HomeMy WebLinkAboutResolutions - 1984.02.23 - 16190Miscellaneous RLIsolution 84036 February 23. 1984
BY: HEALTH AND HUMAN RESOURCES COMMITTEE -M arilynn Gosling, Chairperson
IN RE: COMPREHENSIVE HEALTH ANALYSIS MANAGEMENT PLANNING SYSTEM DEVELOPMENT GRANT
APPLICATICN - MICHIGAN DEPARTMENT OF PUBLIC HEALTH (KELLOGG FOUNDATION)
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Mr. Chairperson, Ladies and Gentlemen:
WHEREAS the Oakland County Health Division has moved forward in the development
of a Comprehensive Health Analysis Management Planning System (CHAMPS) to enhance its
service capability and accountability; and
WHEREAS the Oakland County Health Division, in consort with Oakland County
Computer Services Department, has undertaken this development within its limited
: resources; and
WHEREAS certain aspects of CHAMPS are becoming operational while the timely
devilopment of other aspects require additional resources; and
WHEREAS CHAMPS has been identified by the Michigan Department of Public Health
(MDPH) as one component of a statewide public health data reporting system; and
WHEREAS funding is available through the Kellogg Foundation to assist in
the .development of such a prototype system; and
: WHEREAS the Oakland County Health Division projects multi-year funding in
the amounts of $85,000 for FY 83/84, $250,000 for FY 84/85, $250,000 for FY 85/86
and $165,000 for FY 86/87 will be needed from the Kellogg Foundation to insure the
appropriate development of CHAMPS; and
WHEREAS the development of CHAMPS is a joint venture between the Oakland
County Health Division and Computer Services Department; and
WHEREAS other health jurisdictions have demonstrated considerable interest
in sharing CHAMPS technology; and
WHEREAS this grant application has been reviewed by the County Director of
Federal and State Aid.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners
approve the Co:.oprchensive Health Analysis Management Planning System development
grant application as part of the proposed statewide public health data reporting system.
Mr. Chairperson, on behalf of the Health and Human Resources Committee, I
move the adopt;on of the foregoing resolution.
HEALTH & HUMAN RESOURCES COMMITTEE
REPORT TO THE HEALTH AND HUMAN RESOURCES COMMITTEE
BY: FINANCE COMMITTPE, DR. G. WILLIAM CADDIFLL, CHAIRPERSON
IN RE: 1984-85 CIIMITEBENSIVE HEALTH ANALYSIS MANAGEMENT PLANNING SYSTEM
(DAMPS) DEVELOPMENT GRANT APPLICATION
The Finance Committee has reviewed the proposed grant application and
finds:
1. This is a new grant and covers the period March 1, 1984 through
February 28, 1985,
2. The application is to the Data Management Project, Michigan Depart-
ment of Public Health; the funding source is the Kellogg Foundation,
Battle Creek Michigan,
3. The application is for $85,000, comprised of $68,800 for Data Proces-
sing Programming; $15,221 for Salaries and Fringe Benefits; and $979
for Indirect Cost. The detail is shown on the attached schedule,
4. Any grant funds received for CHAMPS development will accelerate the
completion of the system and reduce future County expenditures,
5. All personnel changes will require Personnel Committee approval,
6. Application or acceptance of the grant does not obligate the County
to any future commitment.
Mr. Chairperson, on behalf of the Finance Committee, I move the acceptance
of the foregoing report, and referral of the information contained therein to
the Health and Human Resources Committee, in accordance with Miscellaneous
Resolution #8145 - revised "Federal and State Grants Application Procedures."
FINANCE COMMITZEE
OAKLAND COUNTY HEALTH DIVISION
GRANT REQUEST
. FOR
DEVELOPMENT OF CHAMPS
The Oakland County Health Division respectfully requests funding from the
Kellogg Foundation, through the Data Management Project of Michigan
Department of Public Health for development of a third generation public
health information management system entitled CHAMPS. This acronym stands
for "Comprehensive Health Analysis Management Planning System." It is a
: comprehensive system in that it is structured to handle any given program-
', matic aspect within the realm of public health practice. It is an integrated
' system since it meets the needs of all types of public health personnel
including doctors, nurses, sanitarians, health educators, nutritionists,
technicians, pharmacists, managers, planners, and administrators.
,Basically, the system is driven by a problem-oriented process Which lends
to the primary purpose of the system, that is, case management. Appropriate
case management is enhanced by a user friendly guidance subsystem which
.informs and educates in regard to up-to-date approaches to the client
problems encountered. Given adequate, individual case management for each
- client, the system will then accumulate any set of clients whether they be
persons, facilities, or individuals by which epidemiologists, managers, and
edmieiQtreters can make correct judgments and inferences in regard to subsets
of the population or that as a whole.
hhile it is recognized that such functions as reporting and third-party
billing are important, these entities are more a byproduct of the system
than a primary function. CHAMPS is aimed mainly towards the professional
staff rather than the administrative -staff. It is being developed to assist
those who deliver services to carry out their assignments in a way that
insures completeness and quality while at the same time reducing the paper- ,
-work that is attendant to it.
The coneeptuel model on whidi CHAMPS is based resulted from a detailed and
e. lengthy interactive process among representatives of all disciplines within
. the Oakland County Health Division. This concept and its application was
thoroughly enalyzed and tested through data flow diagrams to arrive at a
logical model by staff of the Oakland County Computer Services Department.
The systems analysts recomonded an iterative, modular approach to the
,development of C1-1..V,PS so that it would be both within practical and
econumic reaCh.
-2-
Since Oakland County had a large mainframe to call upon, the central
computer prototype with interactive, terminals was selected as the most
appropriate hardware Choice. In addition to the hardware, Oakland County
Computer Services Department also has data-base software systems available
to it, a necessary resource to manage both the high volume of data elements
and required interrelationships between those elements.
The process of conception and arriving at the functional spPoifio.qtions is
Well documented in a published manual that is available from the Health
Division on request. Following this documentation of the process, a cost
benefit analysis was developed showing that substantial resources could be
diverted from the current clerical record-keeping process in order to
increase the professional service staff. The cost benefit document is also
-',available on request.
Oakland County undertook the development of the system with an estimated
completion time for all the modules being five years. The three main com-
ponents of the system are as follows:
Service
Management
Administration
The decision was made to develop the service component first for the
following reasons:
1. Development of a Data Base
The information needed to do any type of analysis for any of
the following: administrative practice, planning, evaluation,
or reporting, would come from the data collected on clients
and the services rendered to them.
2. Establishing the Routes for Data Communication
Ti the data were to reach the top in summary form, it would
have to begin at the intake of each client who was accepted
or mandated for service. In addition, the sharing of common
data on clients across program lines needs to be in place
early in order to take advantage of this efficiency.
3. Iterative Methodology
The methodology of building the data base can be best
developed at the program level on a program-by-program
basis. In this way, priorities can be established by the
organization on the basis of cost-benefit or critical need.
4. Project Organization
Beginning with the service-delivery or case-management level,
allows more _Health Division staff to be involved early on;
and at the same time, allows Oakland County Computer Services
personnel to become more familiar with the work of public
health. As the two disciplines mesh their fields of knowledge,
the components of the system can be constructed with logical
prerequisite ordering.
This service component will have five modules that will apply to 104
program clenents. These five meddles are as follows:
Common Intake
Unique Data
Problem List
Plans and Actions
Evaluation
program element is a discrete functional unit, a listing for Which can
be found in Appendix A.
The modules that will apply to the management and administrative components
can be found in Appendix B and C respectively. These modules will generally
%be developed after the data base has been established through the service
comnonont. Some modules such as the time study and order-entry module ray
be -developed simultaneously should it be found desirable to do so.
The first module worked on was the Common Intake module. It has been
analyzed and is in various stages of programming, testing, and implementation
There are 12 functions handled by this module. Each function may have up
to four actions (add, display, modify, delete). An additional two functions
are being made available through other computer systems.
Name Search - Implemented 04/81
(Display)
This fnnction allows retrieval of clients on file by name. Used
as a verification prior to adding a client to the system.
Pricy Demographics - Implemented 04/81
(Add, modify, display)
Client name, location address and other basic demographic data
may be collected.
Secondary Demographics - Implemented 06/82
(Add, 7.T1dify, display)
This function collects additional data consisting of mailincl, address,
employer, school and insurance information.
Family Relationships - Implemented 10/82
(Ada, modify, delete, display)
Family relationship function will link together each of the family
or organization members.
Alias/Roster - Implemented 02/83
(Add, display, modify, delete)
Each client may have as many alias names as desired. Roster entries
are used with head of household to identify other family Or organization
members that arc not currently receiving service. The alias/roster
names will be searched when using the name search. function.
Alias/Roster/Relationship -
(Disnlay)
Thi:F, function will display
along with alias names and
Implemented 02/83
all members of a family or organization
roster entries for the entered client.
-4-
- Units - Implemented-04/83 ,
(Add, modify, delete, display)
Units function identifies all the organizational areas that are
providing service to a client. It also allows for the entering of
the client record location.
Cross-Reference - User Testing
Estimated Implementation Date 01/84
(Add, modify, delete, display)
This fonetion assigns alternate keys to a client. This key may
then be used by the cross-reference search function to retrieve
clients.
Events - User Testing
Estimated Implementation Date 01/84
(Add, modify, delete, display)
Events are a chronological list of referral and brief free form
description data relating significant happenings to the client.
Address/Sidwell Cross-Reference - User Training
Estimated Implementation Date 02/34
(Display)
Sidwell numbers identify parcels of land. This function will allow
terminal operator to obtain this number by entering an address.
Subdivision Lot/Sidwell Cross-Reference - User Training
Estimated Implementation Date 02/84
(Display)
Knowing the subdivision name and lot number this function can
cross-reference to a sidwell number,
Chronological Events - Not Started
Estimated Start Date 03/84
(Display)
Chronological events will display all events by date for a client
across organizational areas.
Cross-Reference Search - Writing Detailed Specifications
Estimated implementation Date 03/84
(Display)
Cross-reference will retrieve client number, name and address
information based on assigned cross-reference keys. These keys
are assigned to a client through the cross-xeference maintenance
function,
Client Relationships - Not Started
Estimated Start Date 01/85
(Add, modify, delete, display)
This will allow each of the different client types (facility,
individual, group, incident) to be related to each other.
„7he operational functions are currently being utilized by a variety of
progrools (Personal and Preventive Health, Environmental Health and Health
Education and Nutrition) for entering of active clients. We currently have
51,000 clients. This work is being accomplished on the 30 terminals currently
installed. Termioals are being installed at a Tate of one per month with an
expected total of 58 to be installed by the completion of C'EXTS.
- 5-
Some adjustments to the Common Intake software are being made as experience
shows that a particular feature needs to be or is desirable to modify. The
remaining four modules of the service component are currently being analyzed
simultaneously so that data entry can begin on all phases of case leanagement.
The first program elements to be applied will be certain maternal and child
health pro :.,Iram elements. Money was obtained to hire a programmer through
the Jobs Dill te work on this aspect.
'Oaklancl County has committed itself to this project in the following ways:
1. The tjue.e of an interdisciplinary Health Divisien group to
conceptualize the system.
2. The time of systems analysts to develop the functional
specifications for the system.
3. The time of Health Division personnel to work side by side
with the analysts/programers in analyzing, programming,
testing, and implementing each module and the functions
attendant to them.
4. Two full time eligible analysts/programmers have been assigned
from Oakland County Computer Services.
5. Oakland County has picked up the cost of machine time for
programming and testing.
6. Oakland County Health Division has paid for the cost of training
and data entry on the current caseload.
7, Oakland County Health Division has paid for the cost of the
terminals and operational machine time.
To date, the cost to Oakland County for development of CHAMPS has been
calculated at SS14,S43.59. The projected cost for development of the
entire system is $2,335,000.
At the rate of financial input that Oakland County can afford, the system
will not be completed until 1992. We are desirous to finish the development
of OfnIPS for three reasons. First, the sooner each module is in place
the more efficient the system becomes. This allows for greater benefit
of the initial investment. Secondly, the product derived will be extremely
useful to other health departments in Michigan as they gain experience and
.sophistieation in the utilization of electronic data processing. Thirdly,
• the ,Lichiear. Department of Public Health will have tested methodologies for
the eeliection of a broader range of data as well as epidemiologic and
envirermental health interfaces than exists currently.
In order to sherten the developmental process it will be necessary to seek
outside resources to supplement the yearly financial input that Oakland
County can afford. Once the entire system is up and running, Oakland County
is capable of maintaining it.
-6-
Our kenediate need rests in three areas/ It is our request that the
Michigan Department of Public Health.seek an interim grant from the
Xellogg Foundation as soon as is possible for the following support:
1. A computer programer to concentrate on. environmental health
related programs.
2. Substitute clerks to relieve our full-time clerks on an
alternating basis so that they can be trained in the use of
the system.
3. Data entry clerks to help load the system with active records.
Our system will be far more efficient when we are able to
abandon the current written record system and use only our
electronic files.
The cost of this initial step will be $85,000. A breakdown of this
cost will be found in the attached budget pages (Appendix D).
It is our understanding that the Michigan Department of Public Health will
be submitting a statewide Data Management Project request to the Kellogg
Foundation prior to the Foundation's September cycle. It would be
• appreciated if Oakland County's request for a three-year grant would be
included in that proposal. The sum to be requested for the 1984-85 and
• 1985-36 years would be in the amount of $250,000 each. The request for the
1986-87 year would be for $165,000.
These suns would be used as follows:
1. Continue the employment of the personal and preventive health
services programmer currently being supported by the Jobs Bill
money through September 30, 1984.
2. Continue the employment of the programer whose main emphasis
is on environmental health that was obtained through the
interim Kellogg Foundation Grant.
5. Employ a programmer whose main area of emphasis would be on
health education and nutrition.
4, aploy a programer whose main emphasis would be in epidemiology
and administrative modules.
5. The four grant programmers along with OUT analyst and 1.5
programmer would collaborate on development of the management
modules.
6. All above personnel would lend_ assistance to other counties,
especially Washtenaw County which contracts with Oakland County
and other counties belonging to the Southeastern Michigan Health
Association, in adopting those modules of the GIMPS system that
are applicable and desirable to them.
7. Provide advice, consultation, and assistance to the Michigan
Department of Public Health in developing systems to collect,
store, and analyze data from local health departments.
-7-
8. Continue training of stuff to get the most use out of the
system. Funds would be used to hire part-time help while
full-time staff were in training.
9. Continue to hire part-time data entry clerks to load the
system with the active records that have been accumulated.
In summary, the total developmental cost of CHAMPS is projected to be
$-2,335,000 of which $750,000 is being requested from the Kellogg Foundation.
As noted earlier, Oakland County has expended nearly $515,000 as a minimum
contribution on CII.A.\TS development to date. Our intention is to continuo
this extensive com7aitment as an inkind contribution at the same rate until
project caTletion.
'APPENDIX A
SERVICE COMPON7NT PROGRAM ELDIENTS
immnleation for Preventable Diseases of Childhood
Venereal Diseases
Tuberculosis
Heart
Hypertension
Vascular
Dental I-lealth
Dic,estive
Renal Disease
Reproductive System Disease
Diabetes
Other Metabolic
Scoliosis
Arthritis
Muscular/Reletal
Cervical Cancer
Breast Cancer
Oral Cancer
Other Cancer
Endocrine Disease
Blood Disease
Ear/Hearing
Eye/Vision
Speech
Other Neurological/Sensory
Skin and Subcutaneous Disease
Pulmonary Disease
Family Planning
Antepartum
Postpartum
High-risk Infant
Cononital Anomaly
Genetic_ Diseases
Child Health Conference
Normal Growth and Development
Prnject Head Start
M.antal Health/Mental Illness
1\:ental Retardation
Accident/Poisoning/Violence
Nursng Homo Patient Evaluation
E=gency r.eclical Services
Child Passen ,4er Safety (CPS)
Sehool I 1c lth Cul-riculum (SaP)
Preventin ::, Alcohol-Related Accidents (PAZ‘)
Fetal Alcohol SvnJrome (FAS)
Senior Citi:on 'Substance Abuse (SCSA
Public .Information - Other
Consumer/Community Education - Other
Patient Education - Other
Consultation/Technical Assistance - Other
Co7nunity Health Planning
Comunity Organization - Other
Orientation
Staff Eduction
Student Training
Ctmmunity Nutrition
Women, Infants, Children (WIC)
Heads tart Project Consultation Program
Substance Abuse Control Services
AMpient Air Quality
Shelter Air Quality
Fixed Food Service
Temporary Food Service Establishments
Mobile Food Service Establishments
Vending Machines
Retail Food Stores
Food Manufacturers
Type I Supplies
Type II-A 'Supplies (Community)
Type II -B Supplies (Non-community)
Type III Supplies (Other Public)
Private Supplies
Bathing Beaches
hl Swimming Pools
Nursery School/Day Care Centers
Educational Institutions
Mobile Home Parks
Foster Care Facilities
Residential Housing
Transient Housing
Nonresidential Housing
Land Use and Planning
Toxic and Hazardous Vaste Management
Refuse Management
Sewage Disposal Systems
Cemeteries
.:1)PE Campground.;
D55 Campgrounds
CNS Infections
Enteric Tru7octions
Hepatitis
Rabies
P\ah Illness
Respiratory infections
Vaccine Preventable Diseases of Childhood
Oth er Class I Infections
Other Class IT Infections or Infectioa Related Diseases
00:j.lroJk Investigation
Special Projects -
Chronic Disease Data Collection
Eisinterment/Reinterment Permits
APPENDIX B
MANACDINF COMPONENTS
Activity Reporting
Tille Study Interface
Guidance Support Tool
Scheduling
Order Entry
Laboratory
Incident Tracking
Standard Reporting
APPENDIX C
ADMINISTRATIVE COMPONENTS
State interface
Inventory
Administrative Reporting
-Standard
-Ad hoc
.`
APPENDIX D
HO
t
:.•-•• ; 7
I 8,JTJE Per.uu I Dale Prel,ster.
3/1/84 1-02/28/85 1 12/23/33 CW2S revelopmon
falk1in(1. Cou:Itv Hcalth Division I .13 1-Ligat.; r
Bud:3.21. I
Re.. s
Number
LUC-11 Ay:
n•
AGREEi.:ENT 1:31.1DGET II LOCAL F.t..11.)G ET
CATEGORY TOT/V._ I CURET YEAR Sl_P:i...0'-1 E%-:- 1 C!...1 JT
P"'"Irs=— 1 '
51.EQU=NT
t....,,s...._i 1 PCI,P,TIO% YEAR FORTIO% YEAR 19_ YEAR 19_
1 ' Sn:3ries & '...":: :es 14,20C 1 1
I
2 Frtr,[3:;‘. Senek.E. 1,021
.1
3 Travel II
. I
4 Suoores & I
51Contract --).-11 C-C.-ontrz:cts.)
6! Equipment
Other
7 Expenses; 68,800
I ;
1 i 1 ,
i 1 ..._
SI TOTAL DI RECT 84,021
1 979
.,
10! TOTAL EV- II:`,..,`.1 .1.uES 85,000
.
! ,
11 Less: Fees .1:. Cr.Wecti.,J-,-, -
--
I
121 iRt_t%DS 71. ECf_.11 I1 ED SS.00O
I-.. ----.
FO O D SO1P.CTS
1 . 1
13 State Aree.mcnr, 1 85, 000 1 ,
1•1 State Forml..:J
1' P1-13 314 t- '1
,
1
I 11,1 t,'.&C,11
1
I I 17 Fecleral ..
' 1C Lc d; I; I - 1 1 I
I 1
i ' 20!I TOTAL ruüoo 35 ,',x0
1 1.11.1:1:_:.n. represents cot.t t C1 I a:- o yr1 or of 111,'-'
for tt; L'jr! (-_,;--t7t:-)0 of the
tO :irrOD.r)17. 311 refloirLfl
DATE: NA': ii
Progr.,n
Cri-LALPS Develonment
BuZ2,,et P.:*tod ..)71/84 To 2/28/85 pare P-.Nnia,eu
12/23/8 COde
Tot.11 Dir,!ct Time (hours)
Ore Man Year (hours) Man Years DIRECT AN YEAFIS
SUPPORT VIAN YEARS Program AdministratIon and Support Time Man Years
PROGRAM BUDGET - POSITION SCHEDULE
PIN-1 14
L.11
Oakland Cointy Hcalth Division
STAFFING ANALYSIS
Re.,10,:i
NurritreT
Ortginai
Budge/ cri
TOTAL MAN YEARS REQUIRED
i I
POSITIONS ANNUAL TOTAL POSITION DESCRIPTION x
SALARY COMMENTS
1 REQUI RED • SALARY
Several P.T. Non-Eli .. PersorA
Typist II .993 14,295 14,200
, _
,
.. 1 1
1 1
1
i -
I
1
. . ,
i.....
1 1 I
1
i ....,
.1-1M -1- Al Q (211 -'-'-s->.<'''''' I 1 A ?MI I
1---1-10C.711 BUDGT - COST 0 7-TAIL SCHEDUL ro-) 3
:1'1.1 1 S
.74
CiAA)S Developmc=
titia ,s[ Period
3/1/34 2/23/85
(3,11.4P,rodr.4-0
12/23/33
Cilt!i
Flavyt,<1
Bucry=t m
A C; c
c_akland Cunt7 Health Division Reu,sion
Numbw _
818
161
979
21 ESC R I PTIO N 1TE7.11
DTL
SUB•CATEGOR'(
CATEGORY
TOTAL
QUAIITITY
:A.L.NCE Attachme7,+ I
OTHER EXPENSES
Data Processir:g Programm.7:ng for Environmental Health
Programs -1,673 Hours @ $41.00/Hour
INDIRECT COSTS
6.9% of 1934 Salary of S11,361
6.9 of 1985 Salary of S 2,339
NOTE: The 1953 indirect cost rate of 6.9% was used in
the computations as the 1984 proposed rate has
not .e.en approved by Oakland County's Federal
Cogni=ant Aency. When the 1934 rate has been
appr5.Ve:1, that rate will be used for the
portion of sa laries that are used in 1D8-4.
Likeisc, the 1955 rate will be used when
-approved,
1,021
68 )800
ALVVS Development FRINGE BENEFITS GRANT FISCAL YEAR 3/1/84 TO 2/2S/SS
I
:':le Corn- l':.-,:., Hosp. Life.Ins, Ret -Irc. Social 1 Salary Unemp. Dental Totalr '
putcd Co'..-:..). (Actual/Yr. (.4:1G', oi R.InJ Sco',Ar.Ity Contin- Ips. Actual/
Salary (From Ths,,Dd on Sal;lry) (17:49°, (7.n of uation (..529 Ycar 72.cneCit
the first (.1.41 5,, of based on Costs Wer..,:. Current 0 L r
Coo. l':ontly Salary) $37,800) of Salary) Current
Sched.) 1.11.0.$) Salary) n ',olithly
67/mo. Rates'
-$2-,.6.17/=. l-17.70/mc.
3-$231.41/mo. 3-$50.18/mo.
771-7---- - - ,200 '2 k") qS $994.00 __ -- __ . I 0) , _.- , -
,
,
_
----
-- ,
1 .. 1 _.
,
#84036 February 23, 1984
this 23rd day of rev .11, 1984
(14(1416 (RIM 1- ALLEN
Moved by Gosling supported by Susan Kuhn The report be accepted.
A sufficient majority having voted therefor, the motion carried.
Moved by Gosling supported by Susan Kuhn the resolution be adopted.
AYES: Olsen, Per inoff, Pernick, Price, Rewold, Wilcox, Aaron, Calandro, Doyon,
Foley, Fortino, Gosling, Hobart, Jackson, R. Kuhn, S. Kuhn, Lanni, Law, McConnell,
McDonald, McPherson, Moffitt, Moore, Nelson. (24)
NAYS: None. (0)
A sufficient majority having voted therefor, the resolution was adopted.
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lynn D. Allen, Clerk of the County of Oakland and having a seal,
do hereby certify that I have compared the annexed copy of
Miscellaneous Resolution adopted by the Oakland County Board of Commissioners at
their meeting held on February 23, 1984
with the orginial record thereof now remaining in my office, and
that it is a true and correct transcript therefrom, and of the
whole thereof.
In Testimony Whereof, I have hereunto set my hand and affixed the
seal of said County at Pontiac, Michigan
County Clerk/Register of Deeds