HomeMy WebLinkAbout20060783.tiff RESOLUTION
RE: APPROVE APPLICATION FOR DECREASING DIABETES DISPARITIES IN WELD
COUNTY GRANT 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 an Application for the Decreasing Diabetes
Disparities in Weld County Grant between 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, and the Colorado Department of Public Health and Environment,
commencing July 1, 2006, and ending June 30, 2008, with further terms and conditions being as
stated in said application, and
WHEREAS,after review,the Board deems it advisable to approve said application,a copy
of which is attached hereto and incorporated herein by reference.
NOW,THEREFORE,BE IT RESOLVED by the Board of County Commissioners of Weld
County,Colorado,that the Application for the Decreasing Diabetes Disparities in Weld County Grant
between 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, and the Colorado Department of Public Health and Environment be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said application.
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 13th day of March, A.D., 2006.
p 7 s, BOARD OF COUNTY COMMISSIONERS
4 , ELD CO .��TY, COLORADO
ATTEST: �te
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;�:•� peile Chair ,
Weld County Clerk to the y 4, ' ! i
BY: V� �li� l ���2t�� "�� David E. Long, Pro-Tem
D uty Clerk to the Board ' , Vl s
Will' m H. Jerke
AP ED AS T •
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Date of signature: s)2c I
2006-0783
ce > l1_ Cif H
03331 - 0(0
Memorandum
(it
TO: M. J. Geile, Chair
' Board of County Commissioners
From: Mark E. Wallace, MD, MPH, Director
Department of Public Health �&o - _ i
• Environment
COLORADO
DATE: March 13, 2006
SUBJECT: Decreasing Diabetes Disparities in Weld
County
Enclosed for Board review and approval is the completed grant application for the
Health Disparities Grant from the Weld County Department of Public Health and
Environment. The total amount of the request for Weld County is $401,822. The
funding period is July 1, 2006 to June 30, 2008. A similar version of this grant was
submitted last year, but was not funded. We have made some modifications to the
grant and are hoping it will be funded this time.
Weld County Department of Public Health and Environment will use this funding for
three employees (2.6 FTE) to increase the coordination and outreach of diabetes
education and treatment to low-income uninsured and underinsured residents of
Weld County.
I recommend your approval.
Enclosure
2006-0783
DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 N. 17th Avenue
Greeley, CO 80631
WEBSITE: www.co.weld.co.us
I ADMINISTRATION: (970) 304-6410
FAX: (970) 304-6412
C PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420
Q FAX: (970) 304-6416
ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415
COLORADO FAX: (970) 304-6411
Granting Agency: Colorado Department of Public Health and Environment,
Office of Health Disparities
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: Decreasing Diabetes Disparities in Weld County
Contact Person: Gaye Morrison, Supervisor
Amount of Request: $401,822
Time Period of Request: July 1, 2006 to June 30, 2008
Weld County Department of Weld County Board of Commissioners
Public Health and Environment
lmaAelk '
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_ -7 3/13/2006
Mark E. Wallace, MD, MPH, Director M.J. eil , hair Date
Iorso`
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1361 t� _l ; _ d County Cler,c jo theLoard
°'u'‘ •-c. i G4��I 1 CZ ii �1��1�0�Y1
j ty Cllerk to the !bard
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Health Disparities Grant Program
Project Application
2007 - 2008
COVER SHEET
Project Title: Decreasing Diabetes Disparities in Weld County Project
Organization: Weld County Department of Public Health and Environment
ATTESTING TO BOARD OF COUNTY
Address: 1555 N. 17th Ave COMMISSIONER SIGNATURES ONLY
City/Zip: Greeley, CO 80631 detail,
E-mail Address: gmorrison(4co.weld.co.us ATTEST: Eiji
Phone Number: 970-304-6420 ext 2380 WELD COUNTY CLERK TO THE BOARD
FAX Number: 970-304-6452 /
BY: ; littl ��tC7°ec'�Gh,1
Federal Tax Identification Number: 84-6000813 DE TY CL K TO THEjOARD
By signing and submitting this application,the applicant agrees to operate the program as
described in the Application for Funding in accord ce with the grant terms and assurances.
Signature of Authorized Official: ,/6 _au
Date. 3/13/2006 ff Tale: M. J. Geile, Chair, Board of County Commissioners
Project Director or Contact Person: Financial Officer: , nt`
Name: Gaye Morrison Name: Judy Nero ,\►
Title: Supervisor,Health Communications Title: Business Manager I�1 '., 1u =�
�:
t 11
Address: 1555 N. 17th Ave, Greeley, CO 80631 Address: 1555 N. 17th Ave, Greet,,C t'n,t
'K
Phone: 970-304-6420 ext 2380 Phone: 970-304-6410 ext 2122 �` ` ,l
E-Mail: gorrison@co.weld.co.us E-Mail:jnero@co.weld.co.us
Total Amount of Funds Requested for State Fiscal Year 2007* (Year 1): $210,320.23
Total Amount of Funds Requested for State Fiscal Year 2008*(Year 2): $191,501.63
*For this grant purpose,Fiscal Year 2007 includes July 1,2006 through June 30,2007. StateFiscal
Year 2008 includes July 1,2007 through June 30,2008.
:;'Co 6 o-7e3
•
COVER SHEETS
Disease Categories (check all that apply)
❑ Cancer
9 Cardiovascular Disease
Diabetes
❑ Other precursors
❑ Chronic Pulmonary Diseases
❑ Crosscutting(addresses more than one disease)
Geographic area to be served: Weld County
Target Population:
A July 2003 estimate lists the Weld County population at about 209,909.There is a large
Hispanic population at estimated to be 34.32% of the total population in 2004. With the
median age at 28.95, the county is growing very quickly with a lot of the growth being seen in
the young Hispanic population. Uninsured rates among Hispanics are 1.5 to 3 times higher
than Caucasians in the service area.
Project Abstract:
The project has two main goals. The first goal of this program is improve the health status of
Hispanic/Latinos of Weld County to reduce their risk of cardiovascular disease, including
diabetes, through the establishment of a Decreasing Diabetes Disparities Program. The objectives
that support this goal include: hiring two part-time promotoras and a fill-time Project
Coordinator. The promotoras and Project Coordinator will complete necessary trainings for
outreach education components for the"Decreasing Diabetes Disparities in Weld County Project"
and create a system to do chart reviews of people with cardiovascular disease, including diabetes,
in the Electronic Medical Records (EMR). The Project Coordinator will coordinate at least three
trainings for health care professionals including one Cultural Competency Train-the-Trainer
Course, which will allow community members to teach Cultural Competency courses throughout
Weld County. The second goal is to establish and support community education programs for
people who have risk factors for developing cardiovascular disease, including diabetes, or the
medically underserved who have been diagnosed with diabetes.
2
PROJECT NARRATIVE FORMAT
Project Title:
Decreasing Diabetes Disparities in Weld County
Health disparity issue or need to be addressed:
Health disparities among Hispanics are seen at all levels health care, at a national, state and
county level; minority populations have higher rates of disease, disability and death compared to
Caucasians. These disparities are largely attributed to social and economic reasons,rather than
biological. As the minority population continues to grow at a dramatic rate, and if the health
disparities continue, the economic burden caused by these health disparities will also increase.
Diabetes is the ninth leading cause of death in Colorado and people with diabetes are at higher
risk for other health problems such as heart disease, stroke,high blood pressure,blindness,kidney
disease and amputations. As the disparities increase, so do the costs to care for people with
diabetes whose care also includes care for chronic complications associated with their diabetes
and increased need for general care.
According to the Colorado Behavioral Risk Factor Surveillance System(BRFSS),the prevalence
rate of diabetes is highest among African Americans and Latinos. When calculated, if we were to
eliminate the rate of the diabetes health disparity between Caucasians and Hispanics, it would
result in 6,056 fewer cases among minority adults per year. And at an average of$13,243 per
person, the 6,056 fewer cases would result in an$80 million dollar savings every year for
Coloradoans.
Weld County trends mirror the national and state trends. Increasing obesity rates and more people
being diagnosed with diabetes are affecting a community health care system that is already
overwhelmed. Based on a survey conducted between 1997 and 2002,Weld County has more than
25,000 individuals who do not have health insurance. This number represents 16.5% of the
county's residents. That is higher than the state average percentage of uninsured that is at 15.6%.
When compared to the state, Weld County also demonstrates higher disparities with higher
poverty levels, higher percentage of minorities, and fewer physicians per 100,000 people. And
while there is no single measure to establish the level of access to quality health care, it is well
known that factors such as insurance status, income, age, education, citizenship,race and
•
employment can affect the access to quality health care.
Target population:
A July 2003 estimate lists the Weld County population at about 209,909.There is a large
Hispanic population estimated to at 34.32% of the total population in 2004. With the median age
at 28.95,the county is growing very quickly with a lot of the growth being seen in the young
Hispanic population.Uninsured rates among Hispanics are 1.5 to 3 times higher than Caucasians
in the service area.
The target population that will benefit from this project include:
1. Older Hispanic/Latino adults, who have been diagnosed and are attempting to manage
their diabetes
2. Younger Hispanic/Latino adults, that are at risk of developing diabetes
3
3. Hispanic/Latinos who have limited access to traditional health care due to availability,
affordability and acceptability. The addition of a Cholestech Hemoglobin A1C Analyzer
will allow us to better serve our rural/migrant clients.
4. Hispanic/Latino families,ranging from older adults to children, through the involvement
of promotoras who will host platicas at family's homes.
Goal(s) and Objective(s):
The goals of the Decreasing Diabetes Disparities in Weld County Project are to improve the
health status of the Hispanic/Latino population in Weld County by guiding our clients through a
diabetes referral and monitoring system,providing resources to those who have been diagnosed
and those that are at risk, offering health promotion activities to the Hispanic/Latino community
and health care providers, and assisting in early detection and management of health problems.
The first goal of this program is improve the health status of Hispanic/Latinos of Weld County to
reduce their risk of cardiovascular disease, including diabetes, through the establishment of a
Diabetes Disparities Program. The objectives that support this goal include:
Process Objectives:
• To hire two part-time Promotoras de Salud and a full-time Project Coordinator
• The Promotoras and Project coordinator will complete orientation and necessary trainings
by July 30, 2006.
• The Project Coordinator will create a system to do chart reviews of people with
cardiovascular disease, including diabetes, in the Electronic Medical Records(EMR)
• The Project Coordinator will coordinate at least three trainings for health care
professionals including one Cultural Competency Train-the-Trainer Course, which will
allow community members to teach Cultural Competency courses throughout Weld
County.
Impact Objectives:
• By June 30, 2007, Sunrise Community Health Center and the Diabetes Clinic at the Weld
County Department of Public Health and Environment will see an increase in patient
follow-ups due to the new Electronic Medical Records' flagging system implemented by
the Project Coordinator.
• Following each Health Care Professional Trainings,participants will demonstrate
increased knowledge regarding diabetes care issues and cultural competence.
• Participants of the Cultural Competency Training will be asked to teach 4 classes/year to
their organization or within the community after completing the course.
Outcome Objectives:
• By 2008, the rate of diabetes that is clinically diagnosed in Weld County will be reduced
by 5%
• By 2008,the rate of follow-up visits of patients with diabetes will increase by 15%.
The second goal is to establish and support community education programs for people who have
risk factors for developing cardiovascular disease, including diabetes, or the medically
underserved who have been diagnosed with diabetes.
4
Process Objectives:
• To provide regular Dining with Diabetes classes in the community, at least four times in
English, and four times in Spanish, each year.
• Provide at least four platicas (small group discussions) a month using the Small Changes
Make a Big Difference curriculum in homes or other locations.
• Organize and coordinate a walking program for people who have attended a platica or
Dining with Diabetes class.
• Provide a quarterly self-management class in Spanish for the community, which will be
taught by a Bilingual Diabetes Educator,Nurse or Nurse Practitioner.
• Coordinate a 5 a Day Food Coupon Program that will allow 500 WIC and Weld Food
Bank participants to purchase fruits and vegetables at the Greeley Farmer's Market
during the months of July, August, and September 2006.
• To offer regular risk assessments and screenings in geographically convenient locations
for the target population to identify people with elevated blood glucose and therefore
help the target population understand the risk of developing diabetes, as well as
providing education about how diabetes can be prevented or delayed.
Impact Objectives:
• By 2008, meet the community's need for comprehensive diabetes education by
providing regular Dining with Diabetes,platicas sessions and diabetes self-management
classes.
• By 2008, increase the amount of fruits and vegetables eaten by WIC and Weld Food
Bank participants and in turn, increasing the number of participants attending the
Greeley Farmers' Market
• By 2008, increase the number of Spanish-speaking diabetics who have received formal
diabetes self-management classes
• By 2008, diagnose participants earlier by providing screening at geographically
convenient locations
Outcome Objectives:
• By 2008, create a community group to provide ongoing feedback on programs provided
through the Decreasing Diabetes Disparities in Weld County Project and to work on a
plan of sustainability for the program
How project will be accomplished:
This project will be made possible through the collaboration of several agencies: the Weld
County Department of Public Health and Environment(WCDPHE), the North Colorado Health
Alliance, Sunrise Community Health Center, Salud Family Health Clinic,North Colorado
Medical Center, Greeley School District 6-Nutrition Services, and the Colorado State University
Cooperative Extension Office. These organizations have already been working together for
several years through the Weld County Diabetes Coalition. This group meets regularly and has
provided educational events and done other small projects in an attempt to meet the needs of the
community which has limited resources for people with diabetes and an overwhelmed
community health care system. The project being proposed incorporates two goals that are
reflective of the needs that are being demanded from our community. The two components will
be spearheaded by the WCDPHE
5
The first goal is to improve the health status of Hispanics/Latinos of Weld County, to reduce
their risk of cardiovascular disease, including diabetes,through the establishment of a Diabetes
Disparities Program. The first objective the goal will be hire bilingual/bicultural staff,two part-
time promotoras and a Project Coordinator,to implement the goals.Promotoras are lay
community health workers. They typically live in the communities they serve and their expertise
is often based on their experience in the community, enhanced by special training. They are
useful in reaching those"hard-to-reach"communities, in our case Hispanic/Latino,because they
are well established in the neighborhood and are culturally sensitive.
A Project Coordinator will be hired and one of his/her responsibilities will be to create a system
to do chart reviews(second objective) with the Electronic Medical Records,to assist with
teaching diabetes education classes and to coordinate the programs and classes for the program.
The Electronic Medical Records (EMR)is a wonderful tool that can be used to better provide
service to our clients.The system is a shared database with access in six sites in Weld and
Latimer counties. Currently,200 individuals have been trained to access information. The new
system is 95%paperless, allows medical staff to place orders electronically,makes information
accessible to medical staff from anywhere and allows for lab interface-electronic results. This
new system will make reporting easier while increasing the quality of customer service and
patient care for our clients. We will make the process easier by creating a system that will"flag"
patients with cardiovascular disease, including diabetes. This will allow health care professionals
in the health centers to perform appropriate tests,remind patients about follow-up appointments
and to make them aware of any available educational opportunities.
The Project Coordinator will also be responsible for coordinating the educational opportunities
(third objective) for both the medical community dealing with diabetics and the target
population. For medical staff,we will be working with North Colorado Medical Center(NCMC)
to provide Continuing Medical Education(CME) and Continuing Education Units (CEU) for
attending diabetes-related medical trainings. We will also be working with Cross Cultural Health
Care Program at NCMC to provide medical staff and community members a train-the-trainer
course in Cultural Competency. We hope that by providing this training at a community level,
different organization and community members could incorporate cultural competency programs
into their organizations. The course covers elements in an interactive method and focuses on
building culturally competent community partnerships and building culturally competent systems
of care.
The second goal of the proposed grant is to establish and support community education programs
for people who have risk factors for developing cardiovascular disease, including diabetes, or the
medically underserved who have been diagnosed with diabetes. The first objective is to provide
regular Dining with Diabetes classes in the community.We would like to offer the course at least
eight times each year, with four of the series of four(4)classes being taught in Spanish and the
other four being taught in English. Dining with Diabetes is a practical hands-on meal-planning
course that is appropriate for people who are diagnosed with diabetes, those at risk for
developing diabetes and caretakers of diabetics. This program has repeatedly demonstrated
significant increases in participants' knowledge, behavior and self-efficacy by the end of the
series. Dining with Diabetes courses have been taught in Weld County before through the CSU
Cooperative Extension and through volunteers, and it has always been well received by those
who attended.
The second objective is for the Promotoras to host four platicas each month.The platicas
program brings diabetes prevention education to the home. The promotora(s)will recruit women
from the community to host a platica, a small group discussion in their home or church. The
Promotora(s)will facilitate a discussion with friends and family members about diabetes
prevention in the comfort of a woman's home. She will use the Small Changes Make a Big
6
Difference Presentation that was developed by the Colorado State University Cooperative
Extension and the Colorado Depai tment of Public Health and Environment. Hostesses will be
identified from target population members, as well as recruited through Health Talk programs on
a local Spanish language radio station.
The third objective will involve the Project Coordinator and the Promotora(s) organizing and
coordinating a walking program for people from the pl6ticas or Dining with Diabetes classes that
are interested in increasing their physical activity. It would be held in a location that is
convenient for the participants. A walking log will be encouraged and pedometers will be given
to those who have attended five walking sessions.
The fourth objective is to provide a quarterly Diabetes Self-Management class in Spanish.
Unfortunately, there have been difficulties in providing Diabetes Self-Management classes for
our community since the hospital no longer offers outpatient classes to the community. Some
private clinics have been providing classes for their English-speaking clients. Unfortunately, the
need for Spanish Diabetes Self-Management classes is not being met and offering these classes
will help fill that need.
The fifth objective will be to coordinate the"5 a Day"Food Coupon Program so that 500 WIC
and Weld Food Bank participants will be given vouchers to help purchase fruits and vegetables
at the Greeley Farmers' Market. This program will help out the community two-fold; it will
encourage clients to buy and eat fresh fruits and vegetables while supporting our local farmers.
We will work in collaboration with WIC,Weld Food Bank and the Greeley Farmer's Market.
This project has been a goal of the coordinators for WIC and the Greeley Farmers' Market but
has not been realized because of funding constraints.
The sixth objective is to offer regular risk assessments and screening in geographically
convenient locations.This will help better serve the target population since we will be able to
identify people with elevated blood glucose levels and help the target population understand their
risks of developing diabetes, as well as providing education on how diabetes can be delayed or
prevented. We will accomplish this by collaborating with local health fairs, including the 9News
Health Fair held in April in several locations in the county, and the Weld County Senior Health
Fair held in October. We will also join with the American Diabetes Association to coordinate
Diabetes Sunday activities at local churches.
An important equipment purchase would be buying the Hemoglobin Al C Analyzer for our
mobile health van. The Analyzer will allow us to better and faster diagnose our clients. The van
travels all over the county, providing services at school-based health centers and migrant farm
worker camps.
The seventh objective is to create a group of community members to serve as a steering
committee for the Diabetes Disparities Project. It would be composed of key community
members from the target population and public health staff to provide on-going feedback about
the project and to create a plan for sustainability. This steering committee will bring interested
citizens and public health staff together to discuss current projects,provide ongoing community
feedback, and create a plan for sustainability. They will meet with the Weld County Diabetes
Coalition to facilitate communication between health professionals and the Hispanic community.
Describe the interventions or approach selected and the desired outcomes
• Hiring Bilingual/Bicultural Staff: It is important that staff be able to communicate effectively
with the clients in a language that they understand. It is key to have staff that can deliver the
correct message in a manner that is both culturally and linguistically competent.The clients will
be more open to change if they feel comfortable communicating with the bicultural/bilingual
staff.
7
Utilization of Promotoras: The utilization of lay community health workers has worked well in
the Hispanic/Latino communities.Promotoras are knowledgeable about the community and will
receive training in subject matter and leadership. Since the promotoras are well established and
respected within the community,the clients will feel comfortable approaching them with any
questions of concerns.
Using Evidence-based programs: The curriculum for Dining with Diabetes and Small Changes
make a Big Difference will be used. Both programs have evaluation components and have been
tested extensively. Since these programs have been taught on a limited basis in our community
previously, individuals who have attended will encourage others to participate. Research done in
2003 by the Roslow Research Group found that 69%of U.S. Hispanics believe they get more
information when it is provided in Spanish than in English.
Involving the Community: Forming a steering committee will be an important step in
accomplishing the project objectives and will provide important community feedback and
perspectives. Involving the community is key in making the program successful.Asking for
opinions and getting involvement in the process makes participants realize how integral they are
to the success of the program, and therefore more invested in seeing it succeed.
Why this approach was chosen:
All the approaches were chosen because they have been proven to work. The Promotora/Lay
Community Health worker has been successfully used in many health promotion programs. We
have also had experience using some of the programs proposed for this grant, including the
Dining with Diabetes classes,the platicas incorporating the "Small Changes make a Big
Difference"presentation. It is also well established that screening in an essential component of
early detection and early intervention. Screening can be used as a foundation for an educational
component and follow-up referrals,which will be made easier through the "flagging" system
established through the electronic medical records.
Cultural Competency:
The Weld County Department of Public Health and Environment(WCDPHE) strives to serve all
of our patients in a culturally competent manner. Our commitment to cultural competency is seen
in the staff we hire. Currently about one-third of the employees at WCDPHE are bi-lingual.
Some staff members have completed Cultural Competency trainings for their projects. Other
employees have completed the Cross Cultural Health Care Program's Bridging the Gap course(a
40-hour intensive medical interpretation course which teaches the participants how to properly
interpret for clients while being cultural-sensitive). Spanish classes are provided for employees
who are interested in learning or improving their Spanish.
Total amount of funds requested:
Year 1 =210,320.23;Year 2=$191,501.63: Total=$401,822
What are plans for sustainability after the grant period ends?
We hope that the success of this program can be institutionalized within the existing programs at
the WCDPHE. Rallying community support through forming a steering committee and
collaborating with other agencies will be important in securing more funding. Future funding may
come in the form of federal, state, local or private grants, and cash donations from local
businesses and in-kind contributions.
8
Health Disparities Grant Program
2007-2008
WORK PLAN FORMAT
Project Title: Decreasing Diabetes Disparities in Weld County Project
GOAL 1: To improve the health status of Hispanics/Latinos of Weld County to reduce their risk
of cardiovascular disease,including diabetes,through the establishment of a Diabetes Disparities
Program.
Objective Activity Responsible Duration Date
• Party Completed
1. To Hire two part- la Develop job Gaye Morrison 6 weeks August 1,
time Promotoras and descriptions, advertise, 2006
one Project interview,
Coordinator lb Hire staff: Project Gaye Morrison
Coordinator and two
parti-time Promotoras
lc Provide orientation Gaye Morrison
and training as needed
2.To create a system 2a Train staff on EMR Project Beginning On-going
to do chart reviews of System Coordinator August 15,
people with 2b Create"real time" 2006 and
cardiovascular disease, prompts for physicians to Project continuing
including diabetes in use Coordinator
the Electronic Medical 2c Create reports to
Records(EMR) identify clients that need Project
appointments Coordinator
3. To coordinate 3 3a. Identify specific Project Starting Completed by
Trainings for health issues related to diabetes Coordinator September, June 30, 2008
care professionals, that health care 2006
including one cultural professionals are
competency train-the- interested in learning
trainer course about
3b. Work with NCMC to Starting
offer CME trainings Project September,
3c. Offer Cultural Coordinator 2006
Competency Train-the-
Trainer courses for
community partners Project Starting
3d. Identify specialist to Coordinator October,
do trainings, including 2006
Cultural Competency
Trainings. Set-up dates,
location, etc. Project
3e. Invite and encourage Coordinator Starting
health care professionals Community November,
to attend partner 2006
9
GOAL 2: To establish and support community education programs for people who have risk
factors for developing cardiovascular disease, including diabetes, or the medically underserved who
have been diagnosed with diabetes.
Objective Activity Responsible Party Duration Date
Completed
1.Provide regular la Contract with the Project Coordinator September May 2008
Dining with Diabetes Weld County CSU 2006
classes in the Cooperative Extension
community, at least 4 Office to provide a
times in English and 4 Dining with Diabetes
times in Spanish, each class each quarter(4
year per year) Project Coordinator
lb Provide Dining Promotoras
with Diabetes classes in
Spanish to parents in
four elementary schools
in Greeley,working
with Parent/school
liaison
2. Provide at least four 2a Identify potential Project Coordinator Starting Completed
platicas(small group hostesses for platicas Promotora(s) August 2006 June 2008
discussions) a month 2b Arrange classes; Promotora(s)
using the Small provide hostess with
Changes Make a Big $40 gift certificate
Difference in homes 2c Invite participants Promotora(s)
or other locations to join walking groups
or other physical
activities
3. Organize and 3a Establish location Project Coordinator Starting Completed
coordinate a walking and time for walking Promotora(s) August 2006 June 2008
program for people program
who have attended a 3b Develop walking Project Coordinator
platica or a Dining log and provide Promotora(s)
with Diabetes class, pedometers for those
with at least 20 regular who have attended 5
participants walks
4. Provide quarterly 4a Contract with a bi- Project Coordinator September June 2008
Diabetes Self- lingual Diabetes 2006
Management Classes Educator or Nurse
in Spanish Practitioner to provide
classes
3b Identify location for Project Coordinator
classes
3c. Develop brochures Project Coordinator
about classes and
distribute to clinics
5. Coordinate 5 a Day 5a. Set up meeting Project Coordinator July 30, 2006 October, 2008
Food Coupon for 500 with Greeley Farmer's
WIC and Weld Food Market,WIC and Weld
10
Bank participants to Food Bank Project Coordinator
use for the purchase of 5b. Create coupons-
fruits and vegetables Each coupon will be
at the Greeley worth$1; each
Farmers' Market participant will get$5 a
during the months of month/visit to the Weld
August and September Food Bank Project Coordinator
2006 5c. Send explanatory
letter out to sellers at
the Farmer's Market Project Coordinator
5d. Implement
Farmer's Market
Coupon Program Project
5e. Evaluate program Coordinator,WIC
with surveys to sellers Director,Farmer's
and WIC participants Market staff
6. To offer regular risk 6a Collaborate with 9 Project Coordinator September June 2007
assessments and News Health Fair to do 2006
screenings in blood glucose
geographically screenings at all events
convenient locations in Weld County
for the target 6b. Purchase
population to identify hemoglobin A1C Project Coordinator
people with elevated analyzer for use with
blood glucose, and mobile medical van
therefore help the 6c.Help with the
target population Diabetes Sunday
understand the risk of activities at local
developing diabetes, churches with the
as well as providing American Diabetes
education about how Association
diabetes can be
delayed or prevented
7. To create a 7a. Invite interested Project Coordinator October 2006 June 2008
community steering citizens,participants of
committee, composed Diabetes Programs to
of key community and public health staff
members and public to form steering
health staff to provide committee
on-going feedback and 7b. Schedule meetings
create a plan for every other month to
sustainability for the discuss current projects
Diabetes Disparities and plan for
Project sustainability
7c. Work with the Weld
County Diabetes
Coalition to facilitate
communication
between health
professionals and the
Hispanic community
11
Health Disparities Grant Program funds
2007—2008
EVALUATION PLAN FORMAT
Project Title: Decreasing Diabetes Disparities in Weld County
Measures or indicators to be used. Attendees will be counted at each of the
presentations, such as the platicas, the Dining with Diabetes classes, the trainings for
Health Care Providers, walking programs, etc. Dining with Diabetes and the Small
Changes Make a Big Difference (the curriculum used in the platicas) have validated
evaluation tools that are incorporated into the program. The number of patient charts that
are flagged with real time prompts, and then the number of specific issues that the health
care providers address during office visits can be identified on reports from the Electronic
Medical Records (EMR).
Methods/strategies used to determine effectiveness and impact on health disparities.
Weld County is currently being oversampled on the Behavior Risk Factor Surveillance
Survey, so the number of people diagnosed with diabetes who report having received
diabetes education should increase. In the long term, there might also be reduced rates
of diabetes, and less amputation, less blindness, and less kidney dialysis as a result of
delayed complications from diabetes.
How will results be used, disseminated and communicated. Articles in the Greeley
Tribune, and the Spanish weekly newspaper, La Tribuna, can help both create interest in
attending a class, such as Dining with Diabetes, and help inform the community about the
success of the programs. Poster sessions and presentations at the Colorado Public Health
Association Annual Conference and the Rocky Mountain Association of Diabetes
Educators will also help to inform other communities about the programs.
12
Health Disparities Grant Program funds
2007-2008
LINE ITEM BUDGET FORMAT
Applicant: Weld County Department of Public Health and Environment
Project Title: Decreasing Diabetes Disparities in Weld County $401,822
(Round to the nearest dollar)
Fiscal Year 2007 Fiscal Year 2008 Total
(Yr. 1) (Yr.2) (Yr.1 and Yr.2)
Personnel Expenses:
Project Coordinator: 1 @ 1.0 FTE $ 62,202.90 $ 65,476.36 $ 127,679.26
Promotoras: 2 @ .80 FTE each 68,706.31 72,356.09 141,062.40
Administrative Assistant for budget: 2 hrs/week 2,227.95 2,314.12 4,542.07
Itemized Travel Expenses:
In area travel:(600 mi/month at$.425/mile $3060 3060 6120
Itemized Contractual\Subcontracts:
Contract with CSU Extension for quarterly $8000 8000 16000
Dining with Diabetes(DWD)classes 1600 1600 3200
Contract with CDE/NP for diabetes self-
management classes in Spanish 4/yr
KGRE Spanish Language radio 6600 6600 13200
Cross Cultural Train-the-Trainer Course 18000 18000
Itemized Supplies:
Gift cards for platica hostesses 1920 1920 3840
Pedometers 1000 1000
Notebooks for DWD classes 200 200 400
Provider Training Expenses 500 500 1000
Printing 750 750 1500
Farmers' Market Coupons 5000 7500 12500
Materials/food for DWD classes 3000 3000 6000
Office Supplies(toner,paper,etc) 800 800 1600
Indirect: (Not to exceed 15%of Personnel,
Travel,Contractual\Subcontracts and Operating) 18375.07 17425.06 35800.14
10.01%
Subtotal: $201,943.23 $191,5.01.63 $393,443.87
Itemized Equipment Expenses: (including
purchase/lease of vehicles) 3 computers 4647 4647
Computer: Standard PC+Adobe Acrobat+MS
Office Pro—monitor 2102 2102
Cholestech Hemoglobin Al c Analyzer
Analayzer Test Cartridges(192) 1628 1628
Limited Facility Renovation Expenses:
Total Project Cost $210,320.23 $191,501.63 $401,821.86
Signature of Authorized Representative and Date
*For this grant purpose,State Fiscal Year 2007 includes July 1,2006 through June 2007. State Fiscal
Year 2008 included July 1,2007 through June 30,2008.
13
Health Disparities Grant Program
Weld County Department of Public Health and Environment
Budget Narrative
Personnel: This grant would fund one full-time project coordinator and two part-time (.8
FTE) outreach specialists, as well as two hours a week for assistance with the financial
management of the budget. The project coordinator would have the responsibilities of
managing the grant, arranging the contracts with CSU Extension, implementing the chart
review system in the Electronic Medical Record System, organizing the health care
provider trainings, and coordinating the Farmers' Market Food Coupons program. The
bi-lingual bicultural outreach specialist(s) would have the primary responsibilities for the
health education in the home (platicas), the Dining with Diabetes classes in Spanish in
the schools, coordinating the walking program, and referrals to the diabetes self-
management classes.
Travel Expenses: The county rate for mileage in 2006 is 42.5 cents a mile. This is
about 600 miles a month.
Itemized Contractual and Sub-Contracts: The CSU Extension agent is experienced at
presenting the Dining With Diabetes (DWD) curriculum, but it is not included in her
"scope of work." The grant funding would"buy out"her time to do four series of four
classes, plus all the preparation time and materials, one each quarter. Funding is also
included to contract with a bilingual Certified Diabetes Educator(CDE) or Nurse
Practitioner(NP) to teach the diabetes self-management classes. The Health Department
currently uses grant funds for a half-hour Health Talk show on Saturdays at 1 p.m. on the
Spanish language radio station. This grant includes funding to continue that, as well as
pay bilingual diabetes educators to do several programs each year. Radio is a good way
to do health education in Spanish.
Itemized Supplies: This category includes the gift cards used as incentives for the
hostesses in the health education in the home (platicas) to invite their family and friends
and provide healthy snacks. Also included are the pedometers for the walking program,
notebooks and materials for Dining with Diabetes (25 persons per class), coupons for
WIC and Weld Food Bank clients to use at the Greeley Farmers' Market, printing and
other expenses.
Itemized Equipment Expenses: This includes three computers, as well as a hemoglobin
Alc analyzer and test cartridges. This machine will be used primarily on the mobile
medical van with the migrant outreach program. It can also be used at various
educational events and at Diabetes Sundays with the American Diabetic Association.
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