2016 Annual Report. Public Health, Delta & Menominee Counties. or on Facebook at: Public Health It s for everyone!

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1 2016 Annual Report Public Health, Delta & Menominee Counties Visit us on the web at Public Health It s for everyone! or on Facebook at:

2 A Message from the Health Officer, Michael Snyder On behalf of the Board of Health and the employees of Public Health, Delta & Menominee Counties (PHDM), it is my pleasure to present Public Health, Delta & Menominee Counties 2016 Annual Report. This report summarizes the activities, services, and programs which PHDM provided in PHDM continues to strive to meet the public health needs of the residents and visitors of Delta and Menominee counties. These needs could not be met without the highly skilled, industrious, and passionate workforce at PHDM. Likewise, our success would not be possible without the support of our Board of Health, County Commissioners, community partners, state agencies, and loyal customers. We are particularly proud of the following accomplishments which took place during the 2016 fiscal year: In January, 2016, PHDM released the written report of the Community Health Needs Assessment. Three themes emerged from the analysis of the data collected: o Delta and Menominee counties has an older population than the State of Michigan. o The importance of preventions activities. o The effect of income and education on health status. These three themes will be highly relevant to service providers, policy-makers, and other stakeholders when planning for the future. PHDM partnered with the City of Menominee to provide a Community Garden for area residents. The previously vacant lot is now a gathering place for residents to grow fresh, healthy fruits and vegetables. The Flint, Michigan water crisis brought an awareness of safe drinking water, and that aging infrastructure is a risk to the public health and must be maintained. This has given PHDM an opportunity to further educate the public on drinking water safety and potential risks to our drinking water. Also during 2016, we said Goodbye to two long-term PHDM Board of Health members; Mary Harrington and Bob Burie. Bob has stepped down from his position on the Board of Health after serving for twenty-two years, while Mary served for five years. We wish Mary and Bob all the best in their future endeavors. The PHDM Board of Health and staff remain committed to enhancing the quality of life for the community by preventing disease, encouraging healthy lifestyles, and protecting the environment. I encourage you to read this report carefully. Should you want to learn more about our programs and services, do not hesitate to contact us at our Delta office , Menominee office , or visit us on the web at or 2

3 A Message from Dr. Teresa Frankovich, Medical Director Hepatitis C, a virus which infects the liver, is an emerging health threat to U.P. communities. Prior to 1992, blood tests were unable to detect the virus so transmission of the infection often occurred through blood transfusions or organ transplants. That is no longer a concern because blood banks now routinely screen for Hep C in donors. Screening is also routinely recommended and being done for adults born between 1945 and 1965; an identified high-risk group. Then why is Hep C an important topic today? Here are four important reasons: 1) Hep C is often so mild that most people do not know that they are infected. Some people will clear the infection and recover completely; but about eight out of 10 people infected will not clear the infection and become chronic carriers of the virus. Over a lifetime, about 20 out of 100 people infected will develop chronic liver disease such as Cirrhosis, and up to five out of 100 will die from liver failure or liver cancer. Hep C is the leading reason for liver transplant and it is the leading cause of liver cancer the most rapidly increasing cancer in the U.S. 2) The number of Hep C cases is rising rapidly in the U.S., while deaths from other infectious illnesses have been declining. The primary means of infection is now through drug use (i.e. IV drug users sharing needles and other drug equipment). To put this in local context, there were 57 newly diagnosed cases of chronic Hep C in Delta and Menominee counties in 2015, with rates in young people (18-29 years), nearly twice that of the State of Michigan s. This pattern is seen across the U.P. 3) Hep C can be treated with medication, but the treatment has potential risks and is extremely expensive. There is no current vaccine to prevent Hep C, so PREVENTION IS KEY! 4) Finally, Hep C is important because some of the same people who pick up this infection will also become infected with Human Immunodeficiency Virus (HIV), through similar exposures. In 2015, a small rural county in Indiana of only 4,200 residents, experienced an outbreak of HIV in which their typical number of new cases per year exploded from under five to 181. Notably, nearly 90% of these people also were infected with Hep C. So, how do we prevent Hep C? We begin by addressing the increasing problem of substance abuse in our communities. The abuse of prescription opioids leading to the use of heroin and other illegal narcotics has been well-documented. This impacts not only the young adults who become addicted, but also their children. The U.P. s sole regional neonatal intensive care unit has the highest rate of infants in the state born with neonatal abstinence syndrome--infants who are exposed to narcotics in utero and experience drug withdrawal after birth. Reducing substance abuse within our communities is a complicated process and will require looking long and hard at the challenges facing many of our residents; challenges such as poverty, unemployment, low educational attainment, diminishing family supports, and the overprescribing of narcotics in the management of acute and chronic pain. It will not be a quick fix. In the meantime, reduction in the risk of Hep C and HIV transmission can be accomplished more rapidly through evidence-based interventions, such as: Needle exchange programs: These have been controversial and slow to gain acceptance, particularly in rural areas. But they are effective and successfully curtailed the epidemic in Indiana. These programs accomplish at least two objectives: they help to decrease the spread of infection by providing drug users with clean needles/equipment to reduce sharing, and bring individuals struggling with addiction to a setting where they can receive education about reducing their risk and offered assistance in treating their addiction. Harm reduction strategies: These strategies strive to reduce stigmas surrounding drug addiction, help those who choose to continue drug use to do so more safely, and provide assistance to those who wish to quit. Enhanced screening: Identifies those infected in order to offer treatment and provide education about reducing their risk of transmitting the infection to others. It is important to at least begin a conversation about the increasing burden of drug addiction in our communities and ways in which each of us can contribute to solving the problem. 3

4 Board of Health and Administration Mission Statement To enhance the quality of life for the community by preventing disease, encouraging healthy lifestyles, and protecting the environment. Vision Statement To be a community leader in promoting, protecting, and providing for the public s health. Menominee County office th Avenue Menominee, MI (906) Delta County office 2920 College Avenue Escanaba, MI (906) Delta-Menominee District Board of Health Health Officer/Director Environmental Health Michael Snyder, RS, MPA (906) msnyder@phdm.org Finance & Budget Director Lynn Woelffer, BS (906) lwoelffer@phdm.org Nursing Services Director Debbie Poquette, RN (906) dpoquette@phdm.org Medical Director Teresa Frankovich, MD, MPH (906) tfrankovich@hline.org Administrative Support Services Director Irene Huebler, BS, CHRS (906) ijuebler@phdm.org Substance Abuse and Prevention Services Director Mary Claire Massi-Lee, LBSW, CAC, CCS (906) mmassi-lee@phdm.org Back, L-R: Larry Schei, Robert Burie, and Patrick Johnson Front, L-R: Jan Hafeman (Vice-Chair), Mary Harrington, and Tom Trudgeon (Chairman) Emergency Preparedness/ Community Health Promotion Coordinator Dayna Kapp, MPA (906) dkapp@phdm.org 4

5 Financial Data for Fiscal Year Revenue Sources 12.2% 9.7% 8.8% Private Pay Fees 3rd Party Fees 20.0% State/Federal 11.5% 37.8% ELPHS (State) Other Local Appropriations Private Pay Fees $284,652 Other (Sub Abuse, Early On, Misc Grants) $589,215 3rd Party Fees $260,531 Local Appropriations $360,400 State/Federal $1,115,088 ELPHS (State) $337,762 Total $2,947, % 2.7% 2016 Expenses 20.4% Agency Support Environmental Health Alcohol & Other Drug Services 49.5% 8.2% 14.4% Personal Health Services Community Health Promotion Emergency Preparedness Agency Support $601,803 Community Health Promotion $141,542 Environmental Health $424,754 Emergency Preparedness $80,082 Alcohol & Other Drug Services $241,513 Personal Health Services $1,457,954 Total $2,947,648 FY08 Expenses - Actual $3,698,480 FY13 Expenses - Actual $3,034,716 FY09 Expenses - Actual $3,397,486 FY14 Expenses - Actual* $2,757,313 FY10 Expenses - Actual $3,349,920 FY15 Expenses - Actual* $3,002,406 FY11 Expenses - Actual $3,096,858 FY16 Expenses - Actual* $2,947,648 FY12 Expenses - Actual $2,968,708 FY17 Expenses - Budgeted $3,010,296 *Space costs not included PHDM employed an average of 50 staff in FY16: 27 Full-time and 23 Part-time 5

6 Personal Health Programs Breast & Cervical Cancer Control Navigation Program (BCCCNP) provides free annual exams for eligible women aged In FY16, 66 women participated in BCCCNP and 10 women received patient navigation services. Caseload services include uninsured or underinsured women needing breast/cervical cancer screenings and/or assistance related to breast or cervical abnormalities and Family Planning clients referred with cervical or breast abnormalities. Navigation only services include navigation assistance to insured women overdue for breast or cervical cancer screenings. Women who are diagnosed with breast or cervical cancer may be enrolled in the Medicaid Treatment Act to cover cancer treatment and other medical expenses. Children s Special Health Care Services (CSHCS) offers health care coverage for children up to 21 years of age and some adults with certain qualifying medical conditions/diagnosis. PHDM offers families support such as: coordinating specialized services, assisting with mileage reimbursement, lodging, billing issues, nursing care plans, and needed services. In 2016, PHDM assisted 174 CSHCS families. Early On of Delta County offers free early intervention for children less than 36 months that have developmental delays or an established condition. EO staff provided services for 141 children throughout 2015, and received 134 referrals in FY16. Family Planning provides general reproductive health assessments; contraceptive services; STI services; health education, counseling and referrals as needed. In FY16, 726 clients received services. Hearing & Vision Screening offers services for schoolaged children. A total of 1,921 children were screened for hearing and 2,353 for vision in FY16. Communicable Disease In FY16, PHDM staff worked with local healthcare providers and the Michigan Department of Health and Human Services (MDHHS) to document, investigate, and limit the spread of communicable disease infections. The table below shows the number of cases reported for FY16 compared to FY15. FY15 FY16 Flu-like illnesses Blastomycosis 1 2 Histoplasmosis 0 2 Legionellosis 1 0 Ehrlichiosis 3 0 Sexually Transmitted Infection Chicken Pox 2 1 Lyme Disease 9 24 Hepatitis B 3 27 Hepatitis C Meningitis 0 1 Invasive Streptoccus Pneumonia 5 8 Pertussis 5 1 6

7 Personal Health Programs Rural Home Visiting Expansion - Michigan Home Visiting Initiative Fiscal Year 2016 First full year of providing services to families across the Upper Peninsula Six home visitors (one within each health department in the UP) Focus on outreach and enrollment FY 2016 At-A-Glance All 6 sites PHDM Referrals/Screens Positive Screens 138 (98%) 16 (100%) Assessments Completed Positive Assessments Father Present at Assessment 25 (38%) 3 (30%) Enrollments 58 9 Home Visits Completed Home Visits Attempted Family Challenges <18 years old 55% Single Parent 46% Late or no prenatal care 33% Inadequate Income 46% CRITICAL ISSUES Mental Health 52% Domestic Violence 14% Substance Abuse 8% More than 1 Critical Issue 34% Immunizations were provided at PHDM to infants, children and adults on-site and at many off-site clinics such as local schools, businesses, senior centers and housing facilities. PHDM oversees vaccine distribution to area providers who participate in the Vaccines for Children (VFC) Program. The VFC Program continues to provide free, state-funded vaccine to eligible children 18 years of age and younger. PHDM provided 4,642 immunizations to clients in FY16. Lead Prevention offers blood lead testing for children one to three years old. In FY16, 497 children were screened for lead, nine of which had elevated leads. Referrals, follow-ups, education, and home visits were offered/provided for families that have children with elevated lead levels. Maternal Infant Health Program (MIHP) is an evidence based home visiting program that continues to offer services to Delta & Menominee residents. Pregnant women and infants with Medicaid may receive visits from either a Registered Nurse or Social Worker and may see a Registered Dietitian as needed. In FY16, 200 women and children were referred and 580 visits were made through MIHP. Medicaid Outreach- PHDM staff provide application and enrollment information to clients in need of insurance. These insurance programs include Medicaid, MIChild, MOMs and the Healthy Michigan Plan. This fiscal year more than 7,341 clients and callers were screened for Medicaid/Healthy Michigan Plan eligibility; of this, 653 were pregnant women, young children and infants. At the end of September 2016, a total of 10,237 Delta/Menominee residents were enrolled in Medicaid and more than 3,547 were enrolled in the Healthy Michigan Plan. 7

8 Personal Health Programs MCIR, Michigan s immunization registry, was created to collect reliable and up-to-date immunization information from a variety of health care organizations for Michigan residents. Having access to MCIR helps reduce vaccine preventable diseases and over- and under-vaccination. The types of organizations with access to MCIR include hospitals, private provider offices, long term care facilities, schools and licensed childcare programs. PHDM houses the Region 6 MCIR staff, who cover the 15 counties in the Upper Peninsula. The Region 6 staff merges duplicate sets of records, creates new records for adoptions, processes changes to records initiated by the provider offices, sets up new users for many provider sites, and trains new users on the various modules in MCIR, as well as responding to helpdesk calls from across the U.P. MCIR has the capability of accepting electronic transmission of data directly from the provider s EMR/EHR; there are currently 76 sites in Region 6 using HL7, the electronic method of entry into MCIR. STI/HIV- PHDM staff assess risk for HIV and/or STI s. Testing is done on-site (treatment and referral services are in place for those with a positive test). Testing and education services are offered to the county court systems for offenders charged with criminal sexual conduct, and PHDM participates in victim notification and education when needed. In FY16, 38 clients were tested for HIV, five of these were court-ordered. Chlamydia is the most frequently reported bacterial sexually transmitted infection in the U.S. In FY16, PHDM had 160 reported cases of chlamydia in Delta and Menominee counties. Under-reporting is substantial because most are unaware of their infections and may not seek testing. PHDM also reported 13 new gonorrhea cases and 82 Hepatitis C. Number of Clients Enrolled/Screened FY15 FY16 WIC 1,704 1,586 MIHP Early On CSHCS Hearing 2,074 1,921 Vision 2,564 2,353 Lead Seasonal Flu Vaccines 1,580 1,374 Other Vaccines 2,641 3,268 Family Planning HIV/AIDS Individuals Tested for STI s BCCCNP BCCCNP Navigation only new 10 Women s Health Clinic WISEWOMAN

9 Personal Health Programs In the Community Booth in the Ruth Butler Building at the 2016 UP State Fair Nursing Supervisor, Carrie Polley, RN, BSN, giving a flu shot at the Hermansville Health Fair Kid s Fun Fest at the Delta Plaza Mall Fluoride Varnish was offered to WIC clients with infants from six months of age to children up to three years of age. Fluoride varnish is a protective coating that is painted on teeth to help prevent new cavities and helps stop those that have already started. PHDM was able to provide this beneficial service to 41 Menominee County children and 85 Delta County children. Well-Integrated Screening & Evaluation for Women Across the Nation (WISEWOMAN) provides annual screenings of cholesterol, glucose, and blood pressure for women that participated in the BCCCNP. Participants who are ready to make behavior change receive health coaching in efforts to reduce chronic disease risk factors. A total of 71 women were served by this program. Five of the women participated in the Entrepreneurial Gardening Program, and the Menominee Community Garden was expanded to 24 raised garden beds with another $2,000 WISEWOMAN grant in FY16. Women, Infants & Children (WIC) provides free nutrition education, health referrals, breastfeeding support and supplemental food for eligible clients. In FY15, 1,586 clients were enrolled in WIC. In the summer, WIC once again provided $20 Project Fresh coupon booklets to eligible families that enabled them to purchase fruits and vegetables at local Farmer s Markets. Women s Health Clinic (WHC) WHC is similar to the BCCCNP, providing annual exams to insured year old women. PHDM bills the client s insurance and makes referrals for further follow-up if an abnormality is found. If a cancer diagnosis is given, the woman can be enrolled in the Medicaid Treatment Act, if financially eligible, to pay for cancer treatment and other medical bills. WHC screened 64 women in FY16. 9

10 Substance Abuse and Prevention Services Alcohol Highway Safety Education educated 54 clients on the dangers of alcohol/drug use while driving. This course provides information to prevent additional alcohol or other drug-related legal offenses. Botvin LifeSkills Training All Stars works with middle school students to help decrease substance abuse, fighting, and delinquency. This year the program worked with a total of 243 students at six different area schools. Awareness Day was a one-day leadership event held in Menominee County that included a keynote speaker and breakout sessions focusing on encouraging youth to make healthy choices. The program reached 300 middle and 275 high school students. Confidential Substance Abuse Evaluations -provided 73 evaluations based on referrals from various agencies, employers, and the courts. Driver License Appeal Division Assessments - provided a total of 67 Secretary of State evaluations for license reinstatement. Every 15 Minutes is a two-day program delivered to high school students challenging them to think about drinking, driving, personal safety, and making mature decisions. This truly is a collaborative effort as community involvement is necessary. Stephenson and Bark River-Harris Schools participated in FY16. Smart Moves (Skills Mastery & Resistance Training) served 223 youth aged 6-13 years, and promotes positive attitudes and behaviors that lead to healthy lifestyles, and help them overcome difficult situations. Sticker Shock continued into FY16, promoting awareness of the consequences of providing alcohol to minors. Over 3,500 stickers were placed on multipack containers of alcohol throughout 10 stores in Delta & Menominee counties. The Botvin LifeSkills Training Middle School program is a groundbreaking substance abuse and violence prevention program based on more than 30 years of rigorous scientific research. LifeSkills Training is comprehensive, dynamic, and developmentally designed to promote positive youth development. In addition to helping kids resist drug, alcohol, and tobacco use, the LifeSkills Training Middle School program also effectively supports the reduction of violence and other highrisk behaviors. The program is designed to be taught in sequence over three years in middle school or junior high. The curriculum is intended to be taught sequentially to build on skills learned in the previous levels. The first level should be implemented with 6th or 7th grade students, followed by booster sessions until the students complete 9 th grade. Botvin s was introduced to students previously receiving All-Stars. Drug Awareness Conference was held once again at the Island Resort and Casino for the 5 th consecutive year. Approximatley 280 people from all different professions were in attendance to learn about Neonatal Drug Withdrawal and how this is handled in the NICU s. 10

11 Community Health Promotion Partners to Improve Community Health MISH Watersports demonstrates Stand Up Paddling instruction during Free Kayak and Stand Up Paddle Board Physical Activity Day. PHDM, Partners in Community Health (PICH), Mish Watersports, and the Healthy Communities Coalition partnered to make this project possible for the community. Partners to Improve Community Health (PICH), a grant with an initiative to increase healthy eating and physical activity, was funded through the Sault Tribe of Chippewa Indians. A large portion of the grant focused on the 2nd annual UP for Health Challenge. Four local businesses within the Healthy Communities Coalition partnered with the community by providing free kayak rentals, tobacco cessation awareness, healthy eating recipes and giveaways. Upon completion of the challenge, each business was awarded a share of $2000 in funding from the PICH grant that will be used towards future community programs. Childhood Lead Poisoning Prevention PHDM staff continued to work on education in the Upper Peninsula about the risks and warning signs of childhood lead poisoning. With the Flint water crisis gaining so much media attention, information was handed out at local health fairs on what to watch for and how to keep families safe. Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) is a research-tested intervention designed to improve the nutrition and physical activity environment, policies and practices through self-assessment. Day Care centers in both counties worked with PHDM staff to roll out the Color Me Healthy Program. This program gave teachers daily lessons, music, and hands on interaction to help children adopt healthy living skills. National Diabetes Prevention Program (NDPP) NDPP is a yearlong evidence-based lifestyle change program endorsed by the CDC for people with prediabetes or at risk for developing type 2 diabetes. PHDM now has 2 NDPP Lifestyle Coaches trained to provide the classes. The NDPP expanded in Delta and Menominee Counties and is also offered through UPCAP, OSF St. Francis Hospital, the Northern Lights YMCA, the Greater Marinette-Menominee YMCA, and the Hannahville Health Center. 3 new lifestyle change groups were started by PHDM in FY16. Snow Trek PHDM launched the 4 th season of Snow Trek in FY16. Community members rented snowshoes for free from PHDM, the Escanaba Civic Center, Moraska Saw & Supply, and the Greater Marinette- Menominee YMCA. Suicide Prevention - With funding from the Superior Health Foundation, PHMD partnered with several UP counties to provide suicide prevention resources and awareness training. PHDM staff promoted the Dial Help 24/7 assistance and text line for individuals going through crisis. Tobacco Prevention efforts continued around promotion of the Michigan Tobacco Quit Line at QUIT-NOW and 11

12 Environmental Health Environmental Health works to control physical conditions which could endanger the public s health by enforcing state laws and codes as well as local ordinances and by monitoring, inspection, consultation and educational outreach. Environmental Health programs consist of Food Service Sanitation, On-site Sewage Treatment and Disposal, Water Well Construction, Campground inspection, Swimming Pool inspection, Septage Hauling and Disposal, Bathing Beach Monitoring, Non-Community Water Supply, Body Art Facility inspection, Radon, and Licensed Daycare and Foster Home inspection. Environmental Health Program Numbers FY15 FY16 Non-community Water Supplies On-site Wastewater Permits Well Construction Permits Temporary Food Permits Annual Food Service License Inspections of Food Service Establishments Radon Kits Sold Body Art Fixed Facility Inspections 7 8 Septage Inspections Water Well Program Prior to construction of a water well (Drilled, driven point, or a dug well) a property owner must obtain a water well construction permit from PHDM. PHDM will conduct a site visit to determine the best possible location to construct the well and make sure the well will be properly isolated from sources of contamination. Also prior to issuing the permit PHDM will determine if the well site is located within an area of known groundwater contamination. Once the well is completed PHDM reviews the water well record submitted by the person constructing the well, to determine compliance with the Michigan Well Construction Code. PHDM completes final inspections on some of the new wells A safe water sample is also required prior to putting the well into service. Well owners are encouraged to sample their drinking water annually for coliform bacteria. Test kits can be picked up at PHDM. Well water can also be tested for other contaminants such as lead, copper, volatile and/or synthetic organics. On-site sewage treatment/disposal system installation 12

13 Emergency Preparedness During FY2016, Emergency Preparedness: - Maintained National Incident Management System (NIMS) compliance for staff - Conducted annual Strategic National Stockpile (SNS) training with partner schools - Participated in two multi-discipline, multijurisdictional exercises on the impact of dam infrastructure failure - Assessed operational readiness of existing Medical Countermeasures plans Health Department staff from Emergency Preparedness and Communicable Disease were pleased to participate in the Great Michigan Read events at the Escanaba Public Library. The novel selected for the statewide book club was Station Eleven by Emily St. John Mandel. Station Eleven takes place along the shores of the Great Lakes in a post-apocalyptic Michigan. It is the story of a traveling group of actors and musicians surviving in the aftermath of an influenza pandemic that killed 99% of the world population. Staff provided a presentation on what pandemic influenza is, historical influenza pandemics, current threats, and planning considerations for potential future events. Additionally, the presentation linked the reality of pandemic influenza to how events unfolded within the story, which provides an overall accurate portrayal of how quickly pandemic illness can spread worldwide. The discussion-based setting in the Escanaba Public Library was ideal for participants to ask questions as they came up and to engage with Public Health staff and each other. A special pathogen of interest in 2016 was Zika virus. Zika virus spreads to people through the bite of an infected mosquito (two specific species). It can also spread through sexual contact and from a pregnant woman to her fetus. Although Zika virus was discovered in 1947 and the first human case was identified in 1952, on Feb. 1, 2016 the World Health Organization (WHO) declared a Public Health Emergency of International Concern because of clusters of microcephaly and other neurological disorders in some areas affected by Zika virus. Although most people infected with Zika virus have no or only very mild symptoms, the potential that Zika virus infection during pregnancy can cause fetuses to have significant birth defects of the brain (most notably, microcephaly) and defects of the eye, hearing deficits, and impaired growth have raised international alarm. There is no vaccine to prevent Zika virus, therefore, educational efforts are focused on disease prevention efforts including avoiding traveling to areas where Zika virus is being transmitted and, when in areas where Zika virus is being transmitted, reducing the likelihood of mosquito bites by wearing protective clothing and using Environmental Protection Agency (EPA)-registered insect repellent when outdoors. For up to date information, visit 13

14 Public Health Highlights 2016 Sanitarian of the Year Congratulations went out to PHDM s Health Officer, Michael Snyder, who was presented with Michigan s 2016 Sanitarian of the Year Award by the Michigan Environmental Health Association. Presenting the award is Board of Health chairman, Tom Trudgeon. Retirees PHDM said goodbye to two valuable employees, Becky Walter, RN and Marylin Kaikkonen, RN. Becky worked many programs in her 22 years at PHDM including BCCCP, Family Planning, and STI/HIV. Marylin worked for a total of 25 years in PHDM s birth to three home visiting program, Early On. Both were valuable employees and will be truly missed. See You At the Movies PHDM was able to extend outreach efforts in both Delta and Menominee counties thanks to a few grant opportunities. Ads played before every movie at the Willow Creek Cinema 8 Theater in Escanaba, as well as the Mariner Theater in Marinette. Dental Clinic Partnership My Community Dental Center (MCDC) in Spalding, appreciated the opportunity to partner with PHDM to expand access to care for residents in the district. The partnership allowed MCDC to provide $10,294 in charity dental care to people without dental insurance. FY16 MCDC Numbers Patients served 1,390 Number of office visits 3,190 Patients aged 0-14 years 165 Patients aged years 69 Patients aged 21 years and over 1,156 Becky PHDM also said goodbye to two of our Board of Health (BOH) members, Mary Harrington and Bob Burie. Mary served for five years as one of the Delta County Commissioners on the PHDM board. Bob was the Menominee County member-atlarge and served for a total of 22 ½ years. They were great advocates for Public Health and will never be forgotten. Marylin Mary Harrington and BOH Chairman, Tom Trudgeon BOH Chairman, Tom Trudgeon and Bob Burie 14