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HomeMy WebLinkAboutAgenda - 11-05-2003-8gORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: November 5, 2003 Action Agenda Item No. .J SUBJECT: Fees for Weight Management Programs DEPARTMENT: Health PUBLIC HEARING: (Y/N) No ATTACHMENT(S): INFORMATION CONTACT: Rosemary Summers, ext. 2411 TELEPHONE NUMBERS: Hillsborough 732-8181 Chapel HiCI 968-4501 Durham 688-7331 Mebane 336-227-2031 PURPOSE: To consider approving fees for two weight management programs conducted by the Health Department. BACKGROUND: The Health Department is proposing piloting two weight management programs in Orange County -one for adolescents and teens and one for adults. Obesity is one of the underlying, preventable contributors to heart disease and diabetes. According to the most recent Behavioral Factor Risk Surveillance Survey (BFRSS), 16.7% of Orange County adults are obese and an additional 31.5% are overweight when measured by calculating their body mass index (BMI). Overweight is defined as a BMI of 24.9 and obesity is a BMI of 29.9. Women and residents with a high school education or less have higher rates of overweight and obesity. There is a growing epidemic of obesity among our adolescent and teen population as well. Statistics from the North Carolina-Nutrition and Physical Activity Surveillance System show that 17.3% of adolescents from ages 12-18 are at-risk for overweight and 29.6% are overweight in Orange County. Orange County is higher than the state average of 26.3%. Research studies have shown that obesity in children is likely to persist into adulthood. While there are commercial programs available for adults in the area, many individuals need a more focused approach than those programs may be able to provide. There are few, if any, programs in the area specifically targeted to adolescents and teens. Offering the adolescent program is based on requests by local physicians, school nurses, and parents to implement a program in the school setting for this population group. The Chapel Hill YMCA is planning a pilot program based on a different model. The Orange On the Move Coalition submitted a Health and Wellness Trust grant application to start a program at the Chapel Hill YMCA and at the Hillsborough Sportsplex. If that grant is awarded, the Health Department will be cooperating with those programs as well. The Board of Health has reviewed and approved these two pilot programs proposed by the Health Department to begin to address these preventable conditions in specific populations. The Healthy Way: A Weight Manaqement Program for Adults This program began ten years ago at the Rex Wellness Center and has evolved into a multi- dimensional approach for weight management that is geared to enhancing overall well-being. The UNC Wellness Center will also be piloting the program. The Health Department Nutritionist has been working with Rex Hospital and the UNC Wellness Center to update the curriculum for the adult program entitled "The Healthy Way". There are no programs like this in the northern area of the County. The program includes 12 weekly, one-hour group discussion and educational sessions facilitated by a registered dietitian or health educator. Thirty minutes of exercise facilitated by an exercise physiologist follows the educational sessions each week. Since Orange County does not have an exercise physiologist, this component will include establishing weekly goals for walking/physical activity sessions. Each participant will receive a pedometer that will be used to measure walking activity. Research indicates that accumulating 10,000 steps a day will provide the same health benefits associated with regular physical activity. Each participant receives one individual consultation with the registered dietitian to determine nutritional goals and program set-up. A medical release form will be required for participation. Pre and post measures of change include: attitude survey, weight, resting blood pressure, body mass index, resting heart rate, circumference measurements (hips or waist), and aerobic exercise. The fee for the program has been established at $120 or $10 per week for 12 sessions. This will enable the department to recover the costs for the pedometer, duplication of the curriculum, and demonstrations on preparing healthy foods. This is a greatly reduced price from that offered by the Rex Wellness Center and the UNC Wellness Center ($215 for members, $315 for non-members). However, the County does not have the exercise physiologist as part of the program. The pilot program is proposed to begin in January 2004 and will be marketed to Orange County employees as the initial group. Based on the results of that pilot, the department will evaluate whether to continue the program with other targeted groups. BodyWorks: A Weight Manaqement Proqram for Adolescents and Teens BodyWorks is a 10-week family-based weight management program, developed by an interdisciplinary group of health professionals to combat the increasing incidence of adolescent obesity. Dr. Sharon Van Horn, a local physician and Board of Health member, was part of the state team that modified the curriculum for North Carolina. The North Carolina Division of Public Health has field-tested the program and it has been successfully implemented in Wake County through the health department. Unlike programs based on diet and exercise, BodyWorks identifies and treats the underlying contributors to obesity and provides families with the skills needed to succeed at long-term weight management. Since BodyWorks is both an educational program and a clinical treatment for adolescent obesity„ it is implemented by a mental health clinician and aregistered/licensed dietitian. Both of these individuals are currently on staff at the Health Department. Nutrition and exercise components are included in each session. Pre and post measures of change include: survey to test knowledge of healthy eating, lifestyle and body image and six and twelve month follow-up telephone interviews to assess effectiveness. Renee Kemske, the Health Department Nutritionist, is working with the Health Education Coordinator in the Orange County School system to mutually select a middle school or a high school for the project pilot. The fee for the program will be a total of $100 or $10 per session. This will defray the costs of the curriculum duplication, food journals, supplies, and food preparation demonstrations. The Department is seeking clarification from the state on whether Medicaid will reimburse for those who have been referred by a physician. FINANCIAL IMPACT: The fee for both programs is $10 per session. The total cost is $120 for "The Healthy Way" adult program and $100 for the "BodyWorks" adolescent program. The fees will cover the direct expenses of the programs. Staff is already employed by the County and these programs fall within the scope of duties. RECOMMENDATION(S): The Manager recommends that the Board approve the offering of these pilot programs and authorize the fees for each program at $10 per class or a total of $120 for the Healthy Way Program for adults and $100 for the BodyWorks Program for adolescents.