HomeMy WebLinkAboutResolutions - 1979.11.29 - 169059198 November 29, 1979 MISCELLANEOUS RESOLUTION
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THE FOREGONG RESOLI
BY: HEALTH AND HUMAN RESOURCES COMMITTEE - John H. Peterson, Chairperson
IN RE: BREAST CANCER DETECTION AND EDUCATION PROGRAM GRANT RENEWAL APPLICATION
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Mr. Chairperson, Ladies and Gentlemen:
WHEREAS the Health and Human Resources Committee has reviewed the
Public Health Division's Breast Cancer Detection and Education Program
Fourth Year Grant application; and
WHEREAS your Committee strongly supports the continuation of said
program; and
WHEREAS the Oakland County program continues to compare very
favorably with other Breast Cancer Detection programs in Detroit and else-
where in terms of cost per visit, incidence of cancer detected, comprehensiveness
of follow up and overall program quality; and
WHEREAS the National Cancer Institute has tentatively indicated it
will support the Oakland County program in the amount of $137,919 for the
1979-80 program period; and
WHEREAS the required County match together with program needs for
the 1979-80 program year necessitates one additional full-time budgeted
typist position.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of
Commissioners authorize the Public Health Division to submit a grant application
to the National Cancer Institute for funding of the Oakland County Breast
Cancer Detection and Education Program through a sub-contract arrangement with
the Michigan Cancer Foundation in the amount of $137,919 for the 1979-80
program period.
The Health and Human Resources Committee by John H. Peterson, Chairperson,
moves the adoption of the foregoing resolution.
'C•,-MLALTH AND HUMAN RESOURCES COMMITTEE
John H. Peterson,—WaTrperson
11,',4,N CE/ COMM I TTE.E..:
nni Murp'r,y, ChairDerson
REPORT TO THE HEALTH AND HUMAN RESOURCES COMMITTEE
BY: FINANCE COMMITTEE, DENNIS MURPHY, CHAIRPERSON
IN RE: BREAST CANCER SCREENING AND DETECTION GRANT APPLICATION
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Mr. Chairperson, Ladies and Gentlemen:
The Finance Committee has reviewed the proposed grant and finds:
1) This application is for fourth year funding of a five year program and
covers a period of July 1, 1979 through June 30, 1980.
2) Total dollar commitment called for in th, application is $280,236 of which
$137,919 (49.2%) is Michigan Cancer Foundation (M,C.F.) and $142,317 (50.8%) is
County.
3) Funding for County portion of the program is built into the 1979 and 1980
budgets.
4) The $142,317 is $13,678 greater than the current grant of $128,639, $97,779
is personnel cost and $44,538 represents operating costs and volunteer services. A
complete cost breakdown as well as a comparison between the current and proposed
program is provided in the attached schedules.
5) Indirect Cost is omitted from the M.C.F. grant proposal.
6) The County match for the program requires 1.95 more positions comprising
of existing budgeted County positions devoting .95 more time to the program and one
(1) additional full-time budgeted typist position at a cost of $14,569 ($10,479
salary plus $4,090 fringe benefits). The additional budgeted position will require
full Board approval.
7) There is no assurance of M.C.F. funding beyond June 30, 1980.
8) Application or acceptance of this grant does not obligate the County to
future commitment. Should M.C.F. funding cease, continuation of this program will
be at the discretion of the Board of Commissioners.
The Finance Committee, by Dennis Murphy, Chairperson, recommends acceptance of
the foregoing report, and the referral of the information contained therein to the
Health and Human Resources rommittee in accordance with the Miscellaneous Resolution
#8145, Revised Federal and State Grant Application Procedures.
#91 98 November 29, 1979
Moved by Peterson supported by Fortino the report be accepted and the resolution
be adopted.
AYES: Doyon, Dunaskiss, Fortino, Gabler, Gorsline, Hobart, Hoot, Kelly, Lewand,
Moffitt, Montante, Moore, Moxley, Murphy, Page, Patterson, Perinoff, Pernick, Peterson,
Price, Aaron, Caddell, DiGiovanni. (23)
NAYS: None. (0)
A sufficient majority having voted therefor, the report was accepted and 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 #9198 adopted by the Oakland County Board of
Commissioners at their meeting held on November 29, 1979
with the original 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
this day November 19.?.
Lynn D. Allen...................„.Clerk
By..................„.............Deputy Clerk
OAKLAND COUNTY HEALTH DIVISION
BREAST CANCER DETECTION/EDUCATION
BUDGET PROGRAM I WIVE
JULY 1, 1979 TO JUNE 30, 1980
ABSTRACT
DATE: June 11, 1979
FROM: Patricia A. Seibert, R.N.,M.S.N.
Administrator, Cancer Detection Center
Oakland County Division of Health
27725 Greenfield Road
Southfield, Michigan 48076
(313) 424-7100
I.
• The Oakland County Health Division has completed thirty (30) months
of operation of a Breast Cancer Detection/Education Center dating. from
October 18, 1976. The joint funding sources for this program are the
Oakland County Board of Commissioners and Michigan Cancer Foundation by
contractural agreement.
The objective of the program is to reduce morbidity and mortality
from cancer of the breast through the development of an early detection
- and education program impacting upon high risk and at risk populations,
whose target age group is 35 years and older. -
A comprehensive breast examination and selective screening and
diagnostic services are provided by the center to detect, at an early
stage, breast disease and/or breast malignancies. The detection pro-
cedures include a cancer-oriented personal health history, clinical
examination with palpation, individualized teaching of breast self-
examination and selective theifflography and mammography according to
the current protocol established by the National Cancer Institute/ •
American Cancer Society. Medical consultation is available at the
center on a weekly basis to patients who exhibit abnormal clinical
or nammographic findings. Medical-Surgical -resources are provided for
_ le4se patients requiring such services.
Reports of all examinations and consultations are sent to attending
physicians of record. Physicians are contacted by telephone 1j0. 24
hours when cases of suspected malignancies are reported.
• Patients are followed on an annual or more frequent periodic basis
according to the status of their initial examination- Notification by
. nail serves as a reminder for these subsc:nemt visits. Public 1:a"Ift
field nursing service's provide the follow-up for all patients Who demon-
strate a suspected malignancy to encourage- compliance with medical recom-
mendation for care. In addition, Public Health nurses follow-up on other
health related concerns that surfaced during the clinical examination at
the center.
0. 1
In cooperation with American Cancer Society and/or Michigan Cancer
Foundation, our nurse examiners conduct outreach clinics in regional
centers, community settings and at business or industrial sites in the
metropolitan area in an effort to reach high risk and at risk populations
who for one reason or another (low motivation, transportation problems or
time constraints) do not avail themselves of clinic facilities.
In the Fall of 1977, we initiated outreach clinic services independent
of the above organizations and continue to pursue this activity in out-
lying regions of Oakland County and in more densely populated urban area
in an attempt to reach minority populations. Patients served in outreach
clinic operations receive the clinical examination, estimate of risk for
breast cancer through review of personal health history and instruction in
. breast self-examination. Patients who meet the criteria for mammography
' are encouraged to come to the center for that service. Arrangements for
transportation, if needed, are effected through volunteer groups associated
with organizations and community centers with that capability.
The center is staffed by a nurse administrator, registered professional
nurses specially trained in clinical palpation, registered x-ray technicians
and experienced clerical personnel. Medical direction is provided by the
Director of the Health Division, Robert P. Locey, M.D.,M.P.H and Medical-
Surgical consultation is provided by Jerry Rosenberg, M.D., Chief of Surgery
PUtzel Hospital. Kenneth Krabbenhoft, M.D., Professor of Radiology, Wayne
State University College of Medicine, provides interpretation of our Tram-
nigrams
The hours of operation for the Breast Cancer Detection/Education Center
are 8:30 aorn to 5:00 p.m. Mondays, Tuesdays, Wednesdays and Fridays.
Hours on Thursdays are from 12:00 noon until 8:30 p.m. to accommodate
. working women. Dr. Rosenberg is present on Thursday evenings for patient
consultation, by appointment.
The program continues to have a yearly potential of 5000 client slot
Outreach capability has markedly increased this year with the completion
of training of one additional part-time professional nurse. Four Public
Health nurses, prepared in this specialty, continue to provide sixteen
hours per month for a total of sixty-four hours that can be utilized in
outreach activity.
Services to patients are without charge except for mammography and
breast pap smears. All monies generated from laboratory or x-ray
services are put back into the program. Blue Shield provider status,
granted to this agency in October, 1978, has motivated women to accept
mammographic services at the center.
Michigan Cancer Foundation will be requested to provide a total of
$137,919.00 for fiscal year 19794980. Of this amount, $122,960,00 will
be required to cover salaries and fringes for personnel. The balance of
the request($14,959.00) represents rent of the facility.
The Oakland County Board of Commissioners are requested to authorize
the expenditure of $142,317.00 in Support of the program, This sum repre-
sents personnel costs of $73,328.00 (salary and fringes) and the remaining
$68,989.00 will be used for operating expenses as outlined in the attached
budget.
:OAKLAND COUNTY HEALTH DIVISION
BREAST CANCER DETECTION/EDUCATION CENTER
THIRD YEAR SUMMARY
A. Accomplishments
1. Ever-increasing patient participation
We have had a steady increase in numbers of patient visits.
Total number of visits doubled in the second year of operation
(1584 in contract year 1976-77 to 3171 in 1977-78) achieving 63%
of our goal of 5000 visits. At the conclusion of the third year
June 1979, we fully expect to reach 73% of that goal.
2. Breast Cancer Detection Rate
•We are well above the national average in detection of breast
cancers, continuing to demonstrate a ratio of fourteen, (14)
breast cancers per 1000 new patients seen. .
3. Educational Impact ---
a) Asymptomatic women returning for annual breast examination
has averaged 34% of patients notified demonstrating a signi-
ficant educational impact.
b) One-to-one instruction of BSE has been given to 2437 women
in the first three quarters of this third year of operation.
4. Public Information via the media
We ave utilize. Puelic Service radio and TV spots to advertise
Our program and have conducted a newspaper campaign in our com-
. munity dailies. These efforts have produced over 100 new patients
_during this program year.
5. Insurance
The lack of provider status for Blue Shield coverage had set up
• significant barriers to full utili7ation of our miammographic unit
by women recaamended for this service. in October, 1978, after
-several months of negotiation, we were accorded provider status.
We view this additional capability as an important adjunct to our
services that will not only provide greater convenience for our
• patients but will enhance data collection.
6. Outreach Activity_
organized systematic approach was brought to fruition this
year relative to outreach clinics. We have conducted and/or
participated in outreach activities on a monthly basis for
seven out of the last nine months. An outreach clinic coordinator
been designated to plan, publicize and organize outreach clinics
in communities throughout Oakland County. These efforts have accoun-
ted for an additional 308 new patients.
4s.
B. Identification of significant trends
Work site outreach clinics appear to have a significant appeal although
it is acknowledged work release time may be the major inducement.
C. Alterations in program direction
1. Suspension of cervical Pap smear component based on laboratory
results that revealed virtually no pathology suggestive of malignancies.
2. Suspension of routine thermography based on NCl/ACS task force recom-
mendations.
D. Linkages to other phases of MDCCP
1. Coordination of outreach clinics with ACS Straight Talk presentations.
2. Conducting breast cancer detection clinics in NEF Regional Centers.
3. Medical-surgical consultation to patients is provided by YU contract
medical consultant at out BCDC on a regular weekly basis.
4. The majority of our patients recommended for biopsy are hospitalized
at the two Clinical Demonstration hospitals in our county (Beaumont
and Providence).
E. Activities for continuation of Program post-contract
1. Establishing permanent sites in community settings to continue breast
examinations and BSE instruction.
2. Establish fee for service schedule to supplement county subsidy.
3.. Establish early detection Clinics in health care institutions within
the county.
4. Continue joint efforts with ACS and NF in providing breast cancer
early detection clinics.
k
FOURTH YEAR OBJECTIVES
1. Eighty percent of our potential patient slots of 5000 will be reached
by June, 1980.
2. Thirty-five outreach clinics will be conducted during the fourth year
contract.
3. Participation in Oakland County Breast Cancer Detection services by
Macomb County target population will increase from 10.4% to 20% of
- total patient visits.
4. 100% of all new patient visits will receive BSE instruction and 100%
return visit patients (exclusive of consultant's visit or mammogram
only visit) will receive reinforcement in BSE technique.
,
Oakland County .
Board of
Commissioners ........r.......
.,...
Department of
Human Resources
..........,....
Personal
Preventive
Health Services
MDCCP
MCF
Clinical
Demonstration
Hc.pital;
---k 1 Oakland County , BCDC ......., ow?, .„, o - 7-:, ,.:.reacn Services
MCF
BC DC
Outreach Service,;
410araveeranIMOI •
011tir, AIM
OA. C DIVISION
B" -" T CANCER DETECTION/EDUCATION PROGRAM
ORGANIZATION AND INTER-AGENCIES RELATIONSHIP
1. Dr HEALTH
BREAST CANCER DETECTION/EDUCATION CENTER
MONTHLY ACTIVITY REPORT
May Year Program
1979 to date to date
Total Number of Patients 531 1722 8305
New • 342 919 - 5005 . .
Repeat 169 722 2894 , .
Consultant 20 81 406
Patients over 40 . 345 1069 4702
Patients under 40
186 653 3400 ,
No Shows 66 211 .798
Cancellations 24 94 - 627
- PE & BSE Instruction *499 1581 7580
Mammograms -- ,.... 110 457 2190
Suspicious Mammograms 5 31 173
Thermograns 0 37 4442
Patients with palpable masses 60 196 627
. Breast Pap Smears 0 18 173
Suspicious Breast Pap Smears 0 0 24
Biopsies recommended 24 89 - 265
Biopsies recommended (on basis of mans only) 2 16 112
1 Biopsies done • . . . 15 - 54 300
Cancers' . 0 5 , 59
patilninolt reports received -12 54 299 „„, ._,
Private Physician refelials 5 17 325
PHN refeirals to field 4 14 121
Straight Talk cards received 390 930 3456
Straight Talk appointments kept .: 67 285 959
Straight Talk "no shows & cancellations" 32 118 297
Total Reminder Appointment Cards sent: 359 1530 .4819
. Annuals 107 388 1436
:Annual appointments kept . 29 159 483 ,
Total Receipts Remitted $ 1805.72 $ 7853.64 $ 43,242.14
Average - 24 pts/day
Outreach Clinics: S. Lyon 9•
Oakland Service Center . 20
• N. 0. Health Dept. - 123
Madison Towers 62
Gina Carden 6/11/79 Total . 214
.1200
1 10 0
BREAST CANCER SCREENING-
1300, ' COUNTY HEALTH DEPARTMENT
(For years- 1976 thru 1979)
10001
Lu 900 Lu cc
L..) 800
-v) 700 1
. L,IJ 600
cr 500
° -I 400
300
200
100
4:‘
1ST 2N0 3RD 4TH 1ST 3PD t:TH 15'1 7.= D
7 QUARTERS -TEAR 1-3
0
6/11/79
BREAST CANCER SCREENING AND DETECTION GRANT
FINANCIAL ANALYSIS - COUNTY MATCH
1979/80 Variance
1978/79 Applied For (Over) Under
No. Amount. No, Amount No. Amount
Personnel and Salaries
Nurse Examiner (PHN III) 1.00 20,596 (1.00) ( 20,596)
Nurse Examiner (P1-[N II) 1.00 16,665 .50 9,063 .50 . 7,602
Asst. to Admin. - pplis .25 6,687 ( .25) ( 6,687)
Chief of Pub. Hlth, Field Nursing .20 4,659 .20 4,659
X-Ray Technologist .20 2,623 .20 2,993 ( 370)
X-Ray Technologist-Supervisor .20 3,279 ,.20 3,569 ( . 290)
Health Division Director .05 2,536 . .05 2,760 ( 224)
Asst, Director-Health Div. . .05 , 1,451 .05 1,539 ( 88)
Director-P.P.H.S. . .05 1,451 .05 1,627 ( 176)
Adm. of Public Health .05 1,495 .05 1,627 ( 132)
Account Clerk IT - .05 670 .15 2,234 ( .10) ( 1,564)
Community Health Educator .25 4,162 .25 4,532 ( 370)
Auxiliary Health Worker .05 530 .05 331 . ( 219)
Storekeeper .05 607 ( flc,) ( 607)
Clerk/Delivery person .05 572 ( .05) ( 572)-
p1-IN III .20 4,112 ( .20) ( 4,112)
Typist II -1.0 10;479 (1.0)
TOTAL SALAWIFS 2.15 39,571 4.1 73,328 (1,95) ( 33,757)
FRINGE BENF.T.TiS 13 ,792 - . 24.451 ( 10,659) -,_,
TOTAL PF7,:707.-17 1_, COSTS 53,363 97,779 - ( 44,416)
Operating Costs
Advertising 3,144 5,000 (±_ 1;8-56)
Materials & Supplies 265 265
Equipment Repairs & Maintenance 859 1,000 ( 141)
Equipment Rental 22,846 13,222 9,624
Postage 1,570 1,766 , ( 196)
Communications 4,500 ( 4,500)
Rent and Utilities 10,113 10,113
Telephone Charges 3,132 3,132 ,
Laundry 1,269 2,000 ( 731)
BREAST CANCER SCREENING AND DETECTION GRANT
FINANCIAL ANALYSIS - COUNTY MATCH
1979/80 Variance
1978/79 Applied For (Over) Under
No. Amount No. Amount No. Amount
Operating Costs (Cont.) .
Office Supplies 2,015 2,500 ( 485)
Transportation. 1 ,234 , 1,500 ( 266)
Data Processing 254 254
Mammography Supplies 4,500 3,000 1,500
Thermography Supplies 1,000 1,000
Education Supplies 891 1,150 ( 259)
Medical Supplies 284 500 ( 216)
Laboratory Supplies
Laboratory Fees 400 500 ( 100)
Professional Fees
TOTAL OPERATING COSTS 53,776 36,638 17,138
JKE:Ra.
6-20-79
17,764
15,370
12,483
12,652
10,886
10,034
_ 79,189
27,602
106,791
20,596
17,817
14,169
13,776
12,128
11,852
90,338
32,622
122.960
(2,832)
(2,447)
(1,686)
(1,124)
10,886
(2,094)
(11,852)
(11,149)
(5,020)
(16,169)
14,959 9,891
116,682 137,919
Operating Expense
Rent and Utilities
TOTAL OPERATING COSTS
(5,068)
(21,237)
BREAST CANCER SCREENING AND DETECTION GRANT
FINANCIAL ANALYSTS - M.C.F.
1979/80 Variance
1978/79 Applied For (Over) Under
No. Amount NO. Amount No. Amount
Personnel and Salaries
Sr. Nurse Examiner (P.H.N. III)
Nurse Examiner (P.H.N. II)
X-Ray Technologist
Office Leader
Typist II
Typist II
Clerk II
TOTAL SALARIES
FRINGE BENEFITS
TOTAL SALARIES & FRINGE BENEFITS
JKE:ka
6-20-79