HomeMy WebLinkAboutMINUTES - 12092003 - C112 FIS #48 C4011
TO: BOARD OF SUPERVISORSContra
FROM: Family And Human Services CommitteeCosta
DATE: December 9, 2003
A c4UI`X
SUBJECT: Incentives to Promote Healthy Behaviors County
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
ACCEPT attached report from the Health Services Department on incentives to promote
healthy behaviors as recommended by the Family and Human Services Committee.
FISCAL IMPACT:
None. The Health Services Department has been providing up to $30,400 per year from
Contra Costa Health Pian premiums since 2000.
BACKGROUND:
In 2000, the Board of Supervisors approved utilization of small incentives to promote
increased participation in management of chronic diseases, high-risk pregnancy and
preventive health care.
Since that time, there has been steady improvement in the participation rates of members in
the asthma and perinatal programs. This program has been running for four years. Efforts
continue to expand efforts to encourage improve member self care in order to improve the
health of the citizens of Contra Costa County.
CONTINUED ON ATTACHMENT: SIq rATURE: r
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
F DERAL D.GLOVER JOH G IA
ACTION OF BOARD ON L PPROVE AS RECOMMENDED OTHER
VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE
t
UNANIMOUS ABSENT
AND CORRECT COPY OF AN ACTION TAKEN
G� �
{ � AND ENTERED ON THE MINUTES OF THE BOARD OF
SUPERVISORS ON THE DATE SHOWN.
AYES: NOES:
ABSENT: ABSTAIN: /
ATTESTED ✓!
JOHN SWEETEN,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person:Dorothy Sansoe(5-1009)
cc: GAO
Contra Costa Health Services `
BY ,DEPUTY
Report to the Family and Human Services Committee
Contra Costa Board of Supervisors
December 1,2003
By Kate Colwell M.D
Assistant Medical Director
Contra Costa Health Plan
Recommendation
We are recommending that the Board of Supervisors approve an ongoing$30,000 per
year Contra Costa Health Plan(CCHP)premiums for small incentives to members in
order to increase participation in health care and prevention behaviors.
Background
0 In 2000 the Board of Supervisors approved utilization of small incentives to
promote increased patient participation in management of chronic diseases,high-
risk pregnancy and preventive health care.
• Incentives are certificates that we encourage members to use for food or baby
supplies, or products to promote disease control such as hypoallergenic products
for asthma patients;most certificates are for$25 or less.
Each program offering incentives monitors quarterly to assure that the incentives
are being issued as intended.
• No one individual shall receive duplicate incentives or participate in more than
two (2) different incentive programs per year.
• Member incentives are used in our Perinatal Program, our Asthma Disease
Management Program and for our participation in the national "Rewarding
Results"project to study the outcomes of incentives on Adolescent Check-ups.
Perinatal 2003 data(see attached charts)
"Weeks Pregnant When Initiated Prenatal Care"
This chart shows that women who participated with Baby Watch initiated care during the
11th week of pregnancy. This is compared to non-participants,who entered care at an
average of the 13.6 weeks of pregnancy.
"Average Number of Prenatal Visits Completed"
This chart shows that women in the Baby Watch program completed an average of 9.65
prenatal visits, compared to an average of 8.2 visits for non-participants.
"Neonatal ICU Admission Rates"
This chart shows that women in Baby Watch experienced a 2.15%rate of NICU
admissions, compared to a 3.21%rate of admission for non-participants; this is a third
less admissions.
"Perinatal Members Perspective on Incentives"
•
Q
•
f�
Q �
P
4'' 0
P
f
a � N
c�
ton
O
td
C? o�
o
N �
oq �
N �
o
goo,
INK
cr)
0
0
c1r)
v � s
Cd
00
C,
� 11 U
C4
LD
GO
C4 .............................
M
O
O
N
U
cd
0
cri
N �
M cd
i
O
z
4�
CCS �
CCS �
C� H
a
0
o U z
� � M MO
cd O
O
O
v� 4J
cd
Cis
Cis
+, Cd
� rn
Cd
rn
N G�
p pC> o
� p C> 0 p0
tn O
M M nj p p Cd
zu
L
E
Q
r.y
W
^ � C
... w \°
c
V �
co
O
• E
IB.
E
CSA t6 L
� a
c
� o
L
! tU C
co
cl
� L
e«�
M�
Gi
� L �
� C ♦+ Q
O N
c
tU
� N
w
V Q
y
U �
CCHP Asthma Program Incentives 2003
The CCHP Asthma Program has used incentives since the beginning of the
Program in January 1.999 to encourage patients to participate in the Asthma
Program. Patients are encouraged to complete asthma education and a follow-up
appointment with their provider. We ensure that a patient only receives one
incentive per year. Once we verify completion of both a provider follow up and
asthma education the patient is given a $20 gift certificate to Target. During the
past 12 months there were 250 patients who received gift certificates for a total
expenditure of $2, 260.
We are encouraging patients to use the incentives to buy trigger- proofing
materials for the home by providing them with a list of all materials available at
Target and explaining how they can prevent asthma symptoms and hospitalization
through preventive measures in the home. Trigger- proofing materials include
mattress and pillow covers, NEPA filters for the vacuum, boric acid to kill
cockroaches and cleaning products to remove dust and mold. These materials
enable patients who are on limited income to purchase supplies that they couldn't
afford to buy otherwise for removing triggers like dust mites and mold in the
home.
To track how the gift certificates were being used we called back a sample
of thirty patients in the program to determine what they purchased with the gift
certificates. (See attached chart). We found that of the 30 patients who responded,
that 40% reported using the certificates for trigger-proofing materials, 13% for
cleaning supplies, 6.6% for asthma or allergy medication, 26% for clothing, 6.6%
for other supplies and 6.6% did not yet spend the certificate. Adding the three
categories for asthma related products (trigger proofing materials, cleaning
products and medications) together we found that 60% of the survey respondents
were using the gift certificates to purchase products that help to prevent asthma.
Many patients call to thank us because they are so grateful for the gift
certificate. One of the patients in our program whose granddaughter also has
asthma had been waiting several months for the landlord to come and spray her
apartment for cockroaches but once she got the gift certificate she bought boric
acid to use in the kitchen and was able to get rid of the infestation within a few
weeks.
Gift Certificate Expenditures
NIA Year 2002-2043
■ Trigger
Other
7% ■ Cleaning
El Medication
11 Clothing
i
}4 k
■ Other
■ rigge
■ N/A
ar: 1
40%
Clothing
26%
1 `1
7
yY,l a
x
4 yi �3
i�
�0 e3 z
i4
7% Cleaning
13%