Annual Report. Dianna E. Abney, M.D. Health Officer

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 3 Annual Report Dianna E. Abney, M.D. Health Officer

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 2 The Charles County County Commissioners Standing Left to Right - Amanda M. Stewart, Ken Robinson,Vice-president, Peter Murphy, President, Debra M. Davis, Esq., Bobby Rucci The mission of the Department of Health is to protect the health of our citizens, promote wellness and positive habits, and provide a range of health services to ensure the public health of the citizens of the Charles County. The various programs contained in the annual report highlight the accomplishments of the Department. The County Commissioners, in their capacity as the Board of Health, depend upon and value the services of the Department of Health. We thank the Health Officer and the Department of Health staff for the dedication they have shown in improving the health and well-being of our community. We wish the Department continued success in all its undertakings. Very truly, COUNTY COMMISSIONERS OF CHARLES COUNTY, MARYLAND Peter F. Murphy, President Bobby Rucci Ken Robinson, Vice President Amanda M. Stewart, M.Ed. Debra M. Davis, Esq. P.O. Box 2150 La Plata, Maryland 20646 (301)645-0550, Metro (301) 870-3000, Toll Free (877) 807-8790 TDD 1-800-735-2258 or 7-1-1; Fax (301) 645-0560 2 2014 Annual Report

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 3 Our Mission To promote, protect, and improve the health of our community. Our Vision A healthier Charles County 2014 Annual Report 3

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 4 From the Health Officer Dianna E. Abney, MD Now that I have completed my second full year as health officer, I have a better understanding of the complexities of our community and the public health needs of our citizens. e Health Department has continued the strong community and state partnerships that it had when I took office. We have also forged new relationships and partnerships locally, regionally, and beyond. Charles County Department of Health has had a very busy year. Over the past year we opened e Western County Family Medical Center, a primary care community health clinic in the western county. We expanded our existing dental services by adding preventive care in more elementary schools and a Community Health Worker and blood pressure screening in the clinic and community. We participated in several drug forums both locally and regionally. We improved our communicable disease preparedness and response abilities as a result of the Ebola virus concern in the US. As we take stock of the many accomplishments in public health, we are planning for the years ahead anticipating many health and environmental challenges. I look forward to be of future service as I continue in the role as health officer of Charles County. ank you to our elected officials, community physicians, community partners and other governmental agencies. Last but not least, I thank the staff of the health department for their dedication and commitment to serve the citizens of Charles County Dianna E. Abney, M.D. Health Officer 4 2014 Annual Report

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 5 Public Health in 2014 Public health is a multidisciplinary field whose goal is to promote the health of the population through organized community efforts. The public health system s activities in research, surveillance, education and program implementation have made numerous accomplishments possible. In the United States the public health system includes federal agencies such as the Centers for Disease Control, the National Institutes of Health, state and local government agencies, nongovernmental organizations and academic institutions such as schools of public health. This complex array of institutions has achieved success through treatment, education, program implementation outreach, political action and gains in scientific knowledge. Unfortunately, public health achievements are difficult to recognize because it is hard to identify people who have been spared illness. Focus of Public Health: Assessing the health status of the population. Diagnosing its problems. Identifying disease patterns. Searching for the causes for those problems. Designing solutions for those problems. Solutions usually involve communitylevel interventions that control or prevent the cause of the problem. For example, educational programs to discourage teenagers from smoking, screening programs for cancer, laws requiring seat belt use. Leading Health Indicators From the United States Department of Health and Human Services, Healthy People 2020 Initiative The leading health indicators are used to measure the health of the Nation (Objectives are associated with each indicator). As a group, the leading health indicators reflect the major health concerns in the United States at the beginning of the 21st century. They were selected on the basis of their ability to motivate action, the availability of data to measure progress, and their importance as public health issues. The Leading Health Indicators are: Adolescent health Blood disorders and blood safety Dementias, including Alzheimer s Disease Early and middle childhood Genomics Global health Health-related quality of life and well-being Healthcare-associated infections Lesbian, gay, bisexual and transgender health (LGBT) Older adults Preparedness Sleep disorders Social determinants of health Overarching Goals From the United States Department of Health and Human Services: Attain high-quality, longer lives free of preventable disease, disability, injury and premature death. Achieve health equity, eliminate disparities, and improve the health of all groups. Create social and physical environments that promote food health for all. Promote quality of life, healthy development, and health behaviors across all stages. Sources: Schneider, MJ. Introduction to Public Health. Gaithersburg, MD: Aspen Publishers, Inc. 2000 United States Department of Health and Human Services 2014 Annual Report 5

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 6 Spotlight on Accomplishments 2014 Increasing Access to Social Security Benefits The Core Service Agency serves as lead in the implementation of the SSI/SSDI Outreach, Access, and Recovery (SOAR) initiative in Charles County, coordinating over twenty five case managers from various community organizations. SOAR is a national project designed to increase access to the disability income benefit programs (SSI/SSDI) administered by the Social Security Administration for eligible adults who are homeless or at risk of homelessness and have a mental illness and/or a co-occurring substance use disorder. The SSI and SSDI programs provide benefits to individuals that are unable to work due to medical and/or psychiatric conditions. The application process is complex and difficult to navigate. The national approval rate for initial applications is 31% Applicants who are homeless have significantly lower approval ratings of 10-15%. However, the approval rate in Maryland for cases submitted using SOAR is over 80%. Countywide Drug Forums Create Awareness and Opportunity Two countywide substance use prevention forums were held in 2014. In May, A Time to Listen was an opportunity for county leaders to hear local residents ideas on what assistance and support was needed to reduce drug use in the community. A Night of Information and Education, held in October, was a client centered event highlighting the services and information available on the use of evidenced-based treatment approaches to help those in our community. In addition, an educational component focusing on clients was well received. Assisting High School Senior with Life Skills Deputy Health Officer James C. Bridges, Jr. Ph.D. participated in the LaPlata High School mock interview process. Dr. Bridges interviewed and gave feedback to several students on December 4. He provided valable true-to-life experiences for students and advisors. 6 2014 Annual Report Mission of Mercy Mass Dental Clinic The department provided support and assistance to the Southern Maryland Mission of Mercy Mass Dental Clinic held at Northpoint High School on July 18 and 19. Over 700 patients were treated at no cost over the two day event. Fillings, extractions and cleanings were among the services provided to the public. Medical, nursing, tactical and manpower support were provided by the department. Recovery Walk a Big Success The Division of Substance Use Prevention held a successful, well attended Recovery Walk to celebrate those in recovery and bring more widespread awareness of this disease. Peer recovery coaches in the division have reached out and introduced many people to a supportive recovery community. Clients in recovery and their families walked along the Indian Head Rail Trail adjacent to the Department of Health campus. Forensic Epidemiology and Bioterrorism Training The Division of Public Health Preparedness and Response Services sponsored a training workshop on June 10th in Forensic Epidemiology and Bioterrorism at the College of Southern Maryland in La Plata featuring Dr. Michael Freeman PhD MPH DC. The goal of the workshop was to enhance the joint effectiveness of law enforcement and public health in conducting investigations of health problems associated with criminal acts or intent, or of crimes having public health consequences. Workshop participants included law enforcement, emergency services, environment health and public health from Southern Maryland as well as homeland security educators from CSM. Substance Use Services Increased at Detention Center and Family Recovery Court Providing inmates exiting from the local detention center tools to assist in their substance use recovery was a goal of the department. With support from the local detention center, the Division of Substance Use Prevention Services has increased services and the number of programs offered. Three Department of Health staff are assigned full time to the detention center. The Charles County Family Drug Court offers an alternative to incarceration for those who choose to participate and successfully complete the program. The Division of Substance Use Prevention partners with the Family Recovery Court to provide assistance in program management. Participation in the program, which is very popular, has reached and exceeded capacity. Planning for the Ebola Virus Disease As the Ebola virus threatened communities throughout the country, the department prepared for any possible local cases that may have occurred. The department was in weekly contact with the Centers for Disease Control in Atlanta, GA. and the Maryland Department of Health and Mental Hygiene to get information regarding the progress of the disease and receive the latest directives that were issued. The Department of Health monitored local individuals who travelled to the infected countries and coordinated with the local hospital, county and state emergency services to insure the safety of residents. Additionally educational information was provided to Charles County residents regarding the Ebola Virus Disease Western County Family Medical Center The Department of Health secured funding from the Charles County Government and the Maryland Community Health Resource Commission to open a primary care clinic in the Nanjemoy Community Center. This location was selected based on the needs of the community. Additional information regarding the center appears in the Annual Report s feature article. Mental Health Training Center The Division of Mental Health Services

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 7 is a premier training facility for area universities including; John s Hopkins, University of Maryland Baltimore, University of Maryland College Park, Loyola University, Catholic University, Salisbury University, The Chicago School (DC), Marymount University, James Madison University and many more. The Division of Mental Health Services intern program trained and graduated eighteen Master s level clinicians in mental health counseling. All of the graduates passed their licensing exams with their respective Maryland boards. The division has enjoyed the benefits of recruiting new employees from this program. We are pleased to announce that in December, two graduates were offered full time clinical staff positions. Blood Drive a Success The Department of Health sponsored a community blood drive through the American Red Cross in July. The collection took place in the department s conference area. Staff were provided time off from their regular duties to donate blood. Community residents were also invited to donate. Thanks to our staff and community our blood drive exceeded our quota of 20 units of the much needed blood. The department plans to hold 2-3 blood drives each year. Preparedness Exercise for the College of Southern Maryland The Maryland Emergency Management Administration (MEMA) sponsored an emergency preparedness exercise on September 25th held at the College of Southern Maryland (CSM) Prince Frederick campus. The exercise provided valuable training and preparedness preparation based on the scenario of having an active shooter on any one of the CSM campuses. The department would assist at the Charles County campus located in LaPlata if an event occurred. The scenario was based on recent actual events that have occurred around the country. Community Partner Award for Mental Health Services The Southern Maryland Community Network presented a Community Partner Award to the Division of Mental Health Services on November 12. The award stated, in recognition of t he continued dedication and efforts of the Division of Mental Health in connecting consumers with services in the community. Funding Secured for Naloxone Use and Training Health Officer, Dr. Abney secured funding for Naloxone medication and training to be used by the Charles County Sheriff s Department. Through this training, county law enforcement officers will learn how to dispense Naloxone, used to combat opiate overdose, while on regular duty. Prevention messages on billboards and wrap messages on public transportation were seen throughout the county in a widespread effort to educate our community on the dangers of opiate abuse. Demographic Profile: Demographics: Population Data Charles County Maryland Population, 2010 146,551 5,773,552 Population, 2013 152,864 5,928,814 Male, 2013 73,785 (48.3%) 2,874,762 (48.5%) Female, 2013 79,079 (51.7%) 3,054,052 (51.5%) Economic Indicators Median Household Income, $93,160 $73,538 2009-13 average Persons below poverty, 7.0% 9.8% 2009-13 average Homeownership Rate, 79.4% 67.6% 2009-2013 average In labor force, 16 yrs+, 71.2% 69.2% 2009-2013 average Other Indicators Foreign Born Persons, 2009-13 average 5.6% 14.0% High School Graduate, 91.2% 88.7% 25 yr+, 2009-13 average Source: US Census Bureau: State and County Quick Facts: 2010 Census, 2013 Census Estimates, and 2009-2013 American Community Survey 5 year estimates Race of Charles County Population 1% 4% 5% 42% 1% 3% 45% Non- Hispanic Caucasian...71675 Non-Hispanic...66760 African-American American Indian...1426 Asian/Pacific Islander...5890 Hispanic...7656 Other...1211 2 or more races...5075 2014 Annual Report 7

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 8 Demographic Profile: Charles County Population by Age-group, 2013 70000 60000 50000 40000 30000 20000 10000 0 54,564 43,504 38,522 16,274 Under 17 18-44 45-64 65+ Source: 2013 Maryland Vital Statistics Report Rate Trends for the 65 years and older population: 2004-2013, Charles County vs. Maryland Trends in Rate of 65+ population, 2004-2013, Charles County, MD 140 120 100 80 60 40 20 0 MARYLAND CHARLES COUNTY 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 (Rate is per 1000 population) 105 100 95 90 85 80 75 70 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Crude Rate per 1000 population rate on the chart Source: 2003-2012 Maryland Vital Statistics Report Maternal and Child Health Data 2013 Charles Charles Maryland Maryland County County Rate*** Number Rate*** Live Birth Rates 1,803 11.8 71,806 12.1 (per 1000 population) Low Birth Weight Rate* 145 8% 6,080 8.5% (per 1000 live births) Infant Mortality Rate 14 7.8 474 6.6 (per 1000 live births) Early Prenatal Care** 1,170 65% 44,478 62% (Rate per 1000 live births) * Defined as weighing less than 2499 grams at birth ** Defined as starting prenatal care during the first trimester of pregnancy ***Rate calculated per 1000 live births for infant mortality and live births. Sources: 2013 Maryland Vital Statistics Report 8 2014 Annual Report

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 9 County Health Profile: Top 10 Leading Causes of Death: Cause of Death Charles County Charles County Maryland Maryland Rate Number, 2013 Number, 2011- Number, 2013 2011-2013* 2013* All Causes 933 751.6 45444 708.3 Cancer 234 184.2 10545 163.8 Diseases of the Heart 221 184.7 11176 171.7 Accidents 45 344 1679 26.5 Chronic Lower Respiratory Diseases 40 33.6 2044 32.9 Cerebrovascular Diseases 34 34.1 2290 36.5 Diabetes mellitus 34 22.8 1242 19.6 Alzheimer s Disease 21 18.4 911 14.6 Influenza and Pneumonia 19 13.9 1093 16.6 Intentional Self Harm (Suicide) 18 11.2 561 9.0 Septicemia 16 13.7 955 14.1 Cancer Data: Incidence (# of new cases) 2010* Type of cancer Charles Charles Calvert St Mary s Maryland US SEER County County County County Rate Rate Number Rate Rate Rate All cancers 611 451.3 416.2 413.2 449.8 445.0 Lung/Bronchus 75 61.4 61.9 73.0 57.6 57.2 Colorectal 39 30.6 32.5 35.6 37.4 41.3 Female Breast 109 137.7 159.6 107.6 129.0 120.9 Prostate 101 155.6 101.3 107.8 140.6 136.6 Oral 17 11.1 ** ** 10.6 10.7 Melanoma of skin 19 13.7 36.0 20.1 21.4 21.3 Cervical 7 ** ** ** 7.3 7.5 Incidence (# of new cases) 2006-2010* * All age-adjusted rates calculated per 100,000 population. NA: Rate not available for this cause of death Source: 2013 Maryland Vital Statistics Report Source: Maryland Department of Health and Mental Hygiene, Cancer Reports, Cigarette Restitution Fund Programs, 2013 *Rates per 100,000 population. ** Rates based on cells with 25 or fewer cases are not presented. Type of cancer Charles Charles Calvert St Mary s Maryland US SEER County County County County Rate Rate Number Rate Rate Rate All cancers 2580 414.6 453.6 458.2 449.2 463.0 Lung/Bronchus 306 53.4 62.3 69.3 61.2 61.4 Colorectal 250 43.3 40.2 42.1 40.1 45.0 Female Breast 388 107.0 136.1 121.6 125.1 123.8 Prostate 478 164.2 132.5 138.9 153.4 152.0 Oral 68 10.4 11.6 10.9 9.8 10.8 Melanoma of skin 79 11.8 37.4 27.3 20.8 21.1 Cervical 23 5.8 ** ** 6.7 7.9 Source: Maryland Department of Health and Mental Hygiene, Cancer Reports, Cigarette Restitution Fund Programs, 2013 *Rates per 100,000 population. ** Rates based on cells with 25 or fewer cases are not presented.

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 10 County Health Profile: Mortality 2010* Type of cancer Charles Charles Calvert St Mary s Maryland US SEER County County County County Rate Rate Number Rate Rate Rate All cancers 241 198.2 166.9 155.2 170.9 171.8 Lung/Bronchus 71 59.9 46.0 42.4 46.0 47.4 Colorectal 13 ** ** ** 14.9 15.5 Female Breast 23 31.5 ** ** 24.2 21.9 Prostate 11 ** ** ** 22.3 21.8 Oral <5 ** ** ** 2.3 2.5 Melanoma 5 ** ** ** 2.4 2.7 Cervical <5 ** ** ** 1.9 2.3 Source: Maryland Department of Health and Mental Hygiene, Cancer Reports, Cigarette Restitution Fund Programs, 2013. *Rates per 100,000 population. ** Rates based on cells with 25 or fewer cases are not presented. Providing Essential Services to the Community Public health provides services that otherwise may not be available to communities. As community needs expand, the type and number of services offered by local public health expands also. Some services offered include: soil and water testing, restaurant inspection, swimming pool inspection, noise abatement, septic and sewer inspections, communicable disease detection and investigation, prenatal care counseling and classes, behavioral health counseling, oversight of mental health and disability services, competency assessment of the aging, vaccinations and immunizations for all ages and health education. All of these services are vital for the overall health of a community. One of the basic principles of public health is that the organization does not compete with private health providers: physicians, hospitals, dentists, treatment centers, testing services and other health related entities. In some cases, however, this principle may not be followed if another private source is not available. Demographic data illustrated that many residents in western Charles County had limited access to healthcare. The department began looking into the possibility of opening a primary care clinic in the western part of the county. The concept of a medical center in western Charles County came into being when the department applied for but did not receive a grant in 2012. In 2013 the department received a grant from the Maryland Community Health Resource Commission (CHRC) to open a medical center. In addition to the CHRC assistance, the Charles County Commissioners provided space at no cost to house the center. The Nanjemoy Community Center was chosen for the Western County Family Medical Center. Numerous agencies and assisted including: The Charles County Community Services Charles County Government- Building and Trades The Maryland Medical Society (MedChi) Over $17,000.00 worth of office and medical equipment was donated by a local physician to outfit the 10 2014 Annual Report

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 11 Mortality 2006-2010* Type of cancer Charles Charles Calvert St Mary s Maryland US SEER County County County County Rate Rate Number Rate Rate Rate All cancers 1082 195.5 188.3 185.0 179.0 176.4 Lung/Bronchus 306 56.2 53.9 55.2 49.4 49.5 Colorectal 109 20.4 18.3 14.1 16.8 16.4 Female Breast 83 24.5 28.3 22.0 24.5 22.6 Prostate 54 26.7 25.4 35.0 25.0 23.0 Oral 14 ** ** ** 2.5 2.5 Melanoma 13 ** ** ** 2.7 2.7 Cervical 9 ** ** ** 2.3 2.4 Source: Maryland Department of Health and Mental Hygiene, Cancer Reports, Cigarette Restitution Fund Programs, 2013. *Rates per 100,000 population. ** Rates based on cells with 25 or fewer cases are not presented. facility. A local physician was engaged to serve as the medical director and primary physician on staff. The center currently sees patients either by appointment or walk-in five days a week. Hours are: Monday, Tuesday and Thursday 8am to 12pm, Wednesday 3 to 7pm and Friday - 12 to 4pm. All insurances are accepted and no one is turned away. In 2007 local data indicated that there was a severe need for pediatric dentistry in the county. This fact, compounded by a tragic death of a child in the state which resulted from the lack of dental treatment, provided the impetus for the Department of Health to establish one of the first public health subsidized dental clinics in the state. This was accomplished with funding from the Department of Health and Mental Hygiene and the Charles County Government. The Department of Health Dental clinic opened with 2 dental operatories and a staff of one part-time dentist and one part-time dental hygienist. At that time the clinic treated only pediatric patients (under 17 years of age) who were uninsured or underinsured. By the end of the first year, the clinic conducted 1,021 pediatric visits and 121 adult visits. Dental services and the clinic have grown along the way. There are now four operatories and four dentists, one full time and 3 part time. In 2014, there were 1,972 adult treatments and 6,681 pediatric treatments. In addition to full dental services, dental health education and outreach has been conducted in schools, daycare sites, health fairs and community meetings reaching over 5,000 children. Fluoride varnish, sealant application and oral health screenings are also provided in schools. Hours for dental are Monday through Friday 8:30am to 5:00pm and Wednesdays until 7:00pm. Anyone needing these services is welcomed to utilize the dental or medical clinic. The Department of Health is proud to be able to provide these vital services to the community. The department evaluates changing needs for health services and works to fill gaps in service wherever necessary. 2014 Annual Report 11

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 12 The Charles County Department of Health Public Health Services The Charles County Department of Health continues to offer a wide range of public health services via eight program divisions. Below is a description of each division and examples of some of the services provided for 2014. Administrative Services This division provides support to all other divisions within the department by maintaining budgets, payroll, timekeeping, collections, purchasing and receiving, by overseeing the vehicle pool, by providing information technology services and human resources services. Copies of birth and death certificates are also available to the community. Birth Certificates Provided.............................................3,565 Death Certificates Provided............................................8.386 Health Department Personnel............................................280 Total Budget....................................................$18 Million Core Service Agency The Core Service Agency is the Local Mental Health Authority responsible for planning, managing and monitoring the public mental health services in Charles County. Core Service Agencies exist under the authority of the Secretary of the Department of Health and Mental Hygiene, and also are agents of the county government, which approved the organizational structure. The functions of the Core Service Agency are to plan, develop and manage a full range of treatment and rehabilitation services for persons with mental illness in this jurisdiction as stipulated by the Health General Article, 10-10-1203, Annotated Code of Maryland. The Core Service Agency ensures that the local public mental health system provides quality and cost-effective services that meet the needs of individuals and families in need of mental health services. Through development of and collaboration with the network of service providers, the Core Service Agency works to improve access to these services. CSA Services Include: Care Coordination for individuals with mental illness including those who are homeless, transitioning out of State and Local Hospitals, Residential Treatment Centers, the Charles County Detention Center and the Maryland Department of Corrections. 12 2014 Annual Report

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 13 Promote mental health awareness and education to reduce stigma through public awareness activities such as Mental Health First Aid and Youth Mental Health First Aid. Review consumer and provider satisfaction, and process grievances and complaints. Sponsor and provide training programs for staff of provider agencies. Contract with public and private agencies to provide services. Evaluate the cost effectiveness and quality of services delivered, and safeguard against unnecessary utilization of publicly funded services. Disability Services This division provides services to individuals with disabilities of all ages living in Charles County. Services provided include: 1. Eligibility (Comprehensive Assessments) 2. Community Coordination 3. Waiting List 4. Transition Coordination Disability services assists and identifies needed services and supports referred by the Southern Maryland Regional Office to obtain eligibility. Resource coordinators assist individuals to access the best of quality and most appropriate services and supports within various systems and community resources. Infants and Toddlers Program Infants and Toddlers services are provided to children, birth through three years of age who may be delayed in development or have a disability. This program is in partnership with the Charles County Department of Health, the Board of Education and the Department of Social Services. The Department of Health serves as the single point of entry for eligibility. Number of referrals for Disability Services..................................21 Number of Eligible Individuals Receiving Resource Coordination............684 Number of Infants and Toddlers Receiving Services.........................336 Environmental Health Services This division conducts inspections and issues licenses and permits in addition to regulatory functions. Other services include the inspection and licensing of food establishments, swimming pools and public campgrounds, subdivision approvals, soil evaluations, water supply surveillance and rabies control. Perc workload and Septic................................................821 Water Samples Collected...............................................1,459 Food Licenses Issued....................................................596 Animal Bites (Rabies) Investigations......................................738 On-Site Sewage Disposal Permits.........................................122 Well Construction Permits...............................................243 Mental Health Services This division provides comprehensive outpatient services including: psychiatric evaluation and assessment, medication management, individual and group psychotherapy and referral to community services. In response to Charles County Court needs, anger management groups also meet on a regular basis serving over 245 patients annually. Clients treated........................................................1,244 Individual visits......................................................23,441 Nursing and Community Health Services The Nursing and Community Health Services Division provides various clinical case 2014 Annual Report 13

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:31 AM Page 14 The Charles County Department of Health management, care coordination, disease screening, diagnostic and treatment services, health education and surveillance services to meet health care needs of individuals in the community with a population based approach. The services are made available to uninsured, underinsured, and Medicaid recipients. No one is denied service because of inability to pay. Most of these services are exclusive to public health services and are not otherwise available in the community. These services are not competitive with other organizations or health care providers. Programs under the supervision of the Nursing and Community Health Services include: Adult Evaluation and Review Service (AERS), Personal Care Program, Breast and Cervical Cancer, Colorectal and Prostate Cancer Programs, Dental Health, Maternal/Child Health Program, Healthy Start, Child Abuse and Neglect Prevention and Treatment, Child Immunization, WIC, Maryland Children s Health Insurance Program (MCHIP), HIV/AIDS Prevention and Case Management Services, School Health and Nursing Intern Supervision. These preventive and proactive services meet the health care needs of people at various stages of life focusing on health improvement and promoting well being and preventing early diagnosis of certain illnesses. 14 2014 Annual Report The number of individuals serviced by divisional programs is: Breast and Cervical Cancer screening clients................................90 Colorectal screenings provided............................................22 Sexually transmitted diseases treated......................................203 Communicable disease investigations and care coordination...............1,869 Communicable disease consults with the public...........................7,427 Rabies pre-exposure vaccine provided.......................................9 Rabies post-exposure cases................................................82 Age appropriate vaccination provided (adults)..............................414 Tuberculosis screening (PPD)............................................139 Positive TB treated........................................................4 Family Planning Services...............................................1,297 HIV/AIDS testing and counseling.......................................1,072 HIV/AIDS outreach and education......................................5,000 HIV cases managed (tri-county)..........................................260 Adult evaluations and review services.....................................413 Personal care program recipients.........................................254 Seniors receiving preventive health services..............................1,043 Maternal & Child Health case management services & ACCU...............892 Individuals receiving birth control and women s exams..................... 930 Babies Born Healthy/Reproductive Health Education......................3,088 Number of MCHP applications received.................................5,460 Eligible children received MCHP........................................2,027 Eligible prenatal received MCHP.........................................298 Eligible childless adults received MCHP...................................690 Eligible family Medicaid................................................1,165 Student health room visits in county schools (1,000 less students).........209,986 In-school vaccinations (K to Grade 5)...................................2,222 Adult immunizations given..............................................471 Children receiving immunizations........................................212 WIC services recipients (Tri County)....................................6,193 Number of Students for Clinical Rotations.................................108 Flu vaccinations given: Community Clinics....................................................2,888 School Based..........................................................2,619 Dental Clinic visits Adults................................................................1,972

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:31 AM Page 15 Children............................................................. 6,681 Oral Health Education.................................................5,356 School based programs Fluoride Varnish........................................................843 Sealant Application......................................................615 Oral Health Screenings..................................................925 Public Health Preparedness and Response Services The Public Health Preparedness and Response Services Division has the primary responsibility for coordinating public health and medical preparedness, response, recovery, and mitigation activities within Charles County. The program is funded by the federal government as part of the Pandemic and All-Hazards Preparedness Act and is administered by the Center for Disease Control (CDC). Program activities support the Charles County Department of Health in the management and coordination of emergencies of public health significance. Incidents that would involve public health emergency response include: Natural disasters Other acts of terrorism, including Technological disaster chemical and radiological Bioterrorism incidents Pandemics, epidemics, outbreaks The Preparedness and Response Division engages existing program expertise within the Department of Health to provide surveillance, internal and external mitigation, event tracking, rapid health assessment, community education, coordination with community partners, dissemination of information, event command and control through the Incident Command System and post event recovery recommendations. Regional collaboration and planning is essential to the ability to respond to emergency events that might affect large areas of the Washington metropolitan area. The Preparedness and Response Division is a member of the Region V Emergency Preparedness Coalition made up of representatives from multiple health and medical disciplines from Montgomery, Prince George s, Calvert, Charles and St. Mary s counties. The division also represents Charles County on the Metropolitan Washington Council of Governments (MWCOG) Public Health Emergency Planning Subcommittee. This sub-committee facilitates the development of public health emergency preparedness and response amongst the jurisdictions in the National Capital Region (NCR). Substance Use Treatment and Prevention Services The Substance Use Treatment and Prevention Division is licensed to provide a wide range of prevention programs and multiple levels of outpatient treatment to meet the needs of Charles County residents. We are part of a larger continuum of care system guided by a statewide Recovery Oriented System of Care. As a member of the Local Drug and Alcohol Council, we partner with many local and state agencies to identify and address needs of the community. Prevention services include partnering with Project Graduation, parenting programs in the detention center, support of Head Start programs, presentations to public school programs and classes, hosting the annual fishing derby and a strong partnership with the College of Southern Maryland to address underage drinking. Treatment services include comprehensive assessments, client-centered treatment, individual and group services, medication management for opiate use, education focusing on substance use disorders and medical risks associated with substance use, free family support programs, and full services to the Hispanic community. Peer recovery coaches and care coordinators assist clients with entering and returning from residential programs, establishing long-term recovery, re-entering the community and finding strong recovery support. The Cigarette Restitution Grant focuses on prevention and smoking cessation programs. We offer several smoking cessation classes each year to anyone who would like to quit and if needed assist financially with medication. Clients served.........................................................2,290 Treatment Services Attended..........................................25,101 www.charlescountyhealth.org Acknowledgements Department of Health and Mental Hygiene Cover photo of Health Department building by Conni Leigh James, copyright 2003 For more information regarding the Charles County Department of Health or additional information on the contents of this annual report, contact: William T. (Bill) Leebel 301-609-6759 bill.leebel@maryland.gov Charles County Department of Health 2013 Annual Report designed by: JBH3 Graphic Design LLC 301-718-0342 www.jbh3.com 2014 Annual Report 15

Annual Report 2014_Green.qxp_Layout 1 5/14/15 9:30 AM Page 2 4545 Crain Highway P.O. Box 1050 White Plains, MD 20695-1050 www.charlescountyhealth.org The Charles County Department of Health General Information.......................................301-609-6900 Health Officer........................................301-609-6900 Administration........................................301-609-6900 Adult Evaluation & Review Services (AERS)..................301-609-6817 Cancer Screening: Breast & Cervical........................301-609-6816 Colorectal...............................301-609-6832 Adult Immunization...............................301-609-6900 ext. 6025 Child Immunization...............................301-609-6900 ext. 6024 Communicable Disease Control......................301-609-6900 ext. 6025 & Prevention/STD Services Core Service Agency.......................................301-609-5757 Dental Clinic........................................301-609-6886 Developmental Disability Program..........................301-609-6830 Environmental Health.....................................301-609-6751 Family Planning & Women s Health.................301-609-6900 ext. 6018 HIV/AIDS: Prevention Education...........................301-609-6811 Counseling & Testing...................301-609-6900 ext. 6018 Services & Case Management....................301-609-6811 Infants & Toddlers........................................301-609-6808 Maryland Children s Insurance Program.....................301-609-6837 Maternal/Child Health, ACCU, Child Abuse/Neglect...301-609-6900 ext. 6024 Mental Health........................................301-609-6700 Personal Care Services.....................................301-609-6879 Public Health Preparedness.................................301-609-6761 School Health........................................301-609-6866 Substance Abuse........................................301-609-6600 Vital Records........................................301-609-6919 Women, Infants and Children s Program (WIC)..............301-609-6857......................................1-877-631-6182