft ID: TBD
CP Series Description: Commercial Paper Series D-2 can be used for (1) construction of public works, (2) the purchase of automobiles, equipment and machinery, including computers, materials and supplies for the operation of the County’s precincts and departments (3) Professional services, including services provided by engineers, architects, attorneys, auditors, financial advisors, and fiscal agents, in connection with the contractual obligations described in (1) and (2).
Commercial Paper is being requested for the HCPH Mobile Health Expansion - Mammography Unit project and is expected to be repaid within the next three fiscal years either through bonds, budgetary means or pay-as-you-go sources.
Note: Commercial Paper is issued in increments of $5,000 and the excess is not available to be spent by the department.
OMB Financial Management contact: Amy Perez, Deputy Executive Director, Office of Management and Budget
Decision Analysis Matrix scoring tool - Commissioners Court has approved the rubric below for scoring capital projects. Please complete the last two rows for OMB review.
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Scoring option |
Strategic Plan alignment (3x weighting) |
Evidence base |
Impact on outcomes |
Cost effectiveness |
Ease of implementation |
Collaboration / partnerships |
Environmental sustainability |
Equity |
Total |
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-1 |
Antithetical to one or more aspects of the Strategic Plan |
Evidence shows net negative impact on the intended goal |
Impact is clearly negative |
Costs expected (or shown) to outweigh benefits |
County has no/limited existing capabilities and dependencies are likely to impede |
Could negatively impact relationships with partners |
Negatively impacts environment and/or climate change mitigation efforts |
Inequitable |
n/a |
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0 |
Does not align to a Strategic Objective |
Evidence base is not well defined or measurable |
Size of impact on one or more strategic outcomes is negligible or unclear |
Net comparison is unclear |
County has no/limited existing capabilities or dependencies are likely to impede |
Does not involve collaboration with partners |
Net neutral impact on environment and/or climate change mitigation efforts |
Does not consider equity to a meaningful degree |
n/a |
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1 |
Aligns to a Strategic Objective but not to a Strategic Initiative |
Limited evidence-based research on outcomes; may have qualitative/theoretical support |
Outcomes are defined but without target levels and/or expected impact is moderate |
Moderate direct/indirect benefit relative to costs |
County has existing capability to implement or dependencies are unlikely to impede |
Moderately expands County leverage through collaboration with partner(s) |
Marginally positive impact on environment and/or climate change mitigation efforts |
Considers equity to a meaningful degree, but not comprehensively |
n/a |
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2 |
Aligns to a Strategic Objective and a Strategic Initiative |
Outcomes are directly supported by evidence base or credible research supports anticipated outcomes |
Outcomes are clearly defined and include target levels; expected impact on outcomes is high |
Significant direct/indirect benefit relative to costs |
County has existing capability to implement and dependencies are unlikely to impede |
Significantly expands County leverage through collaboration with partner(s) |
Positively impacts environment and/or climate change mitigation efforts |
Considers equity meaningfully and comprehensively |
n/a |
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Score (-1,0,1,2) |
6 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
20 |
Rationale The implementation of a mobile mammography unit directly align with and strongly supports Objective O and Initiative O4. The ultimate goal of deploying a mobile mammography unit is to increase access to preventative services and expand HCPH’s ability to provide a new critical service to communities at the highest risk for breace cancer. Harris County has higher Breast Cancer death rates than Texas and the U.S., demonstrating the clear need to increase access to early screening/detection. Mobile mammography units have proven to be effective in Harris County and other similar jurisdictions to reduce health disparities in underserved communities and prevent advanced-stage cancers. The mobile mammography unit project has clear outcomes and expected impacts. It will enhance access to breast cancer screening through HCPH’s Mobile Health programming, promoting early detection of breast cancer and reducing disparities in healthcare access within Harris County communities. Providing mobile mammography services and detecting breast cancer early saves taxpayer dollars by reducing the need for costly treatments in the end-of-life phase; a cost averaging $76,100 per patient, according to the Center for Disease Control and Prevention. <https://www.cdc.gov/nccdphp/priorities/breast-cancer.html>The mobile mammography unit project aligns with HCPH’s established mobile health expansion initiative, which already delivers various preventive and clinical services to Harris County communities. This existing infrastructure provides a strong operational foundation for integrating the mobile mammography unit. HCPH has the necessary expertise and logistical capacity to manage project dependencies such as acquiring staff, training, and system integration within HCPH’s capabilities. The mobile mammography unit project will foster partnerships to enhance service reach, efficiency, and impact by collaborating with local community organizations to maximize the unit’s footprint, utilization, and effectiveness of outreach efforts in communities with high need for services.By bringing breast cancer screening services directly to communities in Harris County, the mobile mammography unit project could help reduce the need for individuals to travel long distances to receive services at fixed healthcare facilities, ultimately decreasing vehicle miles traveled, which may lead to lower air pollution and greenhouse gas emissions in the county.The mobile mammography unit will be deployed to areas of Harris County with the highest need based on indicators such as high cancer rates, low screening rates, and other factors such as lack of insurance and transportation. Service delivery will also be tailored to ensure community members receive culturally and linguistically appropriate care.