53rd ANNUAL REPORT

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53rd ANNUAL REPORT 2012-2013 Empowering individuals and communities to actively pursue healthier lives through health promotion, disease prevention, environmental protection, and emergency preparedness for all people in Franklin and Williamson Counties.

FOREWORD This 53rd Annual Report of the Franklin-Williamson Bi-County Health Department presents a summary of the activities carried out through the year. These statistics cover a broad array of programs and functions directed toward prevention of disease and promotion of health on a community-wide basis. The Board of Health and the staff wish to express their appreciation to all state and local governments, official agencies, health professionals, schools, and citizens for their support. BOARD OF HEALTH Eric Graham, M.D., President Franklin County Dennon Davis, M.D., Vice-President Franklin County Stephen Leek, D.C., Franklin County Dallas Duty Williamson County Brent Gentry Williamson County Danny Melvin Franklin County Jodi Braid, D.D.S. Williamson County Clark Dixon, D.M.D. Franklin County

TREASURER Charles Helleny FRANKLIN COUNTY BOARD District #1 District #2 District #3 Christy Powers Kenneth Hungate Linda Clark Randall Crocker David Rea James McPhail Ray Overturf/Tom Vaughn William Stark/Allen Price Danny Melvin WILLIAMSON COUNTY BOARD Ron Ellis Brent Gentry Tracey Glenn/Jim Marlow HEALTH DEPARTMENT STAFF ADMINISTRATION Robin Koehl, B.S. Dennon Davis, M.D. NURSING DIVISION Lisa Sorensen, R.N., B.S.N. Kim Spruell, R.N. Laurie Allen, R.N. *Kelli Baney, R.N. Karla Burton, R.N. Sheila English, R.N. Meleah Heim Pam Lukens, R.N. Debbie Morgan, R.N. Hillary Ottolini Jennifer Overturf, R.N. Dawnette Raubach Laura Ray, R.N. ^Robyn Rice, R.N. Cindy Smith, R.N. Kimberly Swain, R.N. Leah VanHam, R.N. Cheryl Walston, R.N. Lisa Weiss, B.S. HOME NURSING DIVISION Angela Cobb, R.N. Deborah Aumiller, R.N. Linda McGuire, R.N. Pamela Rosensteel, R.N. Victoria Sloan, R.N. Maryanne Smith, R.N. Christine Camden, R.N. Pamela Bennett, C.N.A. Marilyn McCutcheon, C.N.A. Ruthann Ronchetto, C.N.A. Executive Director Medical Consultant Director of Nursing Supervisor of Nursing Breastfeeding Peer Counselor Breastfeeding Peer Counselor Vision/Hearing Technician Nutritionist Director of Nursing Home Health Aide Home Health Aide Home Health Aide

HEALTH EDUCATION DIVISION Carrie Eldridge, B.S. Adrienne Bramlett, B.S. *Suzy Ganey, M.P.H. ~James Gentry, B.S. *Jenna Jamieson, M.P.H. Director of Health Ed. Health Educator Health Educator Health Educator Health Educator HEALTH PROTECTION DIVISION Ronda Koch, M.S. Information Technology *Nathan Hamilton, B.S. Bryan Gottschalk, A.S. ENVIRONMENTAL HEALTH DIVISION Tony McEntire, B.A.,M.S., L.E.H.P. Donnie Gaddis, B.S. Richard Hartke, B.S.O.E. Christopher Kane, B.A. James Blake Kearney, B.S. Anthony Nevicosi, M.P.A., M.P.H. Richard Weaver, B.A. Dir. of Health Protection Computer IT Specialist Computer IT Specialist Director of Env. Health Sanitarian Sanitarian Sanitarian Sanitarian Sanitarian Sanitarian CLERICAL SERVICES ~Teresa Boyd Doris Cook Amy Crespi Dixie Dobill Judith Dorris Denise Hawk *Denise Hutchinson Lana Kee ^Linda Moore Danell Morhet Vicki Norris Melanie Randolph Beth Reed Tammy Richard Kelly Sisk Kathy Williams CUSTODIAL SERVICES Thomas Richard CONTRACTUAL SERVICES Joyner Therapy Service Ultimate Rehab. Group, LLC Account Clerk Receptionist Account Clerk Custodian Physical Therapy Speech Therapy Occupational Therapy ^Retired *Resigned ~Terminated

SERVICES PROVIDED BY YOUR HEALTH DEPARTMENT Bioterrorism/Emergency Planning Vital Records Health Education Communicable Disease Control Sexually Transmitted Disease Treatment, Follow-up Tuberculosis Detection, Treatment, Follow-up Immunizations HIV/AIDS Testing, Counseling & Education School Health Consultation Vision and Hearing Screening Maternal/Child Case Management DCFS Case Management Pregnancy Testing Family Planning Counseling Newborn and Premature Infants Visits Referral Services for Children with Disabilities Cholesterol Screening Diabetic Screening Hypertension Screening Metabolic and Liver Screening Lead Poisoning Testing, Counseling and Education Women, Infant and Children (WIC) Program Illinois Department of Public Aid Paternity Testing Health Services to Mentally Disabled Skilled Nursing Care in the Home Home Health Aide Occupational Therapy Physical Therapy Speech Therapy Food Inspections Food Handler Training Courses Microwave Testing Private Sewage Disposal Private Water Supply Nuisances Solid Waste Housing and Dangerous Buildings Rabies Control

ADMINISTRATIVE AND SUPPORT DIVISION In addition to the activities described within this Annual Report, the department maintains an active support function. This includes overall department administration, fiscal management and program promotion. Services -Manage administrative affairs of the Health Department with good public health and business practices. -Prepare budgets and levies. -Prepare grant applications. -Provide qualified staff. -Registrar of Vital Records for Franklin and Williamson Counties. -Issue birth and death certificates and burial permits. -Collect and analyze statistical information on births, deaths, causes of illness and other trends in Franklin and Williamson Counties. -Keep communicable disease records. -Supervise reproduction and printing. -Submit cost analysis reports on overall programming. -Represent the Health Department at statewide public health activities. -Direct and evaluate the staff and program activities. -Investigate the existence of any contagious or infectious disease within the public health jurisdiction and adopt measures to arrest its progress. -Enforce the rules and regulations of local and state laws pertaining to the preservation of the health of the people within our public health jurisdiction. -Provide consultation, advice and information to all city, village, incorporated towns and school authorities in all matters pertaining to sanitation and public health.

REPORT OF OPERATIONS Beginning Balance July 1, 2012 2,565,313.38 Income Grants 1,421,488.78 County Taxes 606,261.85 Fees 1,663,941.08 Other 52,193.23 Total Receipts 3,743,884.94 Expenses Personal Services 2,127,459.18 Contractual 799,296.95 Commodities 435,105.58 Travel 110,623.21 Equipment 50,262.76 Illinois Municipal Retirement Fund 356,626.56 Social Security 162,750.76 Insurance (Professional Liability, Unemployment & Worker's Compensation 87,768.07 Total Expenditures 4,129,893.07 Ending Balance June 30, 2013 2,179,305.25 VITAL RECORDS The Director of the Franklin-Williamson Bi-County Health Department is the appointed official registrar for Franklin-Williamson Counties by the State Registrar of Vital Records. Duties require the registrar to administer and enforce the provisions of the Vital Records Act and the rules and regulations adopted to implement the act. The Director appoints deputy registrars in Franklin and Williamson counties to better serve the public in a fast and efficient manner. The registrar/deputy registrar reviews each birth and death certificate and corrections are made as necessary. Copies of birth and death certificates are maintained in the Health Department and the original is sent to the Office of Vital Records in Springfield, Illinois. Certified copies of birth and death certificates can be obtained at the Health Department on request.

HEALTH EDUCATION & PROMOTION The purpose of public health education is to encourage healthier lifestyle options through community assessment, policy, systems, and environmental changes, collaboration, and education. Community health education is provided by each staff member in his/her daily professional duties, as well as by the Health Education Division. The Health Educators work cooperatively with staff personnel in the planning, organizing, and implementing of comprehensive public health education programs and services. The health department also participates on the Franklin/Williamson Healthy Communities Coalition (FWHCC), whose mission is to actively pursue a healthier community through community assessment, planning, programs, collaboration, and advocacy. Members of this coalition provide technical assistance and teacher training to school districts who are interested in improving or replacing health or physical education curriculum and/or programs. FWHCC has action teams to address priority health problems in our two counties: Access to Care, Healthy Lifestyles, and Healthy Seniors. The Health Education Division actively contributes to one of the three action teams, Healthy Lifestyles. Public awareness and health promotion activities that provide information on health department services, as well as information on a variety of health topics, are presented through news releases, presentations, exhibits, pamphlets, posters, clinics, and patient education sessions. Health education programs are developed and implemented based on priority health problems that are identified in the Illinois Project for Local Assessment of Needs (IPLAN), five-year community health plan. The health department completed this process in 2012, and the following priority health problems were identified: access to care, chronic disease, and behavioral health. In addition to the work of the FWHCC action teams to address these problems, Health Educators promote, participate, and support other initiatives. These include education to those requesting to quit smoking, education to prevent obesity and creating sustainable change in communities that supports healthy living, prevents chronic disease and improves health outcome. 109 Meetings 113 Presentations 22 Media Interviews 4986 Attendance 1021 News Releases/Paid Ads 22 Health Fairs 3768 Attendance

PUBLIC HEALTH NURSING Public Health nurses provide services to residents of all ages in an assigned geographical area. Client referrals are accepted from any source; however, in some instances, the patients' private physician must certify the need and plan of care. COMMUNICABLE DISEASE Communicable disease surveillance is a continuous activity and conducted in cooperation with school authorities, private citizens, physicians and hospitals. 28 Home Visits 2865 Conferences 24 No. Screened for Head Lice 7 Head Lice Shampoo Supplied Reported Communicable Diseases 0 A.I.D.S 0 HIV Infection 0 Arbovirus 1 Lyme Disease 0 Chickenpox 0 Meningitis (Bacterial) 213 Chlamydia 0 Meningitis (Viral) 1 Cryptosporidiosis 1 Mumps 0 E-Coli 0 Pertussis 3 Ehrlicheosis 2 Rocky Mountain Spotted Fever 2 Giardiasis 18 Salmonella 25 Gonorrhea 1 Shigellosis 0 Hepatitis A 0 Staphylococcal Infection 2 Hepatitis B 0 Streptococcal Pneumoniae II 79 Hepatitis C 1 Syphilis 1 Histoplasmosis Immunizations Given 71 Adult Hepatitis A 61 Pediarix 205 Adult Hepatitis B 185 Pediatric Hep A 45 DTAP 167 Pentacel 3071 Flu Vaccine (Trivalent) 62 Pneumonia Vaccine 0 Gamma Globulin 235 Prevnar 74 HIB Vaccine 72 Rotavirus 316 HPV 89 Tetanus/Diptheria 97 Pediatric Hepatitis B 858 Tdap 53 IPV 133 Twinrix 256 Measles/Mumps/Rubella 357 Varicella 56 Measles/Mumps/Rubella/Varicella 199 Zostavax 243 Menactra 164 Kinrix 1 Comvax 7070 TOTAL IMMUNIZATIONS GIVEN 0 Adverse Reaction to Immunization

Tuberculosis 5 Home Visits 11 *Chest x-rays Provided 59 Office Visits 0 New Active Cases (All DOT Therapy) 637 Conferences 5 New Case Suspects (Not confirmed) 3355 Skin Tests Given 12 Patients Under Supervision 10 Skin Tests Positive 10 Patients Supplied Medication *x-rays provided under contract with a local hospital. HIV Counseling and Testing Clinic Testing 40 Off Site Testing 15 CHRONIC DISEASE PROGRAM The Chronic Disease Program provides services to persons of all ages. It consists of prevention, early detection, and the monitoring and provision of health care to those afflicted with degenerative diseases. Cholesterol, hypertension and diabetes screening clinics assist in early detection of these diseases with appropriate education, referral and follow-up done to insure adherence to prescribed treatment. 0 Home Visits 192 Cholesterol, Metabolic Panel, Liver Panel Screenings 32 Conferences 107 Diabetes Screenings 448 Hypertension Screenings MATERNAL-CHILD HEALTH Services are provided to women and children through the Family Case Management Program. Our goal is a healthy start for every infant, through promotion and facilitation of early prenatal care, infant care and risk reducing lifestyles. Health Department nurses provide services that include case management and outreach along with educational and promotional activities aimed at developing a community-based system of primary care and associated support services. Follow-up and services are provided in cooperation with D.S.C.C., Early-on 0-3 Program, D.C.F.S., Head Start, and various other agencies. 385 Pregnancy Tests 170 High Risk Infant Follow-up visits 736 Home Visits to Children 300 D.C.F.S. Wards of the State Case Management 5778 Office Visits to Children D.C.F.S. Wards of the State Case 646 377 Home Visits to Mothers Management Conferences 3062 Office Visits to Mothers 4922 Conferences

WIC PROGRAM Franklin-Williamson Bi-County Health Department provides WIC (Women, Infants, Children) services. This program is funded by the United States Department of Agriculture and is administered through a grant from the Illinois Department of Human Services. The WIC Program provides health assessment, nutrition education and health care referrals to each client. WIC serves pregnant, lactating and postpartum women. They also serve infants and children up to age five to help prevent health and nutrition problems during the most critical time of growth and development. Special emphasis is given to teen and other high-risk pregnancies to work toward the reduction of infant mortality. Breastfeeding is the preferred method of infant feeding and is encouraged through individual counseling and group education. 2693 Average Monthly Participation 6401 Nutrition Education Attendance 32,310 Total Client Contacts 5153 Pregnant 960 Breastfeeding 2454 Postpartum 8539 Infants 15,204 Children VISION SCREENINGS 958 Number Screened and Re-Screened 15 Number Referred 5 Number Referrals Completed HEARING SCREENINGS 955 Number Screened and Re-Screened 1 Number Referred 1 Number Referrals Completed LEAD POISONING PROGRAM Health Department nurses provide follow-up counseling to families who have children with elevated blood lead levels. Nurses also collect blood specimens on adults whose occupation is high risk for lead intoxication. 3 Home Visits 186 Conferences 448 Assessments 0 Screenings (Adult) 83 Screenings (Children) STUDENT EXPERIENCE Fifteen students were given an opportunity to observe Health Department activities during the past fiscal year. These included Associate and Bachelors degree students.

SPECIAL ACTIVITIES 42 Cholesterol Clinics 44 Lead Clinics 11 Blood Pressure Clinics 28 Community Flu Clinics 187 Immunization Clinics 92 Walk-in Clinics 80 Tuberculosis Skin Testing Clinics 45 Late Clinics HOME HEALTH NURSING The Home Nursing staff provides intermittent skilled nursing services to clients who are homebound due to their medical condition. Client referrals are accepted from any source; however, the client's private physician must certify the need and plan of care. 4704 Skilled Nursing Home Visits 1368 Home Health Aide Visits 1288 *Occupational Therapy Visits 3804 *Physical Therapy Visits 144 *Speech Therapy Visits 0 *Medical Social Service Visits *These services are being provided under contract. ENVIRONMENTAL HEALTH The Division of Environmental Health is continually working to achieve its goal of preventing disease through proper sanitation. Environmental health problems are common due to the heavily populated and rural nature of our area. FOOD SANITATION PROGRAM Sanitarians inspect all food-service establishments under this program. Food-service establishments include restaurants, day care centers, schools, taverns and retail food stores. Food-service establishments meeting the requirements of the Franklin or Williamson County Food Ordinance are issued a permit for a period of one year. This permit is to be displayed where the public can see it, and may be temporarily or permanently suspended whenever major sanitation problems are found by the sanitarian. Also included in this program is the testing of microwave ovens. There is no cost for this service. Persons requesting a microwave oven test may call either the Benton or Marion office to make an appointment. 1542 Food Service Inspections 1341 Conferences 708 Permits Issued 0 Food Handler Training Sessions 0 Attendance 479 Literature Distributed 0 Food Samples Take to Lab 0 Suspected Food Poisoning Cases 0 Confirmed Food Poisoning Cases

PRIVATE SEWAGE DISPOSAL PROGRAM Sanitarians are concerned with assuring that all sewage is discharged into a properly designed and operating private sewage system. All private sewage systems installed serving fifteen people or less must have a permit through this department before construction begins. 1187 On-Site Inspections 35 New Cases Opened 1251 Conferences 194 Permits Issued 43 Literature Distributed 19 Warning Citations Issued 2 Citations Issued 0 Court Appearances 11 Sewage Violations Abated 0 Percolation Tests Conducted 131 Private Sewage Disposal Systems Installed 117 Aeration Units 6 Buried Sand Filters 3 Oxidation Lagoons 2 Seepage Fields 3 Other RABIES CONTROL PROGRAM All animal bites must be reported to the Health Department. Sanitarians are also appointed Deputy Animal Control officers by the Rabies Control Officer of each county and work closely in keeping the Rabies Control Officers informed of animal bites in each county. 4 Investigations 1201 Conferences 185 Animal Bites Reported 146 Dog 33 Cat 6 Other 36 Animal Heads Taken To Carbondale Lab 12 Dog 7 Cat 17 Other 4 Rabid Animals

PRIVATE WATER SUPPLY PROGRAM Samples of private water supplies are taken to determine if the supply is safe to drink. Water samples must be taken by the sanitarian in a sterilized bottle. There is no cost for this service. Should the water supply be unsafe, the sanitarian will provide information to the owner about how to make the supply safe for drinking purposes. 53 On-Site Inspections 120 Conferences 8 Water Samples Taken 1 Dug Well 0 Cistern 7 Drilled Well 0 Pond or Lake 0 Other Results of Water Samples Taken: Satisfactory Unsatisfactory 0 1 Dug Well 0 0 Cistern 7 0 Drilled Well 0 0 Pond or Lake 0 0 Other 7 1 Total NUISANCE CONTROL PROGRAM There are many types of nuisances that are commonly found in our health jurisdiction. Types of nuisances include open wells, high weeds, junk vehicles, abandoned refrigerators, solid waste and dangerous buildings. The Health Department responds to all complaints and conducts surveys to identify nuisance conditions. 4332 Investigations 376 New Cases Opened 1987 Conferences 266 Warning Citations Issued 14 Citations Issued 37 Court Appearances 17 Buildings Repaired/Enclosed 47 Buildings Demolished 271 Violations Abated COMPLAINTS During the past fiscal year, the Environmental Health Division received numerous complaints concerning environmental health conditions. All complaints were investigated. If violations were present, the violator was notified to take corrective measures in a reasonable amount of time. If corrective measures were not taken the violator was issued a citation requiring him to appear in court. NUMBER PERCENT TYPE 308 65 General Nuisance 119 25 Food 48 10 Private Sewage 475 100% TOTAL

Williamson County Office: 8160 Express Drive Marion, IL 62959 618-993-8111 Franklin County Office: 403 E. Park Benton, IL 62812 618-439-0951 Visit our Web Site at: www.bicountyhealth.org