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HomeMy WebLinkAbout20080139.tiff RESOLUTION RE: APPROVE CANCER, CARDIOVASCULAR DISEASE, AND PULMONARY DISEASE COMPETITIVE GRANT 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 Competitive Grant 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, 2008, and ending June 30, 2011, with further terms and conditions being as stated in said grant application, and WHEREAS, after review, the Board deems it advisable to approve said grant 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 Competitive Grant 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 C.R.S. Section 24-6-301 (3.5) (a), 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 grant application. 2008-0139 HL0035 00 '. /+L-C1 5) / 08 CANCER, CARDIOVASCULAR DISEASE, AND PULMONARY DISEASE COMPETITIVE GRANT 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 7th day of January, A.D., 2008. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: jOrteiE C .1 E H. Jerke, Chair Weld County Clerk to the Boards tt� 1� D. Aden,T1° T ____- APRDBY: r?lDeput lerktotheBoard AS M: CA C David E. Long u ty Attorney u cz Douglas adema er Date of signature: / 47V CO 2008-0139 HL0035 Memorandum TO: William H. Jerke, Chair Board of County Commissioners FROM: Mark E.Wallace, MD, MPH, Director Department of Public Health and Environmeri;t._a , / � COLORADO DATE: JANUARY 2, 2008 \ J SUBJECT: CDPHE-CCPD grant application Enclosed for Board review and approval is the Weld County Department of Public Health and Environment's grant application to the Colorado Department of Public Health and Environment's Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program. The grant application is for three years of funding beginning on July 1, 2008 through June 30, 2011. The total amount requested is $740,181.43. The grant application is to expand the Women's Wellness Connection's screening services for women in Weld County with new cardiovascular disease prevention services based on the nationally recognized Wisewoman program. The purpose of the project will be to reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 who are uninsured or underinsured, with an emphasis on low income or Latino residents and women enrolled in the Women's Wellness Connection. The key objective is to improve access and reduce health disparities by providing culturally competent screening and education at the community level. Staff includes a 1.0 Public Health Nurse II who coordinates the program, a .75 bilingual health educator (Ofelia Orozco with the Disparities Grant)to work with the Hispanic community, a .5 bilingual medical assistant to conduct screenings and a .1 Data Specialist/Epidemiologist (Cindy Kronauge who with General Health Education) to conduct program evaluation. I recommend your approval. rectr. DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 WEBSITE: www.co.weld.co.us ADMINISTRATION: (970) 304-6410 FAX: (970) 304-6412 PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420 FAX: (970) 304-6416 ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415 COLORADO FAX: (970) 304-6411 Granting Agency: Colorado Department of Public Health and Environment Applicant's Name: Weld County Department of Public Health and Environment Applicant's Address: 1555 N. 17th Avenue Greeley, CO 80631 Applicant's Phone: (970) 304-6420, ext. 2380 Applicant's Fax: (970) 304-6452 Project Title: Heart of Weld Contact Person: Gaye Morrison, Health Communication Manager Date: July 1, 2008 —June 30, 2011 Amount: $740,181.43 Weld County Department of Public Weld County Board of Commissioners HcQlth and Enviro ent Mark E. Wallace, MD, MPH, ctoru William H. Jerke, Chair JA 6 ijnejet4ta Weld County Clerk to the Boar ` :r—) BY: GA i , Deputy erk to the Board Cc3 C/3q CCPD Part 2ciApplicant Information Form 08 :zIO FIv„ "ring �;4�M,g„ rt�!nnnnr I it The CCPD Application Guidelines are available on the CCPD Website. The Application Guidelines include instructions and guidance about funding priorities,the application process(including an Application Checklist),formatting guidelines and additional requirements for new and sunsetting projects. Cancer; Cardiovascular Disease and Pulmonary Disease Competitive Grants Program I Part I: Applicant information Form 1. Agency Information Agency Name: Weld County Department of Public Health and Environment (WCDPHE) Executive Director Mark Wallace, MD, MPH Name and Official Director Title: Phone: 970-304-6410 x2104 Fax: 970-304-6412 Email: mwallace@coweid.co.us Address: 1555 N. 17`h Avenue City, State, Zip: Greeley, CO 80631 2. Type of Agency Please identify the primary applicant's agency type. 1 . Public Health Agency 2. College or University ❑ 3. Worksite ❑ 4. Health Care System ❑ 5. Community Health Center 6. Non-governmental or nonprofit organization ❑ 7. Public or Private School K-12 f] 8. Other Li Is this a multi-agency project? (check if yes) 3. Application Type Please check one: 1. One-time project (one year request) ❑ 2. Two-year request U 3. Three-year request 4. Requested Funding Amount Please enter the total dollar amount. Requested funding for Year 1 (July 1, 2008 — June 30, 2009) $221,941.80 Requested funding for Year 2 (July 1, 2009— June 30, 2010) $255,635.23 Requested funding for Year 3 (July 1, 2010 — June 30, 2011) $262,604.40 1 Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program Part I:Applicant Information Form 5. Principal Investigator (if applicable) Principal Gaye Morrison Investigator Name: Title: Director of Health Communication, Education and Planning Phone: 970-304-6420 x 2380 Fax: 970-304-6452 Email: gmorrison@co.weld.co.us Address (if different same as above from above): City, State, Zip: s .Th'Oject_Manager.. Project Manager Gaye Morrison Name: Title: Director of Health Communication, Education and Planning Phone: 970-304-6420 x 2380 Fax: 970-304-6452 Email: gmorrison@coweld.co.us Address (if different same as above from above): City, State, Zip: 7, F scaIIcOntracts Manager Fiscal/Contracts Judy Nero Manager Name: Title: Business Manager Phone: 970-304-6410 x 2122 Fax: 970-304-6412 Email: jnero@co.weld.co.us Address (if different same as above from above): City, State, Zip: 2 Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program I Part I.Applicant Information Form 8. FY08/09 Funding Priority Please indicate which funding priority your project addresses. Funding priorities are described in pages 1-4 of the CCPD Application Guidelines. Cancer ❑ Other: this application does not address a ❑ specific funding priority Cardiovascular Disease ® Innovative ❑ Pulmonary Disease ❑ Crosscutting (project addresses more than one ❑ priority area) 9. Treatment Allocation Will any of the funds in this proposal be allocated to treatment? Yes: ® No: ❑ If yes, please list the dollar amount devoted to treatment for each year. Treatment funds for Year 1 (July 1, 2008 —June 30, 2009) $2,500 Treatment funds for Year 2 (July 1, 2009—June 30, 2010) $10,000 Treatment funds for Year 3 (July 1, 2010 —June 30, 2011) $10,000 10. CDPHE Funding Please indicate whether you are currently receiving funding from any of the following CDPHE Grant programs. (check all that apply) ❑ Cancer, Cardiovascular Disease and Pulmonary Disease Amount: Competitive Grants Program (CCPD) ® Health Disparities Grants Program (HDGP) Amount: $147,570.88 ® State Tobacco Education and Prevention Partnership (STEPP) Amount: $247,912.00 ❑ Colorado Physical Activity and Nutrition Program (COPAN) Amount: Z Women's Wellness Connection (WWC) Amount: $123,000.00 ❑ LiveWell Colorado Amount: • Other Amount: $491,155.00 Do you intend to apply for funding from any of the CDPHE Grant programs listed above in FY08/09? If so, which programs? STEPP and WWC 3 Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program I Part I:Applicant Information Form 11. Target Population Provide the following demographic information about your target population. (check all that apply) Gender: Male ❑ % Female ® % 100 Other ❑ % Age range: School-Age ❑ 19—29 ❑ 30-39 ❑ 40-49 ® 50—59 ® 60-64 ® 65+ ❑ Race: White Black Hispanic Asian American, Pacific Islander Native American Other ® ❑ ® ❑ ❑ ❑ Sub-population: All underinsured women between 40-64 y/o Socio-economic: ❑ Free/Reduced Lunch (school-age children who are eligible for free or reduced-lunch programs based on financial need). ® Medicaid (individuals who are eligible for Medicaid benefits) ❑ Medicare(individuals who are eligible for Medicare benefits) ® Uninsured (Individuals who do not have any health insurance and who are not eligible for Medicaid or Medicare benefits) ® Under-served (Those who have limited access to clinical preventive or treatment services due to socioeconomic, geographic and/or other barriers to services which adversely affect access) ❑ Other: 12. Geographic Reach Check the geographic area of your project below. Rural or frontier counties are those outside of Denver, Boulder, Broomfield, Jefferson, Arapahoe, Larimer, Adams, Douglas, Weld, Mesa, Pueblo, Elbert, and El Paso counties. Note that statewide reach means that programs/services are locally available in the eastern plains, western slope, central mountains, Front Range, and each corner of the state. Additional guidance is available in the CCPD Application Guidelines. 9. Rural or frontier counties ❑ 10. Regional El 11. Statewide ❑ 4 Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program I Part I:Applicant Information Form 13. Counties Served Please indicate which counties your project will serve. Statewide projects also must indicate the counties in which programs/services are locally available. Adams County ❑ Denver County O Lake County ❑ Phillips County ❑ Alamosa County ❑ Dolores County O Larimer County O Pitkin County ❑ Arapahoe County ❑ Douglas County O Las Animas County O Prowers County ❑ Archuleta County ❑ Eagle County El Hinsdale County El Pueblo County ❑ Baca County ❑ El Paso County O Huerfano County O Rio Blanco County ❑ Bent County ❑ Elbert County O Lincoln County O Rio Grande County ❑ Boulder County El Fremont County ❑ Logan County ❑ Routt County O Broomfield County ❑ Garfield County ❑ Mesa County ❑ Saquache County O Chaffee County ❑ Gilpin County O Mineral County El San Juan County ❑ Cheyenne County ❑ Hinsdale County O Moffat County ❑ San Miguel County ❑ Clear Creek County ❑ Huerfano County O Montezuma County ❑ Sedgwick County ❑ Coneios County ❑ Jackson County ❑ Montrose County ❑ Summit County O Costilla County O Jefferson County ❑ Morgan County El Teller County ❑ Crowley County ❑ Kiowa County ❑ Otero County ❑ Washington County O Custer County O Kit Carson County El Ourav County ❑ Weld County Delta County El La Plata County ❑ Park County El Yuma County El Have you contacted the local public health departments and/or county nursing services in the counties your project will serve? Yes: ® No: El Some: ❑ 1yeJq.vick Larimer Weld Logan Moffat Jackson Phi"'ps fRoutt r Morgan Grand Bonder ,, � I Yuma Rio Blanco „ Adams Washington Garfield Eagle c,- Arapahoe Elbert Kit Mesa Pitkin Park °°°9'a` Carson 4.1 1 i El Delta Gunnison Paso Lincoln Cheyenne Montrose Fremont cro�ey— Kiowa o San Miguel `� _Saguache Custer Pueblo r Otero Bent Provers Dolores It, t 7 Huerfano to S. Rio Montezuma t- Grande �a�da La Conejos Costdla Las Animas Baca Plata Archuleta 5 Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program I Part I:Applicant Information Form 14. Project Title Please provide a 5-10 word title for the project. Heart of Weld (brand and logo to be determined by Advisory Committee). 15. Project Abstract Please provide a half-page description of your proposal, purpose, key objectives and target population, including age group and geographic focus, and expected outcomes. The Heart of Weld is a program that will expand the Women's Wellness Connection's screening services for women in Weld County with new cardiovascular disease prevention services based on the nationally recognized WISEWOMAN program. The intent of the project will be to reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years who are uninsured or underinsured, with an emphasis on low income or Latino residents and women enrolled in the Women's Wellness Connection. In partnership with Sunrise/Monfort Family Community Health Center, Weld County will begin offering cardiovascular disease screening for hypertension, diabetes, hyperlipidemia, and obesity. The purpose of this project will be to improve access and reduce health disparities by providing culturally competent screening and education at the community level. This screening program will identify lifestyle-related risk factors for cardiovascular disease, such as smoking, physical inactivity, and poor nutrition, and offer individual counseling, group counseling and support with a Registered Nurse, a bi-lingual/bi-cultural Health Educator and Medical Assistant, and a smoking cessation counselor, in order to modify these risk factors. The lifestyle intervention program will be a nutrition and physical activity intervention that will seek to help women improve eating and exercise habits, identify and overcome barriers, gain basic problem solving skills, set goals, understand behavior, learn stimulus control and identify the importance of keeping a supportive and healthy environment. The lifestyle intervention will be offered in English and Spanish and will be presented over the course of a year to all women enrolled in the program. The goal will be to provide repeated reinforcement and encouragement to support sustainable lifestyle changes. Due to the high rate of relapse that tends to occur after short-term behavioral interventions, Heart of Weld will implement a maintenance program for all lifestyle intervention participants that will promote long-term adherence to the new behavior patterns promoted in lifestyle classes. Heart of Weld will provide the participants with ongoing contact with health facility staff and relapse prevention counseling to reinforce lifestyle intervention changes for up to a year after each participant enters our program. Additionally, all high risk women will be tracked and encouraged to complete their six month re-screening and all eligible women will be encouraged to complete their twelve month annual screening. Heart of Weld will also strive to connect all community members with community-based lifestyle intervention support services by offering healthy cooking classes and group exercise classes taught in both English and Spanish, as well as, CPR trainings, Cultural Competency trainings for health care providers and media campaigns to raise awareness about cardiovascular disease. The expected outcome of Heart of Weld will be to decrease the incidence of risk factors for cardiovascular disease among eligible women, and to increase their daily activity, improve their diets and/or decrease their smoking prevalence. 6 Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program I Part I:Applicant Information Form 1 �. General Terms •n• C•n•iti•ns Please review the following terms and conditions related to your application for funding. All material submitted regarding this grant application becomes the property of the State of Colorado and is subject to the terms of Colorado Revised Statutes 24-72-201 through 24-72-206, Colorado Open Records Act. Following assessment by state and health department legal counsel, certain projects could be required to comply with House Bill 06S-1023 regarding Restrictions on Public Benefits. The State of Colorado has the right to use any or all information/material presented in the grant application, subject to limitations for proprietary or confidential information. Disqualifications or denial of the application does not eliminate this right. Any additional restrictions on the use or inspection of material contained within the proposal shall be clearly stated in the proposal itself. Successful applicants will be required to participate in meetings, conferences and/or trainings provided regionally and in the Denver Metropolitan Area by the Cancer, Cardiovascular Disease, and Pulmonary Disease Competitive Grants Program. The program anticipates selecting contractors to provide services such as evaluation of the overall program and development of a statewide media and marketing plan through a separate Request for Proposals (RFP) process. Successful applicants for this RFA will be required to coordinate projects with statewide initiatives for evaluation, and media and marketing when those programs are established. Media or marketing activities for a given project must be professionally created and approved by program staff prior to placement or scheduling. Applicants are encouraged to use existing media and marketing materials created by other agencies, e.g., the Centers for Disease Control or voluntary health agencies that have been tested for reach and effectiveness. The state reserves the right to request revisions to the budget and/or scope of work of any applicant. It is the responsibility of the applicant to identify proprietary information and request that the information be treated as such. The contents of the application will become contractual obligations if the project is funded. Successful applicants will be required to submit quarterly progress reports and an annual report. 17. Lobbying Restrictions House Bill 05-1262 explicitly prohibits the use of these funds for lobbying activities as currently defined in the state statute. As defined, lobbying means communicating directly, or soliciting others to communicate, with a covered official for the purpose of aiding in or influencing the drafting, introduction, sponsorship, consideration, debate, amendment, passage, defeat, approval, or veto by any covered official on: (A)Any bill, resolution, amendment, nomination, appointment, or report, whether or not in writing, pending or proposed for consideration by either house of the general assembly or committee thereof, whether or not the general assembly is in session; (B)Any other matter pending or proposed in writing by any covered official for consideration by either house of the general assembly or a committee thereof, whether or not the general assembly is in session. 18. Tabor Amendment Funds from this grant program are exempt from Tabor Amendment provisions. House Bill 05-1262 states that: "For purposes of Section 20 of Article X of the State Constitution and Article 77 of this title, any moneys collected or expended from the imposition of the cigarette and tobacco tax imposed pursuant to Section 21 of Article X of the State Constitution are not included in fiscal year spending, as defined in Section 20 of Article X of the State Constitution, and are excluded from the spending limit contained in Section 24-75-201.1 and any corresponding spending limits on local govemments receiving such revenues." (House Bill 05-1262, Section 2, item 3 on page 9.) Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program I Part I:Applicant Information Form 1 •. H USE -ILL e S-1 23, ' stricti o ns •n 'u•lic - n fits House Bill 06S-1023, Restrictions on Public Benefits, went into effect on August 1, 2006. The interpretation from the Office of the Attorney General is that projects funded by the Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program are required to comply with the bill. The legislation requires that grantees"shall verify the lawful presence in the United States of each applicant eighteen years of age or older for federal public benefits or state or local public benefits," (Colorado Revised Statutes(C.R.S.) Section 24-76.5-103(4))and states that an alien's"affidavit may be presumed to be proof of lawful presence for purposes of this section" (C.R.S. Section 24-76.5-103(7)). Verification is not required for emergency services. Funded grantees will receive additional information related to compliance as a part of the contract. 20. Certificates of Insurance Successful applicants will be asked to comply with the State's insurance requirements to protect State employees, State property, and the vendor or contractor from any damages or loss. The Contractor must submit certificates of insurance showing coverage required by the State as outlined below. The certificate must include the State of Colorado as an additional insured on the Commercial General Liability and Automobile Liability Insurance policies. * Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: I. $1,000,000 each occurrence; II. $1,000,000 general aggregate; III. $1,000,000 products and completed operations aggregate;and IV. $50,000 any one fire. * Automobile Liability Insurance covering any auto (including owned, hired and non-owned autos) with a minimum limit as follows: $1,000,000 each accident combined single limit. 8 CCP D 2 .,,, :, 0 t t • t II 8 0 r j t rr ti The CCPD Application Guidelines are available on the CCPD Website. The Application Guidelines include instructions and guidance about funding priorities, the application process(including an Application Checklist),formatting guidelines and additional requirements for new and sunsetting projects. 1 1. Needs Statement a) Describe how your proposal satisfies an unmet need. Weld County is a large, mostly rural, area located in the northeastern part of Colorado. About one-third of the residents are Hispanic. Weld County has a lower average income than the rest of the Colorado: 26.7% are below the 200%federal poverty level. In 2005, 12% of the people living in Weld County were in poverty. This rate is lower than the U.S. rate and slightly higher than Colorado's rate. 28% of families with a female householder and no husband present live in poverty.' In Weld County the percentage of adults with private or public health insurance decreased from 86% in 1998-1999 to 78% in 2005. This rate is much lower than Colorado's and the national rate.2 ejj Percentage of Weld County Residents 18 Years and Older with Health Insurance Coverage 100% - HP2010 Objective 80% ad'., TT z 's wrSSN akr 60% ° ' opal a $4Q s :lb, .9singip ;claw 40% I ASP L 1 i u r' pg,t- r le i lU r pa. p,glow r 20% �'°ti6 magi iffc stn �y Ipt R7 trt e, 'L„�i w ttr''OPT. Y,5�'�! 0% t 9 li y 'tj;PePP TL L . t f l e 1 1998-1999 2002-2003 2004 2005 Data Source:Weld Behavioral Risk Factor Surveillance Survey From 2003-2006, there were 5,003 deaths among Weld County residents, an average of 1,251 per year. The leading cause of death among females, heart disease, accounted for 23% of all deaths. The third leading cause of death among females was stroke, accounting for 7% of deaths.' This project would provide heart health risk assessments for Weld County women who are uninsured or underinsured, combined with one-on-one counseling and lifestyle intervention classes to help reduce their risks of developing heart disease. It would also provide community-level interventions for cardiovascular disease risk reduction. There are more than 32,500 women between the ages of 40 to 64 years in Weld County. Of women in this age group, 58.9% report they are employed, yet 17.1% report they have no health insurance. Only 19% report that they have had their cholesterol levels checked in the last five years. Of these, 34.9% report having high cholesterol and 18.9% have high blood pressure. 53.6% report a BMI of more than 25. More than half of the women report they do not meet the recommended physical activity guidelines.2 These women would be the target population for this grant. The need is there and we have the knowledge and ability to help these women decrease their risks for heart disease. Many factors are known to increase the risk for coronary heart disease. More than 40 years ago, investigators with the Framingham Heart Study identified several key risk factors and about 10 years ago used this knowledge to develop a tool to predict heart disease risk. Variations exist, but they rely on six pieces of information —age, gender, total cholesterol, HDL cholesterol, smoking status, and systolic blood pressure—to estimate one's chance (risk) of having a first heart attack or being diagnosed with heart disease in the next 10 years. A risk greater than 20 percent is considered high; a risk of 10 to 20 percent is intermediate to high; a risk of 5 to less than 10 percent is low to intermediate; and a risk of less than 5 percent is very low. An accurate assessment of cardiovascular risk is critical in helping health care providers determine which prevention strategies to recommend for any particular patients. Striving for a heart-healthy lifestyle—e.g. avoiding saturated and trans fats, getting regular physical activity, and not smoking —is important for everyone regardless of risk level, and sufficient for those at low risk. This grant, The Heart of Weld, will provide the impetus for women who have moderate to high risk for heart disease to be screened, and then will provide culturally appropriate assistance to make lifestyle changes to decrease their risk factors, such as lose weight or become more physically active. It will be based on the evidence-based WISEWOMAN program which focuses on women ages 40 to 64. However, the grant has also built in a variety of opportunities for women who are currently at low risk for heart disease, or not within the targeted age range (40 to 64 years of age), to participate in community activities, such as the healthy cooking classes or Zumba (a Latin dance/exercise fusion) classes, to develop habits that will help prevent heart disease. This is a multi-faceted grant that will decrease the incidence of heart disease in women in Weld County by providing screening, treatment, lifestyle change education and assistance, as well as community awareness about signs and symptoms of strokes and head attacks, along with prevention messages. During February (Heart Month) and May (Stroke Awareness Day) a coordinated campaign of radio, TV and print ads will provide information in both Spanish and English to listeners, viewers and readers. This will be in conjunction with community classes and other activities to promote awareness and education about prevention and healthy lifestyles. 2. Project Narrative a) Describe your organization's ability to complete this project, and knowledge and experience providing the services proposed, including working with the target population. The Weld County Department of Public Health and Environment (WCDPHE) has an outstanding record of successfully completing grant projects. We have even been referred to as the "poster child"for our outreach to the low-income population with culturally appropriate health education. Starting in 1991, our agency has been a site for the Colorado Women's Cancer Control Initiative (CWCCI), now titled the Women's Wellness Connection (WWC). The outreach coordinators have always exceeded their goals for contacts and screenings. During 2006, the providers and coordinator worked together to reach more rarely and never screened women and were successful. Initially, the coordinator only worked in Weld County, but because of her success, she now coordinates the WWC program in an 11 county area. 3 During the last two years, WCDPHE has received an Office of Disparities Grant to work with prevention, intervention and education related to diabetes. Screenings for diabetes, evidence based classes such as Dining with Diabetes classes, Zumba classes taught in Spanish, walking groups, cultural competency trainings, professional updates, and an active Diabetes Coalition have had an impact on many Weld County residents. During the first year of the grant, 3,241 people attended classes or trainings. Table 1,Dining with Diabetes Program Statistics Number of Program Participants 1) Platicas 317 2) Dining with Diabetes 144 3) Training for Healthcare Providers 43 4) Group Exercise Classes 834 5) Diabetes Self-Management Classes 50 6) Small Changes Make a Big Difference 364 7) One-on-One Diabetes Education 101 8) Diabetes Risk Assessments distributed 1,388 Total Served 3,241 Guadalupe Miramontes, one of the participants in the classes said, " I changed what I eat because of the classes. My family has a history of diabetes. The classes helped me learn what I could do to keep my blood sugars normal. I love the Zumba classes. They changed my health." Because of the success of these projects, and many others, the WCDPHE will be able to complete the work plan for this grant, reach the target audience, and reduce the risk of heart disease for many Weld County women. ail cwu y4,rs� v� .+.. � , 'u-§ .c . .w- -rte � t,k GIf jy Csikr- 7 R yr. alar Dining with Diabetes Class " Zumba class 4 b) Describe the background of your organization in designing, managing and implementing prevention, early detection, and treatment programs in cancer, cardiovascular disease or pulmonary disease. The Weld County Department of Public Health and Environment will celebrate our 70th Anniversary in 2008. As public health has changed over that time, so has the work of WCDPHE. In 2007 the Strategic Plan was updated to reflect the current emphasis on prevention of chronic diseases: "We want all residents to know that prevention is of the utmost importance in chronic and communicable disease. In the areas of chronic and communicable disease, we want to strengthen our partnerships with health care providers. We will have a culturally competent workforce. We will be able to effectively communicate with and educate all residents about chronic and communicable diseases." Weld County Department of Public Health personnel use logic models to develop programs. A logic model for this program was developed and can be found in Table 2 below. 5 Tablet. Heart of Weld Theory of Action Logic Model Project Goal: To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years who are uninsured or underinsured, with an emphasis on low income or Latino residents and women enrolled in the Women's Wellness Connection. Project Components Activities Short-term Intermediate Long-term What happens: Objectives Objectives Objective o Screening for major modifiable Screening&risk Objective 1: CVD risk factors using CCGC assessment by (Screening) Reduce the Screening and Referral qualified clinical staff Eligible women will percentage of By December Guidelines complete CVD risk eligible women 31, 2013, o Integration of screening & Appropriate clinical factor screening with high CVD risk decrease by intervention activities with referrals(including scores 10%from 2009 Northern Colorado Women's smoking cessation) and baseline Wellness Connection clients follow-up Objective 2: measures o Community-based lifestyle (Lifestyle the incidence of intervention classes that target Individual and group Intervention) eligible women people at all levels of risk for counseling(2 one-on- Newly screened Women with risk factors CVD one sessions with RN women will completing the for nutrition, o Research-based curriculum or RD;8 week group complete 4 or more lifestyle physical (New Leaf/Vida Saludable, counseling using lifestyle intervention will activity,obesity, Corazon Contento) modified New Leaf intervention improve their and smoking o Partners: Sunrise Community Curriculum and sessions dietary, physical Health, Inc. and other North Spanish counterpart) activity, and Colorado Health Alliance Objective 3: smoking practices providers Maintenance (Support& o Active collaboration with other intervention at three Tracking) health department partners: months of 4 nutrition Newly screened Screened women WC Diabetes Coalition; Steps and physical activity CVD high risk will complete their to a Healthier Weld; CSU educational mailings women will annual screening Extension Food and Nutrition and 2 brief phone complete their six- evaluation visit Program;Weld County Faith- counseling calls from month evaluation based Initiative; Greeley/Evans health staff screening visit School District 6 o Regular communication with Re-screening at six Eligible women will advisory committees: North months and one year participate in Colorado Health Alliance;Weld community-based County Health Media Advisory Ongoing weekly clinical and Committee; Project Advisory community-based physical activity Committee physical activity and and nutrition o Active target population nutrition classes activities involvement in planning and implementing program Community awareness o Cultural competency trainings campaign for target for health care providers and population administrators o Medical vouchers for clinical services o Participant incentives(e.g.,gift cards,cookbooks,etc.) o Comprehensive evaluation plan; use of E-Cast EMR tracking system 6 In addition to the successful WWC cancer prevention and treatment program, the Weld County Department of Public Health and Environment has taken the lead with prevention programs related to cardiovascular disease. One of our earliest grants (1989) worked with Hispanic churches to provide screening and head disease risk reduction education. Especially in a rural area, working with the churches provided important contacts and gave credibility to the program. WCDPHE has also had grants that successfully addressed nutrition and physical activity for adults and seniors. Screening programs for diabetes have been done at congregate meal sites for seniors and in cooperation with the 9Health Fairs in the county. Because of the success of these collaborative efforts, WCDPHE is considered a key player, even the lead agency, in most prevention activities in the county. The leadership of WCDPHE in prevention activities has been reinforced by the Steps to a Healthier Weld grant, a federally funded initiative to address obesity, nutrition, physical activity and asthma, For the past four years a variety of community activities have been implemented to encourage Weld County residents to move more and eat better. A strong worksite wellness component reaches people who work at many of the larger employers in the county. The Steps grant will end September 2008. This CCPD grant could help continue some of the community-level interventions for cardiovascular disease risk reduction. Because WCDPHE does not provide primary care, except for family planning and immunizations, the treatment of cardiovascular disease has not been done by Health Department staff, other than monitoring blood pressures. This is why we are partnering with the Sunrise Community Health, Inc.in Greeley/Evans. Sunrise Community Health, Inc.has a large new (to them) facility which is perfect for providing the additional screening and lifestyle programs that will benefit their patients and the community. c. Describe the strengths of your organization, including historical accomplishments, experience with public health entities, public health and health care services in chronic disease, and experience with outreach to the target group. The Weld County Department of Public Health and Environment takes the lead in many community collaborations. One group that has addressed a chronic disease is the Weld County Diabetes Coalition, in existence since 1997. Made up of individuals and agencies that work with people who have been diagnosed with diabetes, or with those at risk for developing diabetes, the Diabetes Coalition members have worked together to provide screening, referrals, education for health care providers, educational materials for the library district, and a myriad of other programs which benefit the community. One noteworthy achievement was using the diabetes coalition members as a focus group to determine the needs of the community related to diabetes. Based on their input, a grant was written and funded to provide the diabetes prevention and interventions that had been identified by coalition members as gaps in care and service. The work of the Diabetes Disparities grant has been described as a "Shining Star" by the Colorado Diabetes Prevention and Control program at the Colorado Department of Public Health and Environment, because of the successful outreach to low income, un- and underinsured residents, primarily women. The Zumba classes (a fusion of Latin dance and exercise) are crowded with parents and kids moving to the music. Cooking (Dining with Diabetes) classes are filled and attendees show an increase in knowledge about healthy eating, as well as a commitment to make changes in their shopping and eating. The small discussion groups in the home, platicas, are successful in helping families make changes because the information is delivered in a culturally appropriate manner. 7 At one of the meetings of the Weld County Diabetes Coalition, it was suggested that radio is a great method to get health information to Spanish speaking listeners. Greeley has a Spanish language radio- station with a half-million people in their audio range. According to research reported in 2003 by the Roslow Research Group, 50% of U.S. Hispanics speak Spanish all or most of the time; 88% speak Spanish at least some of the time. The report also stated that information provided on the radio in Spanish is 61% more effective at increasing awareness,than information in English. And 69% of U.S. Hispanics believe they get more information when it is presented in Spanish than in English. For the past three years WCDPHE has sponsored the Health Talk program on KGRE, the Spanish language radio station in Greeley. It has been a very effective method of providing information about diseases, such as diabetes, tuberculosis, arthritis, and heart disease in Spanish, as well as promoting upcoming events and classes. Because of this successful outreach, KGRE received a grant from Sound Partners for community education and activities. WCDPHE is really the lead agency for taking prevention programs and information to community members, especially those who are low income. This grant will provide an opportunity to continue to work with this target population and will continue to make a difference in the lives and health of participants. d. Describe how your proposed strategy or method enhances or expands existing programs but does not duplicate or supplant funding for existing programs and your organization's plan to sustain the proposed project beyond CCPD funding. If you are applying for new funds for a project that has reached the end of the 3 year funding period, provide an explanation regarding why the project is not sustainable at this time and plans to make it sustainable in the future. This grant funding will be used to expand the work of the Women's Wellness Connection (WWC) focusing on women's cancer issues, to include women's risk for heart disease, using the evidence based WISEWOMAN program with the New Leaf curriculum. Currently, WCDPHE partners with Sunrise Community Health, Inc.on several projects. The Sunrise Community Health, Inc.recently moved into a new, much larger facility. Zumba classes taught in Spanish and Dining with Diabetes classes (both English and Spanish classes) have been held in their clinic and been very well attended, The Women, Infants and Children (WIC) offices are in the clinic. This would be a good connection for the community intervention goal of the grant. With increased space, Sunrise Community Health, Inc.is gradually adding more providers. This will be a valuable resource as women are identified with high risk factors for heart disease and need to be connected with a medical home. Denver Health has had a CVD risk assessment grant working statewide to screen women for heart disease. There has been some outreach in Weld County, but typically it has not been available to patients of Sunrise/Monfort Family Health Center, Also, we are not aware of one-on-one counseling or any other intervention being offered to those that are screened and who are considered high risk. This project would provide the risk assessment for Sunrise/Monfort patients, and would also provide the lifestyle interventions. In fact, women from the target population who are identified by a health care provider as having high or moderate risk for heart disease could be referred to the lifestyle interventions. The WISEWOMAN program has been in place in North Carolina for several years. Follow-up surveys done with the participants found that having three one-on-one counseling sessions over a six month period with a health care professional (R.N. or R.D.) created only short-term changes in diet and physical activity. Based 8 on this information, as well as focus group discussions and experience with the Diabetes Disparities grant in Weld County, the work plan for this grant includes weekly group counseling/classes and reminder phone calls for eight weeks, followed by four mailings and two phone calls a month to keep in touch with the participants for another four months. In addition, women with high or moderate risks for heart disease will be encouraged to participate in the community-level interventions such as Zumba and healthy cooking classes. For the past three years, the WWC has held a half-day workshop with educational presentations about cancer prevention and cancer treatment. In 2007, more than 60 women attended, On the evaluations for the event, several participants suggested broadening the health information presented. "Next year I would like to hear more survivors and more about heart disease; it is the#1 killer of women in this country!" This grant would provide the connection to expand the workshop to include heart disease, as requested. e. Applicants may include a "compelling story"about their project, not to exceed one 8 %x 11 in. page. The "compelling story"is included in the 12 page limit for this section of the application. Ms 147G. er— Ofelia "before" Ofelia "after" Ofelia Orozco was an outreach worker under contract with the Weld County Department of Public Health and Environment, doing one-on-one contacts with Hispanic women about breast cancer and breast health. She was also overweight, taking medications for high blood pressure, high cholesterol, and depression. Her husband had lost his job and her son was headed for Iraq with the military. Who wouldn't be stressed and depressed? In the fall of 2005 Ofelia was asked to expand her health education activities to include platicas (small discussion groups) about other health issues. She was trained to use the curriculum, "Small Changes Make a Big Difference", developed by CSU Extension and CDPHE. She also got additional nutrition training. In May 2006 Ofelia went to her primary care physician for an exam. To her dismay, her blood tests revealed that she had type 2 diabetes, plus her liver enzymes were more than four times the normal values. Armed with the knowledge of"Small Changes Make a Big Difference" Ofelia started to make small changes in her life. She started walking around Bittersweet Park. She got rid of the large plates she had been using, replacing them with small plates to better control portion size. She started eating more vegetables and drinking more water. She used less fat when she prepared foods. Within two months, her liver enzymes had returned to normal levels. Over the course of seven months she lost 33 pounds. She no longer needs to take medication for high cholesterol, high blood pressure or depression and she is hoping to be able to discontinue the medication for diabetes soon. She has maintained the weight loss for one year. 9 Ofelia is now an employee of the Health Department, working as a health educator with the Diabetes Disparities Grant. She is even more passionate about the message of healthy lifestyles because of the changes she experienced in her health when she adopted a lifestyle of more physical activity and a healthier diet. This is an example of the type of lifestyle changes that we believe this grant can make in the lives of many people in Weld County. By providing risk assessment screenings for low-income women, combined with nutrition education and physical activity classes, the residents will make the small changes that can make a big difference in their risks for developing cardiovascular disease. 10 Cancer,Cardiovascular Disease and Pulmonary Disease Competitive Grants Program I Part Ill: Work Plan and Evaluation Plan CCPD a 1h, rr . The CCPD Application Guidelines are available on the CCPD Website. The Application Guidelines include instructions and guidance about funding priorities, the application process(including an Application Checklist),formatting guidelines and additional requirements for new and sunsetting projects. Fiscal Year 2008-2009 •"r4er.�H�Ci t r a h �wm.�:vu�'�. To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years who are uninsured or underinsured, with an emphasis on low income or Latino women and women enrolled in the Women's Wellness Connection. ong-ter L By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible ` jgctivei.: - women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld County's Oversample BRFSS and Community Health Survey. interin-eiliatel By June 30, 2011, reduce by 10%from 2009 baseline the percentage of eligible women with high b 1 # CVD risk scores. Short term By June 30, 2009, at least 250 eligible women will complete CVD risk factor screening. es. E" a E* n 'b • r ru .. b S i P'J�' �� A,+sg� p f 9 g p P Tithe. Era 1F✓i SI �� /..-�r�t Yu may" v kl '`` eu j""£sr QZ �@r5" Q3 %' t4 ,¥ � Process Objectives (actiui;iss) ��4 �t � , � / Jul -;Sept I•,M0ct -Dec.r Jan Mai`, Apr �Jputr 1) By July 31, 2008 hire a fulltime Project X Coordinator and a part-time health educator. Priority will be given to bi-lingual, bi-cultural candidates. Provide orientation and training as needed. 2) By August 30, 2008 establish and convene an X advisory committee for the program consisting of at least 3 community health center key personnel, 3 members of the program's target population, 1 Women's Wellness Connection Project Coordinator, 1 Tobacco Free Weld County personnel and 2 public health personnel. The advisory committee will meet monthly thereafter for the duration of the project. 3) By September 30, 2008 establish program X procedures in collaboration with the advisory committee, modeled after CDC Wisewoman guidelines. 4) By December 30, 2008 train clinical staff on how X to use clinical screening equipment and the e- cast system. 5) By December 30, 2008 utilize evidence-based X strategies to reach program eligible women in the community (i.e. Guide to Community Preventive Services). Provide culturally appropriate and linguistically correct recruitment materials to non-English speaking populations. 6) By December 30, 2008 educate providers X external to Sunrise/Monfort Family Health Center, educate the providers and their staff about the project and encourage referrals. 1 7) By December 30, 2008 educate appropriate X community organizations about the project and encourage the organizations to refer women to the program. 8) By December 30, 2008 and on-going project X X X personnel will conduct recruitment with women who previously participated in Woman's Wellness Connection screenings or through the EMR(electronic medical records) system . 9) After January 1, 2009 and on-going women who X X are found to be at elevated risk for CVD disease will be offered a medical and clinical follow-up based on the clinical measures and their individual health history. If the participant does not currently have a medical home, a referral to a clinician or clinic that is accepting referrals will be offered. A letter describing the intervention program and the participant's clinical results will be sent to the clinician receiving the referral. Clinicians accepting medical referrals for patients without a medical home will be eligible for a $100 voucher for the first office visit. .fO eterv ,�� "� ������ ., § ;, .���� � 3�.. <� d. .,,;mz �✓r a�.,r., , �HFf, max,,._ To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years . who are uninsured or underinsured,with an emphasis on low income or Latino women and women enrolled in the Women's Wellness Connection. long term By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible Objective women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld X Count 's 0versam.le BRFSS and Communit Health Surve . , Intermediate By June 30, 2011, at least 75%of women completing the lifestyle intervention will improve their Ob] 2:, dieta , .h sical activit , and smokine eractices. Shortterm By June 30, 2009, at least 50%of the newly screened women with moderate or high risk for CVD Obj,2, will com.lete at least 4 or more lifest le intervention sessions. t Tntfi,_,�.r, `rame' ,< d Process Objectives(activities) Cti S Q3 QA z '', Jul Sept, Oct pDryeryc"`: hq Jan. .Mar, , Apr —Jun fifL % ¢ 5 r1 `` >200 e.f�, t>.. ..2008 ;k ' zs 2009 sm�YLtrta.. t�shMlu �FN ,-r "�S�,2,009.• :a.a Na..10) By November 30, 2008 create CVD intervention X strategy in collaboration with the advisory committee and identify/develop intervention materials for participants. Priority to be given to the evidence based New Leaf and Vida Saludable, Corazon Contendo curriculums. 2 11) By December 30, 2008 provide training on site X for all staff who will be involved either directly or indirectly with the lifestyle intervention including staff that will provide clinical services, conduct the counseling sessions and offer program support. Train all staff to assure culturally competent public health promotion strategies are used to the extent possible. 12) By January 1, 2009 and on-going women who X X are found to be at elevated risk for cardiovascular disease will be offered a behavioral intervention aimed at CVD risk factor reduction over an 8-week period. The behavioral intervention will be initiated for participants with elevated blood pressure, elevated cholesterol, or a combination of both and will address: dietary practices, physical inactivity and cigarette smoking. 13) By February 1, 2009 initiate lifestyle intervention X classes in English and Spanish using a curriculum that highlights positive dietary habits, physical activity appropriate to middle-aged and older women who lack easy access to exercise facilities, serves as a self-help guide or tool for group discussions and facilitates goal-setting and self. 14) By March 1, 2009 and on-going conduct risk X X assessments with all lifestyle intervention participants to allow counseling efforts to be personalized. 15) By March 1, 2009 develop a system to deliver X X telephone counseling to lifestyle intervention clients who miss a lifestyle intervention class. Conduct follow-up counseling sessions by telephone as needed. WOIk Plan c .Q9/Q9} Wt $2 ... °Tz«`�'e..w:..:,t_,aac✓vr .. Y., £.c rn.. for oi11 % To reduce modifiable risk factors cardiovascular disease among women aged 40 to 64 years who are uninsured or underinsured, with an emphasis on low income or Latino women and women enrolled in the Women's Wellness Connection. yLon iv ter , By December.30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible Objective women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld Count 's oversam•le BRFSS and Communit Health Surve . e .vk�v sau,a fnteCdn, edlate& By June 30, 2011, at least 40%of eligible women will complete their annual screening evaluation Cbj. f t visit. Short term By June 30, 2009, at least 30%of high risk eligible women will complete their six-month evaluation ObJ3 , screening visit 3 �,A sr Pracessf Obj"ectives activttt'e y ti Jutr�.�'g6g, t-r Oc . '1Uc ,r'Jan,—Mar, Apr=rJI 'tN R ;4.,- .,,}Al %"�.. `.3.; $r �* �'� Pzon x r";ZQ• .°4.'' 16) By March 1, 2009 in collaboration with the X Advisory Committee develop and implement a "maintenance" program that will promote long- term adherence to the new behavior patterns established for lifestyle participants in the intervention classes. 17) By April 1,2009 provide the lifestyle intervention X participants with ongoing contact with the health facility staff (either in person or by mail). Include relapse prevention training. The maintenance intervention will consist of a minimum of four nutrition and physical activity mailings and two brief phone counseling calls from health facility staff. 18) By April 1, 2009 health facility staff will make a X minimum of two brief maintenance phone calls that will be designed to provide support, build confidence, and increase participants' commitment to improving or maintaining health behavior changes. Participants will receive at least one phone call at month four and eight of the twelve-month maintenance program eflUork Piaa FYDBiD9 ' , . w,✓4 i, oal i, To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years t, :•: who are uninsured or underinsured,with an emphasis on low income or Latino women and women enrolled in the Women's Wellness Connection. 1Lot g term -Y By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible [Objective: women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld 'a Count 's Oversam•le BRFSS and Communit Health Surve . :Intermediate TBD Ob4 Short-term By June 30, 2009, at least 50%of screened women will participate in community-based clinical or Obj,.4 '` physical activity and nutrition resources or activities. 1 Trine game Process Objectives (activities) tf..• Q1 Q2°' .Q3 Q4 u° Jul Sept., y Oct.—Dec, i Jan.-Mar, , Apr. f•• , • 2008 2008 2009 ( • Jun .,,• 4 19) By September 30, 2008 and on-going provide 2 X X X X healthy cooking classes and 2 nutrition education programs per month in the community that will encourage hands-on participation by Weld County residents. Cooking and nutrition classes will focus on Healthy Latin recipes and be taught in English and Spanish. 20) By September 30, 2008 collaborate with other X X X X chronic disease grants currently being funded and administered in the community to leverage resources to cover a county-wide effort on chronic disease prevention. The Project Coordinator will become a member of the established Weld County Health Media Advisory Committee 21) By September 30, 2008 initiate a contract with the X X X X City of Greeley's Recreation Department to start offering Zumba group exercise classes one time a week. Encourage all lifestyle intervention participants to attend weekly Zumba classes. Work with the City to promote class participation among other community members. 22) By September 30, 2008 organize and coordinate a X X X X walking program with at least 20 regular participants. 23) By December 31, 2008 provide a half day seminar on cultural competency in health care delivery for medical staff and community members. 24) By February 1, 2009 partner with the Health Media X Advisory Council members to support Head Month. 25) By April 30 2009 participate in all Weld County X 9News Health Fairs by offering interactive education booths on cardiovascular disease. 26) By May 1, 2009 support Stroke Alert Day, X Disseminate culturally and linguistically appropriate information. 27) By June 30, 2009 provide cardiopulmonary X resuscitation (CPR)training to lifestyle intervention participants. Fiscal Year 2009-2010 and Fiscal Year 2010-2011 �� aa- Wqr`c Plan: FY09110 & Pfi;Of11 v, • ..r'. ., ,., x .,• • ...F ,3. F-Goal1 . To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years who are uninsured`br underinsured,with an emphasis on low income or Latino women and women enrolled in the Women's Wellness Connection. Ooltg term By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible bjective women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld Count 's Oversam.le BRFSS and Communit Health Surve . frrtermedrate- By June 30, 2011, reduce by 10%from 2009 baseline the percentage of eligible women with high 014. t CVD risk scores. 5 4iiiiii.;:tirifiliNi At least 750 eligible women will complete CVD risk factor screening in grant years two and three. .ce < N z • ri a +na d ,„qp n an+a r 1 - s r : u ... is ..�,�r 11'I e� 'd117e'. 'x Process Objectives(activities) .> Q1 Q2 " '.q3:.. .-.,-4,-... . Qat ;,14 -Sept, 0et. Dec., Jan -Mar, i 'Arm-T.4 2008 200$ 2005 ^ s. Jun.; Y H i y ';',•::*-<-1:.-y x �'�. 'f•:.:„2009'' aY�x ,'o.,a !ry w 28) Staff will utilize evidence-based strategies to reach X X X X program eligible women in the community. They will provide culturally appropriate and linguistically correct recruitment materials to non-English speaking populations 29) Qualifying program participants will be screened X X X X using CCGC screening and referral guidelines. 30) Women who are found to be at elevated risk for X X X X CVD disease will be offered a medical and clinical follow-up based on the clinical measures and their individual health history. Clinicians accepting medical referrals for patients without a medical home will be eligible for a$100 voucher for the first office visit. f'Ultrk Plan FY09l10•0, FY.-10/1-..1-1::::::: 1:.::: : , haat '-i7 r-,, ;µ To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years '' r ‘ '' ;' who are uninsured or underinsured, with an emphasis on low income or Latino women and ' women enrolled in the Women's Wellness Connection. niterm .7 " By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible 5 =;Objective: women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld ti, T.w County's Oversample BRFSS and Community Health Survey. r intermediate '' w By June 30, 2011, at least 75%of women completing the lifestyle intervention will improve their C001 2: dietary, physical activity, and smoking practices. Short-term Ohj., At least 40%of the newly screened women will complete at least 4 or more lifestyle intervention 2: , • sessions in 'rant ears two and three. 0 y .rr ,ime Frame" ; yj Process Objectives (activities}. 01 1Q2 =' .•.,:hO, a' Q4 Jut,-Sept., Oct.-Dec, Jr•Jan, Mar, Apr I' 2005 • 2008 '; 12009 f. Jon.,r. . 31) Women who are found to be at elevated risk for X X X X cardiovascular disease will be offered a behavioral intervention aimed at CVD risk factor reduction over an 8-week period. 32) Deliver telephone counseling to lifestyle intervention X X X X participants who miss a lifestyle intervention class. Conduct follow-up counseling sessions by telephone as needed. I i 6 33) All lifestyle intervention participants will be encouraged X X X X to return at six and twelve-month intervals to monitor progress and determine if a medical referral is necessary. Work Plan: FY09/10 &FY10/11- r` ry .Goal 1: To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years who are uninsured or underinsured, with an emphasis on low income or Latino women and women enrolled in the Women's Wellness Connection. Long-term By December 30, 2013,decrease by 10%from 2009 baseline measures the incidence of eligible Objective: women with risk factors for nutrition, physical activity,obesity, and smoking as measured by Weld County's Oversample BRFSS and Community Health Survey. Intermediate By June 30, 2011,at least 40%of eligible women will complete their annual screening evaluation visit. Obj.3: Short-term At least 30%of high risk eligible women will complete their six-month evaluation screening visit in ,Obj.3: grant years two and ree. `.Time Frame. Process Objectives (activities) ' Q1 Q2 Q3 Q4 Jul.—Sept., Oct.—Dec., Jan.—Mar., Apr.—Jun.,. 2008 2008 2009 2009 34) Provide the lifestyle intervention participants with X X X X ongoing contact with the health facility staff(either in person or by mail). Include relapse prevention training. 35) Staff will make a minimum of two brief maintenance X X X X phone calls that are designed to provide support, build confidence, and increase participants' commitment to maintaining health behavior changes. Work Plan: FY09110 &FY10111 Goal 1: To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years who are uninsured or underinsured,with an emphasis on low income or Latino women and women enrolled in the Women's Wellness Connection. Long-term By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible Objective: women with risk factors for nutrition, physical activity, obesity,and smoking as measured by Weld County's Oversample BRFSS and Community Health Survey. Intermediate TBD Obj. 4: Short-term At least 30%of screened women will participate in community-based clinical or physical activity and Obj.4: nutrition resources or activities in grant years two and three. Time Frame Process Objectives (activities) �� 01 02 Q3 Q4 e . ,w � . Jul.—Sept. �,.Oct, 2000Dec.,,Jan.—09 Jun:,ar., 2008 _ t,. 1, 2009 7 36) Provide 2 healthy cooking classes and 2 nutrition X X X X education programs per month in the community. 37) Offer Zumba group exercise classes a minimum of one X X X X time per week. 38) Expand the walking program to include 30 regular X X X X participants 39) Provide a half day seminar on cultural competency. X 40) Provide cardiopulmonary resuscitation(CPR)training X to lifestyle intervention participants. Please answer the questions below, in the order presented, to describe your project and assist the Reviewers in reading your application. a. Cite the researcher documented prior experience that provides the evidence-based justification for your proposal. b. If your project includes screening and early detection activities, describe how diagnosis and treatment services will be integrated and coordinated and estimate the number of people who will need treatment. During the initial year of the project, most of the women who qualify for Heart of Weld CVD screenings will have a medical home already established at Sunrise/Monfort Family Community Health Center. We will integrate the Framingham 10-year Cardiovascular Disease Risk Assessment into clinical practice for these screenings and follow its protocols to determine CVD risk. Each enrolled participant will receive a baseline screening with the results of this screening then determining the intervention. Participants with low risk for CVD will be eligible for a 12 month follow up screening. Participants with elevated CVD risk will receive the usual standard of care services including a medical referral and clinical follow-up and the lifestyle intervention which will include the New Leaf dietary and physical activity counseling sessions. Participant with elevated CVD risk will be eligible for a 6- month follow-up CVD screening to monitor their status and to determine if re-enrollment into the 8 week lifestyle intervention should be offered. During year two and three of the project, we will expand the screening to underinsu 'd women in the community. Those women who are found to be at high risk for CVD through the screening will become eligible for a one time$100 voucher to be given to clinicians accepting medical referrals for patients without a medical home. We estimate that 25 patients in the first year of the project will not have a medical home and will become eligible for the $100 medical voucher. In years two and three of the project we estimate that 100 individuals in the community will be screened and determined to be at high risk for CVD and will not have a medical home. These 100 individuals each year will then be eligible for the $100 medical voucher. 8 c. Describe how your program actively collaborates with other agencies to share resources, coordinate efforts, and avoid duplication of services, including state or local chronic disease programs in your community and local public health departments or county nursing services. The Weld County Department of Public Health and Environment has taken the lead in establishing community coalitions to share resources, coordinate efforts and avoid duplication of services related to chronic diseases. The North Colorado Health Alliance is an organization composed of 12 agencies in Weld County that work together to address the health needs of the uninsured and underinsured residents of Weld County. Shared clinic space,joint projects for school health clinics, electronic medical records system that links the health department and community health clinic records, and diabetes prevention classes in Spanish are examples of projects where the Health Department has taken the lead in collaborating with these agencies. d. Provide evidence of past, successful collaborative projects with other groups and agencies or other chronic disease programs in the community. The Health Department has collaborated with many agencies and businesses on chronic disease issues. For more than 10 years the Health Department has been the lead agency for the Weld County Diabetes Coalition, coordinating a variety of community outreach activities and educational programs for professionals. The health department's Diabetes Disparities Project has partnered with the City of Greeley's Recreation Departments, Weld School District 6 and Sunrise/Monfort Family Community Health Center to offer no cost Zumba group exercise classes targeting Latino women at-risk for developing diabetes. These classes have been offered up to three times a week with an average attendance of 40 participants per class. The Health Department has also collaborated with CSU Extension Service's Food and Nutrition Program to provide Dining with Diabetes classes and an adolescent support group for overweight children and their parents. Both programs were facilitated in English and Spanish. The Health Department has also coordinated two very successful physical activity events in partnership with the Greeley Tribune to motivate community members to collectively "Walk Around the World in 92 Days" and an individual challenge for community members to "Leave their Behinds, Behind". The response was so great(700+ participants) that two trips around the world were achieved with the Weld Walks program. Additionally, the health department also houses a very successful Women's Wellness Connection (WWC) program that has established partnerships throughout the community with clinical providers to offer breast and cervical cancer screenings to low-income underinsured women between the ages of 40-64. In 2006 WWC screened 940 eligible women. e. Provide a list of partners or supporters of the application and a description of their roles. Include a maximum of four (4) letters of support from key organizations for this proposal as attachments. If partnering with another organization, a letter of support by the respective partner must be provided. 9 a. Sunrise Monfort Family Community Health Center will provide qualifying patients for screening and provide space to conduct the screenings, as well as, conduct the group lifestyle intervention classes. They will provide office space for the Project Coordinator and Health Educator, a large room to offer Zumba classes and access to the e-cast system to record data. b. Health Promotion Department of WCDPHE where grants are administered. Steps to a Healthier Weld County, the Weld County Tobacco Program, the Diabetes Disparities Project, and The Women's Wellness Connection will collaborate to leverage scarce resources and prevent duplication of services. c. The Weld County Tobacco Program will provide group smoking cessation classes as needed. d. The Women's Wellness Connection in Weld County will collaborate with the Heart of Weld by integrating recruitment efforts for both projects and organizing joint marketing efforts for both programs. e. The City of Greeley's Recreation Department has offered to host group exercise classes for lifestyle intervention participants. They will provide a large aerobics room and/or gym for Zumba classes and classroom space for group lifestyle intervention classes if needed. f. Describe how those affected by your project have been and/or will be involved in the design and implementation. On December 3, 2007 the Weld County Health Department conducted a focus group of 8 bi-cultural members of the target population who use Sunrise Community Health Center as their medical home. We asked for their input regarding the structure of the lifestyle intervention classes, desired location, length of sessions, what the barriers would be to attend all classes (i.e. childcare, transportation), what additional support they would need to be successful with the intervention (i.e., CPR training, additional opportunities for group exercise, on- going support and follow-up screenings). A minimum of three project participants will be invited to participate in monthly program advisory committee meetings. We will encourage successful program participants to share success stories with local media including local Spanish Radio and local Spanish language newspaper. Additionally, we will provide opportunities for successful program participants to be trained as Promotoras to assist with group lifestyle intervention classes. g. Describe how the project is appropriate culturally, linguistically, and for literacy level for the target population. If your project addresses a health disparity, provide an explanation of the health disparity issue or need to be addressed and the current barriers (structural, social, cultural, etc.) that influence the disparity. The lifestyle intervention classes will use both the New Leaf Curriculum and the Spanish version Vida Saludable, Corazon Contento so that classes may be taught in English and Spanish. The educational materials in these two curriculums were developed for the target population and have been proven successful. We will ensure that all clinical staff and health educators that are involved in the Heart of 10 Weld project will receive a minimum of one cultural competency training within the first 6 months of contract initiation, as well as, follow-up trainings each succeeding year of the project. 11 2. Evaluation Plan a. Evaluating the Reach of Our Project. Based on data from the 2005 Weld County Behavior Risk Factor Surveillance Survey, we estimate there are approximately 32,500 women between the ages of 40 and 64 years of age in Weld County. Women in this age group comprise about 40 percent of all adult women in Weld County and about 20 percent of all Weld County adults. Table 1 outlines several demographic characteristics of women in this age group. Most women in this age group are White (75%), not college graduates (74%), employed (59%), and live in households with an annual income less than $50,000 (51%). Approximately 16 percent of Weld County women aged 40 to 64 years describe their overall health status as fair or poor. Seventeen percent of women in this age group report they do not have health insurance. Table 1. Demographic Characteristics of Women Aged 40 to 64 Years in Weld County(BRFSS, 2005) Percentage Race/Ethnicity Category White, not Hispanic 75.2% Hispanic origin 22.2% Other race/ethnicity 2.2% Education Level No high school diploma 13.7% High school graduate or equivalent 28.4% Some college 31.4% College graduate 26.4% Employment Status Employed 58.9% Self-employed 9.6% Out of work 3.6% Homemaker 13.5% Student <1% Retired 7.3% Not able to work 6.5% Annual Household Income <$25,000 21.6% $25,000-$35,000 11.5% $35,000 - $50,000 18.1% $50,000 - $75,000 22.0% >$75,000 26.8% Self-reported health fair or poor 15.5% No health insurance 17.1% Focusing attention on the prevalence of modifiable risk factors for preventing chronic disease, we estimate that 35 percent of Weld County women aged 40 to 64 years have high cholesterol, 18 percent have high blood pressure, 20 percent are current smokers, 50 percent have inadequate levels of physical activity, and 54 percent have excess body weight (see Table 2). Table 2. Modifiable Risk Factors for Cardiovascular Disease(Weld County 2005 BRFSS Data) Women Aged 40 to 64 Years Total women in target age group 32,503 Cholesterol checked risk factor(more than five years or never) 19.0% High cholesterol risk factor 34.9% High blood pressure risk factor 18.9% BMI >25.00 53.6% Current smoker risk factor 20.1% No physical activity or exercise in past 30 days 24.6% Does not meet recommended physical activity guidelines 50.1% Based on Weld County 2005 BRFSS data, we estimate the target population for this project to be about 10,900 women between the ages of 40 to 64 years or about 33 percent of women in this age group1 We will use several data indicators to evaluate reach of the project into the target population. We will track the total number of screenings, total number of first time screenings, percentage of Women's Wellness Connection women screened, percent of Latino women screened, and percent of women who attended at least one lifestyle intervention session. During the first year of the project, we will recruit women from Sunrise Community Health, Inc. (CHC), which has a site in Greeley and in Evans, Colorado and Weld County Department of Public Health and Environment (WCDPHE) in Greeley, Colorado. Sunrise Community Health, Inc. primarily serves uninsured residents. WCDPHE serves uninsured and underinsured residents. Over the past three years, Sunrise Community Health, Inc. saw 2,480 women between the ages of 40 and 64 years and WCDPHE saw 71 women between the ages of 40 to 64 years. In years two and three the project plans to recruit women from other clinical sites. Over the next three years, we estimate the number of eligible women exposed to the program annually will be 1,000 for a total of 3,000 eligible women over the grant period. The actual number we desire to respond to recruitment annually is 250 in year 1, and 750 in years 2 and 3 for a total of 1,750. Therefore, our estimated reach into the target population over the grant period is 16 percent (1,750 out of 10,900). b. Short-term and Intermediate Outcomes. 15,500 uninsured women (based on 2005 BRFSS) and another 5,400 underinsured women (based on national estimates that another???°/0 are underinsured). p co _ C o C N 0 N co = O O O C in @ U U O N 'D w c on on O a a) c c O L `—. 05 E c o R. a E uj o L U a m Ec = o O_ @ N O 0 f0 U a) O N @ O O L o �. 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'"• . 0 0 0 a C "O U �... 'tr.) c N 0_.C N N N c a) a E a d co Y = a) O. U -O Y C E 0 0 p F- o r a) E .� C a) E = "' O CO — O C 0 >O 0 CO m E: w o 3 O E E �. E 3 E E .0 3 E E o L > j. C 8 .a 3o a Eo w m O00 O p O U 0 0 0@ C p C = . E `' a) -p = S cn 3 Tn- '> cn F- 3 O @ F- 3 c> N acts cn 2 . 3 G 0 C It 70 >` @ > • • • • • '6 4@- N O] Y W U @ • E 0 >• O O) L C K a - C N o' O = = C p U_ O .•• U J •(-B T L .� O@ E .-' C .CNIN CNI@ E o@ j. C.c `o O : Do d N `o w =_ > o 3 a) > o 4-- 3 n a o. O Eo co d �' d r c m 0 3 3 ai .� p o m - '� o °' 'r o ° C, cp`> CF- 0O3U .. Ep•YN = M C a' Q._ca) _ -- a) a _ = = Nd Qna E U > > R c N O N a 0 •-.-) N Y E E c o v) d - C@ E c rn a` (p7 3 a coL v) t`- O m 3 E m md cn .3 m a>> m a—@) cn .3 op .0 cc'a m co c. Linkage to State Strategic Plans The Heart of Weld Project will assist the state of Colorado in achieving the following strategic plan objective: Reduce cardiovascular disease deaths to a rate of 108.9 per 100,000 d. Process Objectives f Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program FY2008-09 Check only one: 0 Year 1 July 1,2008-June 30.2009) ❑rear 2 poly 1,2009 APPLICANT: Weld County Department of Public Health&Environrt June 30.2010) O Year 3(July 1,2010-June 30.2011) PROJECT TITLE: Heart of Weld SOURCE OF FUNDS , Requested Other Source" Other Source' trgictootp, .- .:_. Na 10RVICE_; tPkE — .::,.._z':at ...e4_n me'A_ T - "'a ' ontt. y-ysf _ ..s wt•:� PERSONAL SERVICES FTE Monthly Monthly #of Enter name here Enter name here if applicable if applicable Name Position Salary Benefits Months ` To be determined Project Coordinator R . 1.00 $4,063.21 $1444O7 12,0 $66,087.36 $0O0 $0.00 Ofelia Orozco Health Educator 1 0.75 82,878.25 $1.022.93 12.0 846,814.23 80.00 80O0 To be determined Medical Assistant 050 $1,302.93 $463.06 8O $14,127.92 $0.00 $000 Cindy Kronauge Data Specialist 0.10 $57528 $20445 12.0 89,356.74 $0.00 $0.00 Subtotals: $136,386.25 sow $0.00 Total Personal Services $136,386.25 $0.00 $0.00 k2"..aMtittlitgiat r-a„',,'*,E-` ailian a ea m., '..:' _' . ... 'na. v :. . n. Wan 'Sett . m' '' "r."i','A DIRECT OPERATING COSTS DESCRIPTION Printing/Coping printing,color printer cadridges,paper 82,625O0 $0O0 80.00 Postage/Shipping postage for maintenance intervention mailings $400.00 $0.00 $0O0 Telephone,Fax,Internet Access $0.00 $0.00 $0.00 Computer Equipment 1 laptop computer with docking station&software $2,500.00 $0.00 $0.00 Staff Development attend trainings $998.75 $0.00 $0.00 Office Supplies expendable general office supplies @$1O0/FTE x 2.35 FTE $235O0 $0.00 $0.00 Meeting Expenses money Advisory Committee meetings and 6 personnel trainingslmeedngs $1,350.00 $O00 $0.00 Other Program Cost incentives for intervention class participation,gift cards for childcare providers 82,440.00 $0.00 $0.00 Total Operating Costs ,J $10,548.75 $0.00 $0.00 'bl vp,t3 r : n "v' a ,,,.x m,.< gyy�N$,Yc arH. ' °a ' ;. ' �. _tm�.. , .r,,;$, E t,lio,:ICE#,:'i�.._k.`i ry.{!p;.� i °. g� ts'�"Ea�.im3₹$a.a,,:rav� v4'm.i: ,Rp_.Mae.. ... �.:ts .. TRAVEL DESCRIPTION In-State Only Project Coordinator,Health Educator,Medical Assistant Mileage @39/mile 85,226.00 $0.00 $0.00 Total Travel Costs $5226.00 $0.00 $0.00 i.,,;:,,a.,_4 E ..' p"'k4'Si-..*,wcoo_ *o a.': E a3: 1Y1e&n'o a :pa'r .. r jA i CONTRACTUAL DESCRIPTION — Consultant $O00 $0.00 80O0 Contract Trainers/Speakers Cultural Competency Trainer 84,000.00 $0.00 80.00 Subcontractors Zumba Instructor 1h0week@$20 per hour,Evaluation Assistant l0hrslwk@820/hr $5,800O0 $0.00 $0.00 Total Contractual Costs ry�1 ,m�E � $9,600.00$� $0 00 $0.00 N't . 1 ur V °u"2.IEp2� ,E 1 t '._.. .t E`f.'�4�".t.,a.{ ° '.:.. e R� l E� _. µ t-9... . I[:,} r..11,Myg��9.. ,..r °, r RED`'' ;9!`a`, ,' OTHER COSTS DESCRIPTION Marketing/Media media&marketing materials for Head Month&Stroke Awareness campaigns $10,000.00 $0.00 $0O0 Outreach/Educational Materials pedometers,cookbooks,food for cooking classes,pamphlets,New Leaf Mao's,binders $4,580.00 80.00 $0O0 Screening testing supplies,blood pressure cuffs.CardioChek PA Professionals,scales $6,83050 $0.00 80O0 Treatment metlical vouchers $2,50O00 $0.00 $0.00 Other Costs smoking cessation vouchers 855O00 Total Other Costs 824,460.50 $0.00 $0.00 S"'a""ara S.P ": " a:r e fit ... E,s Y"'r"i.1 ..4,4 _ °7.. SUBTOTALS $186,421.50 $0.00 $0.00 g,;d?},rM,x t n i,},e eiduNg i , !lah 'Jee . rri 2.n ',, r _ ,:.,»•.mom." . , ,.: 1* Itt AE INDIRECT COSTS: 2% Contractual t 8196.00 INDIRECT COSTS: 20% Personal Services,Operating,Travel and Other $35324.30 Total Indirect Cost(Calculated on Amount Requested from CDPHE Only) $35520.30 s4,' :e mi' a!�iF.var rn.._ r ..,v Ll ''„ `' 1d ' s °t i1 t as ,x mq 'c .�. .,...._. n r_.x :,:.E"'*9t �N'�¢s�{'�hi° ICES' P�15..0_. ,. a A�� id .i& ...ter�AEY_m, _ .: ,_t TOTAL AMOUNT REQUESTED FROM CDPHE $221,941.80 ,,_y, is i-: '+L ae'sf v'E esr ,.y a ra ' a1't'e an^,ira�"C+ul;^ £ '.s Sate ?s �w�?> e,. .. _ m . ra,F'r;n.p''a,"'tall,:a. 'Other. Pleas indicate additional revenue it applicable. Signature t Authoriz00 Representative Date Rev.12.11 O7 Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program FY2008-09 Check only one: 0 rear s(Jury 1,2006-June 30.2009) APPLICANT. Weld County Department of Public Health&Enviro. 2+ Year 2(July 1,2009-June 30,20501 0 Year 3(July 1,2010-June 30.2011) PROJECT TITLE: Heart of Weld SOURCE OF FUNDS Requested Other Source' Other Source' % Sh ,, 7 r rreERSO vv, „ W;g °3__. .-; :,1` ..ac.. .'�k'Ia aant{r:. 4 ‘'.>7 Y o-��- : " .` n .Enter name here Enter name here PERSONAL SERVICES FTE Monthly Monthly not if applicable if applicable Name Position Salary Benefits Months ` To be determined Project Coordinator R.N. 1.00 $4,384.18 $1,5514 8 12.0 $71,307.80 $0O0 $0.00 Ofelia Orozco Health Educator 1 0.75 $3,05036 $1,084.10 12O $49,61353 $0.00 $0.00 To be determined Medical Assistant 0.50 $1,404.52 $499.17 12.0 $22,844.31 $0.00 80O0 Cindy Kronauge Data Specialist 0.10 $603.34 $214.43 12.0 89,813.27 80O0 $0.00 0.00 $0.00 $000 0.0 $0.00 $0O0 $0.00 Subtotals: $153,578.91 $0.00 $000 Total Personal Services $153,578.91 $0.00 $0.00 :.n::it v ..H Pg A _ u Ala'-: „4'b fi I.agiR,,,Z.iti 1 "R 12-$r . ?z ;,vg , :pF .. .e. y 9-Mt 4 ? :!piN DIRECT OPERATING COSTS DESCRIPTION Printing/Copying punting,color printer cartidges,paper $4,00000 $0.00 $0.00 Postage/Shipping postage for maintenance intervention mailings 81,200.00 $000 $0.00 Telephone,Fax,Internet Access $0.00 $0.00 $0.00 Computer Equipment $0.00 $0.00 $0.00 Staff Development attend trainings $998.75 $0.00 $0.00 Meeting Expenses monthlyAdvisory Council meetings and4personnel trainingslmeedngs $1,300.00 $0O0 $0.00 Other Program Cost incentives for intervention doss participation,gift cardsfor childcare providers $2,940.00 $0.00 $0O0 $10,438.75 $0.00 $0.00 Total Operating Costs ��$, _ p ��jj�� ' f4 rf4f t^,W 4 >^'� F7r r e i ,.t t yak= a I,,v hm mt..,. .i643`w M,,.� n.ix. .. � 9Fv ... ,._ .. .s-ii .,.. z 3., ..... TRAVEL DESCRIPTION In-State Only Protect Coordinator,Health Educator,Medical Assistants Mileage @.391mi1e $6,318.00 $0.D0 $0.00 Total Travel Costs 4 $6,318.00 $0.00 WOO hh I4 2a p 3'! k:: " "ft m P ,I .i!6T?.r „'if-._a v..v.T rIx'..,?': d�3Ft-�k .,ti !a,a , 'tins: g, ...i� .. ,..;3�'v�x��.. ...4._� `a.,. .. _. :a x&54 ... CONTRACTUAL DESCRIPTION Consultant $0,00 $0.00 $000 Contract Trainers/Speakers Cultural Competency Trainer $4,00000 80O0 $0 00 Subcontractors Zumba Instructor 1 hrhweek@$201hr Evaluation Assistant l0hrsnveek @$20/hr $5,840.00 $0.00 $0O0 Total Contractual Costs ;p $9,840.00 $0.00 $0.00 x.0 =T N 'i ' ymcP4$ fit gq�i ..'a msr a"(.�'ff- e. �v&ii'RtW..�i le E'er'?11e+v"0 a, ;S�X.( ^0 ',�,sP.II,,tee_. {triFw:r_ul�w 4'-ai -�'I _ ..mot OTHER COSTS DESCRIPTION Marketing/Media marketing&media materials for Heart Month&Stroke Awareness campaigns 810,000.00 $0.00 $0.00 Outreach/Educational Materials pedometers,cookbooks,food far cooking classes,pamphlets,binders $10,340.00 $0.00 $0.00 Screening testing supplies $3,54970 80.00 $0.00 Treatment medical vouchers 810,000.00 $0O0 $000 Other Costs smoking cessation vouchers $440.00 $0.00 80.00 Total Other Costs I $34,329.70 $0.00 $0.00 ,::: it a:. ' 1"r ` gAti r' a1`,`s xe'°aJk'G`em.8"0 fi%, s sy ag1t6,e nr i... _ m' Pt..,;$`:4"30 sw "'es n—c.. s .lLvt t,:-,., "t: $d9iea3 SUBTOTALS $214,505.36 $0.00 $0.00 a' do E �...,. „-..;.,. �'.+a::sM �.1 1 `"`�f`�"�-a,,. �m"..:,4 a;P ,�a..S.n.:.nt,4' � ................... _��. . ...,�,. Ta °. _ rx �a,.:. , .:��+,�. .im_ INDIRECT COSTS: 2% ConaacNal 8196.80 INDIRECT COSTS: 20% Personal Services,Operating,Travel and Other $40,93307 Total Indirect Cost(Calculated on Amount Requested from CDPHE Only) $41,129.87 ,_ gy,`,R.ua' rq r_ if0' :, .,! m ,. .. ..r, -. s1`"1„W 5taZal s5;. r a,, 'Z. i ru, SW .„ u i3:Su rm iild A TOTAL AMOUNT REQUESTED FROM CDPHE $255,635.23 ,i M' .a,4 ¢ d' }, 'i "," Lxa'. i3q y ''t t ^k T.- k§ „ ; R�$a{� k�rr _. - :e a lt5 �.E p3,�5Ft�� s'rT to � �p','y,'?,"J :aaRi��5 _ ,.: & 4, , l,. .:,t }Av ::. Cl�,t%,.,5 �X:_ lu .... ��10p 4) .Ip�.M.dttil�`%,h.».t. .iL�:...31kc F -_: _ne P 'Omer. Please indicate additional revenue if applicable. Y Li if ' SignatWa ct4 zed Representat Date Rev.12.11.07 Cancer, Cardiovascular Disease and Pulmonary Disease Competitive Grants Program FY2008-09 Check only one: 0 rear 1(July 1,2008-June 30.2009) APPLICANT: Weld County Department of Public Health&Enviro. ❑year 2(July 1,2009-June 30.2010) Q year 3(July 1,2010-June 30.2011) PROJECT TITLE. Heart of Weld SOURCE OF FUNDS Requested Other Source* Other Source* ,L,.'=. t �_ a aiL r- ,.,t",S , er.. fir.=.a r.,ff' irliiP`=.:tA1 ri.4 +r't tin ' Pr::-;t'y_.,IFS,._A..�.;.vt.., s.: :... r .Anti, +.:Bg0re82m:2 S"5. _.....su, PERSONAL SERVICES FTE Monthly Monthly #of Enter name here Enter name here if applicable if applicable Name Position Salary Benefits Months To be determined Project Coordinator 1.00 $4,543.36 $1,614.71 12.0 $73,896.84 $0.00 $0.00 Ofelia Orozco Health Educator 1 0.75 $3,176.11 $1,128.79 12.0 $51,658.78 $0.00 $0.00 To he determined Medical Assistant 0.50 $1,455.55 $517.30 12.0 $23,674.20 $0.00 $0.00 Cindy Kronauge Data Specialist 0.10 $624.46 $221.93 12.0 $10,156.73 $0.00 $0.00 0.00 $0.00 $0.00 0.0 $0.00 $0.00 $0.00 _ Subtotals' $159,366.55 $000 $000 Total Personal Services $159,386.55 $000 $0.00 ., .,_,mot, "v t . , :?:y,. ,i± _::J-s , x. t p>?_ „t s.;r,;,:'s' ,ay-*FA iii3., ,.44Z4*--a t ,c Nif_.ii',,yti;. , _,xG : DIRECT OPERATING COSTS DESCRIPTION Prinfing/Copying printing,color printer cartridges,paper j. $4,000.00 $0.00 $0.00 Postage/Shipping postage for maintenance intervention mailings $1,200.00 $0.00 $0.00 Telephone,Fax,Internet Access $0.00 $0.00 $0.00 Computer Equipment $0.00 $0.00 $0.00 Staff Development attend trainings $998.75 $0.00 $0.00 Meeting Expenses monthly Advisory Council meetings&4 personnel trainings/meetings $1,300.00 $0.00 $0 00 Other Program Cost incentives for intervention class participation,gift cards for childcare $2,940 00 $0.00 $0.00 Total Operating Costs $10,438.75 $0.00 $0.00 r MI t -! a a A `+'m v la fr yts'uP. .,.`a Jril t t t.fi 5N4 sr ,"s.a o rdt ., T^'=. t°."Sta,-: 0 _r? t TRAVEL DESCRIPTION In State Only Protect Coordinator Health Educator,Medical Assistants Mileage $6,318.00 $000 $000 Total Travel Costs $6,318.00 $0.00 $0.00 1 h ....sa§ ;-:e x,,, nr ", tlm r , 'a ,la;. ' , °-g�`sh', a i . _. 't j . is .: . ft:; ow.L.m y"_. - .� ht , r_ Fv '. ...CONTRACTUAL DESCRIPTION - Consultant $000 $0.00 $0.00 Contract Trainers/Speakers Cultural Competency Trainer $4,000.00 $0.00 $0.00 Subcontractors Zumba Instructor,Evaluation Assistant $5,840.00 $000 $0.00 Total Contractual Costs $9,840.00 $0.00 $0.00 `z .: t a . xs z a, I i :: i r 4 1:.,, t n. IFr .,t, v. t"i r44iil ., ;,_, 'i OTHER COSTS DESCRIPTION Marketing/Media marketing&media materials for Heart Month&stroke awareness $10,000.00 $0.00 $0.00 Outreach/Educational Materials pedometers,cookbooks,food for classes,pamphlets,binders $10,340.00 $0.00 $0.00 Screening resting supplies $3,549.70 $0.00 $0.00 Treatment medical vouchers $10,000.00 $0.00 $0.00 Other Costs smoking cessation vouchers $440.00 $0 00 $0 00 Total Other Costs $34,329.70 $0.00 $000 .{. " :* ¢. ":._ , , _ ..:F'l .., it .,1 ,' :'.i A` 7, _.,.'°� ... ° r",'.t�.::: ., ,r. ;_ , 'p0E,;> ,E'' '1,Yv-0a SoUtr&2„ SUBTOTALS $220,313.00 00. !.....: ,n.t ,R, s,r ! 3"1+I''.., aic mi p'T 2 : ;=`R'2'''Via3 i #r c:. a+x tW.C $kH0 : y INDIRECT COSTS: 2% Contractual $196.80 INDIRECT COSTS: 20% Personal Services,Operating,Travel and Other 842,094.60 Total Indirect Cost(Calculated on Amount Requested from CDPHE Only) $42,291.40 . vc r I �ua� u it k uur} -s R1c.. ik, g .c;:�.N , :rU .::.„'. nests .flu fn S I( OIF v,*"-,v, `t ,. - TOTAL AMOUNT REQUESTED FROM CDPHE $262,604.40 s p>n1 tai UA tist Vii , t ` ,� a r t t t '4vS ' 0 r,%vT`{40 li " , : , .J 1 i_ - z ! 3 i9t aYy )�-,. ta-: � : `Other Please In Icate additional revenue if applicable. Signature -Authorize Representatiy Date Rev.12.1107 Cancer, Cardiovascular Disease, and Pulmonary Disease Competitive Grants Program FY 2007-08 BUDGET NARRATIVE Year 1: July 1, 2008 through June 30, 2009 PERSONAL SERVICES: RN Project Coordinator 1.0 FTE The BSN (Bachelor of Science in Nursing) Project Coordinator will manage the grant, provide general project oversight and supervision of grant personnel, arrangecontracts with clinics to provide CVD screening services, contracts with Zumba instructors, cultural competency trainers, and spokespeople for cardiovascular awareness campaigns. The Project Coordinator will perform recruitment activities in the community, as well as, use the electronic medical records system to identify women who are eligible for CVD screening. This position will recruit community members and clinical service providers to participate on the project's advisory council and arrange monthly meetings. The Project Coordinator will train all personnel involved with the clinical screenings and lifestyle intervention as needed, facilitate the lifestyle intervention group counseling sessions, conduct individual counseling sessions and maintenance intervention phone counseling, arrange follow-up screening, track project related data, complete grant required reporting, and participate with project evaluation. Salary calculation is $48,758.56 per year, which is $4063.21 per month for twelve months. Health Educator .75 FTE Ofelia Orozco, CNA will be the bi-lingual/bicultural health educator. She will provide individual and group lifestyle intervention counseling in Spanish, coordinate a walking program, conduct outreach and recruitment activities for the project, and assist with CVD screenings as needed. In addition, the Health Educator will conduct healthy Latin cooking classes in Spanish throughout the community, assist the Project Coordinator with data collection, and use the e-cast system to enter program information. The salary calculation for this position is $34,539.05 per year, which is $2878.25 per month for twelve months. Medial Assistant .5 FTE The bi-lingual/bicultural medical assistants will provide screening services at contracted CVD screening sites. They will collect medical histories, an assessment of dietary risk, physical activity habits, and smoking status along with all applicable clinical testing. The MA's (medical assistants) will assist with conducting appointment reminder calls, scheduling follow up screenings, assisting with group lifestyle intervention sessions, community intervention classes, entering data into the e-cast system and in recruiting efforts for project participation. The salary calculation for this position is $14,127.92 per year, which is $1302.92 per month. This position will be for 8 months of the first year of funding and then 12 months for grant years 2 and 3. Data Specialist .1 FTE Cindy Kronague, MPH will gather, communicate and manage all Heart of Weld data for reporting and evaluation purposes and provide supervision and guidance to the sub- contracted Data Specialist. The salary calculation for this position is $9356.74 per year, which is $575.28 per month. OPERATING COSTS: Printing/Copying 15,000 copies for promotional and educational printing,patient history forms, and misc. projects @ .10/copy for $1500.00. Color printer cartridges: 3 @ $375 ea. for$1125.00 Total Printing/Copying: $2625.00 Postage/Shipping 4 maintenance intervention mailings per enrolled lifestyle intervention participant: 100 participants x $1.00 per mailing for$400 Computer Equipment One laptop computer with docking station and software for$2,500 Staff Development $425 per FTE to attend various staff development trainings offered throughout the year Office Supplies Miscellaneous general office supplies @ $100/FTE for $235 Meeting Expenses 10 Advisory Committee meetings @ $75 per meeting and 6 project clinical and intervention staff meetings/trainings @ $100 each for$1,350 • Other Program Costs Incentives for lifestyle intervention participation: 1 gift card for$10 per participant who successfully completes four weeks of intervention classes for 100 participants and 1 gift card for $10 per participant who successfully completes eight weeks of intervention classes for 80 participant for$3,600. 32 gift cards for childcare providers during intervention classes @ $20 each for$480. Total: $2440 TRAVEL In-State only 1.75 FTE @ 600miles/mo x 12 months x .39/mile for outreach, trips to contracted clinics for screening administration, and trips to various intervention sites throughout the county for$4,914 .5 FTE @ 200miles/mo x 8 months x .39/mile for travel to clinical sites for screenings, outreach, and to travel to various intervention sites throughout the community for $312. Total for travel: $5,226 CONTRACTUAL 2 half day(4 hour) Cultural Competency in Health Care Delivery trainings for contracted clinic personnel, lifestyle intervention personnel and public health staff @ $2000 per training for$4000.00 SUBCONTRACTORS Zumba Instructor 1 hour/week @$20/hour for 50 weeks for$1000. Evaluation Specialist for 10hours/week @ $20/hour for 24 weeks for$4,800 Total Subcontract charges: $5,800 OTHER COSTS Marketing and Media Air time on KGRE Spanish Language radio in February for Heart Awareness Month and in March for Stroke Awareness Day: $350/30minutes of air time x 2 for $700 Public Service Announcements (PSAs) on KGRE Spanish Language radio: 100 PSAs @ $10 for$1000 Ads for community classes and public awareness campaigns in local publications including La Tribuna Spanish Newspaper: $120/4" x 4" ad for 10 ads for $1,200 Ads to promote community events and to raise awareness on Telemundo Spanish language television: 144 public service announcements over a 9 week period of time for $4000.00 Ads to promote community events and to raise awareness on KUAD radio: 105 radio spots for $3100 Total for marketing/media: $10,000 Outreach/education materials Notebook binders: 100 binders @ $2.00 for$200 Nutrition reinforcement-cookbooks: 50 in English and 50 in Spanish @ $5.00 for$500 Physical activity reinforcement-therabands: 100 @ $3.00 for $300 Physical activity reinforcement-pedometers: 100 @ $6.00 for$600 Food for community healthy Latin cooking classes: 20classes @ $75.00/class for $1,500 Healthy Snacks for lifestyle intervention classes: 32classes @ $40.00/class for$1,280 Heart disease and Stroke educational pamphlets/brochures for distribution at health fairs and other community events: $200 Total for Outreach/education materials: $4580.00 Screening CardioChek PA Professional (test for Total Cholesterol, HDL, LDL, Triglycerides, Ketone and Glucose): 3 units @ $460 for $1,380 Thermal Printer(allows individual test results to be printed out when performing tests on CardioChek PA): 3 units @ $415 for$1,245 Cholesterol, HDL& Glucose Combo Strips: 15ct @ $105 x 20 for $2,100 Thermal printer labels (500 ct) @ $19.95 x 3 for $59.85 Thermal printer paper 1 roll @ $29.95 x 3 for$89.85 Blood Pressure Cuffs: 3 extra large @ $129.95 for$519.80 Stethoscopes: 3 @ $81.00 for$324.00 500KL Digital Medical Scale (with a height arm and BMI function): 3 scales @ $324.00 for $962 Miscellaneous screening supplies (pipettes, lancets, sharps containers etc): $150 Total screening supplies: $6830.50 Treatment Medical vouchers for uninsured patients with high risk screening results for 1 time medical provider consultation: 1 voucher @ $100 for 25 patients for $2500 Other Intervention Costs Vouchers for smoking cessation classes: 50 vouchers @ $11/ea for$550 Indirect Costs Funding to cover grant management, administrative support and other indirect expenses is calculated @ 20% of total direct costs. Contractual flow through is calculated @ 2% of total contractual costs. Total Indirect Costs: $35,324.30 Enclosure Hello