Item Description:
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Authorize public health activities and expenditures to support vascular and diabetes health among Hennepin County residents, including disproportionately impacted African American/Black and Indigenous women - offered by Commissioner Conley
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Resolution:
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BE IT RESOLVED, that the Hennepin County Board of Commissioners authorizes Public Health to support vascular and diabetes health among Hennepin County residents, including disproportionately impacted African American/Black and Indigenous women; and
BE IT FURTHER RESOLVED, that the County Administrator be authorized to issue requests for proposal and to negotiate agreements with vendors and/or providers for care coordination, promotion, outreach, community supports, and public awareness relating to vascular and diabetes health, for the term of January 1, 2024 through December 31, 2024, and for a total amount not to exceed $1,000,000; and that following review and approval by the County Attorney’s Office, the Chair be authorized to sign the agreements on behalf of the county; and that the Controller be authorized to disburse funds as directed.
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Background:
In 2021, more than 9,000 Hennepin County residents died due to heart disease. Heart disease is second only to cancer as the leading cause of death for Hennepin County residents. Indigenous and African American/Black residents experience much greater Years of Potential Life Lost compared to White residents in Hennepin County. The rate of deaths due to heart disease were 18.84 deaths per 10,000 for Indigenous and 8.86 per 10,000 for Hennepin County Black/African American residents. Chronic diseases, including hypertension and diabetes, are two of the largest contributing factors in heart disease.
Optimal vascular and diabetes care can substantially reduce an individual’s risk of developing heart disease. Fewer Black and Indigenous patients across Minnesota have optimal diabetes control or vascular care. An estimated 37% of Indigenous and 31% of Black/African American residents in Hennepin County have hypertension. Almost a quarter (23%) of Indigenous and 15% of African American/Black residents in Hennepin County have diabetes. Mortality data are reflective of known and death certificate recorded persons (decedent) with heart disease listed as the primary cause of death for Hennepin County residents. This includes deaths that have been recorded by the Hennepin County Medical Examiner, hospital staff, funeral home directors, and other similar roles.
Hennepin County Public Health proposes the following activities to support optimal vascular and
diabetes health among Hennepin County residents, including disproportionately impacted African American/Black and Indigenous women. Overall funding is estimated to be approximately $1,000,000. The timeframe is estimated to be January 2024 through December 2024.
1. Clinical systems and services support
a. Community Health Centers provide access to comprehensive primary and preventive medical, dental, and behavioral health care services to patients who are medically underserved. Many patients depend on their affordable high-quality health care provided in conjunction with social and economic wellness programming. Hennepin County Public Health proposes partnering with Community Health Centers and Hennepin County clinics (Mental Health Clinic, Public Health Clinic) to pilot and support care coordination programs for people at risk for heart disease or/or developing diabetes. Hennepin County Public Health Promotion has a current project with the Mental Health Center that we are interested in growing and expanding and it could start immediately on January 1. The estimated cost for this implementation is $250,000-$300,000 and would last at least one year. In this pilot, a Community Health Center staff person(s) would provide care coordination for support to people with pre-diabetes and/or hypertension that includes:
• Lifestyle changes
• Smoking cessation
• Future provider appointments
• Social services and/or resources
b. Hennepin County Public Health would embark on funding a pilot with a healthcare system to support increased care coordination for patients in Hennepin County surviving cardiovascular events. The estimated cost for this implementation is $200,000-$300,000 and would last at least one year. Post-event hospital discharge with a patient could include follow-up on:
• Medication
• Future provider appointments that may include rehabilitation
• Exercise
• Mental health
• Social services and/or resources
2. Outreach and Community Supports
a. Community groups and nonprofits are a key source of trusted information in community and serve as a vital link between healthcare services and community members, particularly for those with higher risk for conditions like hypertension and diabetes. There are many grassroots groups and organizations who are working to support Hennepin County residents, including African American/Black and indigenous women who have experienced health events, and funding support would ensure their work continues and will help expand their reach. Estimated cost for community contracts is $100,000 and would support small mini grants for the following:
• Community education and lifestyle changes
• Linkage to healthcare services
• Support services and groups for community members who have experienced a cardiac event.
b. Increased awareness among Hennepin County residents, including African American/Black and Indigenous women, through an awareness campaign or support of partners communication efforts. It will take 6 months to put together an 8 to 12-week campaign for an estimated cost of up to $200,000. This campaign would:
• Share signs and symptoms of cardiovascular and diabetes
• Share risk factors for hypertension and diabetes
• Link residents to community-based resources and culturally relevant care
This request reduces disparities in the health domain by implementing activities that support optimal vascular and diabetes health among Hennepin County residents, including disproportionately impacted African American/Black and Indigenous women.
recommendation
Recommendation from County Administrator: No Recommendation