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HomeMy WebLinkAbout2008-01-30 Work Session MinutesES 0 Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701 -1960 (541) 388 -6570 - Fax (541) 385 -3202 - www.deschutes.org MINUTES OF WORK SESSION DESCHUTES COUNTY BOARD OF COMMISSIONERS WEDNESDAY, JANUARY 30, 2008 Present were Commissioners Dennis R. Luke, Michael M Daly and Tammy Melton. Also present were Dave Kanner, County Administrator; Erik Kropp, Deputy County Administrator; Dan Peddycord and David Visiko, Health Department; and media representative Hillary Borrud of The Bulletin. Chair Luke opened the meeting at 1:30 p.m. 1. Discussion of Request for Tobacco Program Grant. Dan Peddycord introduced David Visiko, who is the new chronic disease coordinator for the Health Department. Mr. Visiko gave an overview of grant applications related to chronic disease, in particular tobacco use. (A copy of the request for applications is attached.) The State agencies that handle various types of chronic disease are coming together to address tobacco - related health issues. Community partners will be involved and take appropriate training. (He distributed a fact sheet at this time, a copy of which is attached.) Mr. Visiko provided a sample letter to be sent to the State regarding prevention policies. Mr. Peddycord indicated that tobacco is the strongest link with chronic disease, and is number one cause of preventable death. Chair Luke asked what the County's responsibility would be. Mr. Visiko replied that County staff would need to attend training and would afford a part - time FTE to handle the program. Mr. Kanner clarified that the employment letter for grant - funded positions is very specific about the position going away if the funding is discontinued. The Board was supportive of the application. Minutes of Administrative Work Session Wednesday, January 30, 2008 Page 1 of 5 Pages 2. Health Department Update. A discussion took place regarding student -based health centers established at various schools. Mr. Peddycord explained how services are provided and to whom. Mr. Peddycord gave an overview of the Central Oregon Health Collaborative, and upcoming meetings with Secretary of State Mike Leavitt and Representative Greg Walden in February. He said that a request may come to the Commissioners for funding this program in the future. In regard to disaster planning and preparedness, Mr. Peddycord said that the potential role of each department should be clarified. Each department needs to have key staff prepared to handle any disaster that may occur, including a disaster pack that allows these people to be at work if needed at the time of the disaster. He added that there is a regional disaster planning group that meets on a regular basis. Historically COPA has not been providing full information to include in the child immunization database. In regard to Healthy Start Prenatal care, it is clear that it is more cost - effective to provide prenatal care than to provide health care after birth. Groups around the country are attempting to convince government entities that an unborn child of an illegal immigrant should be covered for prenatal care. This is called the SCHIP Rule and has not yet been implemented in Oregon. Of the 190 births through the County's prenatal program, 170 were babies born to Hispanic mothers. Regarding the Ochoco Clinics, there are still issues to address in relation to expenses. At this point, it does not appear there is enough energy or financial ability to include La Pine. The Steffys, who now are struggling to run a health clinic in La Pine, have been asked to consider whether they want to take over the FQHC program there. Minutes of Administrative Work Session Wednesday, January 30, 2008 Page 2 of 5 Pages The federal funding entity is aware of the struggle to run several clinics and that it would be difficult to include La Pine at this time, especially since La Pine has the highest level of uninsured, underinsured and unemployed people in the region. Chair Luke stated that the Commissioners have been trying to get an appropriate health care program in La Pine for a long time. Mr. Peddycord suggested that a 501(c)3 be established to run the program to relieve the County of liability. Mr. Kanner added that the economies of scale are so significant, it would be impossible for two people to handle a program themselves. Mr. Peddycord stated this would be reexamined in the next biennium. Commissioner Daly said he thought the current grant was the last one to be offered. Mr. Peddycord stated that there will likely be funding available in the future, although it is unlikely that this particular grant will be allowed to sit until it can be used. The Northwest Health Foundation is providing a $10,000 grant for a strategic planning update, which is due after three years. 3. Other Items. Dave Kanner provided a draft agenda for the Commissioners' meeting tomorrow to discuss Goals and Objectives. Mr. Kanner stated that he is extremely pleased by the responses from employees to the recent survey. Commissioner Melton said that some employees could be too new to provide accurate answer to some of the questions. There is no way to distinguish whether the persons who replied are managers. Commissioner Melton asked whether the individual comments could be provided. Commissioner Luke observed that the public survey showed that 94% of respondents feel safe in the community; and most respondents feel excellent services are provided by County employees. Mr. Kanner said that he had hoped to release it to the media soon after it has been discussed with the Board. Minutes of Administrative Work Session Wednesday, January 30, 2008 Page 3 of 5 Pages The City of Bend has asked that a County staff person be appointed to the Airport Neighborhood Advisory Board. Mr. Kanner suggested that Erik Kropp might fill that role. Commissioner Luke said that Mr. Kropp will have to get up to speed on the situation quickly, as it is a very sensitive issue and the group is vocal and highly organized. Regarding the proposed cable franchise fee, further discussion will take place soon, probably at the February 11 work session. The KIDS Center Director, Bob Smit, has indicated he would like the County to combine some grant programs with those of St. Charles Medical Center. Mr. Kanner stated that he would be happy to talk with them about it, but the situation becomes difficult because they operate under different meeting and disclosure laws than the County. Commissioner Melton said that United Way also handles a huge amount of grant money and it would be good to know where that funding goes. She said that the employee wellness programs might be a good way to collaborate, but other programs might be much too complicated to do so. Mr. Kanner reminded the Board that there is still a vacancy on the budget committee. Terry Pickering, Tom Zemke and Mike Maier were the applicants. Commissioner Daly said there is some concern about Mr. Maier being appointed due to his previous role at the County. Chair Luke stated that Mr. Maier is very familiar with budgets. Mr. Kanner said Mr. Maier may not be supportive of Mr. Kanner's budget recommendations. Chair Luke added that Mr. Maier would know what questions to ask and where the red flags are. The other budget committee members are relatively new to the process. Commissioner Melton prefers either Mr. Maier or Mr. Pickering, in that order. Commissioner Daly voiced concern that some people might view Mr. Maier as not a member of the public because of his years working for the County. This item will be on the Board agenda for Wednesday, February 6. Being no further items addressed, the meeting adjourned at 3:15 p.m. Minutes of Administrative Work Session Wednesday, January 30, 2008 Page 4 of 5 Pages DATED this 30th Day of January 2008 for the Deschutes County Board of Commissioners. ATTEST: Recording Secretary Dennis R. Luke, C air Tammy (Baney) Melton, Vice Chair Michael M. Daly, mmissioner Minutes of Administrative Work Session Wednesday, January 30, 2008 Page 5 of 5 Pages TES { Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701 -1960 (541) 388 -6570 - Fax (541) 385 -3202 - www.deschutes.org WORK SESSION AGENDA DESCHUTES COUNTY BOARD OF COMMISSIONERS 1:30 P.M., WEDNESDAY, JANUARY 30, 2008 1. Health Department Update — Dan Peddycord 2. Discussion of Request for Tobacco Program Grant — Shannon Dames 3. Other Items PLEASE NOTE: At any time during this meeting, an executive session could be called to address issues relating to ORS 192.660(2) (e), real property negotiations; ORS 192.660(2) (h), pending or threatened litigation; or ORS 192.660(2) (b), personnel issues Meeting dates, times and discussion items are subject to change. All meetings are conducted in the Board of Commissioners' meeting rooms at 1300 NW Wall St., Bend, unless otherwise indicated. If you have questions regarding a meeting, please call 388-6572. Deschutes County meeting locations are wheelchair accessible. Deschutes County provides reasonable accommodations for persons with disabilities. For deaf, hearing impaired or speech disabled, dial 7 -1 -1 to access the state transfer relay service for TTY. Please call (541) 388 -6571 regarding alternative formats or for further information. Deschutes County Health Department Board of County Commissioners Quarterly Liaison Meeting - January 30th 2007 1:30pm • Chronic Disease Grants — David Visiko o Requesting BOCC letter of support to apply • Student Based Health Centers — o Site Planning Grants awarded o MA Lynch Elementary — Redmond (Obsidian MS) o Pilot Butte MS — Bend (Tentative) • Central Oregon Health Collaborative o Ongoing Financial support as part of Departmental & County strategy o Secretary Mike Leavitt and Rep. Greg Walden visit in Feb. • Disaster Planning and Preparedness for Staff o Idea : Disaster Packs for Key staff o Training for Key County Personnel /Dept Heads • Child Immunization Rate Project o Working with COPA regarding ALERT Registry — Grant • Healthy Start Prenatal o Last year of contract with East Cascade Women's Group o Exploring new SCHIP Rule related to "unborn child" • Ochoco Clinics — • Department Strategic Planning o NWHF Grant — Milne & Assoc. • Public Health Advisory Board o Next Meeting : Feb 27th, 2008 Oregon Department of Human Services, Public Health Services Health Promotion and Chronic Disease Prevention Request for Applications For Addressing the Prevention, Early Detection, and Management of Chronic Diseases Phase 1- Building Public Health Capacity Based On Local Tobacco Control Efforts Issue Date: Applications Due: Issuing Office: January 7, 2008 February 18, 2008 Oregon Department of Human Services Public Health Division Health Promotion and Chronic Disease Prevention Section 800 NE Oregon Street, Suite 730 Portland, OR 97232 971- 673 -0984 971- 673 -0884 fax http://oregon.gov/DHS/ph/hpcdp/index.shtml In compliance with the Americans with Disabilities Act, this document is available in alternate formats such as Braille, large print, audiotape, oral presentation, and electronic format. To request an alternate format call 971- 673 -0984 or TTY 503- 731 -4031. Table of Contents Purpose of Funding 2 Eligibility 3 Funding 3 Key Planning Elements For A Program Addressing Prevention, Early Detection, And Management Of Chronic Diseases 3 Program Requirements 4 Important Deadlines And Dates 5 Application Due Date 5 Award Announcements 5 RFP Question Submission Deadline 5 Chronic Disease Prevention Assessment and Planning Process 6 Application Requirements 7 Application Scoring 9 Attachment 1: Application Cover Sheet Attachment 2: Public Health Administrator's Commitment Form Attachment 3: Sample Budget Worksheet Appendix A: Program Element 14 Appendix B: Training Institute Agenda Appendix C: The Oregon Arthritis Action Plan Appendix D: Oregon Arthritis Report Appendix E: Oregon Asthma Leadership Plan Appendix F: Oregon Asthma Surveillance Report Appendix G: Geographic Disparities in Pediatric Asthma Control Appendix H: Oregon Comprehensive Cancer Plan Appendix I: Cancer in Oregon: A Call to Action Appendix J: Action Plan for Diabetes Appendix K: Diabetes Progress Report Appendix L: Statewide Plan for Heart Disease and Stroke Prevention Care Appendix M: Heart Disease & Stroke Report Appendix N: Keeping Oregonians Healthy Appendix 0: A Healthy Active Oregon: Statewide Physical Activity and Nutrition Plan Appendix P: Oregon Overweight, Obesity, Physical Activity and Nutrition Facts Appendix Q: Oregon Statewide Tobacco Control Plan Appendix R: Tobacco County Fact Sheets Appendix S: Website Resources for Chronic Disease Programs 1 Purpose of Funding The purpose of the Chronic Disease Program: Building Capacity based on Local Tobacco Control Efforts is to assist local public health authorities (LPHAs) in planning a population - based approach to reduce the burden of chronic diseases most closely linked to physical inactivity, poor nutrition, and tobacco use. Such chronic diseases include: arthritis, asthma, cancer, diabetes, heart disease, obesity, and stroke. Tobacco use is the single most preventable cause of death and disease in Oregon. Poor nutrition and physical inactivity together are the second leading cause of preventable death and disease. Tobacco control efforts in Oregon are guided by the Centers for Disease Control and Prevention's (CDC) Best Practices. The reduction of tobacco use and exposure to secondhand smoke in Oregon demonstrates that policies and environmental and system changes are critical in changing social norms and behavior around tobacco use and exposure. This experience provides a solid foundation for expanding chronic disease prevention, early detection, and management efforts for tobacco - related and other chronic diseases at the local level. In 2007, the Public Health Division's Tobacco Prevention and Education, Physical Activity and Nutrition, Arthritis, Asthma, Comprehensive Cancer, Diabetes, and Heart Disease and Stroke programs agreed to pool resources and funding to address chronic disease prevention and management through a public health approach at the local level. The Health Promotion and Chronic Disease Prevention (HPCDP) Section will select up to 12 LPHAs to participate in a nine -month Chronic Disease Training Institute. The Training Institute will provide training and technical assistance on community assessment and planning for local chronic disease prevention and health promotion programs. During the institute, LPHAs will develop a work plan specific to each locality. Curriculum in the Training Institute will be based on CDC best and promising practices in tobacco control, physical activity, nutrition, arthritis, asthma, cancer, diabetes, heart disease, obesity, and stroke. At the local level, participants will develop capacity to address chronic diseases through a population -based approach. This approach fosters new partnerships between public health and community partners, and focuses broadly on policy and environmental changes that influence the prevention and management of chronic diseases, rather than individual services, health education, or access to health care. 2 Eligibility LPHAs are designated as local lead agencies for the Chronic Disease Prevention (CDP) programs. Only one application per LPHA will be accepted. Funding LPHAs can apply for up to $32,500 for the 2008 calendar year. Each LPHA must assure ghat the CDP program is staffed at the appropriate level to participate in all required training institutes, and to conduct work with community partners between trainings to complete a community needs assessment and local work plan for the implementation of a Chronic Disease program. Funds for this program element are to be directed toward: 1) personnel and 2) hosting and attending meetings with community partners. Participating LPHAs will be eligible to apply for CDP implementation funds upon completion of the first year required activities. Availability of additional funds is contingent on federal funding from the CDC - Chronic Disease Prevention and Health Promotion Division as weli as state funding for Chronic Disease Prevention and Health Promotion Programs. Key Planning Elements For A Program Addressing Prevention, Early Detection, And Management Of Chronic Diseases Public health's role for chronic disease prevention is to advance policies, establish environments and systems that promote health, and prevent and manage chronic diseases. To successfully adopt and develop a population -based program, the following factors are essential elements to have in place. These key factors will be considered as part of the selection process for LPHA applicants: • Strong leadership able to motivate local public health authority staff and community partners to actively participate in assessment and planning for a community focused population -based Chronic Disease program. • Experience in advancing tobacco policy and sustainable environmental change. • Sufficient time, personnel, and resources dedicated to assessment and planning. • Sufficient time, personnel, and resources to foster collaborative activities with community partners. • A community environment that fosters trust, collaboration, and respect among all partners. • High standards of professionalism supported by meaningful professional development, collaboration and accountability. 3 • Use of data to uncover needs, set priorities, drive decisions, and evaluate effectiveness. Program Requirements Local public health authorities will focus efforts on the list of activities below (a -f). Together these activities will support participating LPHAs in the development of a local work plan to address the community's burden of chronic diseases related to tobacco, physical inactivity, and poor nutrition. (See Program Element 14, appendix A) a Participating in the Chronic Disease Training Institute: The Training Institute is a series of required trainings on best - practice interventions that address tobacco use reduction and other disease prevention and health promotion strategies known to decrease the burden of chronic diseases through a population -based approach. Technical assistance and training will review current policies, systems, and environments essential to supporting chronic disease prevention, early detection, and management. At the conclusion of the training, participants will provide leadership for integrating chronic disease prevention, early detection, and management into community planning, and have the skills to assess and evaluate the community's needs and health outcomes. b Collaborating with community partners: Convene and facilitate partnerships with community and health organizations representing various population groups to promote and support tobacco use prevention, increased physical activity, healthy eating, early detection of risk factors and chronic diseases, and availability of resources for management of chronic diseases and risk factors, primarily through policy, systems, and environmental change. c Completing a Community Assessment: Conduct a community needs assessment that assesses population -based approaches to prevention, early detection, and management of chronic diseases. The needs assessment will focus attention where people live, work, play, learn, and receive care in relation to tobacco - related and other chronic diseases and risk factors. d Gathering and Using Local Data: Identify and use various sources of data that can inform the community about chronic disease prevalence, risk factors, management, quality of life, disparities, morbidity, mortality, and economic burden. Sources may include: survey data (Behavioral Risk Factor Surveillance System and Oregon Heald y Teens), focus groups, community- generated surveys or data, health insurance claims 4 data, clinical data from a disease registry or electronic medical records, and hospital data. e Developing an Implementation and Evaluation Plan: Using the community assessment and local data, conduct a planning process that results in a community action plan to implement best - practice interventions addressing prevention, early detection, and management of tobacco - related and other chronic diseases, where people live, work, play, learn, and receive care. Components of an implementation plan shall include evaluation; policy, environmental, and systems changes; and identifying and addressing disparities. f Promoting the Quit Line and Other Evidence -Based Chronic Disease Self - Management Programs: Integrate the promotion of the Oregon Tobacco Quit Line and other chronic disease self - management programs into prevention, early detection, and management strategies for chronic diseases where people live, work, play, learn, and receive care. Important Deadlines And Dates Application Due Date Applications are due Monday, February 18, 2008 by 5:00 PM. Please send one original, six hard copies, and an electronic copy on a CDRom. Mail applications to: Kirsten Aird, MPH Community Programs Manager Tobacco Prevention and Education Program Oregon Public Health Division 800 NE Oregon Street, Suite 730 Portland, OR 97202 Award Announcements Applicants will be notified of their status by March 1, 2008. Funding will be available for the year January- December 2008. RFA Question Submission Deadline This RFA is competitive. Questions regarding this RFA must be received by January 21, 2008. Answers will be released on Friday, January 25, 2008. Please e -mail all questions regarding tilts RFA to Kirsten Aird at kirsten.g.aird(astate.or.us. 5 Chronic Disease Prevention Assessment and Planning Process Each CDP funded county will identify a "traveling team" to attend the Training Institute. The location selected for the institutes will be a central location for funded counties. Dates for the institutes will be finalized once the location is identified. The traveling team will be a small group of LPHA and community partners. The HPCI)P Section will cover the travel expenses for all team members (LPHA staff and community members). Travel expenditures covered by the state include mileage, hotel, and meals during the institutes. The LPHA staff time dedicated to attend the institute is covered in the grant amount. The community partners' time dedicated to attend the institute is considered in -kind support from the identified community partners. Required members of the traveling team include: • The Public Health Administrator must attend the first institute, and is encouraged to attend all institutes • CDP Program coordinator • TPEP County Coordinator • Community Partner working on strategies to prevent, improve early detection, or manage one or more of the chronic diseases identified in this application (arthritis, asthm a, cancer, diabetes, heart disease, or stroke) * OR- • Community Partner working on improving physical activity and nutrition * OR • Community Partner familiar with one of four settings; worksites, schools, health systems, or livable communities. * * Community partners are required for institutes 2 -5, but are encouraged to attend all institutes. The Training Institute will review current policy, systems, and environmental changes essenti �l to supporting chronic disease prevention, early detection, and self - management. At the conclusion of the institute, participants will be community leaders in integrating tobacco - related and other chronic diseases and risk factors into community planning, and have the ability to assess and evaluate the community's needs and health outcomes. The agenda and learning objectives for the institute can be seen in appendix A. 6 Staff at the Oregon Public Health Division, HPCDP Section will be available to provide individualized, on -site, telephone, and electronic technical assistance to counties between institutes upon request. Application Requirem ents Applications are due by Monday, February 18, 2008 at 5PM. Applications that arrive after 5PM on February 18, 2008 will not be included in the review process. Please send one original application, six hard copies, and an electronic copy saved on a CDRom. Applications can be mailed to: Kirsten Aird, MPH Community Programs Manager Tobacco Prevention and Education Program Oregon Public Health Division 800 NE Oregon Street, Suite 730 Portland, OR 97202 1. Application Cover Sheet (Attachment 1) 2. Signed Commitment forms from the Public Health Administrator and Program Manager (Attachment 2) 3. Completed Budget Sheet (Attachment 3). Note funding for this RFP crosses over two fiscal years. Please provide a budget for the remainder of fiscal year 07 -08 (March 1 -June 30, 2008) and for the first part of fiscal year 08 -09 (July 1, 2008 - December 30, 2008). 4. Letters of support from your County Commission and at least one community partner (e.g. health system, school district, worksite, health organization). The letter of support should demonstrate that the County Commission and community partners have reviewed the county demographics highlighting the health and financial burdens related to tobacco use, physical inactivity, poor nutrition, arthritis, asthma, cancer, diabetes, heart disease, obesity, and stroke. 5. Statement of Need - Provide a clear statement of need describing your plan to expand your current local tobacco prevention efforts to include efforts to promote the prevention i, early detection, and management of chronic diseases. Please include general informatio 1 about your county's existing infrastructure, partnerships, and staffing, and describe how targeted funds for tobacco - related and other chronic disease prevention and health 7 promotion will improve your LPHA's capacity to reduce the burden of tobacco - related and other chronic diseases in your county. (2 page maximum, single spaced 12 point font) 6. Demographics - Provide a brief summary of your county's demographics highlighting health disparities and economic burden related to tobacco use, physical inactivity, poor nutrition, arthritis, asthma, cancer, diabetes, heart disease, obesity, and stroke, specifically highlighting any disparities experienced by population subgroups. (2 page maximum, single spaced 12 point font) 7. Statement of Readiness - Please respond to the following statements within 10 pages of single spaced, 12 -point font text. i. Describe actions the LPHA has previously taken to engage policy makers in tobacco control efforts. Examples include working with a school board to pass a gold standard tobacco -free schools policy or working with County Commissioners to pass a policy ensuring all parks are smokefree. Describe° the policy or administrative rule outcomes of those actions. ii. Describe actions the LPHA has previously taken to support the collaboration of multiple community partners to address tobacco prevention in schools, worksites, communities, and health systems. Please provide an example of coordination or facilitation activities in at least two settings. iii. Describe actions the LPHA has taken to support policies, systems, or environments that assist in the prevention and management of chronic diseases in your community. Highlight any efforts that have engaged multiple public and private community organizations, and describe how working on tobacco prevention increased efforts to enhance other chronic disease prevention and health promotion programs. iv. Describe the leadership demonstrated by your Public Health Administrator with community -wide, tobacco control planning and intervention efforts, and the resulting outcomes. v. Describe how time, staff, and resources will be dedicated to the CDP assessment and planning process. vi. Describe the process for how County Commissioners and community partners were informed about this opportunity, involved in the decision to apply for this grant, and how they intend to participate in assessment and planning for a CDP program. 8 Application Scoring Criteria Points 1. Statement of Need 15 2. Description of demographics 10 3. Letters of support 15 4. Statement of Readiness > Describe actions the LPHA has previously taken to engage policy makers in tobacco control efforts. 10 > Describe actions the LPHA has previously taken to support the collaboration of multiple community partners. 10 > Describe actions the LPHA has taken to support policies, systems, and environments that assist in the prevention and management of chronic diseases in your community. 10 Describe the leadership demonstrated by your Public Health Administrator with community -wide tobacco control efforts. 10 > Describe how time, staff and resources will be dedicated to the CDP assessment and planning process. 10 > Describe the process for how county commissioners and community partners were informed about this opportunity, involved in the decision to apply for this grant, and how they intend to participate in assessment and planning for a CDP program. 10 Total Possible Points 100 9 Health Disparities and Economic Burden in Deschutes County Tobacco Use: According to the 2007 Deschutes County Fact Sheet compiled by the Oregon Tobacco Prevention and Education Program (TPEP): 18% of adults smoke cigarettes compared to 20% in Oregon. 9% of 8th graders smoke cigarettes compared to 9% in Oregon. 27% of 11 th graders smoke cigarettes compared to 17% in Oregon. 13% of babies were born to women who smoked while pregnant compared 12% in Oregon.. 4% of 8th grade males use smokeless tobacco compared to 5% in Oregon. 17% of 11th grade males use smokeless tobacco compared to 12% in Oregon. Oregon TPEP 2005 data shows 7.6% of adults use smokeless tobacco compared to 6.1% in Oregon. Economic Burden: According to the 2007 Oregon Tobacco Prevention and Education Program Deschutes County Fact Sheet, over $40.3 million is spent on medical care for tobacco - related illnesses. Additionally, over $40.6 million is productivity is lost due to tobacco - related deaths. Physical Activity: The Oregon Healthy Teens Survey, 2005 -2006 data states that 39.1% of Deschutes County (DC) 8t graders were physically active less than 4 days in the past week compared to 27.2% in Oregon. Additionally, 43.9 % of DC 11th graders were physically active less than 4 days in the past week compared to 41.8% in Oregon. According to the 2002 -2005 Behavior Risk Factor Surveillance System (BRFSS); DHS/Health Promotion and Chronic Disease Prevention Program 42.5% of DC adults did not meet recommended daily physical activity levels as compared to 45.3% of Oregon. Poor Nutrition: The Oregon Healthy Teens Survey 2005 -2006 state that 77.6% of DC 8th graders did not consume 5 fruits and vegetables daily compared to 74.7% in Oregon. Additionally 81% of DC 11th graders did not consume 5 fruits and vegetables daily compared to 79.7% in Oregon. According to the 2002 -2005 BRFSS; DHS/Health Promotion and Chronic Disease Prevention Program 70.5% of DC adults did not consume at least 5 fruits and vegetables per day compared to 74.2% in Oregon. Arthritis: The 2005 Oregon BRFSS survey data results state that 27% of Oregonians, over the age of 18, are clinically diagnosed with arthritis. At this time, there is no local data for Deschutes County, however extrapolating the data may prove that it is safe to say that higher numbers in DC due to the large population of older adults who settle in Bend, Oregon. Economic Burden: Arthritis costs Oregonians 86 Billion dollars in total costs (Oregon's Arthritis Program fact sheet, 2006), translating into 3.4 billion dollars here in Deschutes County. Asthma: The 2005 -2006 Oregon Healthy Teens Survey states that 15.8% of DC 8th graders have a diagnosis of asthma compared to 17.1% in Oregon. Additionally, 20.3% of 11th graders have a diagnosis of asthma compared to 19.2% in Oregon. According to the 2005 BRFSS and DHS /Oregon Asthma Program, DC has a 6.6% ashtma prevalence rate of for adults, compared to 8% in Oregon. Economic Burden: According to Oregon's asthma report (June, 2007), Asthma hospitalizations in Oregon cost approximately $23.5 million in 2005, which translates into $940,000 in Deschutes County alone. Cancer: The DHS- Oregon Cancer Registry (OSCaR) /Cancer in Oregon, 2003; states that between the years 1999 -2003 DC has had 707 malignant cases of all types of cancers, resulting in 232 deaths and a mortality to incidence ration of .39. The 2004 DHS (OSCaR) states that between 1999 -2003 DC has had 545.5 rates of cancer cases for all types of cancers compared to 484 in Oregon. Additionally, the largest differential in type of cancer was identified in the same data set as prostate cancer 253.5 cases from 1996- 2003 compared to 164 cases in Oregon. Economic Burden: Cancer costs exceed 2 billion dollars in the state of Oregon (CD Summary, 2004 vo.53, #23), and for Deschutes County totals 80 million dollars in costs. Diabetes: The 2005 BRFSS; DHS /Oregon Asthma Program states that in DC 4.9% adults were diagnosed with Diabetes compared to 6.7% in Oregon. Economic Burden: The total cost for hospitalizations with diabetes as a contributing diagnosis was over $700 million per year in Oregon, translating into $28 million dollars per year in Deschutes county (Department of Human Services Diabetes Progress Report, 2006). Obesity: The Oregon Healthy Teens Survey, 2005 -2006 states that 19.5% of DC 8th graders, 22.5% 8th grade males, & 16.7% 8th grade females are overweight or at risk for overweight; compared to 25.8% 8th graders, 28.8% 8th grade males, & 22.5% 8th grade females in Oregon. Additionally, 18.6% of DC 11`h graders, 22.3% 1 grade males & 14.8% 11th grade females are overweight or at risk for overweight; compared to 24.9% 11th graders, 30.6% 11`h grade males & 19.2% 11th grade females in Oregon. According to the Centers for Disease Control and Prevention. State - Specific Prevalence of Obesity among Adults in the U.S., 2005 and the MMWR September 15, 2006; 55 (No.36); Behavior Risk Factor Surveillance System, Adult obese rates in DC is 18.3% compared to 22.1% in Oregon. Additionally, the same data set states that DC has a 38.8% overweight population compared to the Oregon level of 37 %. Heart Disease: The 2002 -2005 BRFSS combined data set shows 4.3% of DC adults diagnosed with coronary heart disease compared to 3.8% in Oregon. Economic Burden: According to Oregon's Statewide Plan for Heart Disease and Stroke Prevention and Care (2006) the economic burden in the State of Oregon mounts to a yearly cost of $1.1 billion in hospitalization costs for heart disease, stroke, and related diseases — translating into $44 million spent per year in Deschutes County alone. Stroke: The BRFSS, 2002 -2005 combined data set staes that DC has a 2.1% of its population has had a stroke compared to 2.6% in Oregon. The Stroke death rate -age adjusted death rate per 100,000 population- Oregon Death Certificates, 2004 identifies 60.15 in DC, while Oregon is 61.94. The Healthy People 2010 Objective is 48. Economic Burden: When considering all hospitalizations of the most common chronic disease the cost to Oregonians exceeds 4.1 billion dollars. In Deschutes County alone, our costs exceed 164 million dollars per year (Keeping Oregonians Health, DHS, 2007). Obesity, tobacco use, inactivity and poor nutrition are modifiable risk factors that contribute directly to the high morbidity and mortality of the Chronic Diseases that follow. January 30, 2008 To: DHS Health Services Dear Grant Administrator: We are writing in support of funding Deschutes County with the 2008 Grant: Addressing the Prevention, Early Detection, and Management of Chronic Diseases. Phase 1- Building Public Health Capacity Based on Local Tobacco Control Efforts. Recently, health educator Kelly McDonald, presented to the Board of County Commissioners, the Deschutes County 2007 Health Report stating local chronic disease data and the economic burdens that are placed on Deschutes County resulting from chronic disease. Health educator, David Visiko followed up this presentation informing the Deschutes County Commission of the opportunity to apply for this grant. With this information, we believe increased funding and additional fosus in chronic disease health areas is a vital component in protecting and promoting the health of Deschutes County citizens. In order to continue comprehensive prevention and education efforts, it is imperative that we have the necessary funding to support this program. As County Commissioners, we embrace the positive outcomes of this potentially funded Chronic Disease Program grant in working to reduce the burden of chronic diseases to benefit Deschutes County. We strive as a community partner to support the beneficial effects on physical & emotional outcomes, and health- related quality of life of our citizens. Additionally, increased prevention, early detection and management of chronic disease will result in fewer emergency (ER) visits, fewer hospitalizations, and fewer days in the hospital, and reductions in outpatient visits thus reducing Deschutes County healthcare expenditures. The work of David Visiko and Deschutes County Health Department allows this partnership with the Board of County Commissioners to influence the community toward greater health policy, education, and social norms. The successful granting of funds to Deschutes County will ensure that important prevention and education efforts and community partnerships will continue. I urge you to fund this important work in our county. Sincerely, Board of County Commissioners, Deschutes County, Oregon