HomeMy WebLinkAbout20100209.tiff RESOLUTION
RE: APPROVE CANCER, CARDIOVASCULAR DISEASE, AND PULMONARY DISEASE
PREVENTION COMPETITIVE GRANT RENEWAL APPLICATION FOR THE HEART OF
WELD PROGRAM AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Cancer, Cardiovascular Disease, and
Pulmonary Disease Prevention Competitive Grant Renewal Application for the Heart of Weld
Program from the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public Health and
Environment, to the Colorado Department of Public Health and Environment, commencing July 1,
2010, and ending June 30, 2011, with further terms and conditions being as stated in said
application, and
WHEREAS, after review, the Board deems it advisable to approve said application, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Cancer, Cardiovascular Disease, and Pulmonary Disease Prevention
Competitive Grant Renewal Application for the Heart of Weld Program from the County of Weld,
State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf
of the Weld County Department of Public Health and Environment, to the Colorado Department of
Public Health and Environment be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the restrictions on lobbying by anyone
using funds pursuant to this grant shall apply to any lobbying, as defined in Section 24-6-301 (3.5)
(a), C.R.S., shall apply to all local government bodies, as well as their members.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said application.
2010-0209
HL0037
0 (1 ° NL ( I C &'l61) 710, c//G
CANCER, CARDIOVASCULAR DISEASE, AND PULMONARY DISEASE PREVENTION
COMPETITIVE GRANT RENEWAL APPLICATION FOR THE HEART OF WELD PROGRAM
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 27th day of January, A.D., 2010.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: �, )u��IBC t)., Vv.�
v 4
Doyglas Rademach r, Chair
Weld County Clerk to the ar 7
aQr. arbara Kirkmeyer, Firo-Tem
BY:
Deputy Clerk to the Board ,`.
Sean P. way
77
APPROVED-AB TO FORM:
William F. Garcia
ounty Attorney EXCUSED
David E. Long
Date of signature: 3/00
2010-0209
HL0037
Memorandum
it
TO: Douglas Rademacher, Chair
Board of County Commissioners
I CFROM: Mark E. Wallace, MD, MPH, Director Department of Public Health
Oand Environment
COLORADO DATE: January 25, 2010
SUBJECT: Cancer, Cardiovascular Disease, and
Pulmonary Disease(CCPD) Grant
Application
The Health Communication, Education, and Planning (HCEP) Division of the Health
Department would like approval to apply for continuation funding from the state health
department's Cancer, Cardiovascular Disease, and Pulmonary Disease (CCPD) competitive
grants program, for the Heart of Weld project. The focus of the Heart of Weld project is
cardiovascular disease (CVD) screening and lifestyle intervention programming for low-income
woman, age 40-64 years, who are under- or uninsured, with an emphasis on Latina women and
women already enrolled in the Women's Wellness Connection program.
Nationwide, CVD is the number one cause of death for woman. Weld County is no exception.
Between 2004 and 2006, there were 3,775 deaths among all Weld County residents; 1,880 were
female. Nearly 595, or one-third, died from CVD; and approximately half(432/882) of those
who die each year of heart disease are women.
Cardiovascular disease, as with many of the chronic diseases that plague our nation today, is
highly preventable. A recent study analyzing the major modifiable behavioral risk factors
associated with mortality found the two leading actual causes of death to be tobacco (18%) and
poor diet and physical inactivity (leading to obesity) (15%). These three risk factors are also the
three major contributors to the development of CVD.
Our particular target population was chosen because it is this group (low income women, with no
or inadequate insurance) that tends to not participate in preventive health care and is thus over
represented in CVD morbidity and mortality rates.
During the first year and a half of implementation of the Heart of Weld project approximately
367 women have been screened and 74 have participated in the lifestyle intervention portion of
the project, which consists of a series of classes, educational mailings, and follow-up phone
counseling. Although the results are preliminary, many of these women have made great
improvements. As an example, almost two-thirds (63%) of the Heart of Weld participants seen
2010-0209
for their six-month follow-up visit (n=70) lowered their total cholesterol. Of those 70
participants, 42 participated in the more intensive intervention (attending classes, etc.) and the
remaining 28 only participated in screening visits. Interestingly (but not unexpected), more
women in the more intensive program lowered their total cholesterol compared to women in the
minimal intervention group (69% vs. 54%).
This has not been the only benefit of the program. Partnerships have been established with
Sunrise Community Health Center, Salud Family Health Centers, and UrgentCare Quick Care
(Greeley). This has opened the door for other collaborative efforts between the health
department and these entities.
With continued funding the HCEP team hopes to continue providing screening and lifestyle
intervention programming, while working with the health department clinic, Salud Family
Health Centers, and Sunrise Community Health to develop a plan for sustainability of the
program into the regular services of these clinics.
Currently,the Heart of Weld project is funded at$230,705 with 2.35 FTE. For the 2010/11 grant
period we will be allowed to apply for up to $222,379. We will be able to maintain the 2.35 FTE
(in order to reach our goal of 450 screenings) but will cut participant incentives, and media and
marketing (as mandated by the state). If allowed to proceed, a full budget will be presented to
the Board at a later date.
I recommend that the HCEP division be allowed to proceed with an application for the 2010/11
grant year.
re_Qiiiir" DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 N. 17th Avenue
Gr
eeley,y, 80631
WEBSITE:www.co.weld.co.us
ADMINISTRATION: (970) 304-6410
FAX: (970) 304-6412
"ilk COMMUNITY HEALTH NURSING: (970) 304-6420
FAX: (970) 304-6416
HEALTH COMMUNICATION, EDUCATION,AND PLANNING (970)304-6470
FAX:(970)304-6452
ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415
FAX: (970) 304-6411
COLORADO
Granting Agency: Colorado Department of Public Health & Environment
Cancer, Cardiovascular Disease and Pulmonary Disease (CCPD)
Competitive Grants Program
Applicant's Name: Weld County Department of Public Health and Environment
Health Communication, Education, and Planning Division
Applicant's Address: 1555 N. 17"' Avenue
Greeley, CO 80631
Applicant's Phone: (970) 304-6470
Applicant's Fax: (970) 304-6452
Project Title: Heart of Weld
Contact Person: Gabrielle Vergara, Project Coordinator, ext. 2375
Amount of Request: $219,953
Time Period of Request: July 1, 2010—June 30, 2011
Weld County Department of Board of County Commissioners
Public Health and Environment Weld County, Colorado
' ' yti:\le Wv 0' . '��'a LI -- obs-ty \o cis,
Mark E. Wallace, MD, MPH, Director Douglas) ademach r, Chair
JAN 2 7 2010
A l' ST:
/yK11
V 4
Weld County(ou Clerk tot `1.1 d t!
BY: wit i. �a�,./1.;�`
,-, )
. ._
Deputy Clerk to thear1 ,,,' a
ao 0- o.2oq
CCPD 2010/11 Competitive Renewal Application
Part II: Project Narrative, Work Plan, and Evaluation Plan
Heart of Weld Project
Weld County Department of Public Health & Environment
CCPD 2010/11 Heart of Weld Project Part II: Narrative,Work Plan, Evaluation Plan
1. Project Narrative
a) Why is your project important?
This project was conceptualized by the Weld County Department of Public Health and Environment
(WCDPHE) as a result of the concern, nationally and locally, regarding the growing burden of
cardiovascular disease (CVD). During the last century, the pattern of chronic diseases leading to
death, illness, and disability among Americans has changed dramatically. Chronic diseases such
as heart disease, cancer, and diabetes are now among the most prevalent, costly, and, at the
same time, preventable of all health conditions. Seven out of every 10 Americans who die each
year, or more than 1.7 million people, die of a chronic disease;and over 90 million Americans live
with a chronic illness. The cost of medical care for people with chronic illnesses exceeds 75
percent of the nation's total medical care costs.
Whereas CVD, which includes coronary heart disease (CHD), stroke, and other cardiovascular
diseases are a major health problem, it is often overlooked in women. However, according to the
American Heart Association, nearly two out of five deaths (39%) among women, in America, are
due to CVD. Coronary heart disease, alone, is the leading cause of death for American women.
One out of four women dies of heart disease and more than half of the persons who die each year
of heart disease are women.
Looking at the leading causes of death among Weld County women, we found that women of all
ages in Weld County are similar to women in Colorado and across the nation in terms of modality
due to CVD. In Weld County, between 2004 and 2006, there were 3,775 deaths among all Weld
County residents; 1,880 were female. During this time period, 595 Weld County women, or nearly
one-third, died from CVD. Head disease alone accounted for 23 percent(432 out of 1880) of all
deaths among Weld County women, and nearly half(432/882) of the persons who die each year of
heart disease are women.
Most diseases and injuries have multiple causes and conditions that can contribute to a single
death. However, a recent study analyzing the major modifiable behavioral risk factors associated
with modality found the two leading actual causes of death to be tobacco (18%) and poor diet and
physical inactivity (leading to obesity) (15%)3. The authors estimated that roughly 400,000 deaths
occur annually due to poor diet and physical inactivity (measured as deaths due to overweight)
compared to 435,000 deaths attributable to tobacco. They also compared mortality trends
between 1990 and 2000 and found that deaths due to poor diet and physical inactivity4 increased
more rapidly than deaths from any other cause or condition.
The need for CVD prevention in Weld County is bolstered by the fact that the demographic profile
of the county is changing. These changes, mainly driven by population growth, are affecting the
county's overall health status. Weld County's population has increased dramatically over the past
decade with an estimated 2006 population of about 237,000. Similar to the nation as a whole, the
age structure of Weld County's population has shifted with older age groups making up more of the
population total. Lastly, over the past three decades, the Latino population has increased.
Currently, about one-third of Weld County residents are Hispanic.
Page 2 of 8
CCPD 2010/11 Heart of Weld Project Part II: Narrative,Work Plan, Evaluation Plan
Keeping in mind what we know about the relationship between income and health, Weld County's
economic profile also signals a need for this program. Weld County has a lower average income
than the rest of Colorado and over one-fourth (27%) of Weld County households live on incomes
that are below the 200% federal poverty level. According to the USDA Economic Research
Service, in 2008, about one out of 8 people in Weld County were living in poverty. This rate is
lower than the U.S. rate but slightly higher than Colorado's rate. Among Weld County families with
a female head of household and no husband present, three out of ten live in poverty. These
indicators, as well as anecdotal data gathered by WCDPHE during regular program and community
assessments, point to a growing population of households struggling to carry on in day-to-day life,
let alone participate in preventive health care.
In terms of health care access and coverage, we know that people who lack insurance or have less
than optimal access to health care are more likely to delay getting health care and are at risk for
experiencing adverse health outcomes. Based on Weld County Behavioral Risk Factor
Surveillance Survey data, it appears that more Weld County residents do not have health
insurance compared to ten years ago. In Weld County, the percentage of adults with private or
public health insurance decreased from 86 percent in 1998-1999 to 78 percent in 2005. This rate
is much lower than Colorado's (84%) and the nation's (86%). The actual number of underinsured
residents is not known but state and national estimates say that another 20 percent of people do
not have adequate health insurance. For those without health insurance, or those with inadequate
health insurance, preventive health services are out of reach.
An in-depth analysis of the 32,500 women aged 40 to 64 years, living in Weld County, found that
only 59 percent report they are employed and 83 percent report they have health insurance. As
well, we found that 19 percent of women in this age group report that they have either not had their
cholesterol levels checked or have not had it checked within the last five years. Among those who
had their cholesterol checked, 35 percent report they had high cholesterol; and among those who
had their blood pressure checked, 19 percent had high blood pressure. Over half the women
(54%) have excess body weight(i.e., BMI of more than 25) and 20 percent are current smokers;
and more than half reported inadequate levels of physical activity, with 25 percent reporting they
have not engaged in any recent physical activity or exercise1. Clearly, there are many women at
risk for CVD in Weld County.
Based on the information we gathered during our research for this project, we determined that the
population, in Weld County, that is currently in most need of a CVD awareness/prevention program
are low-income women, age 40-64 years, who are either under-or uninsured, particularly Latino
women. This will be the population the Heart of Weld project will target. This group tends to not
participate in preventive health care and is thus over represented in CVD morbidity and mortality
rates. Based on previous experience we expect to provide baseline screening for at least 400
women from our target population. This number may not seem extensive, but in addition to
screening we will also provide a comprehensive lifestyle intervention program, which will include
classes, educational mailings, phone counseling, and follow up screenings at 6 and 12 months.
We feel that our program will be attractive to this population because there are very few options for
these women to receive this type of preventive CVD screening, let alone intervention programming
for those at risk. As well, both the screenings and intervention program will be provided where
these women already received medical service, and will be provided in both English and Spanish.
Page 3 of 8
CCPD 2010/11 Heart of Weld Project Part II: Narrative,Work Plan, Evaluation Plan
By creating an awareness among our target population regarding the importance of screening, and
through the promotion of a healthy lifestyle, we believe that the Heart of Weld project will have a
positive impact on many of the strategies outlined in the State's plan for reducing the impact of
cardiovascular disease, including increasing the number of adults who have their blood cholesterol
checked; reducing the proportion of adults with high total cholesterol levels; increasing the
proportion of adults with high blood pressure whose blood pressure is under control; reduce the
proportion of adults with high blood pressure; reduce coronary heart disease and stroke deaths;
reduce tobacco use; and increase smoking cessation attempts.
Chronic disease, especially cardiovascular disease, is a national health problem. In Weld County, it
appears that a significant number of women are at risk for developing cardiovascular disease. We
know the need is there and that many Weld County women are not getting the preventive health
screening and treatment for cardiovascular disease they need. WCDPHE and its partners have
the knowledge and ability to help these women decrease their risk for cardiovascular disease.
b) What do you plan to do?
The goal of the Heart of Weld project is to decrease CVD related morbidity and mortality rates
among the target population. In order to accomplish this, the Heart of Weld project will continue to
provide free CVD risk factor screening to low-income women, age 40-64 years of age, who are
either under- or uninsured, with a focus on Latino women and women already enrolled in the
Women's Wellness Connection (WWC) program (breast and cervical cancer screening program).
Those women identified to be at risk for developing heart disease will then be encouraged to enroll
in the intervention program, which consists of five classes, follow-up screenings at 6 and 12
months (from baseline screening), educational mailings, and phone-counseling. All components of
the program will be offered in settings already proven to be highly accessed by the target
population.
Each woman entering into the program starts with a baseline CVD risk factor screening at either
the Weld County Department of Public Health & Environment (Greeley), Sunrise Community
Health Center (Greeley), or Salud Family Health Clinic (Fort Lupton). Currently, we conduct at
least one baseline screening event (held over several days) per quarter at each of the three
separate clinics, Prior to a baseline screening, the clinic, where the screening is to be held, will
provide a list of their patients who are eligible to participate, based on our target population criteria
(low-income, 40-64 yrs. of age, under- or uninsured, or a WWC patient). Heart of Weld staff uses
this list to make appointments for that particular screening event. We have found that a personal
phone call is more effective than a mailing in getting women to schedule an appointment. In
addition to providing us with a population base to work with, each of our partner clinics also
provides us space within their facilities to hold our screening clinics. We use our own staff (two
medical assistants and two health educators) to conduct the screenings.
Each screening, whether it's a baseline, 6 month, or 12 month follow-up screening, is conducted in
the same manner. At the beginning of each appointment, there is the usual paper work to be
completed: consent form, confidentiality form, HIPPA waiver, and an affidavit confirming they are a
legal U.S. citizen. We also ask them to fill out a brief lifestyle profile, which covers all the basic
lifestyle issues such as diet, physical activity, tobacco use, stress level, etc. After the paperwork is
Page 4 of 8
CCPD 2010/11 Heart of Weld Project Part II: Narrative,Work Plan, Evaluation Plan
completed, each woman completes what we call the "medical" piece of the screening. This
includes measuring their height, weight, and blood pressure, and conducting a simple blood test for
total cholesterol, high density and low density lipoproteins, triglycerides, and glucose levels. For
the blood test, we use a Cholestech machine that requires only a finger poke (for a blood sample)
and provides results in approximately 8 minutes. While waiting for the results from the blood test,
we take a brief "heart" health history. One of the medical assistants will then go over the results
with the patient and, if there are any values of concem (i.e., high cholesterol, blood pressure, or
glucose levels), the medical assistant will advise them accordingly. It can be as simple as
encouraging them to eat more fruits and vegetables to assisting them with making a follow-up
appointment with their primary health care provider to evaluate their blood pressure or cholesterol
levels. One of the benefits of working within a clinic setting is that, if any woman has alert values,
medical care is available on-site and we are able to address the situation right away. Using the
national WiseWoman program as a guide, we have defined alert values to be: systolic blood
pressure greater than 180; diastolic blood pressure greater than 110; total cholesterol greater than
400; and blood glucose greater than 250.
After the medical evaluation is completed, each woman then meets with one of our health
educators to answer a few more questions regarding their lifestyle behaviors (physical activity,
dietary habits, tobacco use, and behavioral health). This provides us with a better understanding
on how best to counsel them. We will then spend some time (approximately 15 minutes) with each
woman to develop simple goals that they can work on to decrease their risk. As part of our
partnership with each of the clinics, we also do a preliminary screening for behavioral health,
colorectal cancer screening program, and the WWC program. If they appear to qualify for these
additional programs, we will make a referral for them to enroll in these programs, if interested.
Because WCDPHE and Sunrise have a shared electronics medical records system, we are able to
input each woman's screening results into their personal medical record and flag their physician for
any needed follow-up. This allows their primary care providers to have immediate access to their
results. This also helps to ensure that those woman who do have an increased risk and may need
medical evaluation, receive the necessary follow-up. We are not able to do the same with those
women who are patients of Salud, but we do provide Salud with a paper summary for each woman,
that can then be filed in their individual charts. As already mentioned, because all screenings are
conducted in a clinic setting, which is usually the medical home for those women participating in
the screening, we are able to facilitate medical follow-up for those women who it. We do
sometimes have women who are not patients of either Sunrise or Salud. If that happens, and they
need medical evaluation soon (within two-four weeks), we have also developed a voucher program
(covers the cost of initial visit) with NextCare Urgent care. We have established the voucher
program because it can sometimes be up to three months before an individual can get into either
Sunrise or Salud for an appointment, due to the financial screening that needs to be done prior to
the first visit. This way they can receive the care they need, while taking the necessary steps to
establish a medical home either at Sunrise, Salud, or other clinic.
At screening, any woman identified to be a risk for developing CVD (has high blood pressure or
high cholesterol levels, is overweight or a tobacco user, has diabetes, or has already been
diagnosed with heart disease) is encouraged to enroll in our lifestyle intervention program, which
spans a 12 month period starting from the baseline screening. The main component of the
intervention program is a series of five classes, focusing on healthy eating, physical activity,
Page 5 of 8
CCPD 2010/11 Heart of Weld Project Part II: Narrative,Work Plan, Evaluation Plan
maintaining weight, decreasing stress, and recognizing the signs and symptoms of a heart attack
or stroke. We do not spend a lot of time on tobacco use or smoking cessation in the classes but
will, instead, refer those women wishing to quit smoking to the Colorado QuitLine and will also
encourage them to enroll in smoking cessation classes held locally.
Because maintaining new healthy behaviors can be difficult, after the completion of the classes,
participants will receive 4 educational mailings, 2 phone counseling sessions, and a 6 month
follow-up screening. The educational mailings provide additional information on a variety of
healthy behaviors (i.e., limiting fat intake, increasing physical activity, drinking more water, etc.).
The phone counseling sessions, conducted by our health educators, provide an opportunity for us
to see how the women are doing and to provide additional support and resources, when needed.
The 6 month follow-up screening allows the participants to see what affect their behavior changes
are having, and to re-evaluate goals, if necessary. The culmination of the lifestyle intervention
program is the 12 month follow-up screening. All women are invited back for this screening,
regardless of their participation in the lifestyle program. As with the 6 month follow-up screening,
the 12 month follow-up screening provides the participant, and us, with some indication of
effectiveness. If there are women at this 12 month screening who have not seen an improvement
in their risk factor values and want to continue with the program, they are allowed to do so. The
same holds true for those women who may not have participated in the lifestyle intervention
program the first time.
c) Who are your key partners?
Our 2010/11 partners will include Sunrise Community Health Center in Greeley, Salud Family
Health Clinics in Fort Lupton and Frederick, and NextCare Urgent Care in Greeley. We will
continue to work with Sunrise and Salud to provide screening and intervention services for their
qualified patients. They will continue to provide us with a space to conduct the screenings and will
continue to be the source of our target population. Our partnership with Sunrise will continue to be
a little more involved, in that it includes a shared Medical Assistant (MA). Funding from this grant
will pay.50 FTE of a MA housed at Sunrise. This MA, however, will assist with screenings held at
all locations, not just those held at Sunrise. This particular relationship dates back to our first year
of funding from the CCPD program (2008-09), when Sunrise was the only clinic where we were
holding screenings. The MA at Sunrise has been instrumental in getting the Heart of Weld project
implemented and sustained at this clinic. If funded another year, we will look at a similar
partnership with Salud. We will also continue to partner with the QuickCare Urgent Care clinic in
Greeley as a referral source for our screening participants who have one or more alert values at
screening, but have no medical home.
Page 6 of 8
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CCPD 2010/11 Heart of Weld Project Part III: Budget Proposal
CCPD 2010/11 Competitive Renewal Application
Part III: Proposed Budget & Budget Justification
Heart of Weld Project
Weld County Department of Public Health & Environment
Page 1 of 4
CCPD 2010/11 Heart of Weld Project Part Ill: Budget Proposal
Budget Justification
Personal Services
Contributing Description FTE Position
Individual& Role Cost
(including
fringe
benefits)
Gabrielle Vergara Gabrielle(Gabri)Vergara will manage the grant, provide general
Project Coordinator project oversight and supervision of grant personnel, arrange
contracts with clinics to provide CVD screening services,and act
as spokesperson for program. Gabri will perform recruitment
activities in the community and work with community partners to
identify women who are eligible for CVD screening. She will also
recruit community members and clinical service providers to .50 $40,302
participate on the project's advisory council and arrange quarterly
meetings; and will train all personnel involved with the clinical
screenings and lifestyle intervention, as needed. Gabri,with the
data specialist, will track project related data,complete grant
required reporting, and assist with project evaluation. Gabri will
also be the lead instructor for the lifestyle classes held in Greeley.
Ofelia Orozco Ofelia will assist at screenings, teach the Spanish lifestyle
Health Educator intervention classes, and oversee Zumba classes and walking
groups. Ofelia will also assist with the educational mailings, phone 75 $53,725
counseling sessions, and setting up screening appointments. She
will be responsible for entry of screening results into each Weld
County Health Department participant's electronic medical record.
Adriana Chairez Adriana too will assist at screenings, and provide back-up for the
Outreach Worker both the English and Spanish lifestyle intervention classes.
Adriana will also assist Ofelia with setting up appointments, and 50 $24,898
will also be responsible for preparation of forms and files prior to
each screening, and sending out results letters to participants after
each screening.
Veronica Castillo Veronica will be the Medical Assistant for Sunrise Community
Medical Assistant Health Center. She will assist with identification and recruitment of
participants from among Sunrise patients, and she will assist with
screenings held at Sunrise and Weld County Health Department. 50 $22,200
After each screening at Sunrise, she will be responsible for entry of
screening results into each participant's electronic medical record.
Veronica will also provide back-up for both the English and
Spanish lifestyle intervention classes.
To Be Determined This person will be the Medical Assistant for Salud Family Health
Medical Assistant Clinic in Fort Lupton. This person will assist with identification and
recruitment of participants from among Salud patients,and will
assist with screenings held at Salud. After each screening at 50 $22,200
Salud,this person will also be responsible for entry of screening
results into each participant's electronic medical record. This
person will also be the lead instructor for the lifestyle intervention
classes held in South Weld County.
Page 2 of 4
CCPD 2010/11 Heart of Weld Project Part Ill: Budget Proposal
Cindy Kronauge Cindy Kronague, MPH,will gather,communicate, and manage
Data Specialist all Heart of Weld data for reporting and evaluation purposes, .10 $10,109
and provide supervision and guidance to the sub-contracted
database management team.
Subtotal Personal Services: $173,433
Fringe Benefits
For Weld County employees Fringe Benefits are budgeted at an average rate of 35%of salaries. The two Medical
Assistants are actually employees of Sunrise Community Health Center and Salud Family Health Center,
respectively. The provided fringe amount for these two positions is estimated on actual benefits paid per month.
During the grant period,the actual fringe benefit cost per employee will be charged to the grant in keeping with
Weld County's financial policies and procedures.
Operating Expenses
Item Description Item Cost
Copying Each participant of the lifestyle intervention program is provided
LSI Workbook with a New Leaf curriculum notebook that we print in-house using
the County Print Shop. We anticipate making approximately 125 $1,500
copies at a cost of$12 per notebook(includes printing cost of and
cost of three ring binder for each).
Copying Miscellaneous copying for the project is budgeted at
Miscellaneous approximately 800 copies per month at.10 cents/copy. Items to $960
be copied included results letters,forms for screenings,
educational mailings,and participant correspondence.
Office Supplies An annual budget for office supplies needed to implement the
project is estimated at$500 for the year. Example supplies $500
include printer toner, paper, pens/pencils, file folders,etc. Actual
expenses will be charged to the grant as incurred.
Screening Includes 700 Cholestech test cartridges at$12/each for a total of
Supplies $8,400. The remaining $5,600 is an annual budget estimate for
other needed screening supplies including, cotton balls, latex $14,000
gloves, lancets, band-aids, alcohol swabs, and Cholestech printer
labels. Actual expenses will be charged to the grant as incurred.
Educational It is estimated that 150 individuals will participate in a lifestyle
Materials intervention program during the year: $10 per individual is
budgeted for education materials appropriate to the course $1,500
content. Examples of educational materials include portion
control plates, pedometers,exercise bands, and healthy heart
cookbooks.
Room Rental An annual budget for room rental is estimated at$1,400 (40 hrs.
@$35/hr.). This is for rental of the gym at the Rodarte
Community Center in Greeley for Zumba exercise classes. $1,400
Zumba classes will be held once weekly,and it is anticipated that,
in one year's time,there will be approximately 40 classes.
Subtotal Operating: $19,860
Page 3 of 4
CCPD 2010/11 Heart of Weld Project Part Ill: Budget Proposal
Travel Expenses
Item Description Item Cost
Mileage Based on travel from previous year, an annual budget for mileage
has been set at$2,400(estimated 5000 miles at.48 cents/mile).
Actual mileage will be charged to the grant as incurred. Mileage
will be used by all project staff to travel to screening clinic sites
and by the Project Coordinator and Health Educator to travel to $2,400
Sunrise and Salud for lifestyle intervention classes. It is also
anticipated that the principle investigator(PI)and project
coordinator will travel to Denver at least twice for CCPD required
trainings or meetings.
Lodging It is estimated that the PI and project coordinator will attend
CCPD required trainings or meetings outside of Greeley that may $300
require an overnight stay(2 nights @ $150/night).
Meals Per Diem Per Diems are budgeted to cover meal expenses for PI and
program coordinator for CCPD required trainings. (2 travelers X 2 $240
trainings X Denver Per Diem rate of$60/day)
Subtotal Travel: $2,940
Contractual
Item Description Item Cost
Subcontract Heart of Weld program staff, currently, spends quite a bit of time
Data Entry Tech entering data into our program database, intervention program
tracking spreadsheet, and patient electronic medical records. If
awarded funding for the 2010/11 grant year, it is assumed that we
will be required to also enter participant information into the eCaste $2,400
system. In order to make the best use of our regular program staff,
we will contract with a data entry technician to enter program data
into all appropriate databases. An annual budget for data entry is
estimated at$2,400(120 hours @$20/hr.).
Subcontract Last year we contracted with University of Colorado Health
Database Mngt. Sciences Center Department of Family Medicine to create a
database for our screenings. As part of that contract,there is a $5,000
yearly management fee of$5000. This includes any upgrades,
alterations,and technical assistance.
Subtotal Contractual: $7,400
Other—Patient Care Costs
Item Description Item Cost
Treatment An annual budget for medical vouchers has been estimated at
$150(10 vouchers @$150/voucher). A medical voucher is
provided to any participant who presents with alert values at $1,500
screening,who has no medical home; ensuring immediate
medical follow-up until a medical home can be established. The
voucher covers the cost of initial visit at NextCare Urient Care.
Subtotal O•eratin': $1,500
Page 4 of 4
APPLICATION BUDGET FORM
Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program
APPLICANT: July 1,2010-June 30,2011
Weld County Department of Public Health&
Environment
PROJECT TITLE: SOURCE OF FUNDS
Heart of Weld Requested Other Source* Other Source*
iCDPHE Source$, ,Source2 r.
PERSONAL SERVICES FTE Monthly Monthly #of If applicable, If applicable,
funding source funding source
Name Position %Effort Salary Benefits Months name here name here
Gabrielle Vergara Project Coordinator 0.50 $4,955.71 $1,761.26 12.0 $ 40,302 $ - $ -
Ofelia Orozco Health Educator 0.75 $4,404.15 $1,565.24 12.0 $ 53,725 $ - $ -
Adriana Chairez Outreach Worker 0.50 $3,061.56 $1,088.08 12.0 $ 24,898 $ - $ -
Veronica Castillo Medical Assistant 0.50 $3,200.00 $500.00 12.0 $ 22,200 $ - $ -
To Be Determined Medical Assistant 0.50 $3,200.00 $500.00 12.0 $ 22,200
Cindy Kronauge Data Specialist 0.10 $6,215.09 $2,208.84 12.0 $ 10,109 $ - $ -
Subtotal Personal Services 2.85 $ 173,433 $ - $ -
OPERATING EXPENSES Unit Quantity Rate
Copying(LSI Wonebook) Notebook 125.00 $ 12.00 $ 1,500 $ - $ -
Copying(miscellaneous) Annual 9600.00 $ 0.10 $ 960 $ - $ -
Office Supplies Annual 1.00 $ 500.00 $ 500 $ - $ -
Screening Supplies Annual 1.00 $ 14,000.00 $ 14,000 $ - $ -
Educational Materials Participant 150.00 $ 10.00 $ 1,500 $ - $ -
Room Rental Hour 40.00 $ 35.00 $ 1,400
Subtotal Operating Expenses $ 19,860 $ - $ -
TRAVEL Unit Quantity Rate
Mileage Mile 5000.00 $ 0.48 $ 2,400 $ - $ -
Lodging Day 2.00 $ 150.00 $ 300 $ - $ -
Meals/Per Diem Staff/Day 4.00 $ 60.00 $ 240 $ - $ -
Other Travel $ - $ - $ -
Subtotal Travel Costs $ 2,940 $ $ •
CONTRACTUAL Unit Quantity Rate
Subcontract(Data Entry Technician) Hour 120.00 $ 20.00 $ 2,400 $ - $ -
Subcontract(Database Management) Annual 1.00 $ 5,000.00 $ 5,000 $ - $ -
Subtotal Contractual Costs $ 7,400 $ $ -
OTHER COSTS Unit Quantity Rate
Patient Care Costs $ - $ - $ - $ -
Screening $ - $ - $ - $ -
Treatment Voucher 10.00 $ 150.00 $ 1,500 $ - $ -
Subtotal Other Costs $ 1,500 $ $
CDPHE Source I : I Source 2
TOTAL DIRECT COST: $ 205,132.89 $ - $ -
INDIRECT COSTS: 2% Of Contractual $7,400.00 $ 148
INDIRECT COSTS: 7% Of All Other $197,732.89 $ 14,672
Total Indirect Cost(Calculated on Amount Requested from CDPHE Only) $ 14,820
TOTAL AMOUNT REQUESTED FROM CDPHE $ 219,953
t J `
'Other: Please indicate additional funding sources if applicable.
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