Message from the Chairman of the Waco-McLennan County Public Health District Board There are many challenges involving public health. Although we have made great strides concerning medical breakthroughs over the last two hundred years, health care professionals are constantly trying to find ways to improve our health and quality of life. That is why your Waco-McLennan County Public Health District is so important. During the 2002-2003 fiscal year, several new challenges were overcome by a hard working, dedicated staff of health care professionals right here in our own backyard. Being married to a health care professional for over 25 years, I understand the importance of having educated, dedicated and public oriented people wanting to serve in this capacity. Believe me when I tell you that we have a lot to be proud of in McLennan County! Unfortunately, people have short memories and while traveling the state I find that other cities and counties are not adequately prepared for potential disasters. Our Public Health District has not forgotten the events that unfolded on September 11, 2001; events that forever changed our way of thinking in the United States. It is essential that we continue to prepare for potential disasters of any kind. Our Public Health District is continually planning and preparing for such an event if one were to occur. Other services affect our daily lives. Services such as vaccinations, the health of mothers and their babies, safer food establishments, control of infectious diseases, safer work environments and an overall healthy community are essential to our livelihood. The cooperation between all of the municipalities, the county and other public entities has never been greater. We all have the same desire for our quality of life to be as great as it can possibly be. I have no doubts that we will continue to see great things happen in the health field. Please take the time to read this annual report. The role of the Waco-McLennan County Public Health District is a vital part of our community. Sincerely, Michael Nicoletti, Chairman Waco-McLennan County Public Health District Board What is Public Health? One goal of Public Health is to have a positive impact on everyone, everyday, everywhere by assuring conditions in which people can be healthy. Accomplishing this ambitious goal requires an integrated, multi-disciplinary approach that utilizes the broad and diverse fields of expertise within public health, engages the community to identify its needs, and facilitates effective partnerships to maximize community resources.
Page 2 PRIORITY Public Health Emergency Preparedness The development of emergency response plans to address threats to homeland security continues to be a priority for the nation and public health. One of the major focus areas for Waco-McLennan County Public Health District staff during the past several years has been to build capacity to prepare for potential disasters, whether they are naturally occurring, accidental or intentional. By building on existing relationships with numerous community partners to coordinate appropriate responses, several plans have been written and will be fully developed during the upcoming year. One of those plans involves smallpox. Another measure to enhance the Health District s ability to better prepare public health response teams has been the renovation of existing space into a training and redundant communications facility. Smallpox Plans have been written to provide care of smallpox cases in the event of an outbreak and for mass vaccination of the McLennan County population in a short period of time. Critical activities include the training and pre-exposure vaccination of public health and health care response teams who would staff the mass vaccination clinics. Large numbers of volunteers are being recruited to assist in responding to a smallpox event. Preparedness Training Facility The Waco-McLennan County Public Health District renovated and equipped a 3,204 square foot state-of-the-art, multimedia training and communications center. The facility allows the Health District to provide distance learning and locally generated training programs for health care professionals and first responders. Teleconferencing, satellite down link and web cast reception capabilities are all available for preparedness training activities and for use in actual emergencies. Funding for the project came through grants from the Centers for Disease Control and Prevention and Texas Department of Health as well as the Telecommunications Infrastructure Board. Other financial support or equipment was provided by the Texas Association of Local Health Officials and the City of Waco. The Ten Essential Public Health Services Texas is the first state to define what is meant by community-based or population-based health. In 1999, during the 76 th session of the Texas Legislature, Chapter 121, Local Public Health Reorganization Act, of the Health and Safety Code was amended to add a definition of essential public health services. The Waco-McLennan County Public Health District adopted the ten essential services and performs activities on a daily basis to address these functions. Here, and on the following pages, the essential services are listed along with 2002-03 highlights of activities. Monitor the health status of individuals in the community to identify community health problems West Nile Virus In 2002, West Nile virus was confirmed for the first time in McLennan County. The Environmental Health Division has been designated as the lead organization in the county to provide public information and coordinate surveillance and sampling activities for the mosquito-borne virus. The staff continues to respond to media requests, consult with citizens about property conditions, and investigate and abate locations with standing water that are conducive to mosquito breeding. Utilizing grant funds and equipment received from the Texas Department of Health, 54 mosquito-trapping locations were established across McLennan County. By July 2003, positive results in both birds and mosquitoes re-confirmed the presence of the virus.
Page 3 Diagnose and investigate community health problems and community health hazards Control of Infectious Diseases In cooperation with school personnel and the Texas Department of Health Region 7, Health District staff responded to an outbreak of tuberculosis at a local high school and a case of bacterial meningitis at an area university. Other communicable disease activities included investigating reports of shigellosis at community childcare centers and managing a significant increase in syphilis cases. Through these experiences, Health District staff have developed and implemented aggressive intervention plans, which include enhanced surveillance, education, and case management. Inform, educate, and empower the community with respect to health issues Breastfeeding Education The breastfeeding education initiatives implemented in the Women, Infant, and Child (WIC) Nutrition Supplemental Program have influenced an average of 50% of WIC mothers to breastfeed their infants at hospital discharge. Health Education Health District staff members provided information on a variety of health topics in the form of presentations, health fairs and health promotion campaigns. Additionally, the public was informed on food establishment inspection scores and temporary closures by utilizing the City of Waco Web page and the Waco City Cable Channel (WCCC-10). The Environmental Health Division provided food safety classes to a record number of 5,188 food workers and managers. Press releases on significant public health issues, including rabies, mosquito control, influenza vaccination, shigella and West Nile virus, were distributed. Mobilize community partnerships in identifying and solving community health problems Hooray for Health! Along with other community organizations, health care providers and local media, the Health District participated in the fourth annual Hooray for Health Day, a health fair for children. Over 1,000 children participated where they were offered immunizations, free health care information and awareness, back to school screenings, nutrition and safety guidelines, and entertainment. Develop policies and plans that support individual and community efforts to improve health Rabies Ordinance In response to an increase of reported rabies cases in McLennan County, the Health District Board developed and approved a model rabies control ordinance that may be adopted by cities or used to amend parts of an existing ordinance. The goal is to increase uniformity of rabies control measures throughout McLennan County. Enforce laws and rules that protect public health and ensure safety in accordance with those laws and rules Food Safety Protection The Environmental Health Division prioritized and increased inspection frequencies to boost compliance and enforcement of the health and safety code provisions. In addition to routine inspections, sanitarians also provided follow up inspections and consultations to ensure corrections of violations and encourage voluntary compliance. Additional measures such as abatement notices, citations, temporary closures, permit suspensions, and permit revocations were utilized to help ensure safer food establishments in our community.
Inside St ory Headline 2002-03 Annual Report Waco-McLennan County Public Health District 225 W. Waco Drive Waco, TX 76707 2002-03 ANNUAL REPORT This story can fit 75-125 words. Selecting pictures or graphics is an important part of adding content to your newsletter. Think about your article and ask yourself if the picture supports or enhances the message you re trying to convey. Avoid selecting images that appear to be out of context. Microsoft Publisher includes thousands of clip art images from which you can choose and import into your newsletter. There are also several tools you can use to draw shapes and symbols. Once you have chosen an image, place it close to the article. Be sure to place the caption of the image near the image.
Page 4 Link individuals who have a need for community and personal health services to appropriate community and private providers Linking Clients HIV/AIDS Services administers federal, state and local funding to help clients stay healthy, maintain their quality of life and minimize further HIV transmission. HIV-positive clients are linked to a network of participating healthcare and dental providers, public housing authorities, opticians, nutritional services, medication suppliers and health education services. Ensure a competent workforce for the provision of essential public health services Immunization Workshop In cooperation with the Texas Department of Health Region 7 and the Family Practice Center, the Health District held the first McLennan County immunization workshop for medical personnel. The event trained area health professionals in disease surveillance, updated immunization information and records assessment. Preparedness Training The Health District sponsored area conferences and satellite courses on preparedness such as: core competencies for public health professionals, incident command system, Severe Acute Respiratory Syndrome (SARS) and smallpox. Attendees included fire and law enforcement, health care providers and other community partners. Research new insights and innovative solutions to community health problems Texas Health Alert Network In 2003, the Texas Association of Local Health Officials provided expansion of the Texas Health Alert Network (TexasHAN) to the Waco-McLennan County Public Health District. The TexasHAN enables federal, state and local public health agencies to establish and maintain a network that supports exchange of information and training over the Internet by linking public health and private partners on a 24/7 basis. The technology permits rapid dissemination of public health advisories to the news media and the community. The network ensures secure electronic data exchange between public health partners to aide in their responses to threats involving homeland security or other public health emergencies. Evaluate the effectiveness, accessibility, and quality of personal and population-based health services in a community Immunizations Compliance All licensed childcare centers, registered family home care centers, private and public schools in the county are required to maintain immunization records and ensure that all of the students are up to date with immunizations. Staff completed immunization compliance audits for numerous registered family homes, Head Start centers, licensed day care centers, private schools and independent school districts. The Health District provided information to physicians, schools and daycare centers on immunization requirements and disease reporting. The Health District will be working with students from Baylor University to research immunization rates throughout the county to target areas with low immunization rates.
Page 5 Approved FY 2003-04 Budget Excludes $855,760 to the Heart of Texas Community Health Center, Inc. (Family Practice Center) State Funds $ 2,252,136 43% Funding Membership Contributions $ 282,012 5% City of Waco General Fund $ 1,230,748 23% Revenues from Fees $ 1,304,483 25% Other Funds County $58,321 Interest on Investment $4,991 Transfer from Surplus $150,000 Miscellaneous Revenue $14,794 Total Other Funds $ 228,106 4% Total Funding $ 5,297,485 100% 43% 5% 23% COMMUNITY HEALTH INFORMATION 4% 25% Disease 2000 2001 2002 2003 To 9/30 Human Immunodeficiency Virus (HIV) Seropositive * 28 18 24 17 Acquired Immunodeficiency Syndrome (AIDS) * 13 12 20 5 Hepatitis A 4 37 16 0 Meningitis, Meningococcal 0 2 2 0 Pertussis (Whooping Cough) 0 5 9 0 Salmonellosis (Food- or Waterborne, Children) 16 27 27 16 Shigellosis (Food- or Waterborne, Children) 36 27 38 247 STD: Chlamydia 1,138 881 1,100 715 Gonorrhea 639 564 604 300 Syphilis 15 10 11 52 Tuberculosis 9 14 12 10 Varicella (Chickenpox) 12 110 38 57 West Nile Virus (Human) NA NA 5 0 * HIV seropositive includes all positive tests. AIDS cases meet the definition for presence of disease. Local reporting for many diseases began improving in 2000. Increased reports of hepatitis A and varicella in 2001 include outbreaks associated with a childcare center. Pertussis increases in 2002 reflects a statewide trend, which does not appear to be continuing into 2003. However, shigellosis and syphilis cases have increased in 2003. Shigellosis reports have been elevated in several areas of the state. No common source has been found, but the organisms responsible are related. Environmental Health: 3,174 food establishment inspections performed in the county 1,113 inspections performed for on-site sew age facilities 5,188 food workers and managers trained Immunizations: 24,992 immunizations were given to clients Women, Infant, Child (WIC) Nutrition Supplemental Program: 29,591 households were served in McLennan County Dental Clinic: 4,538 clients were provided low-cost dental service 1,078 children received dental screening HIV: 2,180 clients tested for HIV 5,886 clients received education/counseling for HIV 373 clients tested for hepatitis C TOTAL SERVICES: 141,937 TOTAL CLIENTS: 87,127 2002-03 Highlights