HomeMy WebLinkAbout20051719.tiff RESOLUTION
RE: APPROVE APPLICATION FOR COLORADO CANCER COALITION GRANT FOR
PATIENT NAVIGATION SYSTEM 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 Colorado Cancer
Coalition Grant for Patient Navigation System 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 15, 2005, and ending April 30, 2006, with further terms and
conditions being as stated in said grant, and
WHEREAS, after review, the Board deems it advisable to approve said grant, 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 Colorado Cancer Coalition Grant for Patient Navigation
System 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 grant.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
'lowing vote on the 13th day of June, A.D., 2005.
La,� BOARD OF COUNTY COMMISSIONERS
t
�,-, WELD COUNTY, COLORADO
IR61 -A ���re ' William H. ke, Chair
(1 , P �, o C Aty Clerk to the Board
BY:
Deputy Clerk to a Board —
Dav' E. Long
A O DA .
Rob . Masde
unty A orney
Glenn as
Date of signature: /F c}-t 05
2005-1719
HL0032
(JO : 4/L n9- /(-mss
Memorandum
WI IDTO: William H. Jerke, Chair
OBoard of County Commissioners
• From: Mark E. Wallace, MD, MPH, Director
COLORADO Department of Public Health and
Environment Outtolf2eS
ThM
DATE: June 3, 2005
SUBJECT: Grant Application to the Colorado Cancer
Coalition
Enclosed for Board review and approval is an application for funding to the Colorado Cancer
Coalition to establish a network of resources for breast and cervical screening, treatment, and
aftercare called the Patient Navigation System. The time period for the grant, if funded, is July
15, 2005 through April 30, 2006. The total amount of the request is $24,999.00.
The Patient Navigation System will be coordinated through the Colorado Women's Cancer
Control Initiative and the Weld County Women's Health Consortium (WCWHC). We will
contract with a bilingual health educator to research available resources and develop a guide that
women and volunteers from the community will use to navigate the cancer screening and
treatment system.
The health educator will train these community volunteers to provide ongoing assistance to
women in their communities after the funding period is over. The WCWHC will work together
with these volunteers to keep the resources up to date and track the success of the program.
I recommend your approval.
Enclosure
ri ta-6: DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
j 1555 N. 17`" Avenue
Greeley, CO 80631
WEBSITE: www.co.weld.co.us
ADMINISTRATION: (970) 304-6410
W
I
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 Cancer Coalition c/o Comprehensive Cancer Program
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. 2382
Applicant's Fax: (970) 304-6452
Project Title: Patient Navigation System for Weld County
Contact Person: Olivia Martinez
Amount Requested: $24,999.00
Time Period of Request: July 15, 2005 through April 30, 2006
Weld County Department of Public Weld County Board of Commissioners
Health and Enviro�my�entt)/)
044\ ' -1-\ /71-At/
Mark E. Wallace, MD, MPH, Director William H. Jerke, Chair JUN 13 2005
W EkteilMald-4
1861 ;A = >30- eld County Clerk the Bo
7 1V`I°'t
��� Deputy Cler to the Board
aoas-i'7/9
Comprehensive Cancer Program
Quality of Life Grants
Project Title_Weld County Patient Navigation Program: Breast and Cervical Cancer Navigation
Services for Underserved Women in Weld County
Applicant Name Weld County Department of Public Health& Environment
Address 1555 N 17th Avenue Greeley CO 80631
Contact Person(Name& Title) OliviaMartinez , CWCCI Northeast Coordinator
Email Address omartinez(aco.weld.co.us
Phone (9 a.m. - 5 p.m.) 970-304-6420 Ext. 2382
Secondary contact person and phone (if applicable)
Gaye Morrison, Health Promotion Supervisor 970-304-6420, Ext. 2380
(Name&Title) Phone(9 a.m. - 5 p.m.)
Amount Requested £24,999 from July 15, 2005 to April 30, 2006
($25,000 maximum) month/day/year month/day/year
LIMIT THE NARRATIVE TO 10 pages, UNLESS INDICATED. PROPOSALS LACKING ANY
OF THE REQUESTED INFORMATION AND/OR EXCEEDING THE PAGE LIMITS WILL
NOT BE CONSIDERED FOR FUNDING.
SUPPORTIVE MATERIALS ARE ALLOWED BUT PLEASE BE SELECTIVE.
ORIGINAL PROPOSAL PLUS FIVE (6) COPIES MUST BE RECEIVED BY CCP BY 12:00
NOON,June 15th 2005.
Please double-space the lines and use at least 12-point type throughout the application.
10. Budget
Please use the following format budget (budget sheet may be recreated)
Budget is not included in page numbers. Please provide an explanation of budget items
(budget justification) for each specific line item on separate page. Please explain how the
4
Comprehensive Cancer Grant Guidance,2004
This form MUST be included with your application:
Signature must be the director of the organization applying.
I, the undersigned, do hereby attest that the information contained within this application is true to
the best of my knowledge. I understand that my application will be disqualified should this
statement be untrue.
Signed: Date: June 3, 2005
Title: Director
Organization: _Weld County Department of Public Health &Environment
3
Comprehensive Cancer Grant Guidance, 2004
•
Weld County Women's Health Consortium
Breast and Cervical Cancer Navigation Services for Underserved Women in Weld County
A. PROJECT SUMMARY
The Weld County's Women's Health Consortium (WCWHC)will assist in prevention and
control of breast and cervical cancer for all underserved women with an emphasis on those from
the Hispanic population in Weld County. By providing easy access to breast and cervical cancer
screening, treatment and after care resources through education and referrals, women will be able
to effectively use resources. Weld County covers an area of 3,999 square miles in north central
Colorado, includes 31 incorporated towns and an estimated population of 217,652 (2004,
Economic Development Action Partnership), including 69.19% non-Hispanic and 30.81% is
Hispanic or Latino. Approximately 20,000 Weld residents receive public welfare assistance.
The proposed Patient Navigation Program (PNP) for Weld County will provide culturally
sensitive breast and cervical cancer-related education and navigation skills to access resources
and services. A Project Director would be responsible for coordinating the program. The Patient
Navigator will train volunteers (lay helpers from the community) to function effectively as
patient navigators. All the activities in the program will be assigned and coordinated by the
Project Director. The CWCCI(Colorado Women's Cancer Control Initiative), housed in the
Weld County Department of Public Health and Environment (WCDPHE), offers free breast and
cervical cancer screenings (mammograms, clinical breast exams, Pap tests and Pelvic exams) as
well as Spanish and bilingual health education to low-income women, ages 40—64 years, in the
Northeast Colorado region. The CWCCI Coordinator will oversee the PNP on behalf of the
Weld County Women's Health Care Consortium. Consortium members include the American
Cancer Society, Banner Health Breast Center, North Colorado Medical Center's Lymphodema,
Weld County Women's Health Consortium
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Oncology, and Rehabilitation centers, Planned Parenthood, Salud Health Care Center, Sunrise
Community Health Center and WCDPHE. These agencies are part of the ongoing efforts to
improve women's health in Weld County. A Patient Navigation System will integrate all these
services and ensure optional and effective use of local resources. Successful implementation of
this program could lead to broadening into other cancer arenas and replication in other
underserved counties throughout the state.
1. Problem Statement:
Breast cancer and cervical cancers occur disproportionately in women who are uninsured and
underinsured. Breast cancer is the most commonly diagnosed cancer in American women. It's
the second leading cause of death in women. An expected 211,240 new cases of invasive breast
cancer are expected to occur among women in the US during 2005. New cases of in-situ breast
cancer are expected to occur in 58,490 women in United States in 2005. An estimated 2,560 new
cancer cases will occur in Colorado in 2005. This puts incidence of breast cancer above all other
cancers occurring in women in Colorado. Breast cancer incidence is higher in Weld County and
Colorado when compared to the national average. In Weld County alone, 17 women died of
breast cancer in 2003. Sadly, with proper screenings these deaths may have been prevented.
Figure 1. Projected Incidence of Breast Cancer, 2005
Estimated Breast cancer incidence for 2005'
16
15.5® I
® ® ■breast cancer
15
14.5
US Colorado
`The incidence rate in Weld County is similar to Colorado.
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Screening mammography is particularly effective in detecting breast cancer in elderly women.
Yet, although half of all breast cancers are diagnosed in older women, statistics show that
women ages 65 and older tend to not to use mammograms for breast cancer screening. Using
Health Belief Model as the theoretical framework, the results indicate that along with
emphasizing the importance of mammograms in early detection of breast cancer, stressing the
importance of mammography as a screening tool may be an effective health education strategy
for elderly women of different racial/ethnic backgrounds.
Cervical cancer is an ideal disease for screening because it has a prolonged asymptomatic phase
and is potentially 100% curable when detected early. The 5-year relative survival rate for early
invasive cervical cancer is 91%. For pre-invasive cervical cancer the 5-year survival rate is
nearly 100% (NCI, 1997). This is compared with a 0%to 39% rate when the disease is detected
at an advanced stage. Cervical cancer can be virtually eliminated by routine Pap smear
screenings at recommended intervals. More comprehensive efforts could help to lower the
incidence of cervical cancer in Weld County. The highest incidence of cervical cancer is seen in
the Hispanic population. Weld County has 30.8% Hispanic population and an estimated 16.9%
of the entire population is below poverty level. (www.quickfacts.census.com).
Pap smear screening can detect cervical cancer at an early stage when it is most treatable. The
factors that hinder cancer prevention and early detection for certain segments of our population
are multifaceted. A woman who is never or rarely screened for cancer is likely to be an older
member of the racial ethnic minority, low income, less educated and uninsured or underinsured
(Burak et al, 1997). She may be unaware or not fully aware of risk factors associated with breast
and cervical cancer and the resources available to her in the community. She may face language
and cultural barriers to care.
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Reasons for not Receiving a Pap test
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Figure 3. By Race/Ethnicity Figure 4. Health Insurance Status
Source: National Health Interview Survey
2. Rationale
We are asking the Colorado Comprehensive Cancer Outreach/Education Projects (CCCOEP) for
$25,000 to fund capacity building, increase access to community resources via navigation
services, and to develop and distribute early detection breast and cervical cancer promotional
materials.
The benefits are comprehensive and include:
• Fulfilling Colorado Cancer Plan's Goal to reduce disparities in cancer incidence and
mortality according to gender, sex, ethnicity, insurance status, socioeconomic status and
place of residence.
• Promote early detection of breast cancer and cervical cancer that will lead to a better
survival rates compared to other kinds of cancer.
• Collaboration among various organizations involved with breast and cervical cancer.
• Recognition of the barriers and addressing the needs of the underserved.
• Effective and optimal use of local resources.
• Improved awareness and empowerment of community members.
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• Ensuring that services and materials are appropriate for low socio-economic, less
educated, uninsured or underinsured and ethnically diverse population.
• Successful implementation of this program may open up possibilities for extension into
other cancer prevention areas for men and women of all age groups.
• This program can serve as a model for replication in other counties and communities with
similar needs.
3. Target Population:
The Patient Navigation Program will provide services to uninsured or underinsured in Weld
County with particular emphasis on rarely or never screened women. The Patient Navigation
Program will be a valuable part of the existing infrastructure of services in the community. It will
provide referrals and easy navigation of local resources tailored around the needs of the people
seeking it.
4. Colorado Cancer Plan:
The Patient Navigation Program's overall goal is to assist underserved/uninsured women
diagnosed with breast or cervical cancer to become aware of and utilize the best possible medical
care available to them and access the existing resources more effectively. The goals of the 2010
Colorado Cancer Plan's Quality of Life chapter which this grant will address are:
• Objective 4.2 Increase the amount of resource information, and access to this
information, that is available in Colorado regarding cancer treatment, care, support,
rehabilitation, and end-of-life services.
The Patient Navigator will create a Spanish and English list of resources in Weld County
about cancer treatment and other services which can be given to health care providers, the
Banner Health Breast Center Library , and individuals and families affected by cancer.
Weld County Women's Health Consortium
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• Objective 4.3 Improve the quality of life for cancer survivors by reversing or eliminating
treatment-related side effects during and following cancer treatments through
rehabilitative interventions.
The Patient Navigator will refer cancer survivors to the Rocky Mountain Cancer
Rehabilitation Institute at the University of Northern Colorado for assistance in
improving the quality of life through prescriptive exercise interventions. This helps to
reverse or eliminate the debilitating side effects of cancer treatment in cancer survivors.
• Objective 4.9 Facilitate the process for comfortable dying with preservation of autonomy
and grieving support for the family.
The Patient Navigator will encourage the families to be involved with Hospice and
Palliative Care of Northern Colorado and its resources, such as the Chrysalis Grief
Center.
5. Project Plan
Goal
The Goal of the program is to provide underserved, underinsured, or uninsured women and their
families, who are diagnosed with Breast or Cervical Cancer with a comprehensive Patient
Navigation Program.
The program will assist these women and their families in accessing local and state resources
related to their treatment and care. The hope is that with the ability to navigate through the
resources, these women will receive the best care available.
Objectives: 1. By September 2005, the Patient Navigation Program will identify women in Weld
County diagnosed with breast and cervical cancer, who are uninsured, underinsured or
underrepresented .
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2. Throughout the grant period, the Patient Navigator will conduct one-to-one
patient/navigator sessions that will serve to assist and empower clients to navigate the
medical system and available resources, as evidenced by client interviews.
3. Throughout the grant period, the Patient Navigator will coordinate and maintain
partnerships with state and local resources.
4. By April 2006, the Patient Navigator will develop, distribute, and collect client surveys
that will provide data to evaluate the effectiveness of the Patient Navigation Program.
5. Throughout the grant period the Patient Navigator will train bi-lingual volunteers to
provide counseling and support for individuals and families affected by cancer. These
volunteers will become part of the American Cancer Society programs for outreach.
Specific Objective Measurement Procedure Relevance Deadline
Make the Patient Navigation Participation Partner and client Objective 1 September
Program available to Rates referrals. 2005
underserved women.
One-to-one Patient Navigator Client Evaluate client's Objective 2 Contract
Sessions. interviews knowledge of period
resources through
client interviews.
Maintain partnerships with state List of Establishing a Objective 3 Contract
and local resources. partners and network of state period
resources and local resources.
Development, distribution, and Survey data Data collected to Objective 4 April 2006
analysis of client surveys. measure the
effectiveness of the
program.
Train bi-lingual volunteers. List of bi- Provide counseling Objective 5 April 2006
lingual and support for
volunteers individuals and
their families.
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Steps and Activities a 7y E . a O Z w •y It c
C o O 0O O 0 p O O O NJ O
to to to — O) aN a, a. C\
Submit Grant Proposal PD X
Hire Project Manager PD X
Coordinate and PN X X X X X X X X
Maintain Outreach
Efforts
Conduct one-to-one PN X X X X X X X
sessions with clients
Train bi-lingual PN X X X X
volunteers
Attend Weld County PN X X X X X X X X X X
Women's Health
Consortium Meetings
Email Monthly Update PN X X X X X X X X
to Colorado Cancer
Coalition
Provide and Review PN X X X
Quarterly Client
Surveys
Mid-Year Grant PN X
Report due
Funding for the X
Program Ends
Final Report Due PN X
Final Invoice Due PN X
Verbal presentation to PN, X
CCP PD X
Key: PN=Patient Navagator; PD=Project Director
5. Collaboration
The following organizations and agencies have agreed to participate in the program: American
Cancer Society, Banner Health Breast Center, Family Physicians of Greeley, North Colorado
Family Medicine, North Colorado Medical Center-Banner Health Systems, North Colorado
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Medical Center-Lymphodema, Northern Colorado Medical Center Oncology SW, Northern
Colorado Medical Center Rehabilitation, Planned Parenthood, Salud Health Care Centers, Sense
of Security, Sunrise Community Health Centers, Surgical Associates of Greeley PC, and Weld
County Department of Public Health and Environment. These agencies and the WCDPHE:
Colorado Women's Cancer Control Initiative formed a Consortium in April 2005. The Mission
of this Consortium is to build an integrated system that reduces barriers to care, promote
information sharing, link women's health care providers and improve access to breast and
cervical cancer screening and specialty care services. This will maximize the utilization of
federal, state and local care assistance programs.
7. Community Resources
The Platicas project is one of the successful natural helper breast cancer education outreach
programs for Latina women directed by Olivia Martinez, CWCCI Northeast Coordinator and the
Weld County Department of Public Health and Environment. Ofelia Orozco,Platicas Outreach
Specialist, facilitates a discussion with clients and their friends and family members about breast
health in the comfort of a woman's home. The CWCCI offers free breast and cervical cancer
screenings for low income, uninsured and underinsured women who are screened through
CWCCI. They are eligible to receive free treatment services through Medicaid.
8. Barriers/ Obstacles
We expect to hire and train a Bilingual Health Educator familiar with this population. We don't
forsee many obstacles to implementing and completing the project. One possible obstacle could
be a delay in finding a qualified individual who wants to work part-time. We will advertise and
recruit with the assistance of the WCDPHE to minimize the delay.
9. Project Future
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This program is modeled after the successful Navigation Program in Larimer County, which is
supported by their local hospital and grants.
The Consortium will continue its support to the Navigation program in providing referrals,
education, and navigation skills. We expect that each member of the Consortium will be able to
provide some funding for this program. We are also seeking support from local collaborative
grants and foundations such as the North Colorado Medical Center Foundation.
Weld County Women's Health Consortium
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BUDGET
Applicant: Weld County Department of Public Health Funding Period: July, 2005- April 30, 2006
Project Title Weld County Women's Health Consortium: Breast and Cervical Cancer Navigation
Services for Underserved Women in Weld County
CCP LOCAL LOCAL TOTAL
Line Item REQUEST CASH IN KIND BUDGET
EXPENSES
Project Director(in-kind)) $ 0 $ $ 4,680 $ 4,680
Project Staff(attach resume) $ 15,200 $ $ $ 15,200
Weld County Women's Health $ $ 24,720 $ 24,720
Consortium (attach list)
Supplies $ 1,400 $ $ $ 1,400
Printing/Copying $ 300 $ $ $ 300
Telephone $ 400 $ $ $ 400
Postage $ 200 $ $ $ 200
Info./Ed. Materials $ 1,325 $ $ $ 1,325
Advertisement $ 400 $ $ $ 400
Travel $ 1,002 $ $ $ 1,002
Meeting Costs $ 0 $ $ 756 $ 756
Consultant Costs $ 2,500 $ $ $ 2,500
Other(specify) indirect costs $ 2,273 $ $ 2,301 $ 4,574
Equipment (in-kind only) $ XXXX $ $ 4,000 $ 4,000
Space Rental (in-kind only) $ XXXX $ $ $
TOTAL EXPENSES $ 24,999 $ $ 36,457 $ 61,456
10. Budget Justification
Grant Costs- $24,999.00
Project Staff: $15,200
We are requesting $15,200 for a contract Patient Navigator position, 20 hours per week at
$20.00/hour for 38 weeks.
Supplies: $1,400
We are requesting $1,000 for office supplies such as pens, notepads, paper and envelopes - $400;
Incentives such as magnets and key chains with program logo and contact information needed
for the outreach - $1000.
Printing/Copying: $300
We are requesting $300 for printing and copying of flyers.
Mailing/Postage: $200
We are requesting $200 for mailing and postage of letters to underserved women requesting
information on the PNP and potential patients.
Telephone: $400
We are requesting $400 for a cell phone that will be the Patient Navigator's main line of
communication with clients.
Educational Material: $1,325
The $1,325 will be used for educational vouchers to purchase books and videos for clients such
as Breast Cancer: The Complete Guide, The Breast Cancer Survival Manual, Women at Risk:
HPV Epidemic and Your Cervical Health, Breast Cancer for Dummies, Cervical Cancer: From
Etiology to Prevention.
Advertisement: $400
We are requesting$400 for advertising the position.
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Transportation costs: $1,002
We are requesting $1,002 for mileage for transportation of the program volunteers to client's
homes when required throughout the program. 2600 miles X 0.385.
Consultant Costs: $2,500
The $2,500 will be used to hire a consultant to develop a tracking system, screening and
evaluation tool for the Patient Navigation Program.
Indirect Costs: $2,273
The $2,273 will be used for billing, purchasing, and equipment provided by WCDPHE.
Local In Kind
WCDPHE: $4000.00
The WCDPHE will provide the use of equipment like printer, copier, AV, plus office space when
needed, rooms for meetings, mailing service.
Weld County Women's Health Consortium: $24,720
The WCWHC is composed of 12 members. These members will contribute 412 hours at $60 per
hour of their time to provide support for the PNP.
CWCCI Coordinator: $4,680
The CWCCI Regional Coordinator will contribute 78 hours at $60 per hour to oversee the PNP
for the WCDPHE.
WCWHC Meetings: $756
The CWCCI program at the WCDPHE will provide meals for 12 WCWHC members meeting
the third Tuesday of the month to inform and update each other on outreach and women cancer
issues.
Indirect Costs In Kind: $2,301
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