DATE: August 21, 2018
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Application for the Diabetes and Heart Disease & Stroke Prevent Programs Grant
RECOMMENDED ACTION(S):
TITLE
Retroactively authorize the Department of Public Health’s previous submittal of a grant application in the amount of $9,365,337 to the Centers for Disease Control and Prevention for the Diabetes and Heart Disease and Stroke Prevent Programs-Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke, effective September 30, 2018 through September 29, 2023.
REPORT
On July 9, 2018, the Director of the Department of Public Health submitted a grant application to the Centers for Disease Control and Prevention (CDC) for the Diabetes and Heart Disease and Stroke Prevent Programs Grant to meet the deadline of July 9, 2018, contingent upon your Board’s approval. There is no Net County Cost associated with the recommended action; if awarded, the program will be fully funded without a required local match. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department will rescind the application.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The Department’s grant application requested the following annual awards, for a five-year total of $9,365,337:
• Year 1 (Sept. 29, 2018 - Sept. 30, 2019): $1,960,846
• Year 2 (Sept. 29, 2019 - Sept. 30, 2020): $1,993,612 (1.7% increase)
• Year 3 (Sept. 29, 2020 - Sept. 30, 2021): $1,954,434 (2.0% decrease)
• Year 4 (Sept. 29, 2021 - Sept. 30, 2022): $1,725,583 (11.7% decrease)
• Year 5 (Sept. 29, 2022 - Sept. 30, 2023): $1,730,862 (0.3% increase)
If the grant is awarded, the Department will return to your Board to accept the grant funds and with any necessary resolutions.
DISCUSSION:
The CDC Notice of Funding Opportunity (NOFO) 1817: Diabetes and Heart Disease and Stroke Prevent Programs-Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke opened on May 28, 2018 to city, county, and state governments with a population, or combined population for collaborative applications, of 900,000 or more. The funding’s purpose is to evaluate the evidence-based strategies aimed at reducing risks, complications, and barriers to the prevention and management of diabetes and cardiovascular disease (CVD) in high-burden populations. The anticipated award notice date is September 29, 2018. Approximately 15 awards will be offered nationwide.
The NOFO 1817 will allow the Department to expand work started in 2014 under the Lifetime of Wellness, Communities in Action (LWCA) grant, which ends September 29, 2018. The four-year funding from the LWCA grant allowed the Department to:
• Subcontract with United Health Centers to implement a Diabetes Prevention Program that has successfully trained 65 residents on how to make healthy lifestyle choices to date, and to expand their health education team to reduce the risk of chronic diseases in vulnerable rural populations;
• Implement worksite wellness initiatives, activities, and policies in the Department such as the “Take the Stairs” campaign, and provide technical assistance to community partners interested in implementing similar projects including the City of Fresno, the Fresno Housing Authority, and Fresno County Economic Opportunities Commission;
• Partner with the Fresno County Public Library to make available for checkout home blood pressure monitoring kits and health education materials at five local branches; and,
• Educate medical providers and other healthcare professionals on relevant chronic disease prevention issues, including hosting the annual Central Valley Diabetes Symposium.
Even with these successes, CVD is still the leading cause of preventable death in the County, and over half of County adults have prediabetes or diabetes, with many cases undiagnosed. The NOFO 1817 would allow the Department to continue and expand the strategies from the LWCA program, including:
• Coordinating community-based and clinical interventions to improve continuity of care in clinic settings, and educating patients on the management of chronic diseases in addition to the prevention strategies currently in place;
• Improving electronic health records systems to help identify patients at high risk for developing CVD or diabetes, diagnose prediabetes as a medical condition, and to track patient referrals to appropriate interventions;
• Improving patient access to CDC-recognized lifestyle change programs such as the Diabetes Prevention Program, including ensuring trained facilitators are available and securing or maintaining insurance coverage for these programs; and
• Offering advanced training to medical staff and lifestyle coaches to incorporate motivational interviewing and other skills to effectively engage with patients.
Due to timing constraints between the CDC grant notification date of May 28, 2018, and the grant application deadline of July 9, 2018, the Department was unable to request your Board’s approval prior to submittal of the grant application. Should a grant be awarded to the County, the Department will return to your Board with any necessary resolutions.
REFERENCE MATERIAL:
BAI #43, June 12, 2018
BAI #34, May 2, 2017
BAI #51, July 12, 2016
BAI #54, August 11, 2015
ATTACHMENTS:
On file with Clerk - NOFO 1817 Grant Application to CDC
CAO ANALYST:
Sonia M. De La Rosa