Item Coversheet
April 13, 2021

Authorize the Administrative Officer to submit a FY22 Appropriations Community Project Funding proposal to Congresswoman DelBene (SR 21-043; H. Thomas, K. Curtis)

Administration / Heather Thomas, Public and Government Affairs Manager 


Congresswoman DelBene’s office reached out to Health District staff regarding the upcoming FY22 Appropriations Community Project Funding period. Project proposals should be $200,000-250,000 and must fit within one of the 30 different project accounts. Each Congressional office may select up to 10 projects for inclusion. Proposals are due to Congresswoman DelBene’s office by close of business on Monday, April 19.


Of the 30 project accounts, the Health District is best situated for the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services. The announcement noted that this subcommittee has historically provided community project funding only in the categories listed below:

o   Health Facilities Construction and Equipment

o   Health Professions Education and Workforce Development

o   Rural Health Outreach

o   Rural Health Research

o   Telehealth and Health Information Technology


Requests that do not fit into one of these categories are unlikely to be eligible for community project funding under HRSA.


Given that, staff would like to submit a proposal focused on telehealth and rural health outreach.


The Tuberculosis Control Program has a need to implement a Virtual Directly Observed Therapy (VDOT) program for patients receiving TB treatment. The treatment of active TB requires at least 6 months of directly observed therapy, which means we are required to witness patients ingest their medications every day, Monday through Friday, for at least 6 months and often up to 12 months.


The Health District does not currently have a secure platform for VDOT, which means we have to do this observation in person, usually at a patient’s home. This requires a tremendous amount of public health resources and is extremely difficult and disruptive to patients as well. With a secure VDOT program, patients would be able to record the ingestion of medications with their phone/tablet/computer and send it to healthcare workers to be viewed electronically.


Washington State Department of Health has started a VDOT pilot for small LHJs using a program called SureAdhere. Unfortunately, the Health District does not qualify for this pilot program, but staff have been looking at funding options while coordinating with DOH for implementation and training.


This Community Project Funding opportunity would allow the Health District to secure infrastructure and technology needed to use VDOT. The Health District would also like to provide valuable feedback, data, and other details to DOH from this new program. Lessons learned and data collected here would help support the goal for eventual implementation and support for the entire state.


With implementation of the SureAdhere VDOT platform, staff anticipate being able to accomplish many improvements for TB control and prevention. These include:


·         Limiting disruption to patients who are working, allowing them to return to work sooner once out of isolation.

·         Maintaining privacy of patients and reduce effects of stigma in the home and workplace caused by having a public health worker deliver meds in-person daily.

·         Improving infection control (both for TB exposure and other contagious conditions such as COVID and flu outbreaks)

·         Increasing flexibility and autonomy for patients to take medications when it works best for them during the day, which will likely improve patient experience and cooperation.

·         Reducing costs related to travel expenses and time. An average patient in our county lives 10-20 miles away, requiring round trip visits 5 days a week for at least 6 months. This would mean 1200 – 2400 miles of travel for the treatment duration for each patient. Our goal would be to utilize this for at least half of our active TB patients.


A rough goal would be to reduce at least 12,000 miles of travel and related costs for TB control each year in Snohomish County. This is in addition to improving patient experience and maintaining high treatment success rates.

Board Authority

Consistent with Resolution 19-20 and the revised Division of Responsibilities (10/8/19), the Board of Health retains contract approval authority for new, extending, or renewing grants and contracts over $50,000 or that require matching funds.

Recommended Motion

MOVE TO authorize the Administrative Officer to submit a FY22 Appropriations Community Project Funding proposal to Congresswoman DelBene.