Clinton County Health Department 2012 Annual Report

Transcription

1 Clinton County Health Department 2012 Annual Report Jerie Reid Director of Public Health 133 Margaret Street Plattsburgh, New York Tel. (518)565 8) Fax (518) Health Information Line

2 A Message from the Clinton County Board of Health Dear Clinton County Residents: Change was once again the primary theme for the Clinton County Health Department and the Clinton County Board of Health in Navigating through these new changes required leadership by the Board members, the Director of Public Health and the staff. Some of the changes are a direct result of the sale of the Home Health Care License, while others are a continued evolution of programs and services due to the 2011 restructure of the Health Department. The official transfer of the Clinton County Home Health License to HCR took place at the end of September All New York State Health Department required processes were completed and the license officially transferred. Overall the transition was smooth due to the diligence of the Clinton County Comptroller, Director of Patient Services and the Director of Public Health. In addition, the Clinton County Administrator provided support and assistance throughout the process facilitating legal paperwork, guidance in staff placement and troubleshooting solutions to last minute license transfer issues. This was truly a team and community effort. The Board of Health has also experienced change in Dr. David Cohen completed his term with the Board along with Dr. Robert Heins, longtime Legislative Liaison. The new Legislative Liaison is Dr. Jonathan Beach along with new Board members Dr. Heidi Moore and Edward Garrow. The Clinton County Board is now comprised of nine Board members. Board expansion was driven by the desire to provide a more comprehensive perspective from county citizenry. The Clinton County Board of Health would like to extend a sincere thank you to all staff for their hard work and dedication to the residents of this county. Maintaining the public s health is always the focus of the Health Department especially during times of tremendous change. Clinton County Board of Health Members 2012 Victor Ludewig, MD President Jerie Reid (Secretary) Director of Public Health Heidi Moore, MD Thomas Everett Lynn Howard, RN, BSN Kathleen Kasprzak, PHD, RN Vice President Jonathan Beach, MD Legislative Liaison Virginia Hay, RN Richard Lacki, MD Edward Garrow Vision Clinton County..Healthy People in a Healthy Community Mission To Improve and Protect the Health, Well-being and Environment of the People of Clinton County 2

3 A Message from the Director. Dear Clinton County Residents: It is hard to believe that a whole year has passed in my new role as the Director of the Clinton County Health Department. While the health department continues to experience change internally within the organization, our primary focus continues to be how best to serve and provide essential public health service in our community. The newly established Divisions within the health department continue to define their roles and purpose to protect the public, prevent illness and promote health throughout Clinton County. The final transfer of the Home Care License was completed with Home Care of Rochester (HCR). While it may have appeared to be seamless to the community, much time and effort was taken to assure that all current and future patient health care needs were maintained and assurances that the fifty plus years of patient quality of care concepts transferred along with the license. I would like to thank all staff that played an integral role in this process along with HCR representatives, the Clinton County Board of Health and Clinton County Legislature. Most importantly I would like to personally thank staff that was impacted. In one way or another each staff person was affected. Staff dedication and professionalism allowed the Clinton County Health Department to complete the change process with grace and to continue to implement its primary vision and mission. As we enter 2013 the Clinton County Health Department continues the national accreditation process, to implement its organizational strategic and community based Community Health Improvement Plan and develop the New York State required Community Health Assessment. The work of public health is dynamic as community health needs change and the CCHD strives to meet the needs of our community residents. Jerie Reid Director of Public Health Table of Contents Year in Review..Page..Page Administration.. Page.. Page 7 Prevention..... Page.... Page 8-98 Promotion.....Page Protection.. Page.. Page Program Statistics and Support Information Pages Fiscal Report. Page. Page 19 Public Health in Clinton County...Page...Page 20 3

4 Clinton County Department of Health Year in Review January Jerie Reid begins her tenure as the new director of the CCHD. February The Environmental Health and Safety Division assists the 21 homes in the Town of Dannemora with finding a potable water source after an aquifer in the area became contaminated with high levels of road salt. March The Adirondack Tobacco Free Network holds a press conference on March 8 th about the release of the Surgeons General s Report on Youth Tobacco Use. April The New York State Commissioner of Health declares synthetic cannabinoids an emerging public health threat and issues an order banning the sale in New York State. Effective April 1, 2012 HCR formally begins providing home health visits to Clinton County residents under the existing Certified Home Health Care License. The Environmental Health and Safety Division conducts a workshop for all county public water systems operators. The second in a series of Navigating Change in the Workplace training is held for CCHD employees. CCHD staff participated in a public presentation for the Recreation committee of the local Vision 2 Action initiative in the county. May Tick season gets off to a strong start as local residents and veterinarians begin to see evidence of ticks on pets, and humans. The New York State Commissioner of Health makes a site visit to the CCHD. CCHD participates in the May 21 st launch of the 1.3 mile Saranac River Trail in the City of Plattsburgh. 4

5 Clinton County Department of Health Year in Review Continued June CCHD staff, emergency preparedness partners and key community members come together for Strategic National Stockpile training. CCHD begins 2013 Strategic Planning process. A small outbreak of pertussis cases is contained to a local elementary school. July Health Department participates in the Vision 2 Action community initiative, presenting at the Transportation event. August Preparations are made to provide support and assistance during the upcoming winter for families in Dannemora still without a potable water source. The New York State Department of Health Commissioner criminalizes synthetic cannabinoids through an emergency change in New York State Sanitary Code. The Environmental Health and Safety Division facilitate local vendor notification as part of process. September HCR receives formal notification from the New York State Health Department that they are now licensed in New York State to provide Home Care services to Clinton County residents. The Health Department receives its new LHCSA license to continue home visit services. The first rabid raccoon in fifteen years tests positive for rabies in Clinton County on September 7 th. For the first time in decades, the Clinton County Board of Health decides to expand the number of Board of Health members from the current eight to nine. October The Health Department and WIRY Radio agree to partner on monthly health topic radio interviews. Super Storm Sandy threatens the entire eastern part of the country including the North Country. Emergency response plans are followed to deal with the potential storm impact. Concern with terrestrial rabies continues as another animal tests positive in the Keeseville community. An additional rabies clinic is added in that area to address the concern. 5

6 Clinton County Department of Health Year in Review..Continued November Two additional animals test positive for rabies prompting additional public education and awareness efforts. Health Department staff attends the required Public Health Accreditation training in Washington, D.C. The clock is now ticking for the CCHD to submit all twelve Accreditation Domains to the Public Health Accreditation Board (PHAB) by November of The New York State Department of Transportation, along with other state agencies begin discussion to build a three million dollar community water system in the Dannemora area that has been affected by road salt storage issues December A full functional anthrax drill is conducted involving many Clinton County Health Department staff and community partners. Pertussis cases begin to increase in several area schools. Clinton County Legislature passes a tobacco free ordinance restricting use of tobacco products on most county owned property. This takes effect July,

7 Administration CCHD National Accreditation The CCHD has moved steadily toward National Accreditation by the Public Health Accreditation Board. The CCHD Accreditation Team submitted the prerequisites (Strategic Plan, Community Health Assessment, Community Health Improvement Plan), completed the identification of all support documentation for the 12 Domains, a staff representative attended a two day training in Washington, D.C. and by November 2013 will submit the entire application. A site visit will follow submission, taking the department closer to achieving the goal of accreditation. CCHD Accreditation Team members Developing Communication Strides were made in 2012 to improve internal communication of the CCHD by developing the Quality Corner newsletter. As a result of staff input, the newsletter was created as an additional communication tool. The Quality Corner will be distributed quarterly, the agency meeting newsletter continues during opposite months. The Quality Corner includes a message from the Director, highlights program goals and initiatives in the community by Divisions and helps to engage CCHD staff. Ongoing public communication and engagement continues through website and Facebook. Home Health Care Change HCR accepted final transfer of the CCHD Certified Home Care License in September. The final transfer marked an almost two year process of providing home care services to Clinton County residents through a private agency. A majority of the nurses moved to HCR to continue to provide home care nursing services, while some transferred into a variety of CCHD Divisions. Transfer of required documentation Official handoff of home health to HCR 7

8 Prevention Prevention strategies in a local health department are varied, and efforts are responsive to both current and ongoing health issues in a community. The Department s three Divisions plan and carry out strategies to prevent illness and disease in a variety of ways. Preschool Program Referrals for this education program serving children ages three to five increased this year. Greater parental awareness and providers referrals help assure every child receives extra support to enhance his/her ability to learn. The NYS Education Department is in the process of revising guidance regarding eligibility and services of this program. Cancer Services Program (CSP) Preschoolers engage in active play The Clinton County CSP turned colors throughout the year in collaboration with community partners. In March, Main Street went Blue in support of Colon Cancer Screening Month with local businesses displaying bright blue ribbons. In October the community was asked to Think Pink to support Breast Cancer Awareness. A Glow Pink concert was held in Rouses Point, the annual Human Pink Ribbon on Champlain Valley Physicians Hospital lawn and Access to Care Day promoted screening opportunities. The community participates in Cancer Services Environmental Health and Safety The Environmental Health and Safety Division worked with officials in the Town of Peru and the owner of the South Acres Mobile Home Park to upgrade the wastewater treatment system for park residents. The collaboration resulted in the owner obtaining grant funds through the New York Community Development Block Grant program. The replacement/upgrade of the system will potentially allow for seventy more mobile homes in the park in the future, and assure safe water for residents. South Acres Mobile Home Park wastewater upgrade 8

9 Prevention Newborn and PostP ostpartum Services Visits to see moms and their new babies continue to be an essential foundation of public health for the Health Care Services Division. Public Health nurses see upwards of three hundred new parents and their newborns each year. While this is an exciting time for the new parents it can also be stressful! Public Health nurses help ease this stress by providing education, offering parenting advice and answering questions. Nurses use this opportunity to assure parents have access to all available support and resources such as immunization information, developmental milestones guidance, safety, nutrition advice and healthy lifestyles. This helps get families off to the best possible start. New residents of Clinton County Water Operator Training A significant number of our county residents receive their water from a community water system. These water systems are closely regulated and are overseen by certified water operators. Training for certified water operators was conducted locally by CCHD. Participants who attended this were better able to provide stewardship over the quality of water generated by the system. They also are well informed about all the required documentation for quarterly operations. Water Operator Training Day Public Health Vaccination Clinics Through the Health Care Services Division, vaccines for hepatitis, shingles, combined Tetanus, Diphtheria and Pertussis (DTap), and many more are offered weekly through clinics. Other clinic programs sponsored by CCHD include Sexually Transmitted Infections (STI) Clinic (by contract), HIV counseling and testing, Tuberculosis (TB), and lead poisoning screening clinic. High dose and mist influenza, HPV and shingles were some of the vaccines in demand Staying healthy with vaccines by consumers this year. Public clinics are held weekly with once-a-month evening hours available. Expanded authorization of vaccinators in NYS has resulted in local pharmacies being key partners to improve access and availability of selected vaccines. 9

10 Prom romotion otion An integral part of local public health is active engagement of community partners to participate in health education and promotion activities that support healthy living in healthy communities. This work is accomplished by working closely with community stakeholders and decision makers in a variety of settings. Tobacco in Our Community The Adirondack Tobacco Free Network (ATFN), a grant funded program of the New York Bureau of Tobacco Control, provides guidance in the development and implementations of policies that prevent youth from smoking and to motivate adult smokers to quit throughout Clinton, Essex, and Franklin Counties. Champlain Centre Mall In 2012 ATFN successfully assisted Powertex in Rouses Point, Champlain Centre in Plattsburgh, Citizen s Advocates in Malone and Saranac Lake, and Paul Smith s College in Franklin County to develop tobacco free grounds policies. ATFN collaborated with the Reality Check youth to discuss the release of the new Surgeon General s Report in March. A press conference was conducted that included staff from the ATFN, Reality Check and students. ATFN and Reality Check Surgeon General s Report press conference Women, Infants and Children (WIC) Program The WIC program continued to nurture healthy beginnings for hundreds of young families through its healthy lifestyle, breastfeeding and Farmers Market initiatives. New this year, the program added the option of grocery store tours that highlighted WIC foods and their nutritional benefits as well as familiarizing newly enrolled participants to the program s check cashing procedures. Forty five families took advantage of the opportunity to learn new ways to shop smarter and feed their families healthier meals. WIC Program promotion on the CPPT bus 10

11 Obesity Prevention in Pediatric Healthcare Settings Taking local, state, and national trends into consideration, working to prevent and reduce obesity is one of the most significant undertakings of contemporary public health. The Obesity Prevention in Pediatric Healthcare Settings project partners public health with local pediatric provider offices to promote and embed best practice policies and procedures in preventing, assessing and treating childhood and adolescent overweight and obesity. The program kicked off its efforts in March with an event with national experts presenting on the childhood obesity epidemic and the transformation of healthcare delivery. Twenty five local healthcare professionals were provided the needed tools, resources and skills to engage families with effective, patient-centered counseling on behaviors that foster lifelong health. Healthy Plates Project With more and more meals being consumed outside of the home, the Healthy Plates Project aims to help local consumers make sound nutrition choices when eating out. Although the project was only piloted in one restaurant in 2012, much behind the scenes work was done in preparation for its roll out. Research provided insight into different programs piloted and instituted in different communities around the country. Nutrition standards were developed based on model program guidelines and the 2010 Dietary Guidelines for Americans. Restaurant recruitment, recipe analysis and promotion characterized the last quarter of the year. The project is geared up for expansion in 2013 with refined standards to include nutrition and food safety. Healthy Plates logo Peru School District pedestrian cross walk on a nearby roadway Clinton County Healthy Schools New York (HSNY) During 2012, Clinton County Healthy Schools NY added three new districts to the five currently receiving technical assistance in Clinton County from the program to strengthen Wellness Policies and develop Physical Education Plans. The outcome of these efforts will be an increase in physical activity opportunities and an improved nutrition environment in area schools. Two district s revised policies have been evaluated using the WellSAT, a tool developed by the Rudd Center at Yale University. Both saw considerable improvement in the comprehensiveness and strength of policy wording. Stronger policies lead to better results and healthier students. Clinton County HSNY began producing a quarterly newsletter in 2012 to enhance communication with school administrators and community decision makers. In March, Clinton County HSNY hosted a Physical Education Plan Writing Workshop. Thirty-one Physical Education staff from thirteen districts participated. The event allowed district staff to begin or continue the process of developing a plan to provide students with high quality Physical Education and Physical Activity before, during and after school and is a mission of Clinton County HSNY. The PE Writing workshop also allowed Clinton County HSNY to outreach to new districts. The Clinton County HSNY coordinator was a copresenter at the Association of Health, Physical Education, Recreation and Dance State Conference in November. Although attendance was low, four district representatives received in depth guidance on writing a quality Physical Education Plan. HSNY facilitated a grant application with the Town of Peru and the Peru Central School District regarding Safe Routes to Schools. This successful endeavor will address sidewalk connectivity issues and unsafe walking/biking routes which dovetail with the HSNY mission to increase physical activity. 11

12 Protection Public health protection efforts are most noted by the public for programs like food service inspections, rabies clinics, and tobacco compliance checks. Public health is much more. Here are some highlights from Public Health Emergency Preparedness As part of standard multi-agency agreements and preparation, CCHD staff conducts rigorous planning, training, and drills to respond to many types of public health incidents and emergencies. During 2012, the CCHD was able to recruit and expand the list of volunteers for the Clinton County Medical Reserve Corps (MRC). In 2012, thirteen exercises of varying types were held to test response and capabilities of CCHD employees, community partners and MRC volunteers. A few highlights include: (1) A training on the Strategic National Stockpile was conducted in June for approximately forty community partners and CCHD staff. The training reinforced the staff knowledge of accepting and distributing medical supplies from the National Stockpile in the event of an emergency. Community SNS training (2) In September, Smallpox training was conducted with forty CCHD staff and MRC volunteers attending. All those participating reviewed the signs and symptoms of smallpox and learned and practiced the proper vaccination technique. (3) An Anthrax Medical Countermeasures Drill was held in December in which CCHD personnel, supplemented by MRC volunteers, tested their capacity to deliver a medical countermeasure to at least fifty people in fifteen minutes-that goal was exceeded by distributing simulated antibiotics; to seventy people within fifteen minutes. CCHD staff training on small pox (4) In addition to drills, staff responded to an actual hazmat situation at the Strand Theatre, on Brinkerhoff Street in the City of Plattsburgh. Staff worked with City Fire, City Police, NYSDEC and County OES to coordinate cleanup of a fuel oil spill inside the building. Anthrax Medical Countermeasures Drill 12

13 Protection Continued.. Youth Tobacco Use Prevention in our Community With the assistance of a NYSDOH state grant, the CCHD Environmental Health and Safety Division implements the ATUPA Program. Staff inspects and monitors 106 tobacco vending facilities for compliance with ATUPA. Inspectionchecks help ensure that these facilities do not sell tobacco products to minors. In 2012, EHS staff held two ATUPA education seminars, provided to help educate clerks working at tobacco vending facilities understand laws related to tobacco sales. A total of 36 clerks were educated during the 2012 ATUPA seminars. Public tobacco product display Rabies on the Rise In 2012, a total of 2,635 dogs, cats and ferrets were vaccinated against rabies. An additional rabies clinic was conducted in the Keeseville community in response to the number of raccoons and skunks testing positive for rabies in Northern Essex County and Southern Clinton County. CCHD conducts rabies clinics throughout the year. The terrestrial form of rabies has not been seen here in Clinton County for many years. This strain is particularly dangerous because raccoons and skunks have a greater chance of interacting with people and their pets. Cute but we need to maintain our distance 13

14 Statistics, Program and Support Information for

15 Health Care Services Division Immunizations Influenza Pneumococcal Tuberculosis Patients Enrolled Clinic Visits Active TB Cases (Civilian only) Prenatal Service: (IPO-Improved Improved Pregnancy Outcome) Participants ** Newborn/Postpartum Visits: Number of Newborns Referred Numbers Targeted With Completed Home Visit Family Service Referrals Children with Special Health Care Needs (CSHCN) Lead Poisoning Prevention Program (EIP) CCHD Children Screened Early Intervention Program (EIP) Number of Referrals Unduplicated Count of Children Total Number of Discharges Children-Delay/Condition Resolved Preschool Education Program Number of Referrals Unduplicated Count of Children on June 1 st Number of Preschool Meetings Sexually Transmitted Infections (STI Clinic) Patient Visits * Local provider offices and pharmacies now provide the majority of this immunization to residents. **High risk IPO clients only ***First time parents/high risk needs/breastfeeding mothers/ipo Program participant 15

16 Environmental Health and Safety Division Food Service Inspections Permitted Operators Motels and Campsites Inspections Permitted Operators Individual Household Sewage Systems Approved * Nuisance Complaints Investigated Rabies Prevention Animal Bite Investigations Non-Bite Investigations People Receiving Post-Exposure Rabies Shots Number of Animals Testing Positive for Rabies Inoculations: Dogs Cats Other Total Inoculation , , , , , ,635 Clean Indoor Air Act (Tobacco) Complaints Investigated Complaints Substantiated Water System Inspections Municipal Community Non-community Migrant Labor Camps Inspections Permitted Operators Pools and Beaches Inspections Permitted Operators * Numbers fluctuate due to the amount of development in rural areas. Much of the development over the last 2-3 years has been through subdivisions in urban areas where municipal services are provided. 16

17 Environmental Health and Safety Division Continued Mobile Home Parks ++ Inspections Permitted Operators Children s Camps Inspections Permitted Operators Tanning Facilities permitted Facilities inspected N/A N/A Lead Poisoning Environmental Case Investigations CCHD Children Screened Adolescent Tobacco Use Prevention Act (ATUPA) Compliance Checks: Environmental Staff Only Staff and Minor Re-inspections Number of Operators Number of Enforcements Healthy Neighborhoods Program (HNP) Dwelling Units Contacted Referrals Received from Agencies Referrals to other Agencies Home-Safe-Home Packets Distributed Health and Safety Items Distributed 1, ,731 1, ,332 1, ,215 Notes: ++ Inspections required only every other year, but CCHD often inspects more frequently due to co-inspection with water systems * Tanning facilities now require inspections and permits per NYSDOH regulations, inspections required every two years 17

18 Health Planning and Promotion Division Professional Education Event Public Education Events WIC Clinic Visits Nutrition and Certification Food Dollars Expended WIC High Needs Referrals 7,984 $1,188, ,220 $1,534, ,148 $1,249, Farmers Market Initiative Coupons Distributed Dollars Expended Food Samples Provided at Market 1,180 $28,320 1,980 1,027 $24,648 2,180 1,130 $27,120 1,200* Breastfeeding Program Breast Pumps Distributed Women Enrolled in Peer Program % of all Women Breastfeeding at Hospital Discharge % of WIC Women Breastfeeding at Hospital Discharge Total Trained Peer Counselors Total Women Provided Services % 68% % 69% 6 1, % 71% 9 1,004 Municipality Tobacco Prevention Policies Implemented Tobacco Free Beaches and Parks Policy Worksite Tobacco Free Grounds Policy Community Education & Presentation Cancer Services Program (CSP) Women Screened (40-64 year olds) Men Screened (50-64 year olds) Colorectal Cancer Screenings Mammograms Healthy Schools NY (New Program in 2011) Participating School Districts Approved Policies Trainings and Committee Representation N/A N/A N/A * Market services began later in season in

19 2012 Expenditures HPP 9.27% HCS 49.79% EHS 11.22% HCU 29.73% EHS Environmental Health & Sa fety Division HCS Health Care Services Division HPP Health Planning & Promotion Division HCU Home Care Unit 2012 Funding/Revenues ($12,582,100 total which excludes County Funding of $5,109,700) HPP 13.08% HCS 41.20% EHS 11.17% HCU 34.55% EHS Environmental Health & Safety Division HCS Health Care Services Division HPP Health Planning & Promotion Division HCU Home Care Unit County 38.92% 2012 Funding/Revenues by Source (includes County Funding) Grant 10.87% Insurance/Fees 2.75% Medicaid 16.66% Art 6 State Aid 8.87% NYSDOH (EIP) 1.27% NYSDOE (Preschool) 12.40% Medicare 7.82% ****2012 CCHD Actual Operating Budget $16,136,300 (includes grants of $1,754,200)**** 19

20 Public Health has an obligation to 1. Prevent epidemics and the spread of disease 2. Protect against environmental hazards 3. Prevent injuries 4. Promote and encourage healthy behavior 5. Respond to disasters and assist communities in recovery 6. Assure the quality and accessibility of health services Essential Public Health Services PUBLIC HEALTH IN CLINTON COUNTY Vision: Clinton County. Healthy People in a Healthy Community Mission: Our mission is to improve and protect the health, well-being, and environment of the people of Clinton County 1. Monitor health status to identify community health problems 2. Diagnose and investigate health problems and health hazards in the community 3. Inform, educate, and empower people about health issues 4. Mobilize community partnerships to identify and solve health problems 5. Develop policies and plans that support individual and community health efforts 6. Enforce laws and regulations that protect health and ensure safety 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable 8. Assure a competent public health and personal health care workforce 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services 10. Research for new insights and innovative solutions to health problems Adopted: Fall, 1994, Source: Public Health Functions Steering Committee, Members (July 1995): Core Values: Advocacy, Commitment to Excellence, Integrity, Ongoing Learning, Resourcefulness, Teamwork American Public Health Association Association of Schools of Public Health Association of State and Territorial Health Officials Environmental Council of States National Association of County and City Health Officials National Association of State Alcohol and Drug Abuse Directors National Association of State Mental Health Program Directors Public Health Foundation U.S. Public Health Service Agency for Health Care Policy and Research Centers for Disease Control and Prevention Food and Drug Administration Health Resources and Services Administration Indian Health Services National Institutes of Health Office of the Assistant Secretary for Health Substance Abuse and Mental Health Services Administration 20