HomeMy WebLinkAbout972462.tiffRESOLUTION
RE: APPROVE HIV PREVENTION CASE MANAGEMENT GRANT PROPOSAL 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 HIV Prevention Case Management
Grant Proposal between the County of Weld, State of Colorado, by and through the Board of
County Commissioners of Weld County, on behalf of the Health Department, and the Colorado
Department of Public Health and Environment, with terms and conditions being as stated in
said proposal, and
WHEREAS, after review, the Board deems it advisable to approve said proposal, 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 HIV Prevention Case Management Grant Proposal between
the County of Weld, State of Colorado, by and through the Board of County Commissioners of
Weld County, on behalf of the Health Department, 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 proposal.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 26th day of November, A.D., 1997.
AP
ORM:
u!: //L
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
eorge E. axt er, Chair
Gam., Ce<��
Constance L. Harbert, ro-Tem
`\
Dale K. Hall
'B
arbara J. Kirkmeyer
W. Hf Webster
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HL0023
State Of Colorado
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, CO 80222-1530
HIV Prevention Services:
HIV Prevention Case Management Grant Proposal
Applicant's Name: Weld County Health Department
Address: 1517 16th Avenue Court
Greeley, CO 80631
Contact Person: Misti Aas, HIV Educator
Karen Spink, Health Promotion Program Supervisor
Phone: (970) 353-0586
Amount Requested: $ i rE oon from January 1, 1998 to December 31. 1998
Date Submitted: November 24. 1997
Weld County Health Department
n S. Pickle, M.S.E.H.
Director
7V s,
Dat
Weld County Board of Commissioners
/Chan an
Date
11/26/97
972462
INFORMAL REQUEST FOR FUNDING
FOR
HIV PREVENTION SERVICES IN COLORADO
PREVENTION CASE MANAGEMENT IN RURAL COMMUNITIES
WELD COUNTY HEALTH DEPARTMENT
1517 16TH AVE. CT.
GREELEY, CO 80631
CONTACT PERSON: MISTI AAS
353-0586 EXT. 2344
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I. DESCRIPTION OF ORGANIZATION
The Weld County Health Department (WCHD) was established in 1938, the
second oldest health department in the state of Colorado. WCHD serves the
144,000 residents of Weld County which includes 29 incorporated towns and
encompasses 4000 square miles. WCHD employs approximately 75
individuals who work in three separate divisions; Administration, Preventive
Health Services, and Environmental Protection. The mission of the WCHD is to
preserve, promote and protect a healthy life and safe environment for all people
in Weld County. Financial support of WCHD consists of the following; county
funds - 3.4%, fees for services - 31.6%, contracts and grants - 28.7%, and misc.
funding - 2.3%.
The governing Board of Directors for WCHD is the County Board of
Commissioners and Public Health Board ( see attachment ). The HIV
Educator/Program Coordinator has no control of gender or ethnic make-up, or
selection of the persons constituting this Board.
WCHD houses a STD clinic and also serves as both an anonymous and
confidential HIV testing site. In addition, WCHD is the lead fiscal agency in
Northern Colorado for the management of the Ryan White Care Act.
The HIV Education program is under the umbrella of the Health Promotions
Section of Preventive Health Services at WCHD. In 1997, public information on
HIV/AIDS prevention and awareness was provided to approximately 780
people in Weld County through community events and educational
presentations to organizations and schools. Upwards of 75,000 persons were
reached through press releases, purchased ads, radio PSAs and interviews.
WCHD is the lead agency for the Weld County AIDS Coalition (WCAC) with the
HIV Educator serving as coordinator. In addition, individual HIV prevention
counseling was provided on a weekly basis through the STD Clinic.
WCHD houses an audiovisual and other educational media supply room.
These supplies include over -head projectors, slide projectors, a portable
TVNCR, flip charts w/markers, and HIV virus model, and a variety of videos on
health -related issues including HIV/AIDS. The HIV Educator has ready access
to all equipment. Condoms and HIV -related brochures and information is
stored in the office of the HIV Educator.
The HIV Educator at WCHD has been involved in HIV Education for eleven
years through the University of Northern Colorado (UNC), WCAC, and currently
WCHD. She is a member of the Board of Directors of the AIDS Coalition for
Education (ACE). She holds a Masters Degree in Agency Counseling, is a
Licensed Professional Counselor, and has facilitated the Weld County
HIV/AIDS support group for the past five years.
II. TARGET AUDIENCE
The target audience to be served through this intervention is any individual
who has HIV infection, or is at high -risk for HIV, who is having difficulty changing
their risky sexual or drug behaviors.
Throughout 1997, the WCHD HIV Educator has conducted individual level
education and HIV prevention counseling in WCHD STD Clinic with individuals
who have been diagnosed with and STD other than HIV. Some of these clients
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have experienced repeat STDS and interventions have explored the reasons
why behavior change is so difficult. Through these interviews and observations,
a deeper understanding of behavior change and its inherent challenges was
obtained, contributing to the planning of the proposed PCM intervention.
The target audience will be identified and recruited through WCHD STD
Clinic and HIV testing site, as well as other area agencies serving high -risk
individuals. The nurses in the WCHD STD Clinic and HIV testing site have the
ability to identify clients who are diagnosed with repeat STDs, as well as
persons who test confidentially for HIV on a "regular" basis. Repeat infection of
STDs and multiple HIV tests (beyond the 6 -month window period) indicate that
an individual is continuing to practice high -risk behaviors. The Partner
Notification specialist at WCHD will be a valuable referral source of individuals
who are having a difficult time changing behaviors that put them at high -risk for
HIV infection of self or others. In addition, WCHD HIV Resource Coordinator will
assist in identifying and targeting those individuals living with HIV who continue
to put others at risk of infection.
There are many individuals continuing to practice high -risk behaviors who do
not seek services from WCHD. In order to reach persons outside of the
immediate agency, a collaborative relationship will be developed with other
agencies serving high -risk individuals. The idea of forming a "Prevention
Referral Network" was obtained from the Jefferson County Department of Health
and Environment (JCDHE) PCM Program. The proposed agencies that will be
involved in this network are Weld County law enforcement and probation, Island
Grove Drug Treatment Center, A Woman's Place, and Greeley Transitional
House. A relationship will be established (if it is not already in place) by
planning trainings with key individuals in each agency. These trainings will be
conducted by the WCHD HIV Educator and will focus on providing effective HIV
prevention education, as well as providing information on the PCM project and
each agency's potential role in the referral process.
The number of individuals to be reached by the intervention in 1998 is
estimated to be 50-75.
When working with a person with a disability, home visits or agreement to
meet at an easily accessible location can be arranged with the client. If a client
has a hearing disability, advance arrangements can be made to have an
interpreter from the Northern Colorado Center on Deafness present at the
intervention. If a phone intervention is required, a TTY phone will be utilized.
III. CULTURAL COMPETENCE AND PROFICIENCY
Because one individual is coordinating this project, the "organization" will be
referred to as the "HIV Educator". The HIV Educator is committed to the ongoing
process of cultural competence and proficiency. The HIV Educator will attend
any trainings offered through the state (or locally) on furthering cultural
competence and awareness, continue to pursue Spanish language classes,
and will read books specifically addressing unique concerns and needs of
various ethnic backgrounds served through the intervention.
There are many cultural factors that influence behavior change. Each
cultural identity has its own unique values, traditions and health beliefs. During
the initial PCM session, each client will be assessed on an individual cultural
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spectrum (this assessment will also be ongoing). The behavior change plan
will incorporate these cultural factors.
IV. Objectives
By December 31, 1998, individuals involved in PCM will be able to demonstrate
how to correctly put on a condom.
By December 31, 1998, 25% of clients participating in PCM will be able to
identify a personal reason or "significance to self" for behavior change.
By December 31, 1998, 15% of clients participating in PCM will follow-through
on a personal behavior change plan (as measured by follow-up surveys).
V. OPERATIONAL PLAN
The coordination of this PCM intervention is the HIV Educator at WCHD.
Client referrals will be received through the community prevention referral
network as described in the Target Audience section. Participation will always
be voluntary on the part of the client. PCM sessions will be carried out in a
variety of setting appropriate to the client's needs , including phone, clinic or
home. Acute needs will be addressed and prevention efforts will be tailored to
an individual's particular circumstances. Ideally clients will be seen on a long-
term basis and PCM will not be time -limited. However, the HIV Educator will
also recognize the need to terminate PCM sessions when the behavior change
plan is successful, or when repeated PCM efforts are unsuccessful.
An interactive client -centered approach will be the primary foundation of the
PCM relationship between the HIV Educator and the client. The counseling
skills tat will be utilized by the HIV Educator include attending, reflecting
feelings, paraphrasing, reframing, open questioning and non -threatening
confrontation.
The activities to be included in this PCM intervention are:
* Talking with people about what makes it hard for them to change their
behavior.
* Making an individualized plan with the client on how they can be as safe as
possible in sex, drug use, or relationships.
* Helping them get other services (money, food, housing, medical care, drug
treatment, mental health) that help them to be safe.
* Discussing why AIDS is a problem for them and their partners and how to
protect themselves and their partners.
* Practicing correct condom use and cleaning works.
* Discussing how to maintain safe behavior.
These activities support the following counseling objectives:
1) Establish and/or improve the client's self -perception of risk.
2) Identify and support behavior changes the client has already attempted.
3) Negotiate a realistic and incremental plan for reducing risk.
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Research on behavior change has repeatedly found four individual
characteristics that seem to influence most people's ability to change:
1) Self -Efficacy - the degree to which a person feels capable of accomplishing
an action or behavior (a sense of control over his/her life).
2) Assertiveness - the ability to communicate clearly what one wants and/or
needs.
3) Rationality - making decisions about one's life and behavior in a fully
considered way.
4) Social affiliation - how and to what degree a person feels her/himself to be
part of a larger group and how important that larger group connection is.
The HIV Educator will follow all counselor legal and ethical guidelines
surrounding confidentiality, boundaries, dual relationships, conflict of interest,
duty to warn and protect, and referral/collaboration with other agencies to
assure continuity of client care. The HIV Educator will obtain ongoing clinical
supervision from a licensed mental health professional chosen from her
counseling network.
Time -Line
By January 31, 1998, a procedure will be established for client referrals from the
WCHD STD clinic, HIV testing site, HIV Resource Coordinator, and Partner
Notification project.
By January 31, 1998, agencies serving at -risk individuals will be contacted
inviting them to participate in the proposed "Prevention Referral Network".
By March 31, 1998, a training on HIV prevention strategies and the PCM
program will be facilitated with key individuals from agencies interested in
becoming involved in the "Prevention Referral Network".
By December 31, 1998, an estimated minimum of 50 persons will have
participated in the PCM intervention.
By December 31, 1998, ongoing communication will have occurred between
WCHD and JCDHE for resource -sharing, technical assistance and project
updates.
VI. EVALUATION PLAN
Formative evaluation was conducted through WCHD STD Clinic as
described in the Target Audience section, as well as through literature research
surrounding behavior change theory.
Ongoing psychosocial assessments to be used for process and outcome
evalualtion will include; sexual history, drug history, HIV risk assessment,
current knowledge and attitudes about safer sex behaviors, assessment of
stage of behavior change, guardianship status, presence of literacy/learning
problems, and/or developmental disability, criminal and/or legal involvement,
mental health history, support systems/resources including Ryan White case
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management, relevant medical history, and cultural and religious
considerations.
Baseline data will be obtained at an initial session. Follow-up data after the
intervention is complete will be obtained through the completion of a behavior
change survey. This will be used to assess whether or not the client has
initiated behavior change, maintained behavior change, or relapsed, and also
whether or not the client has accessed social and medical services.
JCDHE will assist in evaluation efforts of WCHD PCM program through the
sharing of a computer method of tracking clients and individual behaviors, as
well as providing other technical assistance in achieving both process and
outcome evaluation.
VII. BUDGET
HIV Educator
(10 hrs. x $14.23 x 52 weeks)
Administrative Assistant
(1 hr. x $7.98 x 52 weeks)
Fringe
(10% of total personnel requested)
Indirect
(13.2% of total personnel and fringe)
Travel
(6 Denver and 215 misc. miles)
$7399.60
$414.96
$781.45
$1134.67
$269.32
TOTAL FUNDING REQUESTED $10,000
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COLORADO
Memorandum
TO: George E. Baxter
Chair, Weld County Commissi?rt\er1rsi ER\
DATE: November 24, 1997 FROM: John Pickle, M.S.E.H.4eaQ��
Director, Weld County alth Department
SUBJECT: HIV Prevention Case Management
Grant Proposal
Enclosed for board review and approval is a proposal for a contract between the Weld
County Health Department and the Colorado Department of Public Health and
Environment to implement an HIV Case Management project targeting individuals who
are having a difficult time changing their risk -taking behavior.
This project will be based on the behavior change model in HIV prevention counseling
and will entail talking with individuals about what makes it hard for them to change their
behavior, developing a plan on how they can be as safe as possible, helping them
connect with other services, and discussing how to maintain safe behaviors. These
individuals will be sought through a prevention referral network that will consist of Weld
County Health Department Sexually Transmitted Disease Clinic staff, law enforcement,
probation officers, Island Grove Drug Rehabilitation staff, A Women's Place, Greeley
Transitional House, and other agencies serving at -risk clients. We will be collaborating
with the Jefferson County Health Department Prevention Case Management Program
for technical assistance and resource sharing.
The grant request is for a one year period beginning January 1998 and ending in
December 1998. We are asking for $10,000 to implement and maintain this project.
I would recommend your approval of this proposal.
If you have any questions, please feel free to contact me.
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