4-83 Program Locator County Health Heath Department Public Health and Environmental Protection Chronic Disease and Injury Prevention Disease Control and Prevention Headline Measures 50% 40% 30% 20% 10% 0% 100% 80% 60% 40% 20% 0% 04-05 Percent of Children Overweight or Obese 05-06 25% 25% 25% 06-07 07-08 New performance measure for FY 2006-07 08-09 Percent of Clients Demonstrating Improvement in Knowledge, Attitudes, and Behavior Regarding Disease Prevention, Control, and Treatment 90% 90% 04-05 05-06 06-07 07-08 08-09 New performance measure; data w ill be av ailable in FY 2007-08 Program Outcome Statement Chronic Disease and Injury Prevention (CDIP) conducts community health promotion efforts to prevent chronic disease and injuries in order to protect the health and well-being of San Mateo County residents. Services and Accomplishments CDIP contributes to the goals of the Shared Vision 2010 commitment to Ensure Basic Health and Safety for All by providing residents with access to preventive health education and helping vulnerable people achieve a better quality of life within the community. CDIP is currently comprised of staff formerly located in the Health Policy and Planning Division (HPP) of the Health Department and were assigned to such programs as Smoke-Free Start for Families (SFSF), Active for Life (AFL), and Medication Management. As part of the Countywide reorganization in early 2006, the Tobacco Prevention Program was transferred from the Human Services Agency to the Health Department and is now also part of this unit. CDIP will primarily focus on communities that are affected by, or are vulnerable to, injuries and chronic conditions. Programs include Tobacco Prevention, Community Liaisons Project, and Injury Prevention. The Community Liaisons Project convenes Health Department representatives who serve as partners to regional community collaboratives in order to keep the Department up-todate on community priority issues, coordinate Department messages to community partners, and share community resources. During FY 2007-08, a comprehensive strategic plan will be developed for the new unit that will include how to address intentional/unintentional injuries; the primary, secondary and tertiary prevention of chronic conditions; and the role that the Community Liaisons Project will play in the engagement of community members in program planning, implementation, and evaluation. The following are major accomplishments in the current year: Successfully transitioned the Tobacco Prevention Program into the Health Department Convened the Tobacco Cessation Summit in May 2006 to engage key community stakeholders and policymakers around sustaining tobacco cessation services in San Mateo County Successfully implemented a smoke-free beach policy in the City of Pacifica with advocacy from members of the Tobacco Education Coalition Assisted with current consideration of the Board of Supervisors to designate County parks as tobacco-free with advocacy from members of the Tobacco Education Coalition Completed the recruitment of clients into the Active for Life physical activity program, funded by the Robert Wood Johnson Foundation Engaged representatives of community collaboratives in Community Liaisons meetings featuring collaborative leader discussions regarding community demographics, priority issues being addressed, and strategies for increased collaborations with the Health Department Actively participated in regional trainings and discussions about increasing health departments capacity to appropriately serve community health needs
4-84 Provided technical assistance in development of the Filipino Mental Health Initiative Gave presentations at four sessions during the November 2006 American Public Health Association (APHA) annual conference to highlight successes in the tobacco cessation, male involvement, and vulnerable populations efforts of the Health Department Story Behind Performance The Smoke-Free Start for Families (SFSF) program, previously funded by the First 5 Commission, serves primarily pregnant women and families with young children. With leveraged funding from the Tobacco Prevention Program, SFSF additionally serves all other adults who wish to quit their tobacco use. This program is the only free tobacco cessation program for adults in San Mateo County and provides nicotine replacement therapy to program participants. SFSF has been extremely successful, achieving a 30-35% quit rate, whereas national tobacco cessation averages hover around 10-15%. Funding from First 5 was slated to sunset on December 31, 2006; however, in an effort to gauge the value of tobacco cessation to the community, a Tobacco Cessation Summit was conducted in collaboration with the Tobacco Education Coalition in May 2006 wherein community leaders and policymakers were provided with information on the impact of tobacco use in San Mateo County and the current status of tobacco cessation services. Summit participants then prioritized cessation services to sustain. An advocacy effort with the First 5 Commission resulted in the Commission funding the program for an additional six months, through September 2007. SFSF staff began working to identify a community-based organization (Breathe California) that will work in partnership with the Health Department to sustain free tobacco cessation services in the County beyond funding from the First 5 Commission. The Active for Life (AFL) program was a four-year research grant from the Robert Wood Johnson (RWJ) Foundation to determine the efficacy of telephone counseling in encouraging sedentary older adults to become physically active. The focus for the grant in San Mateo County was Latinos, Filipinos, African Americans, lower income residents, and limited-english speakers. There have been tremendous learnings gained from AFL around the need for affordable and accessible community resources for physical activity. The program also learned that older adults value personal contact and engagement in their effort to maintain physical activity. AFL program recruitment ended as of December 31, 2006, with rollover funds supporting telephone counseling activities through October 2007. RWJ intends to analyze data from all nine of its grantees and publish the results of the study. The completion of the Prevention of Childhood Obesity Blueprint has provided the Health Department with the opportunity to develop a multi-sectoral approach to address this pressing community issue. As part of its strategic planning process, CDIP will develop program plans to engage school settings, employer groups, and community partners in promoting nutrition and physical activity. As this is a new OBM Plan, targets for the measures will be developed as part of the overall strategic plan. New Headline Measure 1 the percent of children overweight or obese will be measured every three years as part of the Adolescent Report and is a long-term indicator of program success. An initial target of 25% has been set over the following two reporting periods. It is not expected that substantial progress will be made, even as measured every three years. The initial goal would be to stop the increase in childhood overweight rates before being able to develop objectives for reducing the rates. Areas of program focus, which may take years to demonstrate measurable outcomes, will be reported in the Healthy San Mateo 2020 report. These measures include: (1) reduction of tobacco use in San Mateo County; (2) reduction of childhood overweight rates; (3) reduction of intentional and unintentional injury rates; (4) decrease in avoidable hospitalizations due to chronic diseases; and (5) elimination of the disparities in late stage cancer diagnoses. Another important goal to be included in that report will be reduction of the Countywide heart disease rate (unadjusted) from 185/100,000 to 130/100,000 population, through an effective and comprehensive chronic disease prevention approach that will include the elimination of artificial trans fatty acids in foods distributed or served in the County. As the strategic planning process continues, milestone measures will be developed and incorporated into the FY 2008-09 OBM performance measures. As part of program delivery, a participant survey will be administered that will assess improvement in the knowledge, attitudes, and behaviors (KAB) of participants towards preventing chronic diseases and engaging in healthy behaviors. Major challenges over the next two years will be: To develop a comprehensive Chronic Disease and Injury Prevention (CDIP) program To prepare, train, and monitor staff in their transition from SFSF and AFL program delivery into the community-level effort of the CDIP To integrate the Injury and Violence Prevention and Tobacco Prevention Programs into CDIP and other health promotional efforts within the Health Department To develop meaningful and achievable long-term community health outcome measures, involving input from multi-sectoral partners, with corresponding short-term program outcomes To sustain community partner s interest and commitment to addressing underlying factors influencing the risk of chronic disease Program Objectives Chronic Disease and Injury Prevention will meet performance targets by doing the following: Development of a comprehensive strategic plan to prevent chronic diseases and intentional/unintentional injuries Review existing data and information on program best practices Convene key stakeholders within the Health Department to discuss priority issues and strategies Present strategic plan to Community Liaisons Project participants and other community partners
4-85 Achieve a 90% Rate of Clients Demonstrating Improvement in Knowledge, Attitudes, and Behavior (KAB) Regarding CDIP Programs Review Public Health KAB survey instrument to assess appropriateness for CDIP; develop new instruments as needed Distribute the survey to appropriate client/contact populations Analyze results by program to determine need for program improvement or adjustments Achieve an Overall Customer Satisfaction Rating of at least 90% Distribute the CARES survey to all clients contacted by CDIP staff and analyze results by program to determine need for program improvements or adjustments Conduct staff development activities to ensure effectiveness of program delivery Achieve Three-Year Outcomes Developed by the Community for the Tobacco Prevention Program Complete the Communities of Excellence Strategic Planning Process with the Tobacco Education Coalition Develop Scope of Work in collaboration with the Tobacco Education Coalition
4-86 Performance Measures Summary Table Performance Measures FY 2004-05 FY 2005-06 FY 2006-07 FY 2007-08 FY 2008-09 What/How Much We Do Number of school districts with wellness policies that meet goals set in the Comprehensive School Health Education standards Number of Educational Presentations (data development) --- --- 16 18 20 --- --- --- --- --- How Well We Do It (Quality) Percent of customer survey respondents rating services good or better Percent of customer survey respondents indicating they are better off because of the services they received --- --- --- 90% 90% --- --- --- 90% 90% Is Anyone Better Off? (Outcome) Percent of children overweight or obese (1) --- --- 25% 25% 25% Percent of clients demonstrating improvement in knowledge, attitudes, and behavior (KAB) regarding disease prevention, control, and treatment (2) --- --- --- 90% 90% (1) Data collected every three years. (2) New performance measure; data will be available in FY 2007-08.
4-87 Resource Allocation Summary 2005-06 2006-07 Revised 2006-07 Adopted 2007-08 Change 2007-08 Adopted 2008-09 Salary Resolution 2.0 2.0 4.0 2.0 4.0 Funded FTE 2.0 2.0 4.0 2.0 4.0 Total Requirements 504,284 560,562 665,543 1,293,792 628,249 1,246,439 Total Sources 369,608 534,732 578,427 864,781 286,354 804,781 Net County Cost 134,676 25,830 87,116 429,011 341,895 441,658 NCC Breakdown Tobacco Program MOE 80,000 80,000 80,000 Non-Mandated Services 7,116 349,011 341,895 361,658 Program Net County Cost The portion of this program s FY 2007-08 Adopted Budget which is funded by the General Fund or Net County Cost (NCC) is $429,011 or 36.1%, of which $349,011 or 81.4% is discretionary. FY 2007-08 Program Funding Adjustments The following are significant changes from the FY 2006-07 Revised to the FY 2007-08 Adopted Budget: 1. Adjustments to Provide Current Level of Services Budget adjustments have been made to meet performance targets: negotiated labor increases; inclusion of merit increases; adjustments to carry-forward revenues and deletion of prior year one-time expenses. 181,573 312,202 0 0 130,629 0 2. Transfer in Positions from Health Policy and Planning One Program Services Manager I and one Community Worker II-U have been transferred in from Health Policy and Planning (HPP) to staff this new CDIP unit. In addition,.25 of an Office Specialist position that continues to reside in HPP will be charged to this unit, to provide additional staff support time. 0 211,266 0 0 211,266 2 3. Adjustments to Fund Balance Increased Fund Balance from the prior year is being set aside in Reserves for Tobacco Prevention Program operations. 104,781 0 0 104,781 0 0
4-88 TOTAL FY 2007-08 PROGRAM FUNDING ADJUSTMENTS 286,354 523,468 0 104,781 341,895 2 FY 2008 09 Program Funding Adjustments The following are significant changes from the FY 2007-08 to the FY 2008-09 Adopted Budget: 4. Adjustments to Provide Current Level of Services Budget adjustments have been made to meet performance targets: negotiated labor increases; inclusion of merit increases; and elimination of expiring grant funding and related expenses. (60,000) (47,353) 0 0 12,647 0