HomeMy WebLinkAboutAgenda - 01-19-1993 - VIII-E 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
Action Agenda
Item No. V.izr-E
ACTION AGENDA ITEM ABSTRACT
Meeting Date: January 19, 1993
SUBJECT: Expansion of State Contract for the Comprehensive Breast
and Cervical Cancer Control Program
DEPARTMENT: HEALTH PUBLIC HEARING: Yes X No
ATTACHMENT(S) : INFORMATION CONTACT:
HEALTH DIRECTOR'S OFFICE X2411
1. Notice of Award
2. Service Description and 1992-93
Major Objectives TELEPHONE NUMBER:
3. Contract Amendment Page Hillsborough -732-8181
4. Local Health Department Chapel Hill -968-4501
Budget Page Mebane -227-2031
Durham -688-7331
PURPOSE:
To accept funding from the Centers for Disease Control (CDC) as an addition to
the State Contract to provide the screening and follow-up services for women who
qualify for the Comprehensive Breast and Cervical Cancer Control Program.
BACKGROUND:
The Orange County Health Department Community Diagnosis for 1992-93 identified
cancer as one of the top leading causes of death in Orange County and the
disparity in health indicators between European-American and African-American
population groups in orange County among the highest priority problems.
CERVICAL CANCER: Between 1980 and 1987, 1400 women in North Carolina died of
preventable cervical cancer. The age-adjusted mortality rates for the white
population are 3.5/100,000 and 10.6/100,000 for the black population. The
• mortality percentage for women age 35 and older has increased from 91% in 1985 to
94% in 1989.
BREAST CANCER: In 1989, 1,099 women died of breast cancer in North Carolina
making it the leading cause of cancer deaths in women in the state. North
Carolina's mortality rate of 26.4/100,000 ranks 23rd in the United States. In
race adjusted mortality rates, white women are 25.6/100,000 and black women are
30.7/100,000. For both races, mortality rates are much higher among older
women. In 1986-87, for example the mortality for women less than 50 years
was 6.4 while that for 50 and older was 51.4/100,000.
2
TARGET POPULATION: Older and minority women in North Carolina are least likely
to be screened and are most likely to die. The target population includes
women who are at or below 200 percent of poverty, are older, are uninsured
and are minorities, including Native Americans. Women who are or have
been sexually active, or have reached the age of 18 years are eligible for
cervical cancer screening. Women who are 40 years and older are eligible
for breast cancer screening.
INTERVENTIONS: A clinical breast examination (CBE) and instruction on self-
examination will be provided to each women screened. Mamograms and cervical
cancer screening, including a pelvic exam and pap smear will be provided
according to guidelines developed by the American Cancer Society (ACS) . Finally
public and professional education will be provided to increase public awareness
about breast and cervical cancer and to assure that the services of the Health
Department are high in quality.
STAFFING: The minimum services required by the contract addendum can be
accomplished by a half-time temporary Public Health Nurse I position and an
increase by 10 hours per week of an existing permanent, part-time Family Nurse
Practioner (FNP) position.
FUNDING: The State has allocated, from their CDC Grant, $24,714 dollars to the
Orange County Health Department through the end of fiscal year 92-93. There is a
3:1 federal, non-federal matching requirement; therefore orange County must match
the dollars of state/federal funds with a local allocation of $8,238 dollars.
Fortunately, this can be accomplished by allocating $4,613 dollars of current
operating funds, $367 dollars of anticipated revenue and $3,258 dollars from the
Kellogg Grant. The latter match is acceptable to the state authorities since the
Kellogg Grant will be engaging in community education which will include breast
and cervical prevention. Thus, the total budget for the balance of the fiscal
year will be $32,952 dollars.
RECOrM4ENDATION(S): The Manager recommends as follows:
(1) Accept additional funding in the amount of $24,714
dollars through the state consolidated contract.
(2) Approve the plan for matching funds.
(3) Establish part-time, temporary PHN I position and
expand existing part-time FNP position by 10 hours
per week.
(4) Authorize the Health Director to enter into contracts
for Mammography and Colposcopy services.
(5) Authorize the chair to sign the contract amendment and
the budget pages.
/8"3 3"'
/® / 3
1*-79) - -
State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Adult Health
P.O. Box 27687 • Raleigh, North Carolina 27611.7687 • 919-733.7081
James G. Martin, Governor J. Dale Simmons, M.D.
William W. Cobey, Jr., Secretary Director
November 10, 1992
MEMORANDUM
TO: Local Health Directors
PROM: Georj can stoodt, M.D. , K.P.H.
Chief, Chronic Disease Section
SUBJECT: Contract for the Comprehensive Breast and Cervical Cancer
Control Program
We are pleased to be able to begin developing our contractual
agreements with Local Health _Departments to provide screening_and
follow-up'.services to women in .North .Carolina who qualify for this
Centers-for-Disease' Control''-fading. -Final approval- on the
.attached documents is pending from CDC.
Please complete the Contract Addendum and Budget and submit to
Contracts Administration as soon as possible but no later than
December 31, 1992.
-
C
C)rt r o P C)u fl 1 Health Department will
receive S 7 4 14 -' for screening .a total of no •
fewer than 1Q women. You need to complete the 4
blanks on the 2nd page of the contract addendum. For cervical
cancer screening and follow-up, the minimum is 13 women
under 40 years and 1-P-S) women 40 and over. The minimum
for breast cancer screening and follow-up is 11
women who are 40 and older. Please .remember that. these minim
figures are to be women who are not .receiving complete age-
appropriata=screeaiag--for. cervical and .breast- cancer-through other
•
lieing"aent-under-separate cover ars model subcontracts- for your use -
on..the;_local level where you may be arranging for mammographies,
pap smears and/or colposcopies to be performed by another provider.
•
An Equal Opoortunrty Affirmative irmative Action E
malover
4
Local Health Directors
November 10, 1992
Page 2
Should you need further information or assistance, please call your
regional Adult Health staff or the BCCCP staff at (919) 715-0110 .
GS/f
Enclosures
cc: Dr. Simmons
Barbara Pullen-Smith
•
4-19'-f3 5
DEPARTMENT: Health
SECTION : Breast and Cervical Cancer Screerinc
ACCOUNT NUMBER:
SERVICE DESCRIPTION
Breast and cervical cancer screening is provided to older,
underserved and minority women in Orange County who are at or
below 200% of poverty in order to reduce mortality from
breast and cervical cancer. The program is provided through
CDC monies with a 3 to 1 match as part of the North Carolina
Comprehensive Breast and Cervical Cancer Program. Services
include age appropriate cervical and breast cancer screening,
referral and follow-up. Other components include compliance
with state quality assurance and medical protocols, public
and professional education and surveillance and reporting of
program activities.
1991-92 MAJOR ACCOMPLISHMENTS
New program.
1992-93 MAJOR OBJECTIVES
- Establish a sliding fee scale for a breast and cervical
cancer screening clinic for eligible women in both
health department locations.
- Establish a contract with a mammocraphv facility
accredited by the American College of Radiology for the
70V " E" CM of .=^± .. •.-.his ...:J el ble women ac= 4O n
over.
- Provide education and increase public awareness about
breast and cervical cancer (risks and lifestyle
7rin4mizing factors) and available screening services at
the health department.
- Provide- age appropriate breast and cervical cancer . :
screening and follow-up to 49 women who are at or below
200% of poverty.
a. Provide breast and cervical cancer screening and
follow-up to 45 women who are 40 years and older.
b. Provide cervical cancer screening and follow-up to 4
women who are under age 40 years and not receiving
services in another program.
6
Submit quarterly minimum data elements as required for
program surveillance.
Develop and imniement medical protocols which are based
upon state medical protocols and guidelines .
Participate in continuing education programs provided by
N.C. Comprehensive Breast and Cervical Cancer Control
Program.
•
budget/B&CCS •
Ce ; dev
//1 3
AMENDMENT NUMBER P C
to
CONSOLIDATED CONTRACT
between
THE STATE
and
THE ORANGE COUNTY/DtST I P
HEALTH DEPARTMENT
This Contract covering the period from
12 1 92 to 6 30 93
(Month) (Day) (Year) (Month) (Day) (Year)
is hereby amended to add the following activities:
ACTIVITIES
Comp.Br-. . - • - . . - • ! of
Immunization Action Plan
All provisions and clauses set forth in the Contract are hereby
incorporated in this Amendment and constitute the terms and
conditions applicable for the above activities involving State
funding.
CONTRACTOR SIGNATURES NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT, HEALTH, AND
NATURAL RESOURCES
4,4: / / crt William W. Cobey, Jr. , Secretary
Health Director Da te
Director
Div. of General Some
Z/jr5 i 044 A Cif Qnrv74-0,
Finance Officer to Department Bead's Signature
or Authorized Agent
Ut . 411
Chairman of County • Date
Commissioners
DEHNR 2946A (Revised 10/89 )
General Services Division (Review 10/90 )
l f -9-3 7
NUMBER 05
v1J1
° c
to
CONSOLIDATED CON"T'ZACT
between
TEE STATE
and
T ORANGE COUNTY/Zt.TTR=
HEALTE DEPARTMENT
This Contract covering the period from
12 1 92 to 6 30 93
(Month) (Day) (Year) (Month) (Day) (Year)
is hereby amended to add the following activities
ACT2VITIES
Comp.BrPast & Cprvira1 Canrpr Control
Immunization Action Plan
All provisions and clauses set forth in the Contract. are hereby
incorporated in this Amendment and constitute the r=7771 and
conditions applical1A for the above activities involving State
funding.
CON ACTOR SIGNATURES NOR= CAROLINA D~?AS T OF
EN4IRONn'"=.It'T, EEALME, AND
4 N U AL RESOURCES
� �
w____=m w. _obey a:_ . Jura_
Eea 1th Directo
Date
F iinwnrP- QtEimp" natp. Desia=nenr Itead!..5.-Sig'*''arirre -
__= a� A,t'{,csrized=Agent. tE
Chairman rinan of County Date
Caaan i' si criers
DEENR 2946A (Revised 10/89)
General Services Division (Review 10/90 )
S
LOCAL HEALTH DEPARTMENT BUDGET
N.C.Department of Environment,
•
Health, and Natural Resources Revision Number_
Division of General Services
SFY Divisionof Adult—Health
P. 0. Numb 1 2/1/ 92 6/3 0 / 93 9 3 5 4 ,5 2 ..j
.
Effective Date Termination Date Contract Number
Contractor: Orange County Health Department Activity. Comp . Breast & Cervical Canc+
Control
Project Director: Daniel B . Reimer Total Budget:$ 32 , 952
ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT
E STATE EXPENDITURES:
Salaries & Fringe Benefits SA/FR 1000 14 , 609
X Operating Expenses OP EXP 2000 4 , 465
P Purchase of Equipment EQUIP 5000 3 , 085
E General Contracted or
Purchased Services GENERAL 6100 2 , 5 55
N School Health
D Clinician CLN . 6863
- I
Laboratory - LAB 6862
T Pharmacy Services RX SERV 6865
U Transfer TXIX
R Subtotal State Expend. $ 2 4 , 7 1 4
E LOCAL EXPENDITURES: I LOCAL EXP 9000 8 , 238
S
TOTAL EXPENDITURES—equal to Total Receipts $ 32 , 952
LOCAL FUNDS:
R Appropriation • APPROP 101 4 , 6 1 3
E TXLX/SSBG Fees TXIX/SSBG 102 -0-
Other Receipts OTHR REC 103 3 , 625
C
E Subtotal Local Funds $ 8 , 238
STATE/rt.DERAL/SPECIAL FUNDS:
I 24 , 714
P
T
S
Subtotal State/Federal/Special $ 24 , 714
TOTAL RECEIPTS—equal to Total Expenditures $ 32 , 952
•
Local Authorized Official Signature Date &ma' d Division./Section Signature Date
Led
Finance Officer Signature Date Acc...g...ge Fiscal Management Signature Date
lama
DEHNR 2948(Revisal 2/90)
General Service'Division(Review 2/93)
LOCAL HEALTH DEPARTMENT BUDGET
N.C. Department of Environment, Le Health, and Natural Resources
/ Revision Number__
Division of General Services l i C!SFY �l�J YY' Division of Adult' `Ei ea l th
_, .3. .2.
�
P. O. Number
12/1/ 92 6/30 / 93 9 3 5 4 5 2 _0_ 6 g
Effective Date Termination Date Contract Number
Contractor: Orange County Health Department Activity: Comp . Breast & Cervical Cance
Control
Project Director: Daniel B .. Reimer Total Budget:$ 3 2 , 9 5 2
ITEM DESCRIPTION I CLASSIFICATION ITEM AMO -T
E STATE EXPENDITURES:
X Salaries & SA/FR 1000 Fringe Benefits SA/ 14 , 6 0 9
Operating Expenses OP EXP 2000
P Purchase of Equipment EQUIP 5000 - 3 , 0 8 5
E General Contracted or
N Purchased Services GENERAL 6100 2 , 5 5 5
School Health
D
Clinician CLN .. 6863
,I, Laboratory LAB 6862 •
Pharmacy Services RX SERV 6865
U Transfer TXIX
R Subtotal State Expend. $ 2 4 , 714
E LOCAL EXPENDITURES: I LOCAL EXP 9000 8 , 2 3 8
S
TOTAL EXPENDITURES—equal to Total Receipts $ 3 2 , 9 5 2
LOCAL FUNDS: .
R Appropriation APPROP 101 4 , 613
E TXDC/SSBG Fees TXIX/SSBG 102 –0–
Other Receipts OTHR RFC 103 3 , 6 2 5
C
E Subtotal Local Funds $ 8 , 2 3 8
STAitt/rrllERAL./SPECIAL FUNDS:
I 24 , 714
P IL'4S
T (�lou— S4.5Z—6133
S - .
Subtotal State/Federal/Special $ 2 4 , 714
TOTAL RECEIPTS—equal to Total Expenditures $ 3 2 , 9 5 2
/ ,/ A 2/i V
/Ai I�.A Li ar,/ z� , e . , 4 l
• 'A Ivorucd Official Signs / Date st=a. ' Ii �. r►.tature
' Divisi.n/Sethon Signature Date
g6°1-4– t-e-Li / /1i/ 3/A
Finance Officer , ' - J
er Signature Date w F f– Mana: ment Si., cure &tr
DEHNR 2948(Revised 2/90)
General Services Division(Review 2/93)
•
LOCAL HEALTH DEPARTMENT BUDGET
N.C.Depai meet of Environment, -
Health, and Natural Resources Revision Number
Division of General Services 4 -93 G)_ / 6 •
SFY 93 Division of Epidemiology - —--
P. O. Number
L2:;/ 92 9/ 93 ; 9 3 4 5 2 4 0 6 8
Effective Date Termination Date , Contract Number
Contractor: Orange County Health Department Activity: Immunization Action Plan
Daniel B. Reimer, Health Director 6,225
Project Director: Total Budget: $
ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT
E STATE EXPENDITURES:
X Salaries & Fringe Benefits SA/1-it, 1000 6,225
Operating Expenses OP EXP 2000
P Purchase of Equipment EQUIP 5000 • - . •
E General Contracted or
.r Purchased Services GENERAL " ' 6100
School
Health
D • •
C lamIcra
n
. '�:;Jit`f' > i ? '>' `� i '?�s'i'...,••�"? 'i f'iSi'i` ` ''?` ii5 '??�'i3 �i'i�ri'' �� �>£%`?;a�> tii �?
I
Laboratory
or
Pharmacy
Services
s
U Transfer Transfe
TX
IX
R Subtotal State Expend. $ \i 6,225
E LOCAL EXPENDITURES: LOCAL EXP 9000
S
TOTAL EXPENDITURES—equal to Total Receipts $ 6,225
LOCAL FUNDS:
R Appropriation APPROP 101
E TXIX/SSBG Fees TXIX/SSBG 102
Other Receipts OTHR REC 103
C
E Subtotal Local Funds $
STATE/FEDERAL/SPECIAL FUNDS:
I .
P
T •
Subtotal State/Federal/Special . $ . ' • '6,225
TOTAL RECEIPTS—equal to Total Expenditures $ 6,225
I 1`/Id, 12-1-92 C,c r,'a / `CrA atA.0-v (.t',
G�
t : - S'/3
Local Authorized 0 cial Signatur/ Date Branch Had Divi ' n/Section Sigii ue Date
Initial
7
-
12-1-92
- -- 1/9„a 1�
Finance Officer Signature Date A=.f sc ral Manag t azure Date
initial
DEHNR 2948(Revised 2/92)
General Services Division(Review 2/94)