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2017-832-Resolution No. 2017-058 Recorded 12/13/2017REVIEWED 77 LE AL COUNSEL Recorded in Deschutes County CJ2O1 7832 Nancy Blankenship, County Clerk Commissioners' Journal 12/13/2017 3:42:53 PM BEFORE THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON A Resolution Appropriating New Grant Funds in the Deschutes County 2017-2018 Budget * * RESOLUTION NO. 2017-058 WHEREAS, Deschutes County's Health Services Fund will receive new grant revenue totaling $136,400; and WHEREAS, these new grant funds need to be appropriated; and WHEREAS, ORS 294.326(2) allows the appropriation and expenditures of new grant funds designated to specific purposes; now, therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON, as follows: Section 1. That the following grant be budgeted: Revenue Health Services Fund State Grant $ 136,400 TOTAL REVENUE: 5 136.400 Section 2. That the following appropriations be made within the 2017-2018 County Budget: Appropriation Health Services Fund Program Budget $ 136,400 TOTAL APPROPRIATION 5 136.400 PAGE 1 OF 2 -RESOLUTION NO. 2017-058 (12/13/17) Section 2. That the Finance Director make the appropriate entries in the Deschutes County Budget document to show the above appropriations. DATED this ��f7 th day of December 2017. ATTES cording ecretary PAGE 2 OF 2 -RESOLUTION NO. 2017-058 (12/13/17) BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON adLe 4 -Se Cif TAMMY BANEY, Chair ANTHO Y DEBONE,. ice -Chair PHILIP G. HE DERSO , Commissioner 0 O O O O O O O O O t CO 0 0 0 0 c N a) 10 O O 000000000 V'O O O O 0 0 O ca d CU ct ' Tr 0 a)M t0 N N 07000n M T- d' v V ' ?� V O M M '� O 41 .- V� CO r .- CO fV .N-. M C +L-. c C CCco'- Ctm N�u)�'8 > .3 0 _ _ 0 0) 0 N w O 0 00000000 V'C0000 0 Eo a E000000o n<r0000 0 . 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O•°0 ©Q ` z z Z Z z Z z Z z Z z 2 E oro x 8 S O 8 w W w w Www W W W Www N U -•O }-OOO000CD0OOzOZc E mCo mCn CnCoCnCnCnCOCnCnCOwCn Li' m0'c ro O -05 Z -02222212222(.910 ON ,0 n �Z y �ZZZZZZZZZZcnZtn ‘-0 c j W w 2 2 2 2 2 2 2 2 2 2 T• n 2• ° o 0 I-0 F-0000000000 0h. m-ty,'� ,- 0 S Q S Q Q Q Q Q Q Q Q Q Q U Q U •v, 0 to S 'SSSSS2222Iw2w >,., *r_- (u 3 c (a U)U)couu)coanc4(an(antan0CLL anp c n'ca N ,,, 1 T S T S T T T S= X z S z _ro N o•- C ��yy E 'c "- o U := ° Z Z z Z Z Z Z Z Z Z Z Z CO Z 65- 'O Ill O W W W W W W W W W W 2 W S rn o E p (D 'o 0 00C000O00CD_j0J ''--c Ea-%. ro 2 ' SS 22222522JSJ O. a a a a a a a a a a Q a Q a) O 8 0 ro 0 W CO Cr M M CO CO CO CO CO M M CO .- M r 0 '.- c E O p• Q (D D CO a CO CO CO CO CO to CO Cn (n CO CO CO (n co -0,_ O C E O 0 a) CO Z 2 0 5222222SST222 c (a ILUCYO t‘:1 o Wcc �¢ CD a 11/28/2017 Line Number R Public Health Modernization Grant Fiscal Years 2018 - 2019, starting 12/01/2017.06/30/2019 Year 1 Year 2 Wages $ 70,300.00 $ 187,534.00 Benefits $ 38,700.00 $ 103,335.00 Travel $ 2,894.00 $ 7,477.00 Supplies $ 6,106.00 $ 16,200.00 Contract $ 6,000.00 $ 16,000.00 Total Direct' $ 124,000.00 1 $ 330,546.00 Total Indirect (10% de -minimus) (allows $2,500 for contracts) Total Costs Year 3 1 Year 4 $ ' I$ $ - I$ $ $ $ - $ $ $ $ $ $ 12,400.00 $ 33,054.00 $ $ 136,400.00 $ 363,600.00 $ $ Total grant funds, per year $ 136,400.00 $ 363,600.00 $ $ Total (5 Year Total) Grant deficit $ $ $ $ Year 5 5 500,000.00 I The grant will pay 100% of direct program costs, and will contribute a 10% de -minimus rate, in funding, to the department's administrative overhead. The grant has been awarded for 19 months, starting on 12/01/2017 and running through 06/30/2019. An additional 3.0 FTE are requested to perform the functions of the grant. Given the short-term duration of the grant, the related positions will be designated as limited -duration FTE. The related budget adjustment for FY 2018 will cover the period of 12/01/2017 thru 06/30/2018 (allowing for 7 months of of grant expenses to be incurred during FY 2018). 30Cr, PUBLIC HEALTH DIVISION Office of the State Public Health Director Kate Brown, Governor Hillary Saracen° Deschutes County Health Services Public Health Division 2577 NE Courtney Dr. Bend, OR 97701 Dear Hillary: ax, r Lc?, ea ,stiI outs• 800 NE Oregon St., Ste. 930 Portland, OR 97232-2195 Voice: 971-673-1222 FAX: 971-673-1299 This letter is to confirm your award under Oregon Health Authority RFP 4661 — Public Health Modernization, Track 1 — Implementation. For the period of December 1, 2017 -June 30, 2019„Deschutes County will be awarded a total of $500,000. Payments will be paid monthly once the signed agreement is in place and will be made retroactive to December 1, when services commence. All fund distributions will be subject to the terms and conditions in the grant agreement. Congratulations, and we look forward to working with you. erely, Cara Biddlecom Director of Policy and Partnerships B 1 B .. iAo& ent 1, = fr.n Apel RFP — OHA 4461-17 Central Oregon Public Health Partnership Proposal to The Oregon Health Authority for a Public Health Modernization Implementation Grant to improve Communicable Disease Prevention, Surveillance, and Response in Central Oregon Submission Date: October 24, 2017 JEFFERSON C0L NTit OREGON StiCharies IWAIN Il SYSTEM (.cttrAIOi';ly ealth Dit f: App RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 1 3.6,1 EXECUTIVE SUMMARY — Demonstrate Proposers Meet Minimum Qualifications Background and Project Overview: Central Oregon's public health departments are generally able to effectively respond to and investigate day-to-day communicable disease reports in a timely manner through current local communicable disease programs. While these basic communicable disease investigation requirements are met, there continues to be limited capacity and inadequate resources to focus on communicable disease prevention and surveillance efforts or to complete a thorough outbreak prevention and response, especially within institutional settings with vulnerable populations. When outbreaks of disease occur, the communicable disease teams are greatly taxed and only able to provide the minimal amount of response efforts. This is most evident in Jefferson County where there is only .2FTE dedicated to communicable disease activities. If awarded, this grant will fund the development and implementation of regional strategies to reduce the burden of communicable diseases in Crook, Deschutes, and Jefferson counties through the formation of a Central Oregon Outbreak Prevention, Surveillance, and Response Team. The team will focus on regional communicable disease surveillance and risk communication to health care providers, regional partners and the public, as well as prevention and control of outbreaks in the region's institutional settings that serve vulnerable populations. A regional epidemiologist and two regional infection prevention specialists will provide needed communicable disease support and back-up for under -resourced areas of our region and will work directly with communities that are disproportionately affected by outbreaks (most notably norovirus and influenza outbreaks) such as long-term care facilities (LTCF) and child care facilities. Strategies include working directly with facilities to create culturally responsive educational resources and provide infection prevention training. Child care facilities will be prioritized based on up-to-date immunization rates, with a specific focus on sites with rates lower than 90%. This proposal promotes health equity by targeting vulnerable populations in the region for outreach, education, and training in order to reduce health disparities among identified groups and enhance regional capacity to detect and respond to communicable disease outbreaks. A coordinated regional team will improve upon Central Oregon's capacity to effectively address the burden of communicable disease outbreaks. It will also decrease regional gaps in communicable disease programs and allow the region to more rapidly respond to outbreaks and emerging health threats. Minimum Qualifications: The Central Oregon Public Health Partnership (COPHP) detailed in this proposal includes three agencies designated as Local Public Health Authorities (LPHAs) according to ORS 431.003: Crook County Public Health, Deschutes County Public Health, and Jefferson County Public Health. Deschutes County Health Services Department will serve as the fiscal agent for the project and will work in partnership with Crook and Jefferson County public health agencies, St. Charles Health System, the Central Oregon Health Council (providing oversight for the region's Coordinated Care Organization), Let's Talk Diversity Coalition (the region's health equity coalition), Confederated Tribes of Warm Springs, and several other stakeholders who have signed letters of commitment to participate in the project. Together, the three LPHAs and these regional partners will work together to improve the coordination, expertise, and capacity for communicable disease prevention, surveillance, and response in Central Oregon. None of the LPHAs or other COPHP members submitting letters of commitment to the following proposal are included in any other proposal being submitted to the Oregon Health Authority in response to this RFP. RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 2 L6.2 TECHNICAL PROPOSAL — PROJECT NARRATIVE 3.6.2.a. — Description of Regional Partnership 1. Participating LPHA and partner organizations: (a) Table that includes LPHAs and partner organization names, fiscal agent, and key staff positions and roles Central Oregon Public Health Partnership (COPHP) — Organizational Structure Table Governance and Leadership Roles and Responsibilities St. Charles Health System 1 Central Oregon Health Council Crook County Public Health Jefferson County Public Health Deschutes County Health Services Deschutes County Public Health Community Advisory Members Let's Talk Diversity Coalition Confederated Tribes of Warm Springs Neighborlmpact — Child Care Resources Program; Head Start Central Oregon Early Learning Hub Oregon Child Development Coalition — Migrant and Seasonal Head Start Program, Jefferson Co DHS District 10, Aging and People with Disabilities (APD) Voting Member— Provide input on regional staff hiring and evaluations; help identify, develop and prioritize strategies, programs and policies to improve CD outcomes; assist with work plan development and approval; provide project oversight; assist with performance management and evaluation Voting Member— same as above Voting Member— same as above, plus: • Resource allocation decisions Voting Member— same as above, plus: • Resource allocation decisions Voting Member— same as above, plus: • Resource allocation decisions * Serve as the fiscal agent Voting Member— same as above, plus: • Resource allocation decisions • Serve as lead partner for: o Preparation and submission of semi- annual reports for the state o Staff hiring, supervision and evaluation Roles and Responsibilities Advisory— help identify, develop and prioritize strategies, programs and policies to improve CD outcomes; assist with work plan development; provide insight and recommendations on best strategies for their organization /population; review and provide feedback on implementation progress, deliverables and milestones Advisory— same as above Advisory— same as above Advisory— same as above Advisory— same as above Advisory— same as above Name and Title Kari Coe, RN, BSN, Director, Infection Prevention/Caregiver Donna Mills, Director Muriel DeLaVergne-Brown, RN, MPH, Director Michael Baker, PhD, MSPH, CEHS/RS, Director George Conway, MD, MPH, Director Hillary Saraceno, MS, Deputy Director Name and Title Sareli Beltran, Director Caroline Cruz, General Manager, Health and Human Services Patty Wilson, Director Brenda Comini, Director Heather Rogen, Director Frank King, Interim District 10 APD Manager RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 3 Mosaic Medical, FQHC CD Physician / Health Officer Deschutes County Public Health Deschutes County Regional Staff to be Hired 1.0 FTE — Lead Staff Position, Regional CD Epidemiologist* *Job description available upon request 2.0 FTE Infection Prevention Specialist* Staff time of one primarily serving Crook & Jefferson counties and the second primarily serving Deschutes County, depending on needs *Job description available upon request Advisory— same as above Advisory— same as above Advisory— same as above, plus: • Serve as primary contact to the state • Supervise regional epidemiologist Advisory— same as above, plus: • Serve as back-up contact to the state O Supervise 2.0 FTE Infection Prevention Specialists Roles and Responsibilities Project liaison to leadership team; coordinate regional and local CD teams; conduct active surveillance by analyzing surveillance, programmatic and service - related data; design, coordinate and manage special surveillance and/or evaluation procedures where there is no other existing data available; design and conduct program evaluations; develop and provide training; track work plan implementation progress; prepare and submit quarterly and annual reports. Develop and provide infection prevention trainings to targeted institutions; assess infection prevention practices of staff during outbreaks; provide recommendations on current infection prevention best practices, timely response to and coordination of investigations of CD outbreaks; work with regional epidemiologist to analyze and evaluate surveillance and outbreak data to determine risk factors and cause; provide assistance and back-up on day to day CD investigations. Elaine Knobbs-Seasholtz, MPH, Director of Programs and Development Richard Fawcett, MD Heather Kaisner, MS, Epidemiology Supervisor, Health Information Officer Eric Mone, REHS, Supervisor, CD and Environmental Health To be hired and supervised by Deschutes County, with COPHP Leadership Team input To be hired and supervised by Deschutes County, with COPHP Leadership Team input (please see attached job description in Section (b) Attach bios, resumes or CVs for each member of the leadership team Bios and resumes for Leadership Team members listed above can be found attached in Exhibit 1. (c) FTE dedicated to staffing regional partnership. If hiring, include hiring timeline and who responsible for hiring The 1.0 FTE Regional CD Epidemiologist / Project Lead and the 2.0 FTE Infection Prevention Specialists will be hired and supervised by Deschutes County Public Health, with all hiring projected to be completed by mid-February 2018. The Governance Team, with representation from all three counties and two non-governmental partners, will participate in the hiring process and will provide input on staff evaluations. Dr. George Conway, the Deschutes County Health Services Director, and Hillary Saraceno, the Deputy Director overseeing the Public Health Division, assisted with the development of the proposal and will attend the required meetings. The Health Services director and the public health deputy director's time will be considered in-kind. Deschutes County CD team members and supervisors will also attend meetings and participate in webinars and their time will be considered in-kind as well. The grant will provide much needed expanded CD capacity in Jefferson County. This will also allow Judy Budd, the part-time (0.20 FTE) Communicable Disease Nurse for Jefferson County, to coordinate work with Warm Springs Health & Wellness Center [formerly Known as Indian Health Services (IHS)] and the Confederated Tribes of Warm Springs Health and Human Services Branch. A small portion of her time (.10 FTE) will be reallocated to this tri -county project. Additionally, Joy Harvey, the part-time (0.8 FTE) Family Nurse Practitioner will assist with communicable disease support when Judy is unavailable as a result of outreach or work related to the tri -county project. Jefferson County staff will also provide in-kind Spanish translation services for the project (e.g. education and outreach RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 4 materials, etc.). Michael Baker, the Jefferson County Public Health Director, assisted with the development of this proposal and will attend the required meetings. The Director's time will be considered in-kind. Katie Simpson, the Immunization Coordinator and Clinical Supervisor for Crook County, will have .07 FTE re -assigned to coordinate the efforts in Crook County with the tri -County Team. Katie has experience in the immunization program and working in long-term care facilities, one of the targeted areas for outreach and improvement. Muriel DeLaVergne- Brown, the Crook County Public Health Director, assisted with the development of the proposal and will attend the required meetings with Katie Simpson. The Director's time will be considered in-kind. (d) Status of existing relationships between regional partners Cross -jurisdictional sharing (CJS) is defined by the Center for Sharing Public Health Services as "the deliberate exercise of public health authority to enable collaboration across jurisdictional boundaries to deliver essential public health services." Crook, Deschutes, and Jefferson counties have a long history of successfully collaborating across jurisdictions to optimize service delivery, create and implement innovative region -wide programs, and improve health outcomes in the region. As the region worked toward health transformation and the implementation of Coordinated Care Organizations, the three counties created a tri -county policy to affirm their interest in, and commitment to, identifying and implementing tri -county regional approaches to improve the health of the region's population. The policy, signed by county commissioners in all three counties, stated that Crook County, Deschutes County, and Jefferson County, through each county's designated lead public health agency, will strive for a regional approach to program development, direct services, resource development, resource management and/or advocacy. This commitment to collaboration has resulted in several successful partnerships, including the region's Teen Pregnancy Prevention Program, Nurse Family Partnership, and a Robert Wood Johnson grant -funded project to coordinate public health preparedness exercises and communication across the tri -county region. The counties have also collaborated on successful program consolidation by merging individual county efforts into single regional programs that serve all of Central Oregon, including the Healthy Families Program and the Ryan White HIV Case Management Program. The three counties are currently participating in several additional regional projects, demonstrating a continued commitment to collaboration across jurisdictions to improve services and health outcomes. Examples include Crook and Jefferson county's shared Environmental Health Specialist position, the Perinatal Care Continuum Project with the Central Oregon Health Council, the Assessment Feedback Incentives eXchange (AFIX) Project to improve two-year- old immunization rates, the region's Diabetes Prevention Program, and the development of a Memorandum of Understanding (MOU) for regional environmental health collaboration on communicable disease response. These cross -jurisdictional projects have included the three county public health departments, or agencies, as well as numerous partners from across the region. Depending on the project, the counties have partnered with St. Charles Health System, Mosaic Medical (FQHC), private medical providers, Advantage Dental, High Desert Education Service District, regional school districts, the Early Learning Hub, behavioral health agencies, the Central Oregon Health Council, and numerous non -profits, community members, and other stakeholders. The three public health agencies, along with many partners and stakeholders across the region, also worked together and played an active role in the completion of a regional health assessment and community prioritization process that led to the development of a regional health improvement plan. The three counties have representatives serving together with partners from many other disciplines on all eight of the Central Oregon Health Council's work groups and have collaborated on the planning and implementation of the Central Oregon Health Improvement Plan. (e) Governance structure for decision-making, resource allocation, and work plan implementation and monitoring The Central Oregon Public Health Partnership (or "Partnership") listed in the table above [3.6.2.a.1(a)] provides the framework for the regional governance structure, including roles and responsibilities as they relate to decision-making, resource allocation, and the implementation and monitoring of the approved work plan. Governance members will act RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 5 as the leadership team and have decision-making authority; advisory members will serve as subject matter experts and advisors. The Epidemiologist will coordinate efforts with the communicable disease programs in all three counties. The Partnership will use each county's population as the basis by which votes are counted, with Deschutes County having two votes and Crook and Jefferson counties each having one vote. The two non-governmental agencies serving as governance members will each have one vote on all but resource allocation decisions. A consensus model will be applied, using an established process that has successfully guided past regional efforts. For the initial grant phase, resource allocation decisions have already been agreed upon by the partners, with the three new positions to be hired and supervised by Deschutes County Public Health. The initial Partnership meetings will be held monthly and focus on the review of work plan goals, strategies, and outcomes. The group will also finalize an implementation and evaluation plan, including process measures and performance metrics, and review, approve, and sign MOUs. After initial implementation, partnership members and staff will assess the timeline and monitor initial implementation of the approved work plan. Once established, Partnership meetings may change to a regular quarterly schedule that aligns with quarterly reports and progress updates. The meetings will also provide an opportunity to identify and address any issues that have arisen. In addition to performance and process metrics, program evaluation will include stakeholder customer satisfaction surveys conducted at the initial six month point and annually post -implementation, to further evaluate and monitor the implementation of the project. 2. Systems to engage in non-dominant communities in co -creation of CD control interventions and changes: (a) How the regional partnership will reach out to, engage and co -create with affected communities Strategies for engaging non-dominant communities will be based on a needs assessment of the targeted institutions serving the affected and vulnerable populations. In conjunction with partners, staff will work with non-dominant and affected communities to co -create culturally responsive communicable disease prevention strategies, policies, and educational resources and fact sheets. These will include multilingual web -based resources that will be made available to the community. The work plan also includes strategies for building partnerships with organizations who serve potentially vulnerable seniors—such as the Council on Aging of Central Oregon, faith based communities (e.g. parish nurses) and senior centers—to better understand and address communicable disease health disparities and co -create strategies to address needs. In addition, other stakeholders (e.g. a representative from the Latino Community Association and/or an assisted living facility) may be added to the Partnership and/or invited to participate on an as needed, advisory basis. The work plan includes strategies for building partnerships with organizations who serve non-dominant populations and communities such as the RHEC (Let's Talk Diversity Coalition), the Latino Community Association, Indian Health Services and the Confederated Tribes of Warm Springs Health and Human Services Branch to better understand and address communicable disease health disparities and to co -create strategies to address the needs of these vulnerable populations. The work plan also includes strategies to analyze communicable disease and outbreak data quarterly through the lens of sociodemographic characteristics such as gender, race/ethnicity, age and language to determine risk factors and to monitor and identify populations that are disproportionately affected by communicable diseases and outbreaks, Data will also be monitored and evaluated for intended and unintended consequences of communicable disease -related activities across different populations and communities. Findings will be shared with the regional leadership team and internal staff to assess and address unmet needs. (b) How the Regional Health Equity Coalition (RHEC) will be included in the partnership and funded The Partnership will work with the RHEC (Let's Talk Diversity Coalition or "Coalition") as described in their letter of support. The Coalition operates in Jefferson County and will be an advisory member of the Partnership to provide input and advice on the development and implementation of strategies to best meet the needs of their organization and the population they serve. As an advisory member, they will also review and provide feedback on implementation progress RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 6 reports, programs, policies, and staff performance. Because their participation and role fits within the scope of their current mission and goals, the region's health equity coalition will not receive Partnership funds at this time. (c) How federally recognized tribes in the area will be included in the partnership and funded The Partnership will work with the Confederated Tribes of Warm Springs, which represents the only three tribes in the region, through the Jefferson County Public Health agency and the Early Learning Hub of Central Oregon, both of which have established successful partnerships with the tribes. A tribal representative from the Tribe's Health and Human Services Branch will also serve as an advisory member to the Partnership (see the membership table in section 3.6.2.a.1(a) and their Letter of Commitment included in Section 3.6.6). Specific strategies and activities will be co -created with tribal members to strengthen prevention, surveillance, and response to communicable disease in identified areas of need. Depending on their recommendations and need, funding from the project is included in the sub -contract to Jefferson County and available to the Tribes to address an identified communicable disease -related need or gap in prevention, surveillance, and control. (d) Other partners who work with populations at risk for communicable disease The Partnership includes multiple partner agencies that operate regionally to identify and address the health needs of vulnerable populations in Central Oregon: • St. Charles Health System — owns and operates hospitals and medical centers throughout the region • Mosaic Medical — Federally Qualified Health Center that owns and operates primary care clinics, school-based health centers and a mobile clinic throughout the region • DHS Aging and People with Disabilities — protection for vulnerable seniors and people with physical disabilities • Let's Talk Diversity Coalition — regional health equity coalition • Confederated Tribes of Warm Springs — represents the three tribes in the region • Central Oregon Early Learning Hub — provides support for parents to establish a solid foundation for children's long term success • Central Oregon Health Council — focused on improving the health of the region and providing oversight of the Medicaid population and local CCO, PacificSource Community Solutions, Central Oregon • Neighborlmpact — the region's community action agency; oversees the Child Care Resources Program • Oregon Child Development Coalition — health and education support to migrant and seasonal farm workers and their young children; based in Jefferson County 3. Advancing the public health system: (a) How LPHAs in the regional partnership that have fewer resources or had larger gaps in the public health modernization assessment will benefit from the regional partnership The public health modernization (PHM) assessment revealed noticeably lower scores in several areas for Jefferson County compared to Crook and Deschutes counties. Gaps in capacity are most evident in communicable disease response surveillance, where Jefferson County scored 30% lower than Crook County and 40% lower than Deschutes County. Communication and overall equity scores were also disparate, with Jefferson County scoring 20-30% lower in several areas. PHM implementation funding will allow for a regional partnership that provides resources and enhanced communication necessary to address these gaps through increased staffing. A regional epidemiologist will work with all three counties to build communicable disease capacity, evaluate current communicable disease reporting systems, and work towards more active surveillance and response through regular contact with health care providers, laboratories, and hospital infection control practitioners. Regular review and analysis of communicable disease reports will also be conducted to determine disease trends and emerging threats. For the smaller, more under -resourced counties — particularly Jefferson County — the position will provide significant support for current staff with limited FTE. This will alleviate some of their multi -faceted workload, allowing them to focus on disease investigation and response. Staff will also receive critical and ongoing training opportunities to help reduce communicable disease transmission and outbreaks in vulnerable populations, such as those in long-term care, assisted living and child care facilities. The position will also improve overall regional surveillance and coordination among the three counties. RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 7 A regional partnership among Crook, Deschutes, and Jefferson counties allows for a comprehensive and coordinated approach to active surveillance, communication, and outreach to vulnerable populations. (b) How partnership will demonstrate and document a model that advances a modern public health system. The Central Oregon Public Health Partnership is built on four priorities to modernize the regional public health system: 1. Improved capacity to provide a foundational public health program (communicable disease control) in the tri -county area of Central Oregon through cross -jurisdictional sharing among Crook, Deschutes, and Jefferson counties. 2. Implementation of communicable disease prevention, control and response activities with an emphasis on health disparities and improving equity across the region. 3. Coordination with key stakeholders in Central Oregon to promote evidenced -based interventions to prevent and respond to communicable disease outbreaks. Partners include St. Charles Health System, Central Oregon Health Council (CCO), Early Learning Hub of Central Oregon, RHEC, Neighborlmpact, Confederated Tribes of Warm Springs, DHS Aging and People with Disabilities, Oregon Child Development Coalition, and long-term care and child care facilities. 4. Demonstrated progress toward improved health outcomes through accountability metrics and evaluation of our new service delivery model. Successful cross -jurisdictional sharing arrangements can exist in many forms. The Center for Sharing Public Health Services provides a spectrum of shared services that range from loosely integrated, informal arrangements to full consolidation of LPHAs. The Central Oregon Public Health Partnership adopts a model of integration called 'shared functions with joint oversight.' This type of collaboration allows LPHAs to maintain local autonomy while working together to address regional gaps in public health service delivery, disease prevention, and/or response. If funded, this regional partnership will modernize Central Oregon's communicable disease control programs and further strengthen existing cross jurisdictional partnerships. 3.6.2.b. — Description of Regional Communicable Disease Burden and Health Disparities 1. Summary of local and regional surveillance data describing burden of communicable disease The Central Oregon communicable disease burden compared to statewide rates varies depending on the disease. While 10 -year hepatitis C and pertussis rates are statistically lower in Central Oregon than in Oregon as a whole, E. Coli (STEC), campylobacteriosis and giardiasis affect Central Oregonians at a statistically significantly higher rate compared to Oregon. While gonorrhea rates have been historically lower in Central Oregon than in Oregon, the recent degree of increase has local public health officials particularly concerned. Gonorrhea rates in Central Oregon have increased by over 450% over a 10 -year period compared to a 232% increase statewide over the same period. The concerning increase in gonorrhea rates (and the overall burden of STIs) in Central Oregon is being addressed through an alternate regional grant opportunity; therefore the Central Oregon Public Health Partnership will focus on communicable disease outbreaks, most commonly norovirus and influenza, at institutions that serve vulnerable populations. Because norovirus and influenza are not reportable communicable diseases, the burden and incidence in Central Oregon cannot be estimated. However, outbreak data indicates that norovirus outbreaks are the most common type of outbreak across Central Oregon, representing just over half of all outbreaks. Since 2012, around 70% of all norovirus outbreaks in our region occurred among vulnerable seniors in long term care facilities. Another vulnerable population for potential outbreaks includes young children attending child care facilities that have low immunization rates. Public health modernization assessment data revealed a substantial regional need for surge capacity to address outbreaks and emerging threats. It also revealed gaps in active surveillance capacity and communication with partners and the public. This need is particularly significant in the under -resourced counties, Crook and Jefferson, which face limited capacity conduct these critical communicable disease activities. Additional resources to prevent, assess, and respond to outbreaks and emerging threats will also help alleviate capacity challenges for day-to-day investigations. RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 8 Capacity challenges for CD investigation work have been accentuated by the increase of population in Central Oregon (6% increase from 2010-2015) as well as the increased use of PCR -based testing to detect pathogens. These factors have contributed to an increase in case investigations as well as a growing number of complex and time -intensive investigations for false -positive PCR tests that resulted in no case findings. 2. Summary of local and regional health disparities for communicable disease As described below, communicable disease outbreaks in Central Oregon disproportionately affect institutions that serve the elderly and have the potential to affect young children in child care settings. This disparity is especially concerning given the higher risk for negative health outcomes in these vulnerable populations. Older adults and long term care facilities. The population in Central Oregon is aging. Five-year estimates from the 2015 American Community Survey indicate that the percentage of all residents that are aged 65+ is statistically significantly higher in Crook County (23.4%), Deschutes County (17.4%), and Jefferson County (16.8%) than in Oregon as a whole (15A%). There are approximately 37,000 adults aged 65+ in the Central Oregon region. Among these older adults, 8.4% live below the federal poverty level, which is higher than for all Oregonians aged 65+ who live below the poverty level (8.1 %). Central Oregon long-term care facilities experience a high burden of communicable diseases. Since 2012, the majority (58.2%) of the 91 total outbreaks in Central Oregon occurred in long-term care facilities (LTCF). During this time, outbreaks in LTCF led to 1,299 cases and resulted in 48 hospitalizations in Central Oregon. On average, LTCF in Central Oregon also experienced the highest average number of cases per outbreak (24.5) compared to all other outbreak settings. Most (60%) LTCF outbreaks in Central Oregon were norovirus outbreaks, followed by influenza (22.6%). Healthcare workers in LTCF can transmit communicable diseases such as influenza to vulnerable residents and other staff. Influenza vaccination can prevent transmission, however only 58.3% of skilled nursing facility (SNF) healthcare workers in Central Oregon reported receiving an influenza vaccination during the 2015-2016 influenza season compared to 63% statewide. (Note: SNFs are a subset of LTCFs, and some data is only available for SNFs instead of the broader LTCF category.) Central Oregon SNFs reported varying rates of influenza vaccine among healthcare workers, ranging from 49.2% to 100%. Only one Central Oregon SNF had an employee vaccination rate of 100% (meeting the Healthy People 2020 target of 90%); all remaining facilities had rates lower than 75%. Promoting annual influenza vaccination among LTCF staff, as well as education and implementation of evidence -based infection prevention practices in institutional settings will reduce the burden of outbreaks. National data also supports a focus on LTCFs as a strategy for targeting vulnerable populations. A 2010 study published in the Journal of the American Geriatrics Society found that almost a quarter of LTCF residents visited the emergency department at least once in a six-month period, and 24.6% of these visits were for preventable reasons including communicable diseases such as pneumonia (Gruneir et al., 2010). Cost associated with these visits include a "high frequency of ambulance transport (90.4%), emergent triage (35.3%), hospital admission (62.4%) and death within 30 days (23.6%)" (Gruneir et al., 2010). Young children and child care facilities. In 2016, two-year-old up-to-date immunization rates were higher in Crook County (69%) but lower in Deschutes (65%) and Jefferson (65%) counties when compared to Oregon as a whole (66%). Two-year-old up-to-date immunization rates are currently being addressed through the regional AFIX project, which leverages partnerships with local clinics to improve rates. Despite this ongoing effort, some of our local day care centers still report low up-to-date vaccination rates, putting Central Oregon children and employees in these institutions at risk for vaccine preventable outbreaks. Based on school immunization data for 2016-2017, one-quarter (26% or 33 of the 125) of child care facilities in Central Oregon had up-to-date vaccination rates lower than 90%. Central Oregon child care centers have experienced four outbreaks since 2012, resulting in 66 cases. Child care center outbreaks have resulted in a mean of 17 cases per outbreak. Two of these outbreaks were for norovirus, one very labor- intensive outbreak was for pertussis, and one was of unknown etiology. While the number of outbreaks in child care centers RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 9 is comparatively low, there is a growing concern of increased risk of vaccine -preventable outbreaks due to low herd immunity in 26% of our child care facilities. 3. A summary of relevant findings from the region's local public health modernization assessments The public health modernization assessment revealed a significant need for targeted efforts in communicable disease and communicable disease health disparities across the region. Despite potential subjectivity inherent in the self-assessment, variation in scores for equity, communicable disease, and communication between Crook, Deschutes, and Jefferson counties appear noteworthy. The region's capacity for inclusive communication and engagement scored particularly low among the three counties, while communicable disease response surveillance capacity for communication and overall equity also scored low (see table below). The assessment pointed to the following four areas as an ideal starting point for decreasing regional gaps in capacity. Regional capacity*, as determined by public health modernization assessments, 2016: Crook Deschutes Jefferson Capacity for inclusive communication and engagement 50% 40% 20% Communicable disease response surveillance 50% 60% 20% Overall equity scores 50% 50% 30% 1 Capacity for communication 60% 50% 30% 1 'Capacity was self-assessed on a 1.10 scale and then extrapolated to a representative percentage — e.g., 5/10 = 50% 3.6.2.c. — Description of Regional Strategy to Reduce Communicable Disease Burden Regional strategies and partnerships are already underway in Central Oregon to reduce the burden of communicable disease and reduce health disparities. The Central Oregon Regional AFIX Immunization Rate Improvement Project is an effective strategy being implemented to address two-year-old vaccination rates. This project is funded through the regional CCO, Pacific Source Community Solutions. Within the first year, 17 clinics received AFIX assessments and feedback, resulting in a 7% increase in 2 -year-old vaccination rates within the participating clinics. In addition Crook, Deschutes, and Jefferson counties have applied for and received a grant to address HIV and the increasing rates of STIs in Central Oregon. LPHAs in Central Oregon effectively respond to and investigate day-to-day communicable disease reports in a timely manner through individual county communicable disease programs. While basic communicable disease investigation requirements are met, there are limited capacity and resources to focus on communicable disease prevention and surveillance efforts. LPHAs are also challenged to implement outbreak prevention activities and thoroughly respond to outbreak situations, especially within institutional settings that serve vulnerable populations. When outbreaks of disease occur, the communicable disease teams are greatly taxed and only able to provide minimal response efforts. This is even more evident in Jefferson County where there is only .2 FTE dedicated to communicable disease activities. The Central Oregon Public Health Partnership includes a regional strategy to fill these gaps in capacity by forming a Central Oregon Outbreak Prevention, Surveillance, and Response Team to reduce the burden of communicable disease and reduce health disparities across the tri -county area. This regional team will consist of 1.0 FTE communicable disease epidemiologist and 2.0 FTE infection prevention specialists, who will improve upon current efforts and interventions to prevent, detect, and control the spread of communicable disease outbreaks. The team will focus on regional communicable disease surveillance and risk communication to health care providers, regional partners, and the public, as well as prevention and control of outbreaks in institutional settings who serve vulnerable populations, The infection prevention specialists will work directly with communities that are disproportionately affected by outbreaks (most notably norovirus and influenza outbreaks) such as LTCF and child care facilities. Strategies include working directly with facilities to create culturally responsive educational resources and provide infection prevention training. Child care facilities will be prioritized based on up-to-date vaccination rates, with a specific focus on sites with up- to-date rates lower than 90%. RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 10 This regional approach promotes health equity by targeting vulnerable populations for outreach, education, and training in order to reduce health disparities among identified groups and enhance regional capacity to detect and respond to communicable disease outbreaks. Regional health disparities were considered in the design, implementation, and evaluation of activities and metrics. Key innovative strategies and interventions this team will implement include: Prevention Strategies: • Provide infection prevention and control technical assistance and training to LTCF and targeted child care facilities that serve vulnerable populations and/or have low up-to-date vaccination rates (<90%). • Develop, engage, and maintain regional strategic partnerships to prevent and control communicable diseases and promote health equity. Partners include Neighborlmpact, Central Oregon Health Council, Mosaic Medical, St. Charles Health System hospitals and clinics, RHEC, Early Learning Hub of Central Oregon, Confederated Tribes of Warm Springs, DHS Aging and People with Disabilities, Oregon Child Development Coalition, child care facilities, faith based groups, local health care providers, and long term care facilities. • Promote and provide educational resources to LTCF staff on the importance of annual influenza vaccinations. • Build partnerships with organizations who serve seniors such as Council on Aging of Central Oregon, faith based communities (i.e. parish nurse group) and senior centers to better understand and address communicable disease health disparities and needs and to co -create strategies to address needs. • In conjunction with organizational partners (Neighborlmpact, Central Oregon Health Council, Mosaic Medical, St. Charles, CO Early Learning Hub, Confederated Tribes of Warm Springs, DHS Aging and People with Disabilities, Oregon Child Development Coalition, and long term care facilities), develop culturally responsive communicable disease prevention educational resources and fact sheets, including multilingual web -based resources, that will be made available to the community. Surveillance Strategies: • Conduct surveillance on communicable diseases and produce and share timely reports with health care providers, partner agencies, and the public. • Analyze communicable disease and outbreak data by sociodemographic characteristics such as gender, race/ethnicity, age, and language to determine risk factors and identify populations that are disproportionately affected by communicable diseases and outbreaks. • Organize and lead outbreak investigations within Central Oregon with a focus on addressing the needs of vulnerable populations and populations disproportionately affected by communicable diseases and outbreaks. • Create an annual report on communicable disease (including STIs) and outbreak data, trends, emerging threats, and health inequities for Central Oregon. Distribute this report to health care providers, public health partners, advisory members, and the public • Promptly identify outbreaks in the Central Oregon region and assess and evaluate response efforts and recommend changes and/or improvements in practices. • Participate in county and regional meetings, as needed, to discuss communicable diseases and emerging threats and/or outbreaks. • Engage and educate health care providers on communicable disease reporting requirements. • Provide timely, coordinated, and culturally responsive regional communications, through multiple platforms, with the public about outbreak investigations and current communicable disease threats. • Leverage effective multi -sectoral collaborations to improve health through community engagement and support. • Evaluate and monitor intended and unintended consequences of communicable disease programs across different populations and communities. Response Strategies: • Assess and evaluate communicable disease response focusing on the needs of vulnerable populations and populations disproportionately affected by communicable diseases and outbreaks. • Recommend changes and improvements in practices based on evaluation of response efforts. • Identify and/or develop appropriate interventions to mitigate the effects of institutional outbreaks. RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 11 • Provide ongoing regional peer support and training to communicable disease staff. • Provide assistance and back-up on day-to-day communicable disease investigations in individual counties as needed (particularly in under -resourced counties). A coordinated regional team that focuses on outbreak prevention and response as well as surveillance, assessment, and communication of communicable disease patterns and trends will improve upon Central Oregon's capacity to effectively address the burden of communicable disease outbreaks. It will also decrease regional gaps in communicable disease programs and allow the region to more rapidly respond to outbreaks and emerging health threats, 3.6.2.d. — Commitment to Participate in Learning Communities and Evaluation 1. Regional partnership leadership members who commit to attending state provided in-person learning opportunities: All of the following will attend at least two in-person learning opportunities: 1) Crook County Public Health — Muriel DeLaVergne-Brown, Director 2) Deschutes County Public Health — Hillary Saraceno, Deputy Director 3) Jefferson County Public Health — Michael Baker, Director 4) Regional Epidemiologist/Project Lead — TBD 5) Regional staff supervisors will participate in at least one in person opportunity — Heather Kaiser, Eric Mone Funding has also been included in the budget to support at least one other Leadership Team member to attend each of the in-person collaborative learning opportunities, depending on the purpose and topics covered. 2. Other staff who commit to participating in in-person and/or conference calllwebinar learning opportunities: The following Partnership and staff members will participate in conference call/webinar learning opportunities: 1) Crook County Public Health — Muriel DeLaVergne-Brown, Director 2) Deschutes County Public Health — Hillary Saraceno, Deputy Director 3) Jefferson County Public Health — Michael Baker, Director 4) Regional staff supervisors: Heather Kaisner and Eric Mone 5) At least one CD staff member from each county 6) Regional Epidemiologist/Project Lead — TBD 7) Infection Prevention Specialist — TBD 8) Infection Prevention Specialist — TBD 9) Two or more Central Oregon Public Health Partnership Community Advisory Team members — TBD 3. Regional partnership leadership members who will participate in program evaluation efforts: All of the following will participate in program evaluation (with input from Advisory Team members): 1) Crook County Public Health — Muriel DeLaVergne-Brown, Director 2) Deschutes County Public Health — George Conway, Health Services Director 3) Deschutes County Public Health — Hillary Saraceno, Public Health Deputy Director 4) Jefferson County Public Health — Michael Baker, Director 5) St. Charles Health System — Kari Coe, Infection Prevention/Caregiver Director 6) Central Oregon Health Council — Donna Mills, Director 7) County QI Specialist — Channa Lindsay 8) Regional staff supervisors — Heather Kaisner and Eric Mone 9) Regional Epidemiologist/Project Lead — TBD RFP 4461-17 Public Health Modernization - Deschutes County on behalf of the C.O. Public Health Partnership 12 00601770M C HFP 4461- Cost Proposal 6017- Lna Item t§Dago 1 and N4rrativ. Workuheut- Da6c'I otos County Attachment C RPP 4481 - Cost Proposal Form • Line Item Budget and Narrative Worksheet _55_55.. .. 5555., 'Please comp1019 106 following Line Dom Budget for: 18, 900111 Ou,,100t for Public Heetlh Modernisation (111116.9639119) 1407204 OM' 5Jhdeleneddt5A4 640m PGbst 10 ooh 7Fie%WhitOiiM 5162 nny 004.604067710077140951,010770,4404 de )hg ti6Yn1 deed(ueresor eir91697014vloets Budget Categories Al Belery 219) fringe Denies S7) Equipment 11.6r ar Aver 007714,406701,077 leieve7004941 'C .Y47 &3,0'446` ii/MO&.y100141400Altt95,G+51 dems.. Wood Peerne Number: Oeecrlpllon Ia111a00 4 T(610) SALARY ��+•^� IDee Bartel`.' Sworn 541.02,1449 vtueerrolnwn IfestAF G4o61 Memo Eaucaar 11 Epat4'reerepraltl.ua31 Public Meeilh Depuly Director 006100.4,46006'0601 iniucWr, PlovolOon SpeciaOet DuRereitor Aderev '1nsxu AN1701 Wlon *Wel 019,123 554.752 578.011 5127 881 080,e09 169,440 579 271 Io.111a0 a 0000 Bary 4o rA 8 1 75,264.4 2 76284461 107,26513i 4 12.166 10! u 17,201.01 6 13,417201 7 3663651 167,06 mow 4681414ae01184.40 Fa. N005er: I10at4m. xelm0000 006.16411N 5,10 76,70 107,265,1 100.16 105 100,00% 105 1000CY 166 1100051 2000% 16 5 165 1500% 16 1 5 00% 16. 58 5200 58 00141 51 00%I 0114 To141;Ma. 43.664 99 43,604 09 64,705 21 t14144o4m9e11. V4146 act 61 Spxw-t-0 640.7 A. 4.19 snt r A,VL,x'p.r.l )TDIALEOu1PU4N4 (46400, SRatrz O. PWB.. 53,00%! 6603x1 4900% 44005' .1 T3'oo 46 4650+:40 s,pl+oioo r0oAl9+9e,5n.4't3o,Ae440' at 404]0&'. de14, 19801,54490000,8646451,7,0020,017 11•40a.va.�iF:Y chN uW, arvt 14 'I000r.9..xeft a',ro^•af skly 14er,awPM0«asT.w 5142,035 19 70161 6Hend Wary ( 41.101,1lakry "d1000 000 00 00 12,760 10 17,281.40 13,417.20 3,963 56 1257,634 147,430 66 000 000 000 0 00 000 40.08 In411nd Map. I 0.105619 Mao. 9001 900 -�, 0 00 .�.W.••�. U 005 000 000 9,15935 0.00 "1767i75 0.00 1,747,56 _.m 000 4142,016 124,24454 09,2211 10 1 E 9.541 EO 29,080 19,000 ON 04 ' IM004016rp 30 16.00 10 Se is RFP 4461-14 Public Health Modernization - Deschutes County on behalf of CA Public Health Partnership Deschutes County Budget 1 I ZI r 1 0#ll11 •:.;,l1,i jil(f_4-11l _iiu )8•. 1.1,41.1,142 t7.',175 30 • I r mavei 41,44424 10100114 4441 1444,1444;,'6,2444.4.4,1,4 14, .4 4.40 i1.4A44 .0)130 .14,24n442,14 1 '2 ,; 42442%2'4u-, SOUL CITVIER 01 440,11, :1:04 330*30303 04 0.1R24444,4411.4418 0 001, I—, )0, Glook County Seffetson county *03A3 030000883 yrottaarIVI), :141,S,O.1 1,1 rorm›; 12114003 444 ') 445,45$ It:wool /13 I) S1,442,41 034.4 140142481411.11141 klocieri343.444:1 /WWII RN, 4.44 • /41404.1$ 414;414.1244 .1)2 Ste, 8a4 Moor ),1 34 50 1*5 , • , .• 1*0 45 $U SU 0001 $0 104.447 $80,6711 11.101 7141,641 $500,000 $222,417 70 3U 75 78 RFP 4461,14 P04114 MoiorMui:ori - Desch:11es County on behalf or C 0 Publto Health Parinstsuip Deschutes County Budget 2 etititiet 8/1 1411V.3 Key pekdrone fit Mr lerod 201138 Hearth 117lidisfectran Prevunlita Spot -0649 er Stop .{",1 , telap 4 wi1401 t oadTrey. Sue 1; Section 3,8.7 3.1 lot tor brookno fut hiring S(oo (00073 10! 1118 390 estimeler 004 oil to degolidant 7700 (90 Cteerkiehee 80(0770, 4073 skier. er got candidates ()trod Job Detsegtrone averldH0 rd outmost. Al calor posMorts amassed to coerced ern .11,01,1 See iteittee glad prnjtjpo 0etuy, r.estirepos./pirusperyst Hvith DebAt&rocter,Esolornrologiel Supthersor,trylocieen Prover:119n Stirectottet Sopieyestue), (011(00 beneills Includo po'reormel services other (000 salary that can be attributed to an ornproyee Fringe benefits include the follewingt koolthbanIdi insoranso, Public Employee Retirement Contributions, Sedill Security, Medicare. Unemployment. Life-long term diseh ty, etc ) Rotes vary 05000 00 c!.'0'11)1Ttodfli".Idti4IPTaiiro oid rtilit'te0YOss„ „ nee tatiit 537 (07 compilers d oniverate eiocsinP ‘teitet, .1910010010(4 for eec7ieetil'k$a1,800, a KeyPenkid fevieeient !,!./..T9.9A9A1nt.5,11,Anta;053.1.) t'Ith!!!!!!!!!!! 1-4,5?Q Project team staff will use hest practices and partner llllllllllll lo develop culturally responsive educational resources for multiple platforms 'thee far, the learn Henri/led the 0000 (0!. 54 746 for Infection prevention educational materiels (250 Tool Kits, 500 Plu Vaccination Materials) - see Aged:mord ft SMART °elective (31; and $600 for Annual Report - See Attachment 1) SMART Objective (5) $3,24010 meeting food incompliance kniti Attachment Healthy Meetings 70)7119 3914 based 00 (074(0 per diem .010, 0477 support up to MO leadership and Community Advisory Team meeting 901 010073 gotrolvas _ tearculaeon Is based ori Ian staff attendIng 18 meetingsot thIpsi,, rate). ,4900 for 0111to fittroclios. Roy staff (up to 5) will attend twodmperoon Ischia) health moderrriaaliOn coSaboralwe learning opportunities Waal (8162 Mi.—) for two nights/per gip( and per-d(em (hosed on training day 004 (109107 day par (op) le based on 05A rates for Portland Mrleago Is based an state 9010 101 roundldp liond/Porirandi Additional 190007 03)3 inclurte: 2,800 regional travel miles 00. 0(0 mliespe rate for Epidemiologist travel 1 day/month to Crook 000 201100700 County Pubic Healtn Departments, Leadership Teem trevel to monthly meetings in Redmond In es/di:ion, (00 HE 1(0 will utilize 0 Deschutes County Health San/lovas oar cosigned (0 (00 project for travel of an ostimated 19,465 mtles to conduct Ted odtreach to 00110 ma centers, assioted living facrilges and long term ergo fealties in Croak. Deschutes 008 20001020 Counties and ro travel ono dayiwesk to Ihe Grook and teffernen Dowdy thahlth Departments Tfregropt:veilthredspproormatesly,4,300 miies odd Deschutes GountywIll pro)edo the baking/a imided The Epidendorogist and HE 11's w rettelVe 8 040 hlehthtle n.riths cell phone allowance ($1,060) The EmidernlologIst termites the use (.1 33(023 11710049014t7(7fottl7 a.S 1 Deschutes County wilt enter into an Inter <governmental Agreement with Crock County Health Deportment a 1,2,0001 ano Jefferson County Public Health Department (512,000) far tho horded jemmy 1, 2015 Inrcrogh Jure 30 2010 Crock Ceterty Hough Deportment will assign:I 07 FTE immunization coordinator and clinkrai sinter visor to cocrdinste veth Deschutes County infection prevention specie isto to provIde technical assistance and (90791(0(1 00 Infection prevention and control to lerrei 1007oara facilities and targeted ehrld oate feeilil . lhat serve vulrerablo populations ardor hevo low raytoidate vaccination rules. till'ereett Couety Public Health will assign 1 FTP communicable dtkeasogremuniodlion toincoonlluelo with Deschutes County Infeerion preventIon 0(10010:10(0 10 provide technical 0001u)0000 008 training on infection prevention and cohlrel to lorg term core feciliteur and targeted 08(00090 facilities that serve vr.lnerarrle populations oryilor have low up-Lvida(e 0000i1,3400 rates, 2) protide Spun sh genolehen services for (00 ,0(0(001 )u 9. 04003(100 and outreach ma(errals, oth,), and 3) work with Confederated Tribes of Wares Springs Pitral nteretvers coiereate ettatogiesfactivilies to strengthen prevention, surveillance and *000:1000 (0 communicable disease in identified areas nr need .1016e1011 County PUNIC Health Dopariment will allocate 74,000 in Kinds to address a rhutuelly Wont fled and agreed upon communicable diseaseireia led need or gap in CD prevention, suiveslano and e001r013esgktutttyt6mItnt.Tops7'rnent 001 .1110191 CotattyHubric Health Depahment budgets ore attached Deschutes County 97.4( 003730 Me grant a "dremIntmos" indirect rate ot 100 el the total direct charges Yhe County 0 actual indreot iglu is 35% within 100 7078(0 health division; therefore, 010 8009100 (0 3(811001 0001900071 I 00 scorned as 1,4100 indireot otiotgeo. Total nitwit Chem. (Grant & ireK(nd) $722 ely‘ vells tot& ihdlireet chEgee cotoutraval in he 3102,504. although only. e hertior 1043e (540 403) 01,1 00 9100704 te the Tent) 877 444)94 Public Health Modern's:Akron - Deschutes County hlt boned of 0 G Fieraith Pannerenip Deschutes County Cudgel, 3 Attachment C HFP 4461 -Cost Proposal Form - Line Item Budget and Narrative Worksheet - Crook County Attachment C RFP 4461 • Cost Proposal Form - Line Item Budget and Narrative Worksheet Please complete the following Line Item Bl Crook Co. Crook County 18.Month Budget tor Public Health Modernization (1/1718.6130119) Identify only funds re wasted under Public Health Modernization. List any applicable In-kind or matching funds provided by the fiscal agent and/or strategic partners. Fiscal Crook County Agent: Fiscal Muriel DeLa Vergen Brown Contact E-mail fndoleveran013rown00h.Co.CfoUk,Uc(r address: Number: 941-447-5165 x206 IFax Number: ]541.447-3093 Phone Budget Categories Doacrlptlon Illi (A) Salary Position 8 Me of Position Sentry (annual) j %of (Ims m 5 of in(M requested Total Sellars (FTE) 1 CD/immunization Supervisor 553,105 7.00% 16.5 5.117.13 2 PH Director 592.747 11 00% 16 5 0 00f 3 j .,...,,. 0.00 4 0.001 TOTAL SALA(4Y 55,117 131 Narrative.: (6) Fringe Benefits (0) Equipment (0) Supplies (0) Travel Position 0 2 3 i 4 j( TOTAL FRINGE List aquipm ni, Include as s1,rarnr-1 TOTAL EQUIPMENT Noiraliva' Total Salary 5,117 13 10,000 00 0.00 0.00 Beta if A aliraxa 56 he n( 35.00%+ 35 00%1 Do not ilst These items Include supplies for meetings, general office supplies le. paper, pens, computer disks, highlighters, binders, folders, etc MIS covers in -Mato, o44otslate, and travel to an reeved 150101ngs Minato Oat 0101210 Narrative' Two required tops to Portland for two stex members from Crook Per Diem tae Hoist: 728 Ar tele. 0 Total Fringe 1,701.00 000 0 00 0 00 61,791 00 00510154 Tota 65,117 In -Kind Salary i Matching Seery I 0.001 0.00 10000.001 0.00 0.00 0 00 0 00 0 00 010,000.00 E0.00 in4(Ind Fringe Matching Fringe 0 00 0 00 3,50000 51,791 03.505.00 50.00 S0i 50 50 so( so 00 S0 5730 57251 SO 50 fn.Kfr4 'Cravat 50 00 0400 Metahina Trans 50 50 50 001 RFP 4461-14 Public Health Modernization - Deschutes County on behalf of C.O Public Health Partnership Crook County Budget 1 (F) Omer Ali t:i('r1i r1Ea 31 .. I:E f' •5 ri1-{.0.,'. Pi <xu; s.: Pru r.. ;.inn i}: w BL .1110 Col mty iit.ta '""• t li5 (a.,,,- „ f; sat, ., 1.,:0i Y, GSr51 TOTAL TRAVW:I, Please list. Printing Materials for Community Partners and Program Information Meeting Supplies (coffee for partners) TOTAL OTHER (G) Contractual: Ust total of all subcontracts and all contractual costs Include a separate bud el worksheet for each suhcuniractor j(H) Total Direct (I) Indirect IP) TOTALS Fringe Benefits: Equipment: Supplies: Travel: Other Contractual: TOTAL CONTRACTUAL (Sum of A through G) Indirect @ 10 00% 0909 (Sum of H & I) Should equal Public Health Modernization Award Request " Attach Budget Narrative on a Separate Sheet - See below Crook County Budget Narrative Kolie Simpson, the immunization Coordinator and Clinical Supervisor for Crook Courtly till bo roassigned a 07 to coordinate the efforts in Crook County Nth the Tri•County Team Katie has experience In the Immunization program and has direct experience working In long term care facilities. one of the targeted areas for Improvement 50 SO 5765 $330 $124 50 SO 00 01.7231 s0( SO SO 04001 $0 $0 $0 5D 50 So $0 90 60 50 09,091 513,900 5909 50 910,000 513.900 50 00 00 50 s0 s0 so s0 50 50 50 90 $0 90 90 The fringe benefits are 35% of the 07 01h. salary in Crook County Travel to required training for two Crook Staff members - 2 dayo travel to Portland - per diem - $236 00, Hotel for required training for two Crook Staff Members - 4 nightsi5182 night total - 5728; Mileage for Level to meetings in the Central Oregon region - 800 lolal miles for travel 111 Central Oregon Printing01 materials for Crook County y pallr.ors and meetings, 380 copies per menta 0 050 (20 05) x 16 menthe iii 5330; Supplies for Partner Meetings in Crook - Coffee Muriel DeLaVergne-Brown, the Crook County Public Health Director assisted with the development of This porposal and will attend the required meetings wish Katie Simpson, from ndlret: her slelf. The Director's time Is considered in-kind RFP 4461-14 Public Health Modernization - Deschutes County on behalf of C.O Public Health Partnership Crook County Budget 2 Attachment C RFP 4461 - Cost Proposal Form - Line Item Budget and Narrative Worksheet - Jefferson County Attachment C RFP 4461 - Cost Proposal Form - Line Item Budget and Narrative Worksheet Please complete the following Line Item BiJefferson CO. Jefferson County l0 -Month Budget tor Public Health Modernization (111118.6130119) identify only funds requested under Public Health Modernization List any applicable in-kind or matching funds provided by the fiscal agent and/or strategic partners. [Fiscal Fiscal Jefferson County Fiscal Contact: Michael Baker E-mail michaol,hakori00co,lotferson.or.us address: Phone Number, 641-475-4456 `Number. Description Total Budget Categories (A) Salary (0) Fringe Benefits Position* 2 3 4 Title of Position CDilmmunlzalion Supervisor pH Director Bilingual/Interpreter Nurse l't ltioner TOTAL SALARY NarrallVe' Position 9 Total SWry 3 4 0.001 11,921.121 2,516 141 6,859.39 Salary (annual) $22,406 586,699 $30,828 566,515 Sato I1 Weal,. Xoltlma Nat menthe rorta461od 10 00% 16.5 10.00% 16,5 5.00% 18,5 7.50% 16 5 %� 0.00% 49 00% 70.00% 50 00% TOTAL FRINGE C) Equipment Llet equipment. Include all equipment necessary for program (I e. computer, pnnler) TOTAL EQUIPMENT !Narrative' j (D) Supplies ibo not list, these items Include supplies for meetings, general oflca supplies le, paper, pans, computer disks, highlighters, binders, folders, etc (ti) Tmfel it naso*Mac+u010,to( of Nnls, and lr,vea to etred,,rea vw0rys 1 mstp'4 11,10131'y* Narrative' Per Own Nolel Ar fire 140 required (rips l0 Portland for Iwo staff members from Jefferson 006 728 Tidal Salary I 3,080.871 0.00 0,00 0.00 $3,080,87 Total kings 0,00 0.00 0.00 0.00 $0.00 s6 5058 5728 001 63,081 5e S0 $0 11.0100 Salary Matching Beim 0,00 1192112 0.00 2518,14 0 00 6859 39 0.00 021,298.651 $0.0D 104008 Fringe 1 Metching Fringe 0.00 0.80 5,912.87 1,762,70 3,429.701 $11,105.27150.00 S01 SD SO1 90 In•Nlnd Travel 68 001 $o $4001 Sol ( Matching Travel 1 601 sol 60! RFP 4461-14 Public Health Modernization - Deschutes County on behalf of C.O. Public Health Partnership Jefferson County Budget 1 (F) Other (G) Contractual: Attach El RFP 4,161 Cool Plopo',al r-uim t L'ne Item Oltlf,,10t and Narrative Vtorks;Iinc I • Jefferson County FN I `oo i t.i, S TOTAL TRAVEL Please list. :Printing Materiels for Community Partners Culturally appmpnaie training matone,s IRelmbursement costs for Confederated I dbes of Warrn Springs I TOTAL OTHER List total of all subcontracts and all contractual costs. include a separate budget worksheet for each subcontractor TOTAL CONTRACTUAL (11) Total Direct (Sum of A through G) (I) Indirect (J) TOTALS Indirect 10 00% (Sum of H & I) Should equal Public Health Modernization Award Request. 51,091 • Attach Budget Narrative on a Separate Sheet • See below ,,tri 001 So sol 5o! So 51.0201 SO SO 8400 SO S400 $938 04,000 $0 50 SO $5,424 Sol SO SDI SD $0 00 $ol SO 801 SO 50 $0 S9 $0 50 50 50 SO SO 110,909 $32,804 S0 $1,091 $0 SO 512,000 832,804 50 RFP 4461-14 Public health Modernization - Deschutes County on behalf of C.O. Public Health Partnership Jefferson County Budget 2 Salary: Fringe Benefits: Equipment: Supplies: Travel: Alt.IGhir,or,t C RFP 14 (t1 - C:ost Proposal Point • 1 Inn Item (lrldctat and Nair alive Wet ksl;aet - J81)r:rson County Jefferson County Budget Narrative Judy Budd, the Communicable Disease Nurse for Jefferson County, Is the parttime (0.20 FTE( employee that is designated as i8a lead to coordinate the work with Warm Springs Health & Wollneao Center [formerly Known as Indian Health Services (IHS)) and the Confederated Tribes of Warm Springs Health and Human Services Branch. Jefferson County Public Health will assign 1 F1 E her time to: 1) coordinate with the region's infechon prevention specialists to provide teohn,cal assistance end training on infection prevention and control to long form care facilities and targeted child care facilities that servevulnerable populations and/or have low up -lo -dale vaccination rates; and 2) work with Confederated Tribes of Warm Springs ldbai mend -role to cu -create strategies/activities to strengthen pievonlion, surveillance 011(1 respens0 to communicable disease in Identified areas of need Additionally, Joy Harvey, the parttime Family Nurse Practitioner (0.8 FTE) wbi asatst In communloebie disease napped when olhor staff is unavailable es a result of outreach et work related to the tri -county project Jefferson County staff will also provide le -kind Spanish translation services for the project (op education and outreach materials, 0(0.), The parttime employees (Communicable Disease Nurse) do not receive fringe benefits in Jefferson County. N/A Deschutes is budootino supplies The grant has mandatory (raining and travel requirements. travel will be required training for two Jefferson County staff, The required 2 days training In Portland (including per diem and lodging) Is estimated 0(01, 384 Total mileage for travel to required meetings wdh partners throughout the Central Oregon region and the Confederated Tribes of Warm Springs estimated al 2,000 miles for the duration of the program Estimating 0488 for printing of materials for Jefferson County endears and meetings. An additional $938 is budgeted for the developing and printing of culturally appropriate materials that may need to be created and review before ua0 in the community Support Staff Ill9ntorpreter services will be available as part of this project as In-kind. The Support Stuff Ill/Interpreter (Mayro Benitez) will coordinate directly with the Latino Association to translate andlor develop culturally appropriate educational outreach materials. $4,000 has been budgeted to coordinate the work with the Confederated Tribes of Warr Springs in nyder to develop specific strategies and activities (hal will be co -created with tribal members to strengthen prevention, surveIliance and response to communicable disease in identified areas of need Depending on their recontrnendalions end need, funding from the project is included In the subcontract to Jefferson County and available to Iho Tabes to address an identified communicable disease -related need or gap in prevention, 011ier surveillance and centro( Contractual: Jefferson County has an established indirect rale. This rate will vary based on the requirements of the Finance Department. Tho estimate of 10% is the highest allowable by county indirect: cods RFP 4461-14 Public Health Modernization - Deschutes County on behalf of C.O. Public Health Partnership Jefferson County Budget 3 Deschutes County Board of Commissioners 1300 NW Wall St, Bend, OR 97703 (541) 388-6570 — Fax (541) 385-3202 — https://www.deschutes.org/ AGENDA REQUEST & STAFF REPORT For Board of Commissioners Business Meeting of December 13. 2017 DATE: December 7, 2017 FROM: Wayne Lowry, Finance, 541-388-6559 TITLE OF AGENDA ITEM: Consideration of Board Signature of Resolution No. 2017-058, Appropriating Grant Funds - Health Dept Public Health Modernization RECOMMENDATION & ACTION REQUESTED: Staff Recommends approval of Resolution 2017-058 appropriating grant funds for Public Health Modernization CONTRACTOR: N/A AGREEMENT TIMEFRAME: N/A INSURANCE: Insurance Certificate Required: No Insurance Review Required by Risk Management: No BACKGROUND AND POLICY IMPLICATIONS: The Health Department did not include funds for Public Health Modernization in the FY 2018 budget because the award was not known at the time the budget was adopted. The award of $136,400 must be appropriated to allow the department to spend the additional funds on the program. FISCAL IMPLICATIONS: Resolution 2017-058 appropriates the new award for Public Health Modernization for FY 2018 in the amount of $136,400. Approval of this resolution approves 3 limited duration positions to coincide withe the term of the funding, 12/1/17 to 6/30/19. ATTENDANCE: James Wood, Health Department