Quit Assist for McDowell County,

WV SmokersMina Schultz

Lucy Lowenthal

Overview•Welcome to McDowell County, WV•Who is Welch Community Hospital•The Impact of Smoking•Existing Programs•Quit Assist Program•Why Quit Assist Will Work•References

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Welcome to McDowell County, WV

Charleston

Source: Google, 20163

Where Does McDowell Stand?

Source: QuickFacts: McDowell County, WV, 2015.

Sources: McDowell County, West Virginia, 2016. McDowell County: Behavioral Health Epidemiological

County Profile, 2014.

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Community•Who is Welch Community Hospital (WCH)• Only acute care hospital serving McDowell• Comprehensive medical services

•Mission: To be the Provider of Choice of Quality Health Care for McDowell County and

Southern West Virginia Focusing on the Needs of our Patients and Customers

Source: Google, 20165

Current Health Issues• Smoking• WV ranks 50th in U.S. for smoking, low cessation rate• McDowell in top 10% worst-performing counties in U.S.• Increased susceptibility

• Lung Disease• Lung cancer leading cause of cancer deaths in WV• Smoking accounts for 80% of COPD cases• McDowell has highest prevalence of COPD in WV

• Supports:• WV Tobacco Quitline• Medicaid coverage of cessation services• Tobacco tax• Welch Community Hospital

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Impact of Smoking

Sources: Percent of Adults who Smoke by Gender, 2014. QuickFacts: McDowell County, West Virginia, 2014.

West Virginia Behavioral Risk Factor Survey Report, 2013.

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Existing Interventions

• Medicaid Coverage• Tobacco Tax• WV Tobacco Quitline:• Over the phone support for smokers attempting to quit• 8 weeks free tobacco cessation products• Budget= $1.4 million

• Impact• Enrolled over 73,000 smokers since 2000• 33.4% success rate in WV• Smoking rates steady over past decade

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WV Tobacco QuitlineStrengths Weaknesses

1. Cost effective2. Extensive reach3. Proven effectiveness

in some populations

1. Not personalized2. Inadequate

promotion3. Not preventative

Opportunities Threats

1. Increased cell phone use

2. Tobacco Tax funds

1. Budget concerns2. Community

communication preferences

3. Community demand for service

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Quit Assist• Will reduce smoking in McDowell County by

10% after 2 years of implementation• Personalized approach to cessation• One-on-one counseling, 24-hour support, peer

motivation• Based at Welch Community Hospital

• 5 full time, local but mobile staff• Flexible locations• Multiple options for communication• Total project cost: $310,300

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PERSONNEL TITLE EFFORT SALARY SALARY BENEFITS** TOTAL

PT Program Director 5% $60,000 $3,000 $750 $3,750 FTE Program Coordinator 100% $33,000 $33,000 $8,250 $41,250 FTE Peer Support Specialist 100% $27,000 $27,000 $6,750 $33,750 FTE Peer Support Specialist 100% $27,000 $27,000 $6,750 $33,750 FTE Peer Support Specialist 100% $27,000 $27,000 $6,750 $33,750 FTE Peer Support Specialist 100% $27,000 $27,000 $6,750 $33,750

Total FTW 505%Total Salaries/Wages/Fringe Benefits: $144,000 $36,000 $180,000

OTHER DIRECT COSTS*Note: FIXED PRICE rent and consultants are excluded from modified direct costs (MTDC)Rent (fixed price) $12,000

$0 Training $20,000 Domestic Travel $15,000 Advertising $10,000 Supply/ Materials $15,000

Total Other Costs: $72,000 Total Direct Costs $252,000 Modified Total Direct Cost (MTDC) $220,000 Indirect Costs @ 26.5% rate (audit agency negotiated rate) $58,300TOTAL FUNDING REQUESTED $310,300

Quit Assist Budget

Source: U.S. Bureau of Labor Statistics. (2015). State Occupational Employment and Wage Estimates: West Virginia. Retrieved from: http://www.bls.gov/oes/current/oes_wv.htm

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How can WV reduce smoking in McDowell County in order to improve health outcomes?• Background:• Human and economic cost of smoking to state• Why McDowell is unique• Programs already in place

• Landscape:• Severe budget shortfall• New governor with other priorities• Still early for tobacco tax results

• Role of WCH:• Already hub for health care in county• House Quit Assist• Reduce costs of lung disease

Source: Google, 2016 12

Summary of Program Options  Quit Assist Raise tax

on tobacco products

WV Quitline

Feasibility Moderate Low Moderate

Cost Low High Moderate

Community Factors

High Low Moderate

Political Factors

Moderate Low Moderate

High= Highly effective Moderate= Somewhat effective Low= Not effective

• Quit Assist is the best choice for McDowell County• Counseling works• Personalization will be effective for this community• Politically and economically feasible

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References• Bader, P., Boisclair, D., and Ferrence, R. (2011). Effects of Tobacco Taxation and Pricing on

Smoking Behavior in High Risk Populations: A Knowledge Synthesis. International Journal of Environmental Research and Public Health, 8(11): 4118–4139. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228562/

• County Profile: McDowell County, West Virginia. (2012). The Institute for Health Metrics and Evaluation. University of Washington. Retrieved from: https://www.healthdata.org/sites/default/files/files/county_profiles/US/County_Report_McDowell_County_We st_Virginia.pdf

• Croyle, R. (2010). Increasing the Effectiveness of Tobacco Quitlines. Journal of the National Cancer Institute, 102(2): 72-73. Retrieved from: http://jnci.oxfordjournals.org/content/102/2/72.full

• McDowell County: Behavioral Health Epidemiological County Profile. (2014). West Virginia Department of Health and Human Resources Bureau for Behavioral Health and Health Facilities. Retrieved from: http://www.dhhr.wv.gov/bhhf/Sections/programs/ProgramsPartnerships

• McDowell County, West Virginia. (2016). County Health Rankings and Roadmaps. Retrieved from: http://www.countyhealthrankings.org/app/west- virginia/2016/rankings/mcdowell/county/outcomes/overall/snapshot

• Miners Hospitals. (2010). e-WV: The West Virginia Encyclopedia. Retrieved from: http://www.wvencyclopedia.org/articles/1819

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References (cont.)

• Percent of Adults who Smoke by Gender. (2014). State Health Facts. Henry J. Kaiser Family Foundation. Retrieved from: http://kff.org/other/state-indicator/smoking-adults-by- gender/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Male%22,%22sort%22:%22desc%22%7D

• QuickFacts: McDowell County, West Virginia. (2015). United States Census Bureau. Retrieved from: http://www.census.gov/quickfacts/

• Quitline FactSheet. (2016). West Virginia Tobacco Quitline. Retrieved from: http://www.dhhr.wv.gov/wvdtp/cessation/Quitline/Documents/Quitline%20Factsheet.pdf

• Tobacco is Killing and Costing Us. (2013). Division of Tobacco Prevention. Retrieved from: http://www.dhhr.wv.gov/wvdtp/Resources/reports/Documents/2-

page%20KCUs%20Summary%2007-30-13.pdf• State Occupational Employment and Wage Estimates: West Virginia. (2015). U.S. Bureau

of Labor Statistics. Retrieved from: http://www.bls.gov/oes/current/oes_wv.htm• Welch Community Hospital. (2016). West Virginia Department of Health and Human

Resources Bureau for Behavioral Health and Health Facilities. Retrieved from: http://www.dhhr.wv.gov/bhhf/facilities/WelchCommunity/Pages/default.aspx

• West Virginia Behavioral Risk Factor Surveillance System Report. (2013). West Virginia Department of Health and Human Resources Bureau for Public Health. Retrieved from:

http://www.wvdhhr.org/bph/hsc/pubs/brfss/2013/BRFSS2013.pdf15