New Hanover County Health Department

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New Hanover County Health Department First Quarter Report July 1 September 3, 212 13 years of Public Health Service At the New Hanover County Board of Health s August 212 meeting a brief presentation was given by Joshua Swift, Deputy Health Director, and Carla Turner, Personal Health Services Manager, on the Affordable Care Act (ACA) and its impact on Public Health. The following is a short narrative describing the key points of the ACA which was enacted on March 23, 21. By the time it is fully implemented (214), 32 million people are expected to gain health insurance coverage. The acts various components are being implemented over a four year time frame from 21 to 214. In September 21, new private health insurance plans were required to address pre-existing conditions in children, cancellation of coverage for illness, lifetime caps, preventive care fully covered and dependent coverage up to 26 years of age. Medicare payments to hospitals, home health, nursing homes and hospice were also reduced. The effects on public health will not be fully realized until Implementation of mandates in 214. Medicaid income eligibility will expand and additional funding will be available for the Children s Health Insurance Program (CHIP) for two years. Individual insurance mandate and penalties will also begin in 214. Insurance companies will be barred from: denying coverage for pre-existing conditions; charging higher fees based on gender; and imposing annual limits on coverage. Health Insurance exchanges will be established. The good news for Public Health is that we will see an expansion of public health services and prevention. There will be more transparency by insurance companies and more protections for health plan members. We expect to see an increase in the number of clients who have Medicaid and other health insurance. We will continue to maintain and enhance our role as health data and in formation experts for the community. 229 South 17 th Street Wilmington, NC 2841 (91) 798-65 www.nhcgov.com/health www.facebook.com/nhchealth www.twitter.com/nhchealth Board of Health Michael E. Goins, OD Chair Virginia W. Adams, PhD Vice-Chair Richard G. Catlin County Commissioner Donald P. Blake Public Member Melody S. Evans, DVM Veterinarian Member Robert E. Lewis Public Member Kim Thrasher, PharmD, BCBS, FCCP, CPP Pharmacist Member Robert J. Schiffel, DDS Dentist Member Robert M. Shakar, Jr., MD Physician Member C. Benjamin Spradley Public Member For more information on the Affordable Care Act, go to www.healthcare.gov. Health Director David E. Rice, MPH, MA

New Hanover County Health Department The vision of the New Hanover County Health Department is Healthy people living in a safe environment to sustain a strong community focused on prevention and wellness. Healthy People. Safe Environment. Strong Community. The mission of the New Hanover County Health Department is to promote a safe and healthy community. Environmental Health Services 12 1 8 6 4 2 88 163 Food Safety/Child Health/Instititutions Routine Inspections 1st Qtr 11/12 1st Qtr 12/13 45 43 75 On- site & Water Protection Evaluations 121 Vector Control Services Acres Larvacided Vital Statistics 11/12 12/13 Births 1,8 1,51 Deaths 564 581 212-213 New Hanover County Health Department Quarterly Report

Personal Health Services Clinic Services Services 11/12 12/13 Child Health Visits 61 71 *STD Visits 1,84 1,17 Family Planning Visits 96 943 *BCCCP Clients 3 38 Limited Physicals (Adults & Children) 128 26 *TB Skin Test Read 1,69 944 Travel Clinic Visits 17 17 Immunizations to 18 years 1,461 1,719 Immunizations 19 and > years 1,66 2,844 Refugee Health Clients 31 18 *STD- Sexually Transmitted Disease *BCCCP- Breast and Cervical Cancer Control Program *TB- Tuberculosis Lab Services 11/12 12/13 In House Procedures Gonorrhea Cultures 591 83 Hematology 146 148 Pregnancy Testing 445 499 Syphilis Screening 972 9 Urinalysis 15 128 Water Bacteriology 83 6 Referral Procedures Chlamydia / Gonorrhea 777 349 HIV 931 878 Lead 395 597 Pap Smears 317 238 Samples may include blood, urine or other body fluid. *Water Bacteriology tests are samples from wells. Reportable Diseases Disease 12/13 Campylobacter 4 Chlamydia 243 Cryptosporidiosis 1 Foodborne, other 1 Gonorrhea 7 Haemophilus Influenzae 1 Hepatitis B, Acute 1 Hepatitis B, Carrier 5 HIV Infection 4 Legionellosis 1 Lyme Disease 1 Non-Gonococcal Urethritis 68 Rocky Mount Spotted Fever 2 Salmonella 63 Shigella 5 Streptococcal-Group A Invasive 1 Syphilis 3 Vibrio 1 212-213 New Hanover County Health Department Quarterly Report

Personal Health Services Community Health 1st Q 11/12 1st Q 12/13 4 341 3 2 254 22 24 261 145 1 Homeless Medical Clinic - Visits Mobile Dental Unit - # of children provided dental services - Unduplicated count Tuberculosis Patients Required to be Directly Observed Taking TB Meds (Home Visits) Nutrition Services 11/12 12/13 *WIC Nutrition Visits 3,51 2,795 General Nutrition Visits 48 48 New Clients in Breastfeeding Peer Counseling New Clients in *DERP 5 84 14 8 *WIC- Supplemental Nutrition Program for Women, Infants, and Children providing nutritious food, nutrition education, and breastfeeding support for pregnant and postpartum women and infants and children up to age 5 years who qualify for the program. *DERP- Diabetes Education Recognition Program: 1 hours of diabetes self-management education classes provided by a registered dietitian and/or registered nurse. Pregnancy Care Management: Case management and home visiting for pregnant women. Postpartum/Newborn Home Visits: Home visits for new moms and babies discharged, recommended within 2 weeks, upon discharge from the hospital. Health and Behavior Interventions: Counseling services for high risk pregnant women. Maternal Health Services Pregnancy Care Management Enrolled Postpartum/Newborn Home Visits Health & Behavior Counseling Contacts 11/12 12/13 581 572 7 7 26 37 212-213 New Hanover County Health Department Quarterly Report

Personal Health Services School Health 1st Qtr 11/12 1st Qtr 12/13 3, 2, 1, 18,662 16,218 5,429 4,936 21,39 2,123 1,565 1,951 Student / Staff Visits to School Nurse Number Medicated/Special Procedures Parent/School Staff Colaborations Emergency Action Plans Developed/Updated Visits to school nurse include health concerns, vision screenings, first aid, medication administration, special procedures (glucose checks for diabetics, urinary catheterizations, etc.) Collaborations include phone calls or letters/notes to parents, updates to staff on particular health issues, referrals for follow-up health care, and phone calls to physician offices concerning a student Emergency Action Plans are plans that are created and put into place for students with health concerns in the event the student has an emergency while at school School Mental Health School Mental Health provides psychotherapy services (individual, family, and group therapy) to children/adolescents and their families in fifteen elementary and middle schools in New Hanover County. 15 1 5 344 371 1st Qtr 11/12 1st Qtr 12/13 1282 117 Number of Clients Therapy Sessions Total School/Community Collaborations 678 66 Care Coordination for Children (CC4C) Services 11/12 12/13 CC4C Contacts 789 1,72 CC4C -Clients Receiving Services 269 321 In-Home Counseling/Home Visits 67 75 CC4C Contacts: number of contacts with families either by phone, home visits or contacts with someone in the community on their behalf CC4C Clients Receiving Services: total number of children served for the quarter, unduplicated In Home Counseling Service Contacts: number of face-to-face contacts for family therapy 212-213 New Hanover County Health Department Quarterly Report

n-home Counseling/Home Visits 67 75ber of Children < 1 year referred to CDSA/new referrals 3 142 212-213 New Hanover County Health Department Quarterly Report