HomeMy WebLinkAbout930329.tiff RESOLUTION
RE: APPROVE IMMUNIZATION GRANT APPLICATION TO THE COLORADO DEPARTMENT OF
HEALTH AND AUTHORIZE CHAIRMAN 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 Immunization Grant
Application to the Colorado Department of Health from the Weld County Health
Department, commencing October 1, 1993, and ending September 30, 1994, with the
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 Immunization Grant Application to the Colorado
Department of Health from the Weld County Health Department be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chairman 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/A' vote on the 19th day of April, A.D. , 1993.
/I �/ .l1 / BOARD OF COUNTY COMMISSIONERS
ATTEST: i4v /L/(/��� WELA COUNTY, COLORADO
Weld County Clerk to the Board l 09-C J�te----1i Ls�
Constance L.
LLL...`H4rb[(ey/7rpt, Chairman
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BY: 4.44,-1,1%', -Gs / a"V P�" L��1"/s �./fiDeputy to the Board s W. TPA}
Webster, Pr -Tem
APPROVED__A.§ TO FORM: c / f i'-xZ
GeorgeiE. Bax er r-- .1"/ /--aunty Attorney Dale K. all
1__)dc- .-t .. / CASini_2(p•A
'barbara J. Kirkmeye O
930329
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WELD COUNTY HEALTH DEPARTMENT
IMMUNIZATION GRANT APPLICATION
October 1, 1993 - September 30, 1994
Applicant's Name Weld County Health Department
Address 1517 16th Ave Court
Greeley, CO 80631
Contact Person Rosemary Spence, R.N.
(Name & Title)
Immunization Action Plan Program Coordinator
Phone 303-353-0639
Amount Requested $167,790
Grant Period Oct. 1, 1993 - Sept 30, 1994
Date Submitted April 21, 1993
WELD COUNTY BOARD OF COMMISSIONERS MI WELD COUNTY HEALTH DEPARTMENT
lect
Constance L. Harbert 6V72/A93 Ran o�hGordon, M.D. , M.P.H.
Chairman Director
ATTEST: Weld ty/Cingkc ;to the Board
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By: SI;Ul Y., /( &1ti.
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GOAL:
By the year 2000, 90% of all children ages two-and-under will be fully
vaccinated.
OBJECTIVE:
To increase the number of age appropriate immunizations given to Weld County
children by 10% and to increase immunization levels by 5% per year by decreasing
the barriers of: distances to medical providers, lack of information of the
importance of immunizations at the recommended ages, and the lack of easily
accessible immunization records.
PURPOSE:
The 1991-92 Retrospective Kindergarten Immunization Survey showed that only 58.3%
of Weld County Children were fully immunized at age two. The kindergartens with
the lowest proportion of children fully immunized were located in remote rural
areas of the county and low socioeconomic areas in Greeley. It is estimated that
4,000 out of the children in Weld County live in poverty. Immunizations are
available from private physicians, two Community Health Centers, and Weld County
Health Department (WCHD) . However, there still remain significant barriers to
children receiving immunizations.
One barrier is the large size of the County-- 4,000 square miles-- and the
distance some families need to travel to receive health care services. In some
communities, the low demand for immunization and a limited appreciation of the
importance of beginning immunization in infancy has been reported among parents
who may be isolated from the health care system. There is also a lack of clinics
offering immunizations to children. Sunrise Community Health Center is presently
taking only one to three new families per week and the WCHD is not open on
weekends. North Colorado Family Medicine is not currently taking any new clients.
In Weld County, 37% of the births in 1991 were to Medicaid mothers yet there are
only one to four providers at any one time accepting Medicaid clients for child
care.
Weld County has nineteen clinic sites outside of Greeley. Due to limited
staffing the number of clinics held at each site has been decreased. Current
funding allows us to set up immunization clinics at these sites on only an annual
basis. Studies in other agencies have shown one time clinics outside routine
clinics proved disappointing with only small proportions of the estimated target
population vaccinated. Such campaigns don't build permanent improvements in the
vaccine delivery system essential to sustain the high coverage levels required
to provide present and future vaccines. Increased funding is needed to provide
recurrent immunization services in the rural and low socioeconomic areas.
Another barrier addressed in this grant request is the lack of knowledge about
the importance of time appropriate immunizations. Cultural and language
differences between local clinic personnel and the populations they serve have
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been shown to be barriers. Eighteen percent of the Weld County population is
Hispanic. Many parents, particularly those from minority groups, lack
information about the importance of immunizing their children at the recommended
ages. Funding is needed to provide outreach in each community by a staff person
that is bilingual and culturally sensitive.
The last barrier is medical records are not easily accessible. Weld County has
a very mobile population seeing multiple providers. Communication between
providers is limited therefore a rapid method of immunization assessment is
needed. The absence of a hard copy record should not be a reason for not
vaccinating. Funding is needed for a centralized personal immunization record
system.
ACTION STEPS:
1. By December 31, 1993 additional staff will be hired.
2. By December 1, 1993 provide a Saturday clinic at the WCHD once per month.
3. By January 31, 1994 provide a clinic every other month at 12 rural sites in
Weld County.
This differs from action step #2 in last year's proposal in two ways:
a) The current Saturday clinics which are not routine have been well
attended. Acknowledging that routine clinics help sustain the
immunization levels needed over one time clinics, we feel
routine Saturday clinics are necessary. b) Saturday clinics at the
rural sites are not well received. The communities prefer school
based or evening time periods so this part of the action plan has
been modified.
4. By February 15, 1994 provide a clinic once a month at Social Services.
5. By January 31, 1994 establish routine clinics at 3 public housing sites.
These two new action steps represent a change and expansion of action
step #3 from last year's proposal. The sites at public housing and
Social Services this year have been only moderately successful. We
still feel taking clinics to low socioeconomic areas is essential and
we would like to make the changes in order to increase the number of
children vaccinated. We define routine clinics as those held at the
same site either monthly or every two months (to match the
immunization schedule) . This will assist the population to become
accustomed to the staff and the regularity of the clinic. This also
allows for parent education and enabling parents to plan for their
child's health care.
6. By January 31, 1994 establish twice yearly clinics at two local businesses.
7. By January 15, 1994 contact all day care homes in Weld County to offer to
review records and inform of services.
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8. By March 31, 1994 work in conjunction with Weld County Environmental Health
staff to train them to review records or to provide the staff with information
to be given to day care providers when the inspection is made.
Action plan #4 from last year's proposal has not been feasible due
to the number of day care homes and the lack of interest by day care
providers. As stated in the quarterly reports, information and
offers of service have been sent to all day care homes. The WCHD
Environmental Health staff has now contracted with the Department of
Social Services to do day care inspections and licensure.
Environmental Health staff has agreed to work with IAP staff. The
new action plans deal with re-contacting all day care homes to offer
services and collaborating with Environmental Health.
9. October 1, 1994 continue the call back system for children failing to come
in for scheduled immunizations at WCHD programs.
The call back system at WCHD (last year's action plan #5) has been
established and is working well. We would like to continue the
system as well as expand the system by offering it to private
physicians or clinics.
10. By January 31, 1994 explore and work with private physicians and the public
clinics to provide recall for their clients.
11. By November 30, 1993 provide IAP staff to audit a minimum of 2 agencies to
determine the number of immunizations given and the percent of their two year old
clients adequately immunized.
In the 1992-1993 contract year, both Community Health Centers were
approached to obtain immunization levels of their two year old and
younger clients. One agency was very resistant and did not allow
access until late 1993. The data received from these agencies was
of little use as the method of evaluation differed in each agency and
the criteria of what constitutes adequate immunization was not the
same. Therefore, action plan #11 deals with IAP staff auditing at
least two agencies (who serve large numbers of children) using the
CDC Guidelines for Assessing Vaccination Levels of the 2-year-old
Population in a Clinic Setting. The ideal would be to audit early
in the grant period to get baseline data and then yearly thereafter.
The WCHD will audit its records twice yearly.
12. By September 30, 1994 explore the feasibility of a county-wide immunization
data base.
13. By January 15, 1994 collaborate with Larimer County Health Department (LCHD)
to investigate their new client tracking system.
Recently LCHD began to develop a community wide data base system.
We will work with them to learn about the system, how it was
developed and implemented, and how it is working after one year.
Larimer and Weld counties border each other. Clients frequently
utilize services in both counties. We will work to make the two
county systems compatible.
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14. By January 31, 1994 work with North Colorado Medical Center to obtain birth
records in order to notify parents of the need for immunizations, services
available, and client recall.
15. By November 30, 1993 collaborate with Plan de Salud Community Health Center
to assist in providing services to their clients which include a large migrant
population.
EVALUATION
The Retrospective Kindergarten Survey does not allow whole county data evaluation
of the grant's activities for at lease four years. We will utilize the audits
of WCHD and the two other agencies to give an indication of changes in
immunization levels for the county. The audits will also indicate changes in the
number of children immunized and the number of immunizations given.
The evaluation component has been changed to better assess adequate
immunization status. It is feared that monitoring the 4th DTP only
will not evaluate if the child received all the other vaccines
recommended.
NUMBER OF JOBS CREATED
A total of five positions will be funded by this project:
2 FTE Community Health Nurse
1 FTE Office Secretary
1 FTE Outreach Worker
1 FTE Epidemiologist
ADDITIONAL HOURS CLINICS WILL BE OPEN
Saturday clinics once a month 30 hours
Social Services clinics once a month 60 hours
Rural site clinics - 12 sites each every other month 216 hours
Public housing sites - 3 sites each every other month 54 hours
Local businesses - 3 sites each every six months 24 hours
Total increase in clinic hours 384 hours
ADDITIONAL CHILDREN IMMUNIZED
The number of WCHD clients, age 2 and under, immunized will increase by 10%.
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IMMUNIZATION PROGRAM BUDGET
PERSONNEL
2.0 FTE Community Health Nurse $ 53,112
1.0 FTE - $ 2,262/mo. X 12 mo. = $ 27,144
1.0 FTE - $ 2,132/mo. X 6 mo. = $ 12,792
- $ 2,196/mo. X 6 mo. = $ 13,176
1.0 FTE Office Technician 14,616
$ 1,218/mo. X 12 mo. = $ 14,616
1.0 FTE Outreach Worker 17,490
1.0 FTE - $ 1,436/mo. X 6 mo. = $ 8,616
- $ 1,479/mo. X 6 mo. = $ 8,874
1.0 FTE Epidemiologist 30,882
1.0 FTE - $ 2,535/mo. X 6 mo. = $ 15,210
- $ 2,612/mo. X 6 mo. = $ 15,672
Sub-Total Personnel 116,100
Fringe Benefits @ 17% 19,736
Total Personnel & Fringe Benefits 135,836
OPERATING EXPENSES
Supplies 1,000
Postage 2,500
Printing 1,500
Travel 2,000
8,000 miles X $ .25 = $ 2,000
Sub-Total Operating Expenses 7,000
INDIRECT COST/OVERHEAD
Indirect Cost/Overhead 24,954
* 18.37% of Salary & Fringe Benefits
Sub-Total Indirect Cost 24,954
TOTAL EXPENSES $ 167,790
* Weld County Health Department's approved indirect cost for Community Health
Nursing grants
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fstf, mEmORAnDUm
Constance L. Harbert, Chairman
111 D Board of County Commissioners April 15, 1993
I
; ' M/
� To Date J-"
COLORADO Jeannie K. Tacker, Business Manager, Weld County Health Dept.
From
Immunization Grant Application
Subject:
Enclosed for Board approval and signature is a grant application to the Colorado
Department of Health requesting continuation of funding for the Weld County
Health Department (WCHD) 1992-93 Immunization Program.
The goals of the grant will be to: 1) increase the number of age appropriate
immunizations given to Weld County children by 10%; 2) increase immunization
levels by 5% per year by decreasing the barriers of distance to medical
providers, lack of information of the importance of immunizations at the
recommended ages, and the lack of easily accessible immunization records.
WCHD is requesting approval of $167,790 for the period October 1, 1993 through
September 30, 1994 to carry out the objectives of the program.
I would recommend your approval of this grant application.
If you have any questions, please feel free to contact me.
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